Repeated Malaria

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QUESTION

Since January 2011 I got three times malaria. Is it come regularly? Last week also I got maleria and I took medicine but still I have mild headache and sweating feeling tiredenes in between..

ANSWER

The timing of the repeated malaria episodes you have experienced means that it could be recrudescence (where treatment does not completely kill all the malaria parasites in your blood), relapse (where the malaria goes dormant in your liver, then comes back—this is only caused by Plasmodium vivax and Plasmodium ovale malaria) or even re-infection.

However, first of all, the most important thing is to make sure you are properly diagnosed with malaria and secondly, that you receive the right type of treatment for the kind of malaria that you have.

The symptoms of malaria are very general (fever, chills, nausea, tiredness, aches) and can also be caused by many other illnesses and diseases. As such, in order to confirm you actually have malaria, you should have a blood test (thick and thin blood smear, looked at under the microscope by a trained technician, or a rapid diagnostic test (RDT). In some places you can buy these RDTs from local pharmacies and do the test yourself at home).

Depending on where you live, there may be different types of malaria present; in this case, if you do have malaria, it is important to find out which one you have.

P. falciparum is the most common kind in sub-Saharan Africa and first-line treatment is an artemisinin-based combination therapy, such as Coartem – most areas have P. falciparum that is resistant to chloroquine, so this is not appropriate as treatment, nor are sulfadoxine and pyrimethamine combinations (such as Fansidar).

If you have P. vivax or P. ovale, chloroquine may be used, again depending on where you are and whether resistance is known from your area or not. In addition, you might also talk to your doctor about taking primaquine to prevent future relapse and recurrence of the infection.

Repeated re-infection can be prevented by protecting yourself more thoroughly against getting bitten by an infected mosquito. For example, you should sleep under a long-lasting insecticide treated bednet, screen your windows and doors and wear long-sleeved clothing at night and in the evenings. Indoor residual spraying, which coats your walls with insecticide, can also prevent mosquitoes from persisting inside your home.

Information About Malaria

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QUESTION

What is malaria?

ANSWER

Malaria is a serious and sometimes fatal disease caused by a tiny parasite that commonly infects a certain type of mosquito (of the genus Anopheles) which feeds on humans. People who get malaria are typically very sick with high fevers, shaking chills, and flu-like illness. Four kinds of malaria parasites can infect humans: Plasmodium falciparum, P. vivax, P. ovale, and P. malariae. Infection with P. falciparum, if not promptly treated, may lead to death. Although malaria can be a deadly disease, illness and death from malaria can usually be prevented.

Malaria’s Scientific Name

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QUESTION

What is malaria’s scientific name?

ANSWER

The genus name for the single-celled parasite which causes malaria is Plasmodium. In the genus, there are five species which infect humans: Plasmodium falciparum (the most deadly kind), P. vivax, P. ovale, P. malariae and P. knowlesi.

Simulations Plus Announces Preliminary Success in Malaria Drug Design Project

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Simulations Plus, Inc., a provider of consulting services and software for pharmaceutical discovery and development, today announced that preliminary testing shows that one of the molecules it has designed to inhibit the malaria parasite has been shown to be a potent inhibitor of the malaria parasite.

Dr. Robert Clark, director of life sciences for Simulations Plus, said: “We’re excited to announce that, as a result of initial testing of five of the compounds we designed to inhibit the Plasmodium falciparum malaria parasite, four of the five showed some inhibition of the parasite, and one of those four showed very potent inhibition at a level suitable to be a therapeutic agent. Of course, inhibiting the parasite does not necessarily mean that this molecule would be a good drug. There are many more properties that must be acceptable and years of development needed before that could happen. But this is a remarkable achievement nonetheless, because it demonstrates that using only predictions and design methods from our MedChem Studio(TM), MedChem Designer(TM), ADMET Predictor(TM), and GastroPlus(TM) software and some public domain data, we were able to design completely new chemical structures that can hit a target. There remain a few more molecules in synthesis, and those will be tested once synthesis and purification have been completed by our synthesis company, Kalexsyn, Inc., of Kalamazoo, MI. Among those molecules are the ones we believed would be the most potent inhibitors of the malaria parasite. They are a bit more difficult to synthesize, but Kalexsyn indicates that they are well along in the process and expect to complete the final steps very soon.”

Dr. Michael Lawless, team leader for cheminformatics studies for Simulations Plus, added: “The first round of tests was against the drug-sensitive strain of the malaria parasite known as 3D7. The next round will be against the drug-resistant strain — a more important measure of the potential usefulness of these new molecular structures. We hope to have results by the end of the month from those experiments. We’re shipping samples of the first five molecules to a company that will perform a series of experiments to measure a few other properties, including some physicochemical and metabolism properties. Those experiments will tell us if our predictions for some important ADME (Absorption, Distribution, Metabolism, and Excretion) properties were on the mark.”

 

Source: Business Wire

Malaria Drug Binding Site

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QUESTION

What is malaria, and drug binding site?

ANSWER

Malaria is caused by a single-celled protozoan parasite of the genus Plasmodium. Five kinds of Plasmodium are known to infect people: P. falciparum, P. vivax, P. ovale, P. malariae and P. knowlesi.

There is no one drug binding site with respect to malaria: different anti-malarial drugs have different modes of action, and not all are well described. I will briefly outline the proposed mechanism of action of two of the most common types of anti-malarials: artemisinin (and derivatives) and chloroquine (quinine is thought to act similarly to chloroquine).

Artemisinin is thought to have anti-malarial properties by virtue of possessing an endoperoxide moiety, or double oxygen bridge (-Carbon-Oxygen-Oxygen-Carbon). In the presence of intracellular free ion, this moiety is converted by a chemical reaction to “free radicals”, atoms with unpaired electrons which are highly reactive. The free radicals act as alkylating agents and induce cell death, but only those that are already pathologically crippled, for example due to malaria infection. Another hypothesis is that the free radicals directly damage the malaria parasite.

Chloroquine is thought to act by causing buildup of the toxic by-product of hemoglobin metabolism, heme – the malaria parasite usually converts heme to hemozoin, a non-toxic crystal, and stores it in the digestive vacuole. When chloroquine diffuses into an infected red blood cell, it reacts with heme to “cap” it, preventing further conversion into hemozoin. Moreover, chloroquine also converts hemozoin into a highly toxic substance called the FP-Chloroquine complex. This build-up of toxicity leads to breakdown of the cell membrane, and eventual cell death and autodigestion.

Celebral Malaria and Blindness

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QUESTION

I live in Nigeria. Good friend of mine complained of headaches in Dec 2011. Did an MRI went to Germany had a general check up. Back in Nigeria in January, headaches increase, she gets blind in one eye, following day the other eye, now in Germany where they have induced her into a coma. They said that she got a brain Haemorrage from the malaria. Can malaria bring blindness. What are the chances of surviving and getting back eyesight.

ANSWER

Although rare, brain hemorrhage is sometimes associated with severe cerebral malaria (caused by infection with Plasmodium falciparum, the most deadly form of malaria). This bleeding in the brain could cause blindness—whether the visual impairment is permanent or not depends on the extent of the bleeding and how much damage it caused.

I have found one case in the literature where severe malaria caused a brain hemorrhage which resulted in permanent blindness, and the authors report their case is only the second they have heard of, so this is rare indeed. Similarly, her survival will depend on how well she responds to treatment, which will likely be intravenous quinine, at least at first. Given that she is in Germany, where health care is excellent, I would say her chances are as good as they would be anywhere else in the world. I hope she makes a full and swift recovery!

What are the symptoms of malaria?

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QUESTION

What are the symptoms of malaria?

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.

When did malaria start?

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QUESTION

What year did malaria start?

ANSWER

Malaria first emerged as an infection of humans tens of thousands, if not hundreds of thousands, of years ago. The species of malaria that infect humans probably evolved from closely related malaria species that infect macaques (in the case of Plasmodium vivax) and gorillas (in the case of P. falciparum).

The earliest records from human history of malaria come from a Chinese medical parchment almost 5000 years ago, and it is believed the ancient Egyptians also recognised the symptoms of the disease. Written accounts of malaria also occur in ancient Roman and Greek texts, though the true causes of malaria were not discovered until the 19th century.

Malaria Transmission and Deaths in the United States

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QUESTION

How do you get malaria? How does malaria come to the United States? How many people have died from malaria?

ANSWER

Malaria is caused by infection with single-celled parasites called Plasmodium. There are five different species which infect humans; of these, Plasmodium falciparum is the most deadly. The Plasmodium parasites are transmitted to humans through the bite of an infected female Anopheles mosquito; when these mosquitoes bite a human, they transfer some of the parasites in their saliva.

After undergoing one set of multiplications in the liver, the malaria parasites are released into the blood, where they repeatedly infect and destroy red blood cells, multiplying in the process. These cycles of infection and destruction of red blood cells cause the cyclical fever that is characteristic of malaria. Eventually, the parasite produces new types of cells, called gametocytes; if the patient is then bitten by another mosquito, the mosquito can take up gametocytes as well as blood when it feeds, and the cycle continues.

Malaria used to be relatively common in the United States, though usually only occurring during the summer months and restricted to the warm, wet south-eastern region. However, a concerted control campaign in the 1940s, focusing mainly on vector control (i.e. killing mosquito and reducing their opportunities for breeding) swiftly led to the eradication of malaria from the US.

Nowadays, virtually all malaria cases in the US are imported from abroad, whereby people get infected when traveling to other countries, but are only diagnosed as having malaria when they return home. There are about 1,000 cases of malaria reported each year in the US, and most of these were actually caught outside the US. Very rarely, an Anopheles mosquito will bite one of these travelers once they have returned from abroad, and therefore have the potential to transmit malaria within the US. However, due to a strong public health network and good access to malaria diagnosis and treatment, these events rarely lead to more than a handful of cases before they are quickly treated and transmission eliminated again.

The World Health Organisation estimates that last year, approximately 700,000 people died of malaria. Of these, 90% were in sub-Saharan Africa, and the vast majority were children under the age of 5.

P. Falciparum Malaria Treatment

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QUESTION

I dont have high fever yet have been diagnosed with P. falciparum malaria. How can this disease be treated and is it completely curable?

ANSWER

Don’t worry, if diagnosed early and given appropriate treatment, P. falciparum infection is very easily cured. You should be given a type of medication called artemisinin-based combination therapy (ACT). An example is Coartem, which is a combination of artemether and lumefantrine.

Other artemisinin derivatives that are commonly used include artesunate and dihydroartemisinin. You should start to feel better after just a few days and will make a complete recovery. Make sure you get the correct dose for your age and weight from the doctor, and take the medication for the full length of time the doctor tells you – this is very important to make sure the infection is completely cured, otherwise the infection may be able to come back.