by Malaria Q&A
QUESTION
Could an onset of joint pain and swelling plus hurting all over be a residual for someone who has had malaria?
ANSWER
Once someone has been treated for malaria, they should not experience any further residual effects, particularly if the infection was uncomplicated and treated using oral medication. Joint pain, swelling and pain could well be indications of another infection, and so medical advice should be sought immediately.
by Malaria Q&A
QUESTION
does malaria still exist?
ANSWER
Yes, malaria still exists, and is responsible for 250 million cases of illness every year, of which about 700,000 result in death. So it is a very serious global health problem!
Some countries, such as the United States, have managed to successfully eliminate malaria through a combination of vector control strategies (i.e. spraying for mosquitoes, reducing the presence of water bodies where mosquitoes breed, etc) and better health infrastructure for diagnosis and treatment. This strategy has also been successful in other settings, such as the Mediterranean and much of the Middle East, as well as even in some high transmission tropical settings such as Malaysia (particularly in urban areas).
The widespread distribution of long-lasting insecticide treated bednets has further assisted in malaria prevention in high transmission areas. However, much of the rest of the world is still struggling to control malaria, though the number of deaths is dropping every year, and some organisations hope to reduce malaria mortality to zero by the year 2015.
If you have taken medications for malaria, please help Malaria.com by taking our Malaria Survey. Thank you!
by Malaria Q&A
QUESTION
My son is playing tennis in Rwanda, Africa. He feels terrible and I suspect it may be the Lariam. He has a fever and has been seeing stuff like snakes, etc. I am very worried as there is no doctor nearby. Is there anything to do to help him? The last Lariam he took was on Saturday.
ANSWER
Certainly Lariam is associated with some severe side effects, which include hallucinations such as that which you describe. Unfortunately, the best way to deal with the side effects of Lariam is to stop taking the drug.
If your son decides to do this, I strongly suggest he looks into taking a different malaria prophylactic for the remainder of his trip in Rwanda—doxycycline is readily available from most pharmacies in the region and is very modestly priced. Your son will probably need to take one tablet (100mg) every day (if he is under 8 years old the dosing is slightly different) and should be continued for 4 weeks after he leaves the malarial area. Side effects to look out for include severe sun sensitivity, so he should be diligent with sun block if he starts taking doxycycline.
A more expensive alternative is Malarone, which is also harder to find in Africa, but which has milder side effects and only needs to be taken for a week after returning home.
We are always very interested in our readers’ experiences with malaria preventative drugs and treatment, and we actually have a survey about malaria prophylaxis up on our home page at the moment&mdsh;please have your son take our Malaria Survey when he gets a chance.
by Malaria Q&A
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.
by Malaria Q&A
QUESTION
What can I do if my infant (6-12 months) gets malaria and how can I tell if they have it?
ANSWER
Your infant can easily be diagnosed by a blood test, so visit a clinic, doctor or hospital immediately. The diagnosis will either be done by looking at a thick and thin blood film under a microscope, or by a rapid diagnostic test.
It is important that a blood test is done in addition to a clinical diagnosis—the symptoms of malaria are very similar to many other infections but the treatment may vary. If found to be positive for malaria, the doctor will recommend appropriate treatment and dosage for the type of malaria they have and their weight/age.
If you live in a malarial area, it is also important to take measures to prevent malaria, such as having your child sleep under a long-lasting insecticide treated bednet, and perhaps spraying your rooms in the evening with insecticides to reduce the number of mosquitoes.
by Malaria Q&A
QUESTION
Is it ok to treat with NSAIDs or aspirin, or is paracetamol preferred?
ANSWER
If the question relates to headaches caused by malaria, then yes, most over the counter analgesics (pain relievers) can be used to treat the headaches and joint pain associated with malaria. Paracetamol may also assist in reducing fever.
by Malaria Q&A
QUESTION
Is there any evidence that successfully treated malaria (when young or a young adult), has any deleterious effects for patients in their 70s and 80s? Is risk of vascular disease, stroke, or MIs any greater?
ANSWER
I don’t think there is any evidence for any long-term deleterious effects of malaria that was successfully treated, particularly if the malaria infection was non-complicated and did not result at the time in any severe cerebral complications (coma, impaired consciousness, etc).
by Malaria Q&A
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!
by Malaria Q&A
QUESTION
I believe my fiance who lives in Kenya has malaria but refuses to go for a test. She has headaches and now flu like symptoms. I am returning in late December, if the symptoms have gone can I still take her for a blood test to see if malaria is still present even if the symptoms subside?
ANSWER
Most malaria diagnosis in Kenya is done by looking at a small sample of the patient’s blood under the microscope. Unfortunately, using this method, it is almost impossible to detect malaria that is non-symptomatic. In this case, one option would be to use a rapid diagnostic test which looks for antibodies in the blood against malaria – as these antibodies can sometimes persist after the infection has subsided, it can sometimes tell you whether that person recently had malaria. These rapid diagnostic tests are available in most of the main cities in Kenya, in larger pharmacies, and maybe even in some big supermarkets like Nakumatt. However, given how rapidly malaria can progress and how serious is can become, I would highly recommend that your girlfriend goes to a clinic or doctor and has a malaria test! That way she can receive treatment early, before her symptoms get worse.
by Malaria Q&A
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!