Can malaria affect the liver and stomach?

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QUESTION:

Can malaria affect the liver and stomach? I had two attacks of P. falciparum few years back. Now I doubt there is some swelling under my right rib bone. Please clear my doubt.

ANSWER:

Malaria can certainly affect many of the organs in the body, including the stomach and liver. This is due to the sequestration (attachment) of red blood cells to the tiny blood vessels in these organs, and is especially common in infections with P. falciparum. Given the large amount of blood that flows through the liver, this is a common organ to be affected by malaria, and can often seen to be swollen during the infection. However, it is unusual for the enlargement to persist after treatment, and so I would recommend you visit your doctor or hospital to check out any residual concerns you might have.

What does the word “malaria” mean?

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QUESTION:

Where does the name MALARIA come from?

ANSWER:

It comes from Medieval Italian, “mala aria,” meaning “bad air”, reflecting the early belief that bad-smelling air caused the disease. Indeed, bad-smelling air was also associated with swamps and marshes, which are perfect habitats for the breeding of malarial mosquitoes, so the people who came up with the association were actually on to something!

Malaria Blood Work

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QUESTION:

What means smear for malaria – value 1?

ANSWER:

In most cases, I would suggest this means a positive result, though the exact meaning of that depends to some extent to the type of blood test it was. You mention a smear; to me, that implies that the test used traditional microscopy to look for red blood cells infected with malaria parasites. In this case, a result of 1 would indicate that one infected red blood cell was observed, meaning the patient is positive for malaria, although with a light infection (at least at that point in time – especially if the patient had falciparum malaria, the intensity of the infection can increase very rapidly). Otherwise, blood can be used in malaria rapid diagnostic tests (RDTs), which look for antibodies to malaria in the patient’s blood. In this case, the test result can sometimes be denoted by a binary value: in other words, 0 indicates negative and 1 indicates positive.

It is very important to find out from your doctor or clinic exactly what kind of test they ran and what the results mean, to ensure that correct and effective treatment is administered as quickly as possible.

Malaria in Saipan

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QUESTION:

Should I worry about Malaria while in Saipan for 1-2 months? I leave soon and would like to know if I should be vaccinated.

ANSWER:

The first thing I should say, which is crucially important, is that THERE IS NO VACCINE FOR MALARIA! There are, however, many other ways of effectively ensuring that you do not get infected when travelling to or living in malaria transmission areas. In any case, the Center for Disease Control (CDC) considers the Northern Mariana Islands (including Saipan) as free from malaria, so you probably don’t need to worry about asking your doctor about preventative medicine, which you should certainly do if travelling to a highly malarial zone. There are certainly various mosquito species present on the islands, however, and so it might still be beneficial to take precautions against getting bitten, such as wearing insect repellant and long-sleeved clothing, especially at dawn, dusk and at night.

Vomiting During Malaria

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QUESTION:

How can I reduce vomiting during malaria?

ANSWER:

The most important thing to do when suffering from malaria is to get diagnosed promptly by a doctor or clinic and then receive appropriate treatment. This is the quickest way to reduce symptoms of the disease, such as vomiting, as well as prevent progression of the disease. Once treatment has begun to be administered, your doctor or nurse may also be able to give you medication to reduce nausea and vomiting, but you should certainly consult with medical professionals before taking any other medication while being treated for malaria.

Malaria Fever

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QUESTION:

How many days will the fever last?

ANSWER:

There is no set amount of time for the duration of a malaria fever, and in fact it will depends on several factors, namely the type of malaria the patient has, their level of acquired immunity, whether they were taking preventative medicine for malaria (prophylaxis) at the time of infection and how quickly they receive appropriate treatment.

There are, however, known “cycles” to the progression of fever during a malaria infection. Plasmodium falciparum, P. vivax and P. ovale, three of the types of malaria that normally infect humans, are known as “tertian” malarias, as they produce fevers that peak every two days. P. falciparum, due to its severity and rapid increase in the human host, can sometimes present with more frequent, or even constant, fever. P. malariae, on the other hand, is considered a “quartan” malaria, as it produces fever in approximately three-day cycles.

High Risk Areas for Malaria

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QUESTION:

Where are the high risk areas of malaria?

ANSWER:

Global malaria incidence rates (courtesy of the World Health Organisation)

Malaria is found in many tropical and sub-tropical parts of the world, although a few areas, through concerted control and prevention efforts, have eliminated the disease locally. Examples of this are the USA, most of the Mediterranean and parts of Central America. The highest burden of the disease is in Africa, although many parts of Asia, particularly India and south-east Asia, also suffer from a large number of cases every year. The map shows the risk of malaria around the world.

Illness from Uganda trip

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QUESTION:

I just came back from a visit to Uganda Africa. I was unable to take Malarone as I had bad side effects. Vomiting. I was only exposed once when we walked into a swampy rain forest. This of-course was the only day I did not have repellent. We were taking the kids on a nature walk and the German volunteer got a little lost. I ran as fast as could out of the area. Started to feel tired and weak 7 days later, getting severe headaches and going from hot to cold. 5 kids ended up with Malaria shortly after our walk. (I found this out after my return).

A missionary on the plain said I must likely had malaria and gave me Lumartem. By the time I got home I was having sever diarrhea and real bad body aches, low grade fever. The doctor here took my blood but reported my results would take 7 days. I started taking the Lumartem, & I felt better, the runs slowed down the boy aches lessened. Now I am finished with my 3 day prescription Feel pretty good compared to how I felt b4. Still have stomach cramps and small runs. What now? Should I go have a blood test to see if its gone or just wait and see???

ANSWER:

Considering you were in Uganda, it is not unlikely that you didn’t also pick up some sort of intestinal bug or parasite, which might be responsible for the residual runs and cramps. However, it is certainly important to take a blood test to ensure that you have completely cured the malaria infection; P. falciparum is common in Uganda, and causes a very severe form of malaria. While it can’t come back directly once it has been cured, if treatment is not entirely successful small numbers can remain in your blood stream and then start reproducing again once you have stopped taking medication, resulting in what is called “recrudescence” of the infection.

If possible, try to find out from the doctor that performs the blood test what type of malaria you had/have, as this will also determine whether you need additional medication (called primaquine) to prevent recurrence or relapse of the infection at a later date. Recurrence is due to a dormant phase of the malaria parasite hiding out in your liver; while P. falciparum cannot produce these dormant phases (and therefore can only relapse if the initial blood infection is not completely cured), two other malaria parasites, called P. vivax and P. ovale, can have liver stages, and so you may need to take primaquine if you are found to have been infected with either of these types.

Malaria Survey in Mumbai, India

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QUESTION:

I want the past year’s malaria survey in Mumbai and other states.

ANSWER:

The Lancet, one of the world’s leading medical journals, recently published an article summarising the mortality of malaria in India. The citation for the article is as follows:

Dhingra, Jha, Sharma, Cohen, Jotkar, Rodriguez, Bassani, Suraweera, Laxminarayan and Peto (2010), ‘Adult and child mortality in India: a nationally representative mortality survey’, The Lancet, 376: 1768-1774.

A slightly older article (from 2007) discusses the burden of malaria in India:

Kumar, Valecha, Jain and Dash (2007), ‘Burden of malaria in India: A retrospective and prospective view’, American Journal of Tropical Medicine and Hygiene, 77: 69-78.

Person to Person Malaria Transmission

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QUESTION:

If someone had malaria but they don’t have it any more can they give it to someone else?

ANSWER:

Regardless of whether a person is still infected with malaria or not, malaria can almost never be transmitted directly from one person to another.

Normally, malaria is only transmitted via infected mosquitoes; so, a mosquito has to bite an infected person, and then bite another person, and the malaria parasites are transmitted via the mosquito’s saliva to the second person. The exception to this is blood transfusions; in area where blood is not thoroughly screened, there have been cases of a person becoming infected with malaria after having received blood from a person with a malaria infection.

Secondly, although the actual disease cannot be transmitted this way, pregnant women who are infected with malaria can pass antigens and antibodies to their unborn child via the placenta, which can cause problems to the baby. For this reason, and others, preventing malaria in pregnant women is a huge priority in global malaria prevention.