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.

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.

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.

White Blood Cells and Malaria

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QUESTION

Does malaria cause loss of white blood cells / antibodies?

ANSWER

The parasites that cause malaria reproduce in the human host by infecting red blood cells, then multiplying asexually and bursting out into the bloodstream, ready to infect more red blood cells.

As such, malaria parasites do not destroy white blood cells. However, patients with malaria may display reduced white blood cell counts during blood tests; this is usually thought to be due to relocalization of the white blood cells from the limbs (where blood is usually taken from during these tests) to the spleen and other internal organs also affected by the malaria infection.

As for antibodies, the malaria parasites contain antigens, which are proteins that cause an antibody response in the patient, thus usually resulting in an increase in antibodies during infection, especially if the patient has been exposed to malaria previously.

Having Malaria after being tested negative

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QUESTION:

In April 2010 I was in India, had symptoms of malaria, had blood work done, platelets low but rapid antigen and smear were negative. One year later, May 2011, had low platelet count, chills, no fever or fever spikes. Could this be malaria again even though I was tested negative.

ANSWER:

This response is courtesy of Dr Jaya Swarup Mohanty, a physician in India:

Malaria doesn’t affect the platelet count or the white blood cell count. The Plasmodium species causing malaria are either lodged in the hepatocytes (liver cells) or the RBCs (red blood cells) where they undergo asexual multiplication.
Any change in platelet count would rather indicate dengue (another mosquito borne disease with fever, chills, prostration, bone pain, low platelet count) or some blood disorders (where there would only be decrease or increase in platelet count). In this case there is only low platelet count and chills with no fever or fever spikes which may indicate some disorder in blood or immune system or as a reaction to some medication. It would be advisable to consult a physician as soon as possible for further work up.

Malaria effects on body’s digestive system

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QUESTION:

How does Malaria affect the digestive system?

ANSWER:

Malaria does not usually affect the digestive system directly, although nausea and abdominal pain can be symptoms of the disease, usually due to the high fevers caused by the infection. Having said that, some of the drugs given as treatment or prevention of malaria are also known to have gastrointestinal side effects; both chloroquine and proguanil (one of the active ingredients in Malarone) are known to cause nausea and abdominal pain as common side effects, and both can also sometimes (in rare cases) result in gastrointestinal bleeding. It is recommended that these medications be taken with food, to reduce the likelihood of experiences any such side effects.

Are there dietary restrictions for malaria?

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QUESTION:

What are the dietary restrictions of malaria?

ANSWER:

There are no dietary restrictions, as such, when infected with malaria. A person who is suffering from malaria will have high fevers and potentially nausea, which might decrease the appetite—it is crucially important to try to stay hydrated  by drinking lots of fluids and trying to eat when possible. Certain drinks, such as bitter lemon and tonic water, contain quinine, which has long been used as a natural remedy against malaria, and can help prevent infection with certain types of malaria, though it is far more effective to use other preventive actions, such as sleeping under an insecticide-treated bednet and/or taking prophylactic medication when in a malarial area.

Do I have malaria?

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QUESTION:

Hi, I went to Ivory Coast August/2003 back March/2004, took some pills to help prevent Malaria on my trip but ran out and did not get more. While I was there I got many mosquito bites.

Around October/03 became very sick, got tested for malaria at the hospital in Quebec but negative. Now May/2011 still have all the same symptoms, flu like symptoms, feeling cold most of the time, chills headaches, tired.

Is there any way I got it? I’ve gone to doctors and doctors and no one can seem to find what is causing this? I am tired of taking tylenols all the time for the body ache. My wife is from there and she’s so sure that I got it from seeing how I am since she’s been around it all her life. Can you help me?

ANSWER:

There are definitely types of malaria that can cause relapses of symptoms many months or even years after an initial infection. These types are not common in the Ivory Coast but if you had many mosquito bites then it is certainly possible that you were exposed. What kind of test did you have for malaria when you returned to Canada?

Often, the test is by looking at a microscope slide of your blood under the microscope—the problem with this test is that it is not very sensitive for low levels of malaria, for example, after the worst of infection, and especially with the types of malaria that cause relapse (these types, P. ovale and P. malariae being the ones you might expect from Ivory Coast, tend to cause less severe illness than the more common type of malaria in Africa, called P. falciparum, doesn’t relapse in the same way, but results in much higher levels of the malaria parasite in the blood, which makes it easier to diagnose on blood slides). Also, since malaria is relatively rare in northern countries like Canada, laboratory technicians are not as experienced at diagnosing the parasite as they are in countries where malaria is endemic.

Having said that, there are of course lots of other illnesses which also cause symptoms similar to that of malaria – fevers, chills, etc. What I would recommend is that you re-visit the doctor, and ask for a more sophisticated test for malaria. Mention that you have had a relapse of symptoms—this should prompt them to use more sensitive tests, such as PCR or a rapid diagnostic test, and to look specifically for P. ovale or P. malariae. Not only will this answer your question about whether you have malaria, but it will allow the doctors to give you the appropriate treatment for your current symptoms (probably chloroquine) as well as treatment to prevent any further relapses (primequine).

Hope this helps!

How do you get malaria?

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QUESTION:

How do you get malaria?

ANSWER:

Malaria is caused by parasites called Plasmodium, of which different species cause different types of malaria. A person gets malaria when they are bitten by certain female mosquitoes (of the species Anopheles) that carry Plasmodium parasites in their saliva. The mosquitoes themselves pick up the parasite by feeding on the blood of people already infected with malaria.

Once a person has been bitten by an infected mosquito, the parasites are released into their bloodstream. Inside the body, they reproduce and multiply—different types of malaria have different lengths of reproductive cycle and different locations in the body where the life stages reside. It is the process of reproduction and movement through the body that causes the fever, chills and other symptoms that are associated with a malaria infection.

What is malaria?

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QUESTION:

What is malaria?

ANSWER:

Malaria is a disease caused by parasites of the genus Plasmodium. Transmitted by mosquitoes, there are several different kinds of malaria distributed throughout the tropical and sub-tropical regions of the world, causing somewhere between 300-500 million cases of disease each year, and as many as 1 million deaths. In fact, malaria is one of the biggest killers of children under the age of five in sub-Saharan Africa, one of the regions of the world where the burden from malaria is the highest. Malaria is usually an acute disease, manifesting itself with severe fever, chills, headache and often nausea as well. Some types of malaria can have relapsing episodes over a time period of many years.

Having said this, malaria is easily preventable, through avoiding mosquito bites by wearing appropriate clothing and sleeping under insecticide-treated bednets, or through taking preventative medication (called prophylaxis). Malaria is also treatable once symptoms appear, through ingesting safe, effective and relatively cheap drugs. With such control measures at hand, you may ask why malaria is still such a huge problem in our world; the answer is that delivering control strategies and treatment to populations most at risk is difficult, and often countries with high malaria burdens don’t have efficient and effective health systems in place to coordinate control efforts.

International non-governmental organisations such as the World Health Organisation, as well as a multitude of non-profit organisations such as the Malaria Consortium and Malaria No More, work tirelessly to bring malaria control and treatment to the places that need it most, with the aim to eradicate malaria as a disease of public health importance.