Malaria untreatable?

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QUESTION:

I just want to find out what can cause malaria to be untreatable because have been injected (13) times and no changes. What can cause it, and i need a drug name that can take care it.

ANSWER:

Treatment for malaria is very rarely in the form of an injection, so I suspect you are not being treated appropriately. Malaria is caused by being bitten by a mosquito infected with parasites called Plasmodium, which enter your blood stream as the mosquito drinks your blood. If you have the symptoms of malaria, and live in an area where malaria is found, it is very important that you get diagnosed before you are treated. Many other diseases have similar symptoms to malaria, and so unless you know for sure what disease you have, you might not get the correct medication. Moreover, some forms of malaria require different drugs to others, which is another reason why accurate diagnosis is crucial.  You can find more information here on Malaria Prevention and Treatment. If you have or suspect you have a malaria, you should consult your physician.

 

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.

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.

 

Malaria in Malaysia

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QUESTION:

Is there malaria in Malaysia?

ANSWER:

Yes, there is malaria in Malaysia, although efficient vector control campaigns, alongside a well-functioning health system which effectively diagnoses and treats malaria cases has vastly reduced the transmission of the disease in peninsular Malaysia at least. Transmission is still a problem in rural, interior areas, and especially in Sabah and Sarawak.

The history of malaria control in Malaysia is actually something of a success story; back in 1961, there were over 240,000 reported cases of malaria across the country; this was reduced to about 40,000 cases by 1980, due to the measures mentioned briefly above, and in 2008, that number had further dropped to only about 7,000 cases a year.

The fatality rate of malaria in Malaysia is also very low, being about 0.09%, or about 50 deaths a year, which is a testament to the effectiveness of national health systems at monitoring for the disease. Having said that, Plasmodium falciparum, the most severe type of malaria, is present in Malaysia—it was this that was responsible for all the reported fatalities in 2008. As such, if you are visiting or living in rural regions of Malaysia, where malaria transmission still is relatively high, it is recommended that you take preventative measures against the disease, such as sleeping under an insecticide-treated bednet, or taking prophylactic (preventative) medicine. This latter measure is usually only worthwhile if you are visiting a malaria area for a relatively short time, as the drugs can be quite expensive.

If you have visited these rural areas, and have symptoms of malaria, such as fever and chills, within two weeks of returning, you should go to the hospital or visit a physician immediately for diagnosis. If it is malaria, the doctor will be able to provide you with the most appropriate medicine for the type of malaria that you have.

What is malaria, and how can it be cured?

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QUESTION:

What is malaria? How could we cure it?

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. There are also many research groups around the world that are striving to create new, more effective medications and drugs. For some time now, there has also been work in progress trying to develop a vaccine against malaria; at this point, there has been little applied success, but with further research and efforts, an immunization against Plasmodium may be forthcoming in the future.


Can malaria kill you?

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QUESTION:

Can malaria kill you?

ANSWER:

YES! Malaria, especially of the kind caused by Plasmodium falciparum parasites, can be an extremely severe illness and even deadly. Somewhere between 700,000 and 1 million people die of malaria every year, and the majority of these are children under the age of five years old, which is the age group most susceptible to severe malaria attacks. Pregnant women are also at elevated risk, due to their compromised immune systems. Therefore, preventing malaria in young children and pregnant women is the single most effective way to reduce the number of malaria fatalities; in highly endemic areas, this is usually achieved through the distribution of insecticide-treated bednets, to sleep under at night to reduce mosquito bites, or preventative medication such as intermittent preventive therapy (IPT).

Given the seriousness of malaria, it is prudent to check with a doctor or go to hospital if you live in a malaria endemic area and come down with symptoms of the disease such as high fever, chills and nausea. The majority of malaria cases are easily treated with oral medication, given swift and accurate diagnosis.

What is malaria?

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QUESTION:

What is malaria?

ANSWER:

To answer your question, I have copied below the answer to an earlier post, published on the 1st of May, 2011, which also asked “What is malaria?”:

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.

 

Treating Malaria by Health Extension Workers: A Case Study from Ethiopia

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For many years the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) have been promoting an Integrated Management of Childhood Illness (IMCI) training package to ensure that nurses and doctors are capable of treating sick children at health facilities.  Over the years, with the realization that many children did not have access to health facilities and therefore were not being ttreated, the two organizations published a Joint Statement on Managing Pneumonia in Community Settings (2004)[1].  This groundbreaking document calls on countries to bring treatment of childhood illness – pneumonia as well as malaria and diarrhea closer to communities that need it, by empowering trained community health workers to identify and manage these problems. Many countries have followed this advice with excellent results.  Here is a story from Ethiopia.

Aminata is a health extension worker (HEW) at the Tebisa health post, located in a rural, hilly area of East Amhara, some 400 kilometers away from Addis Ababa, the capital city of Ethiopia. Aminata received training on integrated community based management of common childhood illnesses (iCCM) in early 2011. After the training, she carried the essential materials and supplies with her back to the health post, and started treating children suffering from pneumonia, malaria, diarrhoea and/or severe acute malnutrition.  In the last two months, she has treated 35 children under five.

HEW Ethiopia
A Health Extension Worker (HEW) with Almaz and her family. Photo: Dr. L. Pearson

One of the children suffering from malaria is a five year old girl, Almaz (which means diamond in Amharic). She developed fever one night in April. Her mother took her to the health post and she was seen immediately. Aminata checked her temperature (39.0 OC), and respiratory rate (children sometimes have pneumonia and malaria at the same time) and pricked her finger to obtain a drop of blood to perform a Rapid Test for Malaria (RTM) to look for malaria parasites [Ed: Rapid Diagnostic Tests, or RDTs, are another, more general term for these tests].

Almaz did not have rapid breathing, an indication of pneumonia, but she did have falciparum malaria (the most severe and deadly of the types of malaria found in humans, and caused by the Plasmodium falciparum parasite).  She was given Coartem (Arthemeter-Lumefentrine) treatment by mouth for three days.  Aminata gave the first dose of medicine and gave the mother the rest of the tablets, explaining when to give them. Aminata made a point to discuss how important it is to feed a sick child so they do not lose weight, and to be alert to certain ‘danger signs’ in case the child is not getting better, in which case they should return immediately to the health post.

On the second day of treatment her mother brought her back to the health post for a follow up check.   Almaz’s mother expressed her gratitude. “If the HEWs are not providing treatment for sick children, I would have to carry Almaz to the health center some 4 hours away by foot. I would also have to pay for the treatment.  We were frustrated before iCCM started because we were not able to help children with malaria and pneumonia”.

malaria medicines at health post Ethiopia
Malaria medicine available, for free, at the Tebisa health post in Ethiopia. Photo: Dr L. Pearson

“The communities trust and support us even more now”, said Aminata. “Now the mothers are so happy, they even bring the children for immunization without us having to push them”.

In the next two years, about 20,000 HEWs will be trained and supported to provide iCCM in 10,000 rural villages. Hundreds and thousands of young children in Ethiopia will benefit from the iCCM programme jointly supported by the government of Ethiopia, Catalytic Initiative of Canada, UNICEF and other development partners. Program implementation will focus on remote and harder to reach villages and households, to ensure every child is covered, no matter where they are and who they are.

The iCCM is be an important opportunity to further improve quality of care provided at the health posts, and accelerate toward the achievement of Millennium Development Goal 4, to reduce deaths of children under 5 by two-thirds by 2015.

[1] Management of Pneumonia in Community Settings (PDF)

Does malaria spread from a person to another?

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QUESTION:

Can malaria spread from one person to another?

ANSWER:

Usually, no. In most cases, the malaria parasite has to first pass from a human host into a mosquito as the mosquito takes a blood meal, and then from the mosquito into another human via the mosquito’s saliva. This severely limits the amount of person-to-person transmission that exists. In fact, the only mechanisms for direct transmission between humans are when malaria parasites are passed between a mother and her unborn child via the placenta (congenital transmission) and through unscreened blood transfusions.

Congenital malaria is the more common type of human-to-human transmission; across various surveys of newborns in West Africa, between 8-24% were found to be infected with malaria parasites.

All four main species of human malaria (P. falciparum, P. vivax, P. ovale and P. malariae) have been implicated in congenital transmission. Infection with malaria during pregnancy not only puts the mother at greater risk of severe disease episodes (probably through reduced immunocompetence during pregnancy) but may also negatively impact the baby; although in endemic areas it is rare for babies to be symptomatic for malaria when acquired congenitally, even if they have parasitaemia, they have been shown to have a higher mortality rate than non-infected newborns. In non-endemic areas, babies with congenital malaria often display symptoms, which usually manifest themselves between 2 and 8 weeks after birth. Both quinine and artemisinin-based therapies have been successfully used to treat congenital malaria.

Malaria infection as a result of blood transfusion was first identified in 1911 and is one of the most common illness transmitted via transfusion, although the risk of being infected, particularly in non-endemic countries, is very low.

As it is difficult to screen blood directly for malaria infection, a number of standards have been put in place by blood-collection services to reduce the risk of obtaining blood containing malaria parasites. For example, in many places, you will not be allowed to donate whole blood if you have visited an endemic malarial region in the last three months, nor should you donate if you have previously had malaria unless you have been symptom-free for at least three years.

Due to the longevity of Plasmodium malariae in the blood, you are unlikely to be able to donate blood if you have ever been confirmed as positive for P. malariae. Serological screening of blood for malaria antibodies has recently been shown to be a sensitive method for testing for malaria in blood, although it is expensive and therefore not cost-effective for screening every sample, especially in non-endemic countries. However, it can be effective and efficient to avoid wastage when employed together with a travel-based questionnaire to ascertain donors who are high-risk for malaria.

It is worth mentioning that transmission of malaria via plasma only is very uncommon, and so frequent travellers or residents in malarial areas, who may be denied the right to donate whole blood, should ask about the possibility of donating plasma instead.