Rash and Malaria

by

QUESTION

Is random rash-like swelling on parts of your body coupled with back pains and joint aches and cold sweats all malaria symptom? If so, what is the parasite type and the cure?

ANSWER

Rashes are not usually associated with malaria infection; the symptoms you describe are however consistent with several other infections, some of which can be quite serious, such as dengue fever. You should go to your doctor or a hospital to have a blood test which can assist in diagnosing you.

For future reference, if you did have malaria, you would still probably need to have a blood test to determine which species of malaria you had, and therefore what kind of treatment would be appropriate.

Untreated Malaria

by

QUESTION

If I am infected with malaria and I get a wrong diagnosis and be treated for flu, can the other symptoms disappear but continue to experience severe headache especially on the right side temple and jawbone area combined with general weakness and numbness in the legs?

ANSWER

Certainly the symptoms of malaria can often be confused with other infections, including flu. Given that treatment for flu will often include anti-fever medications such as aspirin or paracetamol, these drugs may also ameliorate some of the symptoms associated with malaria, without actually curing them.

However, numbness in the legs is not usually characteristic of malaria infection, though headache and weakness could be—again, these are general symptoms of many other infections as well.

If you suspect you have been misdiagnosed and have malaria, you should ask your doctor for a blood test; these can also be carried out at any local hospital or clinic. There, by looking at your blood under a microscope or using it in a rapid diagnostic test, they will be able to determine accurately whether you have malaria.

Malarial Attack Recurring

by

QUESTION

My Father aged 65 years was diagnosed with malaria 15 days back and was on medication. Fever was recurring frequently and he had developed a lung infection. Three days back fever stopped and did not occur for 2 days and malarial infection was reducing. Now the Fever has started coming but other parameters are normal. Can you please suggest what needs to be done?

ANSWER

If your father also developed a lung infection, was he treated with antibiotics? If not, his later fever could be caused by that infection, and could be unrelated to the malaria.

He should have another blood test, to look for the malaria parasites; if they are still present, then you should talk to his doctor about trying another type of anti-malarial medication—the World Health Organization recommends artemisinin-based combination therapies (ACTs), such as Coartem, Alu and Duo-Cotecxin, as the first-line treatment against uncomplicated malaria.

However, given that your father appears to have concurrent other medical conditions, it may be that other treatment is more appropriate, and as such it is very important that you check with your doctor before taking additional medication.

Malaria Treatment with Fansidar

by

QUESTION

My husband has Malaria following a trip to Kenya and has had a fever for three days. We are in Russia and the only drug available at the pharmacy was Fansidar (we also have some Doxcycyclin). He took three Fansidar tablets last night and feels better but the fever has still not completely gone. What should we do? Take more Fansidar? Thanks for your help.

ANSWER

A single dose of three tablets is the correct amount for an adult over 45kg in weight—do not take any more. Unfortunately, Fansidar is not recommended as the first-line drug against malaria any more since many strains of P. falciparum (the most dangerous type of malaria, and the most common type in Kenya) now have resistance to Fansidar. This could be one reason why the treatment is not fully successful, though it could also be that the treatment has worked, but it will take a day or two more before your husband fully recovers.

Make sure your husband takes in plenty of fluids, and anti-inflammatory drugs such as ibuprofen might help with the fever and any aches he could also be suffering from.

If your husband is still feeling sick after a few days, you should try to have another blood test to see if the malaria parasites are still present in his blood. If you, you should try to find an artemisinin-based combination therapy, such as Coartem, Duo-Cotecxin or Alu. These are the most effective medications against malaria that are currently available, and are recommended as first-line treatment by the World Health Organization (for uncomplicated malaria).

Do I need malaria tablets to live in Nigeria?

by

QUESTION

Do I need malaria tablets to live in Nigeria? I was born and bred in the UK and want to go back to live in Nigeria for about 2 years, do I need malaria tablets?

ANSWER

It is not usually recommended to take malaria tablets for long periods of time (i.e. more than a few months). People living for extended periods in areas with malaria should focus on other methods of prevention, such as sleeping under a long-lasting insecticide-treated bednet.

The mosquitoes that carry malaria, Anopheles, feed mostly in the evenings and at night, so it is particularly important to protect yourself during these times. Screening windows and doors tightly can help prevent mosquitoes form entering, as can air conditioning inside the house (it makes the climate less suitable for the mosquitoes).

In many parts of Africa, insecticide is sometimes sprayed indoors, again to prevent mosquitoes from being inside the house. Personal protection is also important; wearing long-sleeved clothing, particularly at dawn, dusk and at night, can prevent mosquitoes from biting you, as can wearing mosquito repellent, particularly kinds containing the chemical DEET.

Regarding tablets to prevent malaria, if you really want to pursue this option, the only medication which is recommended for long-term use is doxycycline, but you should consult with your doctor about its suitability for periods of longer than 6 months, and they should also explain to you the possible side effects associated with taking it.

While the above mentioned forms of prevention should be the mainstay of your efforts to avoid malaria, it is also important to know what the symptoms are and what to do if you suspect you might be infected.

Malaria is characterized by high fever, chills, aches and nausea most commonly, and if you think you may be infected, you should immediately go to a doctor or a clinic for diagnosis. The doctor/clinician should take a blood sample and either look at it under a microscope to look for malaria parasites or they will use a drop of blood in a rapid diagnostic test. In both cases, you should only take medication to treat malaria if you are positively diagnosed.

Socio-Economic and Environmental Conditions Contributing to Malaria

by

QUESTION

what socio-economic and environmental conditions contribute to the disease?

ANSWER

Malaria transmission requires the presence of Anopheles mosquitoes; as such, conditions which favor the growth and persistence of these mosquitoes will also be hotspots for malaria transmission, provided the climate is also sufficiently warm for the development of the parasite within the mosquito.

Rural areas without sophisticated water and sanitation systems often utilize streams or ponds for everyday water needs; if these produce stagnant patches of water, they can be an ideal location for the development of mosquito larvae. Similarly, if rural farmers dig canals or ditches to irrigate their fields, these can become breeding areas. Urban areas tend to have less standing water, apart from cisterns, so in many cases transmission is less prevalent in urbanized locations. As a further socio-economic factor, preventing mosquitoes from entering the house and biting people is  key way to prevent infection. Rich people in malarial areas may be more able to have fully screened houses, possibly even with air-conditioning, which will prevent mosquitoes from establishing in the house. They may also be more likely to have access to a long-lasting insecticide treated bednet, which further reduces mosquito bites, and also access to accurate diagnostic screening and treatment, if they do happen to get infected.

All of these factors contribute to making malaria burden highest in some of the world’s poorest areas, with the highest levels of mortality in sub-Saharan Africa.

Can’t Get Rid of Malaria

by

QUESTION

Each and every month I am suffering from malaria ..Treatment is also going on but I am unable to get rid of it.

ANSWER

It is very unusual to be reinfected so constantly with malaria. First of all, how are you getting diagnosed? You should be getting a blood test, and not relying on symptoms only; the symptoms of malaria are very general and it could be that you are suffering from something else entirely. The two main methods for accurate diagnosis are blood smear and rapid diagnostic test. The blood smear is used throughout the world, but can sometimes miss light infections (though if you feel sick, your infection is likely heavy enough to be detected by this method). The problem is that it requires a trained technician to take the sample, prepare it properly, and read it thoroughly and accurately. In my experience, many clinics, especially if they are rushed and busy, will not take the time to read a blood slide properly, and will just diagnose malaria without looking. This is really bad! It is very important to be properly diagnosed, so you can get the correct treatment, and if you don’t have malaria, you can be diagnosed for something else. The second kind of diagnostic is a rapid diagnostic test, or RDT. This looks for antibodies to malaria in your blood, and is very sensitive and quick. In an ideal world, you should try to have both done, to cross-check the results.

The next thing is to check whether you are receiving the correct treatment for the type of malaria that you have (if you are positively diagnosed with malaria). In many parts of the world, malaria has become resistant to some of the main medications used against it. Notably, this is the case in many places with Plasmodium falciparum, the most dangerous kind of malaria, which has become resistant to chloroquine in many parts of the world, to sulfadoxine-pyrimethamine (sold as Fansidar in many places) and also to mefloquine (sold as Lariam) in some places. As such, the World Health Organisation NEVER recommends these treatments be given as first line drugs against P. falciparum malaria – instead, they recommend artemisinin-combination therapies (ACTs), such as Alu, Coartem or Duo-Cotecxin. If you have been diagnosed with P. falciparum, you must try to take these kinds of drugs first. No resistance to ACTs has been reported, so if you take the full dose correctly, as prescribed by your doctor (and check to make sure the drugs are not expired), then you should be cured of malaria.

However, treatment does not stop you from getting infected again, and this is where prevention comes it. Preventing malaria is a cornerstone of control efforts. Since malaria is transmitted by a mosquito, preventing mosquitoes from entering the house, and particularly stopping them from biting you at night, is crucial. Screening all doors and windows can help stop mosquitoes from getting in, and in high transmission areas, many people will also spray inside their houses every once in a while with insecticides to kill any lingering insects. In addition, sleeping under a long-lasting insecticide treated bednet can drastically reduce the number of mosquitoes that are able to bite you at night. If you already have a net, it may be worth re-dipping it in insecticide (usually permethrin) to make sure it is still working effectively. The mosquitoes that transmit malaria feed at night, so if you are walking around outside in the evenings or at night, it is important to try to wear long-sleeved clothing, to prevent them from accessing your skin. All of these efforts will help prevent you from getting malaria again in the future.

Malaria Recurrence

by

QUESTION

I had malaria 5 months back it has again reoccurred. this time there has been increase in the size of the spleen. As of now it is being treated but I fear of getting it again. Is it true the malaria which i am down with reoccurs every 6- 8 months ??? Local people call it as registered malaria.. .

ANSWER

There certainly are types of malaria that can reoccur relatively regularly, at various intervals. This malaria is caused by one of two species, either Plasmodium vivax or Plasmodium ovale.

With both, it is important to get it diagnosed via a blood test with a doctor before getting treated again, to make sure it is indeed a relapse of the same malaria, and not a new infection with a different kind, or indeed some other disease (the symptoms of malaria can often be confused with other infections).

There is also medication that can be taken to prevent future relapses and re-occurrences—it is called primaquine, so you should talk to your doctor about the possibility of taking this medication. Please note it is not suitable for people who have G6DP deficiency, so you should be tested for that before taking it.

Swelling of Lymph Nodes and Malaria

by

QUESTION

I would like to know if swelling of lymph nodes in neck is any way connect to malaria?

ANSWER

Swollen lymph nodes are often a sign that the body is trying to fight off an infection, and so swollen lymph nodes are certainly sometimes observed in malaria patients. However, most malaria infections would also be associated with other symptoms, such as fever, chills, nausea and aches.

In some cases (but not all), malaria patients experience cyclical fever, whereby they have a high fever one day and no fever the next, but the fever returns on the third day, and the cycle continues. One type of malaria exhibits a cycle of fever one day, then no fever for two days, then fever returns on the fourth day. However, many patients do not experience these cycles, which means their symptoms are very similar to those for many other illnesses, which is why if you are in or have been visiting an area where malaria is transmitted and you have some of the above symptoms, it is very important to visit a doctor or clinic to get diagnosed for malaria. This can be done with a simple blood test, and the results are usually available very quickly. Then, if you are diagnosed as positive for malaria, the doctor can recommend appropriate treatment and instruct you in the proper way of taking it.

Coartem Treatment

by

QUESTION

my husband has been taking coartem for 3 days now. He was fine yesterday and then last night the symptoms re-appeared like it was day one. Can I carry on with coartem and start another course? Or shall I switch to something else ? If so, what? We live in zambia by the way.

Thank you for your help.

ANSWER

If your husband still has strong symptoms after taking all doses of the Coartem, go back to see your doctor  or to the clinic for another blood test. If it is positive, then your doctor may recommend trying a different form of anti-malarial medication—artemisinin-based combination therapy (a group of medications that includes Coartem) is recommended as the first-line treatment against malaria, but a second line option could be atovaquone-proguanil (Malarone) or another medication. Please note that Fansidar (sulfadoxine and pyrimethamine) and chloroquine are not recommended for use in Africa as levels of resistance are high. 

It could be that the medication hasn’t had time to fully act, which is why it is important to wait until the full dose has been taken, and then to confirm that malaria is still present. Sometimes the side effects of anti-malarials can appear similar to malaria itself, such as nausea, chills, body aches, etc, so it is important not to start another course of treatment without further diagnosis.

We are actually very interested in learning about our readers’ experiences with anti-malarial medications, and so we would be very grateful if you might be able to take a few minutes to complete our malaria survey we are running on Malaria.com. We will post any findings that may be of interest to our readership on Malaria.com later this year—all submissions are completely anonymous. Many thanks for your time and help, and I hope your husband recovers fully soon.