Malaria Cure

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QUESTION

What medicine is good for curing malaria?

ANSWER

There are lots of different types of medication which are effective against malaria. However, for uncomplicated, unsevere cases, the World Health Organization (WHO) recommends using a type of medication called artemisinin-based combination therapy, or ACT. Again, there are many types of ACTs, so the name may vary depending on what is most common in your area, but some widespread brands include Coartem, Lonart, Duo-Cotecxin, etc. In some countries, they are known by an abbreviation of the drug name – for example, in Tanzania, the most common ACT is a combination of artemether and lumefantrine, and the different brands are collectively known as Alu.

For severe or complicated malaria (there is no hard and fast definition, but the clinical diagnosis may include cerebral involvement, seizure, coma, inability to take oral medication, severe anaemia, etc), the WHO recommends intravenous  (IV) artesunate, with quinine as a second choice.

There are also additional forms of treatment which may be used in certain settings, depending on the geographical region and the type of malaria, or if one of the above treatments is not successful. Likewise, pregnant women should not take ACTs, so they need to seek alternative forms of treatment, such as chloroquine (if the local malaria is known to be sensitive), mefloquine or sulfadoxine-pyremethamine.

Malaria Diagnosis

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QUESTION

My body is getting hotter after taking artesunate and mtivitamen tablet, the pain subsides, but later in the evening my body starts getting hotter, I have taken almost four artesunate, yet the body pain and headache refuse to go, pls sir is it malaria or what.

ANSWER

Unfortunately the symptoms of malaria are quite general, and just having a fever could be a sign of malaria but also of many other diseases. You should go to a doctor or clinic to have a blood test—there, they will take some of your blood and look at it under the microscope to determine whether you have malaria parasites in your blood. If you do, they will give you appropriate treatment—it is actually not recommended to take artesunate by itself, and rather it should be taken together with a secondary anti-malarial drug, in a combination known as an artemisinin-based combination therapy (ACT).

Common forms of ACTs available in Africa include artemether-lumefantrine (sold as Alu, Lonart or Coartem) and dihydroartemisinin-piperaquine (sold as Artekin or Duo-Cotecxin). Artesunate comes in combination with amodiaquine, and is often abbreviated as ASAQ.

If you do not get properly diagnosed in a medical facility, you risk treating yourself with unnecessary drugs if in fact you actually have another infection, or you might find you are giving yourself the wrong type of treatment for your malaria infection.

Paracetamol to Control Fever

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QUESTION

If I take paracetamol to help control my temperature will it affect my blood test results— can they fail to detect the plasmodium?

ANSWER

No—taking paracetamol (also called acetaminophen, and sold variously as Tylenol, Panadol and other brand names) is a good way to control your temperature during malaria infection, and it won’t affect your blood test results. If you haven’t done this already, if you think you have malaria you should go to a doctor or clinic to get a blood test for diagnosis. Once you have been positively diagnosed, you can be given appropriate treatment, probably one of a number of available artemisinin-based combination therapies (such as Coartem, Alu, Lonart, etc).

Malarial Attack Recurring

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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 Fever

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QUESTION

My Father aged 65 years was diagnosed with 2 types of malaria almost a week back. he has been given medicines but temperature is fluctuating and not coming down. all other organs are functionining properly except platelet count which is little less.

Now he has been suggested new medicines for a duration of 14 days.
How fast can he recover from this malaria and when will the fever come down?

ANSWER

When patients are given the appropriate treatment against malaria, the fever is usually reduced very quickly and the patient will start to recover after a few days. The right kind of treatment depends on the severity of the infection and the type (or, in your father’s case, types) of malaria the patient is infected with.

If your father was infected with P. falciparum alongside another type of malaria (probably P. vivax, P. malariae or P. ovale), then he should have first received an artemisinin-based combination therapy (ACT) drug first. These drugs combine artemisinin or a derivative (such as artemether, artesunate or dihydroartemisinin) with another anti-malarial, such as lumefantrine. Common brand names of these ACTs include Coartem, Alu and Duo-Cotecxin.

There are no reported cases of resistance to these combination therapies at present, so if your father continued to feel sick after completing this treatment, he should be re-tested for malaria; it is possible that the malaria parasites were killed, and his continuing fever was an after effect either of the medication or just an indication that the body was recovering from the infection.

If he was re-tested and found positive, then other second-line drugs can be prescribed. However, it is important to note that malaria is resistant to chloroquine in many areas, and so this drug is not suitable for treatment in these places. Similarly, resistance is widespread to sulfadoxine-pyrimethamines, such as Fansidar, and in south-east Asia, P. falciparum is also resistant to mefloquine (Lariam) in some cases. As such, your father’s doctor should be careful to prescribe him an appropriate treatment for the area in which he is living.

In addition, if your father was found to be co-infected with either P. vivax or P. ovale, then there is a chance of later relapse into malaria again, weeks or even months after the initial infection has been treated. This is because the parasites in these types of malaria can form dormant stages in the liver, where they escape being killed by the normal forms of treatment. In this case, your father should ask about the possibility of being treated with primaquine; the course is normally 14 days, so it may be that this is what his doctors have currently given him. If so, this will kill the dormant liver stages and prevent relapse. Prior to taking primaquine, patients should be tested for G6DP deficiency, as patients with this condition may become dangerously anaemic when they take primaquine.