How quickly should patient take medicine for malaria?

by

QUESTION:

My sister has been suffering from malaria for three months. She consulted with doctor in the first symptom of malaria but doctor gave only fever medicine at that time. Blood test was not done at that time. So my question is: “within how many days or months malaria patient has to immediately take medicine?”

ANSWER:

One of our collaborating medical doctors has assisting in providing this answer:

It depends on the type of malaria….with Plasmodium vivax infection she could have a low burden due to concurrent treatment or recent prophylaxis which is breaking through because of low grade resistance. Alternatively, it could be P. malariae or P. ovale, both of which sometimes cause only mild disease that may or may not progress.  P. falciparum shouldn’t act this way; it is usually a much more severe, aggressive infection. Another option is that she might not have malaria at all.  She needs qualitative and quantitative smears to confirm the diagnosis, together with a comprehensive travel/exposure history to support any clinical suspicions.

 

 

Diagnostic test for malaria?

by

QUESTION:

What are the possible diagnoses tests?

ANSWER:

A blood test is usually required to diagnose malaria, although the blood can be used in a number of different ways. The most common, traditional form of diagnosis is a blood smear, observed under a microscope by a qualified technician. These can be “thick” or “thin”; the “thick” smear examines a whole drop of blood for the presence of the malaria parasites infecting the patient’s red blood cells. Because a relatively large volume of blood is examined in this way, the thick smear is useful for detecting low levels of parasites in the blood, and therefore is good for an initial “positive or negative” diagnosis. The thin smear allows for a closer look at the infected blood cells, and thus can be used to identify the species of malaria, which can be important for giving the patient appropriate treatment. The danger with blood smears is that very low intensity infections can sometimes be missed, given the a low number of parasites in the blood.

More recently, a number of antibody tests have been developed to test for malaria. These so-called “rapid diagnostic tests” (or RDTs) do not require the expertise of a blood smear and only need a tiny droplet of blood, and so can even be performed at home as part of a self-testing kit. Different tests have been developed to test between the various different species of malaria. While quick and easy, there are some concerns over the sensitivity and specificity of the various tests; trials in the field have gone some way to quantifying the effectiveness of these tests in different contexts. One potential advantage of RDTs is that in some cases they seem capable of positively diagnosing low intensity infections, that would be missed by traditional blood smear. A disadvantage for wide-spread use of these tests, especially in low resource settings, is that they are very expensive.

Finally, the advent of DNA-based techniques for identifying malaria parasites means that PCR (polymerase chain reaction) can be used on a patient’s blood for an almost fool-proof diagnosis, not only of species but also, to a certain extent, of intensity. However, this procedure takes time, is expensive and requires a fully equipped laboratory with trained personnel; as such, it is not usually used for every day diagnosis of malaria infections, and especially not in developing countries where the vast majority of malaria cases occur.

Full recovery from malaria?

by

QUESTION:

Does a person get over malaria?

ANSWER:

The majority of malaria cases are uncomplicated, and if diagnosed and treated early enough and correctly, the patient has every chance of making a full recovery from the infection. However, if treatment is delayed, or inappropriate treatment given, the infection can develop into more severe disease. Again, the chances of recovery are high given proper medical attention, but if not, malaria can certainly be fatal. Infection is usually most severe in children under 5 and pregnant women, meaning it is even more crucial for diagnosis and treatment to be made available for these high-risk groups. In many parts of the world, medical facilities are limited and treatment unavailable, which accounts for the high mortality caused by malaria, despite being easily treated in may circumstances.

Malaria Blood Work

by

QUESTION:

What means smear for malaria – value 1?

ANSWER:

In most cases, I would suggest this means a positive result, though the exact meaning of that depends to some extent to the type of blood test it was. You mention a smear; to me, that implies that the test used traditional microscopy to look for red blood cells infected with malaria parasites. In this case, a result of 1 would indicate that one infected red blood cell was observed, meaning the patient is positive for malaria, although with a light infection (at least at that point in time – especially if the patient had falciparum malaria, the intensity of the infection can increase very rapidly). Otherwise, blood can be used in malaria rapid diagnostic tests (RDTs), which look for antibodies to malaria in the patient’s blood. In this case, the test result can sometimes be denoted by a binary value: in other words, 0 indicates negative and 1 indicates positive.

It is very important to find out from your doctor or clinic exactly what kind of test they ran and what the results mean, to ensure that correct and effective treatment is administered as quickly as possible.

Vomiting During Malaria

by

QUESTION:

How can I reduce vomiting during malaria?

ANSWER:

The most important thing to do when suffering from malaria is to get diagnosed promptly by a doctor or clinic and then receive appropriate treatment. This is the quickest way to reduce symptoms of the disease, such as vomiting, as well as prevent progression of the disease. Once treatment has begun to be administered, your doctor or nurse may also be able to give you medication to reduce nausea and vomiting, but you should certainly consult with medical professionals before taking any other medication while being treated for malaria.

What is the malaria antigen test?

by

QUESTION:

How does the malaria antigen test work? After how many days presence of malaria can antigens be detected in the blood ? Is it posible to detect antigens on the first day of fever ?

ANSWER:

The malaria antigen test works by detecting antigens in the blood which are released by the parasite. The antigens are usually LDH (lactate dehydrogenase) or HRP2 (Histidine-rich protein 2). If the test is in RDT (rapid diagnostic test) format, there is an antibody against one of the parasite antigens stuck onto the test strip. A tiny drop of blood (usually from a fingerprick) is placed in a well at one end of the test, and covered with a test buffer solution; as the patient’s blood migrates up the test strip, the parasite antigen will be captured by this antibody. The parasite antigen is then bound by another antibody which is coupled to colloidal gold, which will show up as a positive band on the test.

Detection of the malaria antigen in the blood depends on the sensitivity of the test and the parasitaemia (number of parasites) in the blood. If the parasitaemia is high enough it should be possible to detect antigen on the first day of fever.

Mobile App for Diagnosing Malaria

by

Focusing on the millions of people at risk from malaria in sub-Saharan Africa and other parts of the world, Lifelens is a project that has created a smartphone app to diagnose the insidious, mosquito-borne disease. The most prevalent diagnostic tool is the rapid diagnostic test RDT, which is known to be associated with a 60 percent incidence rate of false positive results. That, in turn, results in the treatment of many people who don’t actually have Malaria, driving up the costs of anti-Malaria treatment significantly. The Lifelens project aims to make the process both cheaper and more accurate by analyzing blood digitally instead. [Read more…]

Do I have malaria?

by

QUESTION:

Hi, I went to Ivory Coast August/2003 back March/2004, took some pills to help prevent Malaria on my trip but ran out and did not get more. While I was there I got many mosquito bites.

Around October/03 became very sick, got tested for malaria at the hospital in Quebec but negative. Now May/2011 still have all the same symptoms, flu like symptoms, feeling cold most of the time, chills headaches, tired.

Is there any way I got it? I’ve gone to doctors and doctors and no one can seem to find what is causing this? I am tired of taking tylenols all the time for the body ache. My wife is from there and she’s so sure that I got it from seeing how I am since she’s been around it all her life. Can you help me?

ANSWER:

There are definitely types of malaria that can cause relapses of symptoms many months or even years after an initial infection. These types are not common in the Ivory Coast but if you had many mosquito bites then it is certainly possible that you were exposed. What kind of test did you have for malaria when you returned to Canada?

Often, the test is by looking at a microscope slide of your blood under the microscope—the problem with this test is that it is not very sensitive for low levels of malaria, for example, after the worst of infection, and especially with the types of malaria that cause relapse (these types, P. ovale and P. malariae being the ones you might expect from Ivory Coast, tend to cause less severe illness than the more common type of malaria in Africa, called P. falciparum, doesn’t relapse in the same way, but results in much higher levels of the malaria parasite in the blood, which makes it easier to diagnose on blood slides). Also, since malaria is relatively rare in northern countries like Canada, laboratory technicians are not as experienced at diagnosing the parasite as they are in countries where malaria is endemic.

Having said that, there are of course lots of other illnesses which also cause symptoms similar to that of malaria – fevers, chills, etc. What I would recommend is that you re-visit the doctor, and ask for a more sophisticated test for malaria. Mention that you have had a relapse of symptoms—this should prompt them to use more sensitive tests, such as PCR or a rapid diagnostic test, and to look specifically for P. ovale or P. malariae. Not only will this answer your question about whether you have malaria, but it will allow the doctors to give you the appropriate treatment for your current symptoms (probably chloroquine) as well as treatment to prevent any further relapses (primequine).

Hope this helps!

Treatment for Malaria

by

QUESTION:

How do you treat malaria?

ANSWER:

Malaria can be treated with a number of different types of medication; which one to use depends on the type of malaria you have, as well as whether resistant strains are known to occur in your area. Below I have copied the response I wrote to a similar question on malaria treatment, posted on the 2nd of May, 2011:

In most cases of non-Plasmodium falciparum malaria (the most deadly form of malaria, found throughout the world but most prevalent in sub-Saharan Africa), and even in some places where P. falciparum has not yet developed resistance, treatment with chloroquine is sufficient.

The dosage will depend on body weight (usually approximated by age). Where there is a risk of chloroquine-resistant malaria occurring, treatment of non-complicated cases will usually consist of orally-administered artemisinin-based combination therapy (or ACT) – again, the dosage will depend on age/weight.

For severe malaria, parenteral ingestion of drugs is required. For the treatment of cerebral malaria, caused by P. falciparum, quinine is the traditional drug of choice, though artemisinin has also been shown to be effective. Anti-convulsants and anti-pyretics (to reduce fever) should also be administered.

In cases of infection with P. vivax or P. ovale, the parasite can become dormant in the liver and result in a relapse of the disease if not treated properly. As such, patients with either of these forms of malaria should also be treated with primaquine.

If you have, or suspect you have a health problem, you should visit a physician for a medical diagnosis and treatment.

Started Late on Anti-malaria Medication

by

QUESTION:

I’m in a malarious country and I had no idea about anti-malarials until I got here, so I started taking anti-malaria(doxycicline) two weeks late. It has been three weeks since I started taking the medicine. Do you think it would work or should I stop taking it?

ANSWER:

It depends a bit on where you are, and what types of malaria are in your region. Plasmodium falciparum usually takes between 7 and 14 days for symptoms to develop after exposure; P. vivax and P. ovale take between 9 and 14 days. P. malariae, on the other hand, sometimes doesn’t show symptoms until 30 days after infection. However, the most acute and dangerous form of malaria is that caused by P. falciparum; as such, if you haven’t had any symptoms since you started taking anti-malarials three weeks ago, you should be ok, and it certainly would be advisable that you continue with the preventative medicine while you remain in the malarial area.

It’s also worth mentioning that because of the lag between infection and symptoms, in many cases you need to continue taking antimalarials for some period of time after you leave the malaria zone. Of course, if at any point you start to develop symptoms, such as fever or chills, go to a hospital or see a doctor for prompt diagnosis.