Malaria Recurrence

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QUESTION

My friend suffers malaria due to plasmodium falsciparum at least every two weeks. It has been treated with coartem, artequine, artesunate+fansida, quinine/quinimax since 2004 without any relief at all. It returns a week or two later and lab tests attest to same. What else should be done?

ANSWER

It is rare for someone living in an endemic area to suffer so regularly from malaria—usually after repeated exposure the body builds up a certain level of immunity which prevents mild attacks developing into serious illness. Also, P. falciparum is not resistant to Coartem, so something else is probably going on. 

The first thing to make sure is that your friend complies fully with the medication they are given, and completes the full course of drugs. If they stop taking the pills before the full course is completed, the malaria parasite might be reduced enough for symptoms to subside and for the parasite to be undetectable in blood tests, but is still there in low numbers and so can bounce back after your friend stops taking the pills, resulting in a new bout of disease. This process is called recrudescence, and can be prevented by ensuring that the full course of medication is taken, so that ALL the malaria parasites in the blood are killed.

Otherwise, it is clear that your friend needs to take more preventative measures against contracting malaria. These include sleeping under a long-lasting insecticide-treated bednet, spraying the inside of the house with insecticides to prevent malaria mosquitoes from persisting inside and wearing long-sleeved clothing and insect repellent in the evenings and at night, when mosquitoes are biting most actively.

Your friend may also want to look into taking malaria prophylaxis (preventative medication) at times of the year when they are most at risk from infection, or if they know they will be undertaking activities that leave them vulnerable to mosquito bites (i.e. working outdoors at night for a period of time). Some anti-malarial prophylactic drugs, such as doxycycline, are readily available in most malarial countries at a very good price. However, they cannot be taken indefinitely, so for people living in endemic areas, other preventative measures should be considered first.

Is it Common to Die of Malaria?

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QUESTION

is it common to die of malaria? Why? Why not?

ANSWER

Thankfully, these days it is not very common to die from malaria. Out of an estimated 250 million cases of malaria around the world every year, there are only about 700,000 fatalities. However, 700,000 deaths every year is still a lot!

If left undiagnosed and untreated, malaria can progress very rapidly and be a very serious disease. This is particular true of Plasmodium falciparum, a specific type of malaria which is found throughout tropical regions in South America, Africa and Asia.

It is dangerous because it reproduces very rapidly in the body and can cause red blood cells to clog up inside blood vessels in organs, restricted blood flow. When this occurs in blood vessels in the brain, the patient may suffer “cerebral malaria,” which can rapidly lead to loss of consciousness, coma and even death if not treated promptly.

The people most at risk from malaria are children under the age of 5 and pregnant women, and so it is particularly important for these people to seek medical care very quickly if they suspect they have malaria.

On a positive note, deaths from malaria are becoming less common around the world due to a number of factors. First of all, there have been many very successful prevention strategies, for example through distribution of long-lasting insecticide treated bednets to at-risk communities living in malaria endemic regions. Indoor residual spraying with insecticides have also drastically reduced the number of mosquitoes in households where this procedure has been carried out, thus reducing transmission. Moreover, improvements to point-of-care diagnostics and other health infrastructures have enabled poor people in developing countries to have access to ways in which their infections can be diagnosed, and then given the appropriate treatment. All of these measures have brought the number of annual deaths down from 1 million just a few years ago to 700,000 today.

The goal is yet more ambitious: organisations such as Malaria No More seek to eliminate deaths from malaria, all over the world, by the year 2015. So, we hope in 2015 we can add to this answer by saying it is now very rare indeed to die from malaria!

Long term health effects of malaria when young?

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QUESTION

I’m trying to find out if having malaria at a young age can have long term effects on health.

Around 25 years ago when I was 4 years old I contracted malaria when living in central Africa. Unfortunately I do not know the type of malaria, only that I received medication and recovered without complications.

Over the last few years I’ve had a general feeling of poor health and fatigue. Blood tests indicate I have some level of liver damage but I’m at a loss for the cause.

Is there any chance of having picked up liver damage (or other long term effects) from contracting malaria at a young age?

ANSWER

There is little evidence for any long term complications associated with uncomplicated malaria infection. One thing to investigate might be the type of malaria you had as a child; Plasmodium vivax and Plasmodium ovale, while not as common as Plasmodium falciparum in Central Africa, both occur in this region, and differ from P. falciparum in that they can have a dormant liver stage.

While I still have not heard of liver problems being associated with dormant malaria parasites, it is conceivable that if you had one of these two types of malaria and did not have the liver stages treated, you might later feel some ill effects; relapse from P. vivax has been known to occur decades after the initial infection. The good news is that there is a drug available, called primaquine, which can kill these liver stages (known as hypnozoites). So, if you know you had P. vivax or P. ovale, you could mention this possibility to your doctor—prior to taking primaquine you should have a test for G6DP deficiency, as such as deficiency makes it dangerous to take this medication.

If you have ever taken anti-malaria medication, please take Malaria.com’s brief Malaria Medication Side-effects Survey: Treatment and Prophylaxis.

What is Malaria?

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QUESTION

what is malaria?

ANSWER

Malaria is caused by a parasite called Plasmodium, which is transmitted via the bites of infected mosquitoes. In the human body, the parasites multiply in the liver, and then infect red blood cells. Usually, people get malaria by being bitten by an infective female Anopheles mosquito. Only Anopheles mosquitoes can transmit malaria and they must have been infected through a previous blood meal taken on an infected person. When a mosquito bites an infected person, a small amount of blood is taken in which contains microscopic malaria parasites. About 1 week later, when the mosquito takes its next blood meal, these parasites mix with the mosquito’s saliva and are injected into the person being bitten.

Because the malaria parasite is found in red blood cells of an infected person, malaria can also be transmitted through blood transfusion, organ transplant, or the shared use of needles or syringes contaminated with blood. Malaria may also be transmitted from a mother to her unborn infant before or during delivery (“congenital” malaria).

Symptoms of malaria include fever and flu-like illness, including shaking chills, headache, muscle aches, and tiredness. Nausea, vomiting, and diarrhea may also occur. Malaria may cause anemia and jaundice (yellow coloring of the skin and eyes) because of the loss of red blood cells. Symptoms usually appear between 10 and 15 days after the mosquito bite. If not treated, malaria can quickly become life-threatening by disrupting the blood supply to vital organs. Infection with one type of malaria, Plasmodium falciparum, if not promptly treated, may cause kidney failure, seizures, mental confusion, coma, and death. In many parts of the world, the parasites have developed resistance to a number of malaria medicines.

Malaria and the Brain

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QUESTION

How long does it take malaria to reach your brain?

ANSWER

The process by which malaria affects the brain is complicated, and the amount of time also varies. First of all, only one species of malaria parasite is associated with the brain – this is Plasmodium falciparum, the most deadly form of malaria. It is dangerous because when it infects red blood cells, it makes them “sticky,” so that they become lodged in the small blood vessels in the body’s organs. This process is called sequestration, and results in reduced blood flow to the organs, which can result in further complications.

When infected red blood cells sequester in the brain, the result is so-called “cerebral malaria,” which can lead to impaired consciousness, coma and even death. P. falciparum reproduces rapidly, so if not treated promptly, cerebral manifestations of the infection could appear within a matter of a few days of the initial onset of malaria symptoms. The good news is that treatment is very safe and effective, especially when started early, so when malaria is suspected as the possible cause of an illness, a blood test should be performed immediately to test for malaria, and also to determine if the species is P. falciparum.

If you have taken medications for malaria, please help Malaria.com by taking our Malaria Medication Side-effects Survey: Treatment and Prophylaxis. Thank you!

Malaria Symptoms

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QUESTION

WHAT ARE THE SYMPTOMS?

ANSWER

Symptoms of malaria include fever and flu-like illness, including shaking chills, headache, muscle aches, and tiredness. Nausea, vomiting, and diarrhea may also occur. Malaria may cause anemia and jaundice (yellow coloring of the skin and eyes) because of the loss of red blood cells. Symptoms usually appear between 10 and 15 days after the mosquito bite. If not treated, malaria can quickly become life-threatening by disrupting the blood supply to vital organs. Infection with one type of malaria, Plasmodium falciparum, if not promptly treated, may cause kidney failure, seizures, mental confusion, coma, and death. In many parts of the world, the parasites have developed resistance to a number of malaria medicines.

Deadliest Malaria Parasite

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QUESTION

which malarial parasite is deadliest for humans, and why?

ANSWER

By far the most deadly malaria parasite is Plasmodium falciparum, as it is responsible for >95% of all malaria deaths every year. Most of these fatalities occur in young children in sub-Saharan Africa.

The causes for why P. falciparum is so deadly are still not fully understood. This parasite has the ability to cause infected red blood cells to become “sticky”, and therefore clog up small blood vessels called capillaries inside the body’s organs. This process is known as “sequestration”. Sequestration reduces blood flow to major organs, resulting in a variety of secondary conditions, perhaps the most famous well-recognized of which is so-called “cerebral malaria”, where oxygen flow to the brain is reduced and as a result of this and other effects of sequestration, impaired consciousness, coma and even death can occur.

Irregular Quotidian Fever

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QUESTION

Why quotidian fever is irregular?

ANSWER

Actually, the fever cycles associated with all types of malaria can be irregular. This is particular true in the initial stages of the fever, when the merozoites (the form of the parasite that leaves the liver to infect red blood cells) from different infection broods mature at different rates.

Over a few cycles of reproduction, the maturation synchronises and the parasites burst from the red blood cells in unison, creating more regular cycles of fever (no one really knows how the malaria parasites times emergence so closely!). P. falciparum may also always exhibit irregular cycles of fever, again due to asynchronous destruction of red blood cells.

Malaria Disorder

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QUESTION

what is the malaria disorder?

ANSWER

Malaria is caused by a parasite called Plasmodium, which is transmitted via the bites of infected mosquitoes. In the human body, the parasites multiply in the liver, and then infect red blood cells. Usually, people get malaria by being bitten by an infective female Anopheles mosquito.

Symptoms of malaria include fever and flu-like illness, including shaking chills, headache, muscle aches, and tiredness. Nausea, vomiting, and diarrhea may also occur. Malaria may cause anemia and jaundice (yellow coloring of the skin and eyes) because of the loss of red blood cells. Symptoms usually appear between 10 and 15 days after the mosquito bite. If not treated, malaria can quickly become life-threatening by disrupting the blood supply to vital organs. Infection with one type of malaria, Plasmodium falciparum, if not promptly treated, may cause kidney failure, seizures, mental confusion, coma, and death. In many parts of the world, the parasites have developed resistance to a number of malaria medicines.

What are the Symptoms of Malaria?

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QUESTION

What are malaria symptoms?

ANSWER

Symptoms of malaria include fever and flu-like illness, including shaking chills, headache, muscle aches, and tiredness. Nausea, vomiting, and diarrhea may also occur. Malaria may cause anemia and jaundice (yellow coloring of the skin and eyes) because of the loss of red blood cells.

Symptoms usually appear between 10 and 15 days after the mosquito bite. If not treated, malaria can quickly become life-threatening by disrupting the blood supply to vital organs. Infection with one type of malaria, Plasmodium falciparum, if not promptly treated, may cause kidney failure, seizures, mental confusion, coma, and death. In many parts of the world, the parasites have developed resistance to a number of malaria medicines.

For most people, symptoms begin 10 days to 4 weeks after infection, although a person may feel ill as early as 7 days or as late as 1 year later. Two kinds of malaria, P. vivax and P. ovale, can occur again (relapsing malaria). In P. vivax and P. ovale infections, some parasites can remain dormant in the liver for several months up to about 4 years after a person is bitten by an infected mosquito. When these parasites come out of hibernation and begin invading red blood cells (“relapse”), the person will become sick.

Infection with malaria parasites may result in a wide variety of symptoms, ranging from absent or very mild symptoms to severe disease and even death. Malaria disease can be categorized as uncomplicated or severe (complicated) . In general, malaria is a curable disease if diagnosed and treated promptly and correctly.