How to Prevent Malaria

by

QUESTION

How to prevent malaria?

ANSWER

Despite its wide geographic range and potentially severe consequences, there are actually several effective strategies for controlling malaria, many of which have been successful of reducing the burden of the disease, and especially the number of deaths, in various regions.

The first step towards control is prevention. This has largely been achieved through the distribution of long-lasting insecticide treated bednets, which prevent people from being bitten by infected mosquitoes as they sleep at night. While this has drastically reduced the number of cases of malaria in some settings, and particularly in certain high risk groups such as children under five and pregnant women, some worrying new data just was published which suggested that in high transmission zones, bednets may actually exacerbate re-infection rates for older children and adults, and lead to insecticide resistance in mosquitoes. As such, while bednets clearly are still a key prevention strategy, their effect should be closely monitored.

Secondly, there is diagnosis and treatment. These go hand in hand, as they usually require the availability of health services or health professionals. If malaria infections are rapidly and accurately diagnosed, appropriate treatment can be swiftly given, preventing the progression of the disease and allowing the patient to recover. Appropriate administration of medication, as well as adherence to the full course of the drugs, can also help to prevent drug-resistance from emerging.

Finally, there are on-going research initiatives looking to find new ways to tackle malaria. For example, many scientists are involved in the search for a malaria vaccine, which, if safe, effective, and sufficiently cheap, could transform the way we think about fighting malaria. Similarly, due to the unfortunate circumstance of ever-increasing drug-resistance, particularly in Plasmodium falciparum, new types of medication are constantly being tested and trialled. The combination of all these efforts has managed to reduce the mortality of malaria greatly over the past few years; the aim now, espoused by organisations such as Malaria No More, is to get to a point where deaths from malaria are eliminated by the year 2015.

 

Paludisme Depuis 5 Mois (Malaria for 5 Months)

by

QUESTION:

En fait je souffre d’un palu que le médécin a mal traité après une analyse sanguine. J’aimerais savoir comment faire pour m’en débarrasser car je traine ce palu maitenant depuis 5 mois.

ENGLISH TRANSLATION:

In fact I suffer from malaria which the doctor has treated poorly after a blood test. I would like to know how to clear myself of this because I have been carrying this malaria now for 5 months.

ANSWER:

C’est rare de souffre telle longtemps que 5 mois continuellement avec palu; plus commun c’est de observer plusieurs episodes d’infection en serie, si la traitement n’est-ce pas un succes. Mais tout ca depend un peu du type du palu. Vous devrez tenir un autre test sanguine pour determiner ce type du palu, de preference au hôpital ou dans un clinique de santé. Avec celle information, le médécin peut vous recommender un traitement approprié. Par example, si vous avez un infection de Plasmodium vivax ou P. ovale, le parasite peut rester en repos dans le foie pendant plusieurs semaines ou bien plusieurs mois. Des médicaments qui traitent l’infection dans le sang, comme chloroquine ou ACTs, ne touchent pas cette stages de vie dans le foie. Dans ce cas, vous devez parler avec votre médécin sur un autre médicament, qui s’appelle primaquine, qui tue a les parasites dans le foie et previent encore plus de rechutes.

ENGLISH TRANSLATION: It’s rare to suffer from malaria continuously for five months; it is more common to see multiple infections over and over in series, if the disease is not treated appropriately. But all of this depends on the type of malaria that you have. You need to have another blood test to determine the type of malaria, and based on this information, the doctor can give you appropriate treatment. For example, if you have Plasmodium vivax or P. ovale, the parasite can rest dormant in the liver for several weeks or even months. The drugs which treat the initial infection in the blood, such as chloroquine or ACTs, don’t affect these liver stages. In this case, you must talk to your doctor about taking another medication, called primaquine, which kills the liver stages of the malaria parasite and prevents further relapses of the disease.

History of Fighting Malaria

by

QUESTION

What are some examples of attempts of fighting this disease that happened in the past?

ANSWER

The battle against malaria has been going on, in one form or another, for literally thousands of years. The ancient Chinese mention the symptoms of the disease in a medical scroll as early as 2700 BCE – even more remarkably, a herb called Artemesia has been used in traditional Chinese medicine for more than 2000 years to treat malaria, and compounds extracted from that same herb are the basis for some of the most effective modern medications, known as artemisinin-based combination therapies (ACTs). Indigenous tribes in the Americas also had traditional medicines to treat malaria; having conquered the New World, the Spanish learned of a bark, from the Cinchona tree, which could cure malaria. Quinine, extracted from this same tree bark, is still used today to treat malaria.

However, back then the causes of malaria were not known—it wasn’t until the late 19th century that a more complete understanding of malaria would emerge. The first key development in this process was the observation of the parasites that cause malaria in a patient’s blood, which was first done by Charles Louis Alphonse Laveran in 1880.

A few years later, in 1897, a British army doctor called Ronald Ross discovered that the parasite was transmitted via the bite of infected mosquitoes, of the genus Anopheles. This latter finding allowed for the emergence of the first programmes for malaria control, which focused on vector control, through insecticide use and elimination of water bodies used by the mosquito larvae. An early example of the success of this approach came in the building of the Panama Canal; started in 1906, progress was initially slow, due to the enormous proportion of workers who fell ill from yellow fever and malaria. With vector control, the number of cases plummeted, and the canal was finally opened in 1914.

While prophylactic quinine had also been part of the control strategy during the building of the Panama Canal, it played a much more secondary role to vector control. Using similar strategies, focusing primarily on killing adult mosquitoes through insecticide spraying (mainly DDT), the United States of America successfully eliminated malaria from its shores in the early 1950s. Prior to this, transmission had occurred across most of the south-east of the country.

In the last 50 years, access to early diagnosis and effective treatment have gained a more prominent role among many malaria control strategies, although prevention is still seen as crucial. Many developing countries, where malaria is still rife, have set up national control programmes, which seek to ensure that all communities have access to adequate care and information about malaria prevention.

A key tool in the prevention arsenal has been the long-lasting insecticide treated bednet; sleeping underneath one prevents bites from the mosquitoes that carry malaria, which are most active in the evenings and at night, especially in children and pregnant women, who are among the people most at risk from infection. Bednet distribution has been a major focus of many malaria campaigns, and very successful in many places; in 2008, for example, bednet coverage was estimated at over 80% of the at-risk population in Djibouti, Mali, Ethiopia and Sao Tome and Principe.

Does malaria kill?

by

QUESTION

Is malaria a killer disease?

ANSWER

Yes. Malaria causes somewhere between 700,000 to 1 million deaths worldwide, mostly in children under five, and mostly in sub-Saharan Africa. As such, it is actually one of the leading causes of death in young children in developing countries.

Given this high mortality, many initiatives working to control malaria are dedicated to reducing the number of deaths as a key way of lowering the overall burden of this disease; groups such as Malaria No More and the Roll Back Malaria Partnership have committed to bringing the number of deaths from malaria to zero or near zero by 2015.

Where does malaria come from?

by

QUESTION

Where does malaria normally come from?

ANSWER

Malaria is caused by single-celled parasites of the genus Plasmodium; the parasites enter the human body via the bite of an infected mosquito. However, the mosquito has to pick up the infection in the first place from another infected human; so in a sense, you could say that malaria both comes from mosquitoes, as well as from other people, although only indirectly!

More generally, your question could be read as asking where does malaria come from geographically—malaria is actually distributed over most of the world, and at some point or another has been found on all continents except Antarctica. In modern times, it tends to be restricted to the tropics and sub-tropical regions of the world, since temperature is a key factor pertaining to its survival. However, seasonal transmission (especially in the summer, hotter months) still persists even in some temperate regions. Moreover, with global climate change, it is feared that the distribution of malaria will continue to spread, and even more people will be affected.

Malaria Treatment Time and Hiccups

by

QUESTION

I am suffering from pf malaria with enlarged liver and spleen under the treatment from last one week and the abdominal pain has subsided. But I am experiencing hiccups. How long it will take for complete recovery?

ANSWER

It is a good sign that you are already feeling better following your treatment for malaria. Interestingly, hiccups have been linked to infections with parasites, including malaria; in one case, it was discovered that the treatment the patient was taking (doxycycline) had actually caused some secondary problems of the esophagus which was causing the hiccups. The patient was given medicine which treated these secondary problems and cured the hiccups. So if you continue to experience hiccups after you have completed the treatment for malaria, you should ask your doctor if it is possible to arrange for an endoscopy, to check for any secondary problems caused by the medication.

As for recovery time otherwise, you will probably feel much better as soon as the course of medication is completed. However, many malaria patients still feel fatigued for weeks or even months after they have had the disease, so full recovery can take some time.

It is important, however, to visit your doctor again if you have any recurring symptoms of malaria after you have finished the medication (such as fever or nausea) since this could indicate that the infection was not completely cured the first time; another blood test may then be required, with another course of treatment if you test positive again for malaria.

Typhoid and Malaria

by

QUESTION:

Since i was suffering with fever for 5 days I consulted a doctor, have undergone blood test, and got typhoid as positive, but the treatment didn’t work. I was tested for malaria and result was positive. Ii’ve been given chloroquine for three days and primaquine for 28 days. After chloroquine was completed I started using primaquine. During this time I got fever and I got typhoid positive. My question is though iI’ve been treated for typhoid before malaria is conformed why it has come again?

ANSWER:

Typhoid and malaria are very different illnesses, caused by different disease organisms. Typhoid is caused by a Salmonella bacterium, whereas malaria is caused by single-celled animals, called protozoa, of the genus Plasmodium.

Typhoid is usually transmitted by eating food or drinking water which has been contaminated by sewage or handled by someone else with typhoid fever. It is usually treated with antibiotics; however, these antibiotics do not prevent re-infection with the disease. The best way to prevent re-infection is through washing food thoroughly in clean (boiled) water and by washing hands regularly, especially after going to the bathroom. There is also a vaccine against typhoid which you can get which will prevent further re-infection. As such, if you think you have typhoid again, you will need to visit your doctor again for more treatment, as it is unrelated to your malaria infection (apart that you might have been weakened by one infection, leaving you more susceptible to a second disease). While at the doctor, you should also have another test for malaria to ensure that the treatment was successful.

Malaria and Sexual Contact

by

QUESTION

Is a person with malaria allowed sexual contact or not?

ANSWER

Malaria cannot be transmitted between people through sexual contact (or indeed, between people at all—it must go through a mosquito before it can pass into another human host), so from the point of view of spreading the disease, sexual activity is not disallowed. However, people with malaria often feel very sick, and moreover, will need their full strength to ensure recovery, so it might not be a bad idea to refrain until the patient is fully recovered!

Pathophysiology of Malaria

by

QUESTION

What is the pathophysiology of malaria?

ANSWER

Malaria causes disease through a number of pathways, which depend to a certain extent on the species. Malaria is caused by a single-celled parasite of the genus Plasmodium; there are five species which infect humans, being Plasmodium falciparum, P. vivax, P. ovale, P. malariae and P. knowlesi.

All these species are introduced into the human blood stream through the bite of an infected mosquito; the life stage of malaria at this point is called a “sporozoite”, and they pass first to the liver, where they undergo an initial stage of replication (called “exo-erythrocytic replication”), before passing back into the blood and invading red blood cells (called “erythrocytes”, hence this is the “erythrocytic” part of the cycle). The malaria parasites that invade red blood cells are known as merozoites, and within the cell they replicate again, bursting out once they have completed a set number of divisions. It is this periodic rupturing of the red blood cells that causes most of the symptoms associated with malaria, as the host’s immune system responds to the waste products produced by the malaria parasites and the debris from the destroyed red blood cells. Different species of malaria rupture the red blood cells at different intervals, which leads to the diagnostic cycles of fever which characterise malaria; P. vivax, for example, tends to produce cycles of fever every two days, whereas P. malaria produces fever every three.

In addition, Plasmodium falciparum produces unique pathological effects, due to its manipulation of the host’s physiology. When it infects red blood cells, it makes them stick to the walls of tiny blood vessels deep within major organs, such as the kidneys, lungs, heart and brain. This is called “sequestration”, and results in reduced blood flow to these organs, causing the severe clinical symptoms associated with this infection, such as cerebral malaria.

More details on the exact biochemical mechanisms for sequestration and its effect on the pathology of the infection can be found on the Tulane University website.

 

Malaria and Anemia

by

QUESTION

How does malaria cause anemia?

ANSWER

Anemia is the result of a decrease in the number of red blood cells in the blood. Malaria specifically attacks red blood cells, invading them and then undergoing multiple cycles of reproduction inside them. Once replication has been completed, the malaria parasites burst out of the red blood cell, destroying it in the process. Over the course of an infection, this can destroy many red blood cells, resulting in anemia in the patient.