Malaria Medicine for Pregnant Women

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QUESTION

What medicine can be given to a pregnant woman who has malaria?

ANSWER

The type of anti-malarial that should be given to a pregnant women depends on the type of malaria they have, its severity and how long she has been pregnant. Chloroquine, quinine and artemisinin-derivatives can be given during all trimesters, but in many places malaria is resistant to chloroquine.

In general, the World Health Organisation recommends ACTs (artemisinin-based combination therapies) as the first line treatment against uncomplicated malaria. Mefloquine and pyrimethamine/sulfadoxine are able to be given the second and third trimesters; again, in some areas, resistance to mefloquine has been detected. Moreover, some people are allergic to sulfas, and so pyrimethamine/sulfadoxine would not be appropriate for these patients. Primaquine, doxycycline and halofantrine are contraindicated during pregnancy.

Do malarial drugs engender joint pains?

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QUESTION

I am now over 50 and I lived all my life in Africa during which time I have had a considerable incidences of malarial attacks. Each time I took any anti-malarial drug I experienced some side-effects including blurred vision, fatigue and joint pains. The pains especially have since become a permanent part of me and even severe enough to hamper my mobility. Does my condition sound to have any relationship with the several quantity and varieties of anti malarial drugs that I took almost all my life?

ANSWER

There are no known long-term side effects to taking modern anti-malarial drugs. However it could be that you have had a reaction or allergy to the specific kind of anti-malarials you have used in the past. For example, quinine sulphate is associated with joint pain in rare cases. However, in Africa these days, the World Health Organisation recommends only the use of artemisinin-based combination therapies (ACTs, such as Coartem) as the first-line treatment for malaria. The side effects of ACTs tend to be mild, and limited to nausea, dizziness and vomiting. As far as I am aware, joint pain and blurred vision have not been reported as side effects.

We at Malaria.com are very interested in hearing people’s experiences with antimalarial medication, so we would be very grateful if you would take the time to complete a survey on malaria treatment which we are running on the website. Thank you!

Malaria’s Impact on Tourism

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QUESTION

How is malaria’s impact on tourism?

ANSWER

These days, with effective preventative measures such as prophylactic medication and long-lasting insecticide treated bednets, the risk of contracting malaria as a tourist is greatly reduced. However, there is some evidence that the risk of contracting malaria is a deterrent for some tourists, particularly during high transmission periods of the year, in certain places.

For example, in South Africa, a group of researchers surveyed tourist facilities in KwaZulu-Natal and found that risk of contracting malaria was the major cause behind lack of bed occupancy. Improving tourists’ awareness of how the disease is transmitted and ways of preventing infection will go a long way to reducing the negative impact of the disease on the tourism industry in malarial countries.

Malaria Recovery Time

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QUESTION

How long does it take to recover from malaria?

ANSWER

A number of different factors affect recovery time from malaria. These include the type of malaria, how quickly treatment is administered and the immune status of the patient. For example, children and pregnant women tend to get much more severe cases of malaria, due to their reduced natural immunity. 

The type of malaria will impact on the severity and length of the infection as well—P. falciparum is the most severe kind, and can result quickly in death if not treated promptly, whereas less rapidly progressing forms of malaria, such as P. malariae, may persist for longer but not cause severe disease. For most cases of uncomplicated malaria, once the appropriate form of treatment is started, the patient will start to recover within a couple of days.

Malaria in the Brain

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QUESTION

I would like to know how dangerous is malaria in the brain?

ANSWER

Only a certain kind of malaria, Plasmodium falciparum, is usually associated with causing problems in the brain. The P. falciparum parasite infects red blood cells and changes their surface structure, causing them to become “sticky”. These sticky red blood cells become lodged in the small blood vessels that flow through organs, causing blockages and reducing oxygen flow.

When this process occurs in the brain, the result is called “cerebral malaria”, and can result in impaired consciousness, coma and even death. As such, once malaria-infected blood passes into the brain, it can be very dangerous. Luckily, however, if people are diagnosed promptly and given treatment, it is usually possible to stop the progression of P. falciparum malaria before it enters the brain, allowing for a swift and uncomplicated recovery.

Malaria Muscle Aches

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QUESTION

I am someone who has traveled to malaria-infected areas in the past and will do so again in the future. I also happen to have a form of musculr dystrophy (myotonic dystrophy type II) that, among other things, causes me to experience frequent episodes of muscular pain. Thus, the mere presence of muscle pain, in my particular case, can tell little about whether I might have malaria.

Though I do understand there are several other symptoms to look for, I also would still like to have a better understanding of what malarial muscle aches tend to feel like in the hope that this information could perhaps help me distinguish this particular form of muscle pain from the other muscle pains I already experience. For example, I have also occasionally experienced pulled muscles, or muscles that simply were overused during a recent, too prolonged session of resistance training. Thus I am familiar with how these feel and how they differ from the more usual pains caused by my muscular dystrophy. This helps me recognize what is likely causing a particular muscle pain on a particular occasion.

Can you describe malarial “muscle aches” in more detail? For example, which muscles are affected? (The muscular dystrophy tends to cause pain more often in certain muscles while others are more rarely, or not at all, affected … so this information alone could be helpful). Does the ache tend to stay in one set of muscles, or does it move around, hurting one set of muscles on Monday morning and another on Monday night, etc.? Is it a persistent, steady pain (hurting as much on Wednesday as it did on Tuesday) or does it fluctuate? Is it a sharp pain? Dull? Throbbing? What? Does moving or using the aching muscle make it hurt more? Does it come with joint pain, or not? What?

I do, of course, intend to educate myself further about malaria and am already aware of other symptoms that are more helpful for me to be aware of. (Headaches is NOT among these since I have so many of those also, but some of the other symptoms I’ve read are far more unusual for me and thus more helpful in signaling to me the possibility that I’m actually sick and not just having a “bad pain day”) But knowing more about typical malarial muscle pain would help give me an additional data point to consider.

Your assistance will be much appreciated.

ANSWER

I have checked in with one of our medical advisors here at MALARIA.com and this is what he has replied:

Unfortunately, there is no useful characterization of muscle aches associated with malaria. Malaria is not a subtle disease that needs to be detected by characterizing the location or quality of muscle pains.  The main symptoms of malaria are high fever and shivering/shaking chills.  The presence of these symptoms should prompt an evaluation for malaria.  That being said, it should not be an issue if the person takes malaria chemoprophylaxis and uses appropriate mosquito avoidance measures.

Hope that helps!

Blood Transfusion and Malaria

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QUESTION

Do people need to receive blood if they get malaria?

ANSWER

Usually not. Most cases of malaria are uncomplicated and are treated using oral antibiotics. However, if the disease progresses sufficiently and the patient is not promptly treated, it can become more severe. This is particularly true for infection with Plasmodium falciparum malaria, which can lead to impaired consciousness, coma and even death. In these severe cases, maintaining the patient’s balance of fluids, electrolytes and blood pressure is crucial, and so administration of plasma or blood might be required.

Regular Fever after Malaria

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QUESTION

I am from Indore (India). I was affected by malaria positive vivax. My doctor give me some tablet but soon my fever is gone. After few months my fever is come back and fever is repeated every time but does not leave for long time. Fever will repeated after few hours. What can I do?

ANSWER

It sounds like you might have recurring P. vivax malaria. This is when the malaria is treated in the blood stage of infection, but some parasites are able to remain dormant in the liver, and come back and cause disease later on. You should talk to your doctor about taking primaquine—this is a drug that can kill the liver stages and thus prevent future relapses of infection. However, you should be tested for G6DP deficiency first. Also, when you experience a recurrence of the fever, you should still go to your doctor for diagnosis, to confirm that you do have malaria and not another disease. The symptoms of malaria are very generic and can be mistaken for many other things.

vomiting

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QUESTION

Is it normal to be vomiting after taking malaria tablets?

ANSWER

Side effects are generally rare with most malaria medication, though vomiting is one of the more common side effects that have been reported. We at MALARIA.com are very interested in hearing about people’s experiences with malaria medication, so please take our malaria survey. Many thanks for your time!