Can Child Be Affected by Mother’s Malaria

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QUESTION
If the baby’s mother has malaria, can it affect the child?

ANSWER

If the mother is pregnant when she gets malaria, particularly if it is her first pregnancy and particularly if she has never had malaria before, the effects on both the mother and child can be very serious. For the mother, this is because her immune system changes when she gets pregnant. This leaves her more vulnerable to the effects of malaria, including anaemia.

The most dangerous type of malaria, P. falciparum, also seems very able to infect cells in the placenta, leading to a higher intensity infection, and also reducing oxygen delivery to the baby. This, combined with the mother’s illness and anaemia, can lead to low birth weight, anaemia and other complications in the child once it is born. Malaria can also pass through the placenta, or be transferred to the baby through blood during childbirth, resulting in “congenital malaria”; that is, malaria which has been passed from mother to infant. Since newborns have inexperienced immune systems, malaria in the first days or weeks of life, and especially if the child is already low birth weight, can be very dangerous.

As such, a lot of effort has gone to finding ways to prevent malaria in pregnancy and to treat women who do get malaria while pregnant to prevent negative effects both to her and her unborn child. These efforts mainly involve the distribution of long-lasting insecticide treated bednets, and in some places also include the administration of intermittent preventive therapy, where women are given periodic doses of anti-malarials during pregnancy to protect against the disease.

P.vivax Malaria Treatment

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QUESTION

Which drug should be given to a p.vivax malaria patient with deficient glucose 6-phosphate for prevention of relapse?

ANSWER

Unfortunately, primaquine is the only drug that is known to kill the latent liver stages of P. vivax and P. ovale. Since it can induce haemolysis in people with G6DP deficiency, this drug is usually not recommended for people with this deficiency. However, there are actually gradations of severity of G6DP deficiency, and so in some cases, primaquine at therapeutic doses may be tolerated by people with only mild G6DP deficiency, if they are carefully monitored for anaemia throughout the process. This may be preferable to no treatment, since no other known medication can prevent relapse.

Malaria and Pregnancy

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QUESTION

Can your baby become immune if you’re pregnant and you have malaria?

ANSWER

Some of the protective antibodies that the mother produces when she has malaria can pass to her baby via the placenta. There is also evidence for immune system “priming” in foetuses when their mothers have been infected my malaria during pregnancy. However, these potentially protective effects are usually far outweighed by the negative effects of malaria during pregnancy.

Due to changes to the mother’s immune system and also perhaps due to the creation and physiology of the placenta, pregnant women are very vulnerable to malaria. For reasons which are not fully understood, women experiencing their first pregnancy (primagravidae) are most susceptible to malaria and their foetuses are most likely to have severe effects. These effects vary depending on the immune status of the mother and whether she is from an endemic or low transmission malaria environment, but typical results include low birth weight, anaemia and spontaneous abortion—abortion rates due to malaria can vary between 15-70%.

There is also the risk (up to 33% in some studies) that malaria will pass directly from the mother to the baby, either through the placenta or in blood during childbirth—this is called “congenital malaria,” and can manifest as early as 1 day after delivery but a late as months after. The symptoms are similar to that of adult malaria, with fever, anaemia, lethargy, etc.

Given these negative effects, it is very important to protect pregnant women against malaria, and bednet distribution schemes in many places target these women. In high transmission settings, women may also be offered intermittent preventive therapy (IPT) which consists of at least two doses of anti-malarial medication, usually once during the second and once during the third trimester.

Malaria Drugs Side Effects

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QUESTION

I was affected by malaria 5 months back. I am feeling tiered and weakness and heart trembling symptoms.

Any suggestions to overcome weakness?

ANSWER

Your fatigue is probably not caused by the treatment—one of the potential residual effects of malaria infection is iron deficiency, which can lead to anaemia, and this can cause tiredness. Eating iron-rich foods or asking your doctor about iron supplements might help if indeed you find your iron levels are too low. Recovery from any illness can sometimes take a long time, and getting plenty of rest, eating well and keeping well hydrated will all help you to regain your strength.

If you have recently taken malaria medication, perhaps you would be willing to spend a few minutes to take our Malaria Medication Side Effects Survey? We are very interested in hearing about the experiences of people who have taken different types of malaria medication, and particularly any side effects they have experienced. The survey should only take a few minutes and will be anonymous; we will publish the results on the website for you to see. Many thanks for your assistance!

Symtoms of Malaria

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QUESTION

Please tell me the symptoms of malaria.

ANSWER

Symptoms of malaria include fever and flu-like illness, including shaking chills, headache, muscle aches, and tiredness. Due to the way in which the malaria parasite reproduces in the human body, fevers occurring in a cyclical fashion (i.e. high fever one day, no fever the next day, then recurrence of fever on the third or fourth day, depending on the type of malaria) are a characteristic symptom of malaria, but may not be present in all cases. 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. When blood supply to the brain is disrupted during malarial infection, the resulting condition, characterised by seizures, mental confusion, coma, and death, is known as “cerebral malaria”, and is associated with Plasmodium falciparum, the most deadly form of malaria.

Please check your article: Symptoms and Causes of Malaria

Malaria Symptoms

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QUESTION

How does the virus cause the symptoms?

ANSWER

Malaria is actually not caused by a virus—it is caused by a microscopic single-celled parasite called Plasmodium. Several different species cause malaria in humans, the most common of which are P. vivax and P. falciparum.

To describe the process in a very oversimplified way, the malaria parasites cause disease by infecting red blood cells, multiplying inside them, then simultaneously bursting out again, destroying then red blood cell in the process. The sudden destruction of lots of red blood cells, plus the debris and waste products left behind by the malaria parasites, stimulate a rapid immune reaction, which itself causes the rapid spike of fever. The characteristic cycles of fever sometimes seen with malaria sufferers occurs because the malaria parasites synchronise their emergence from the red blood cells. The destruction of red blood cells, together with concurrent physiological changes associated with immune response and inflammation, can also lead to decreased haemoglobin levels and anaemia.

More severe clinical symptoms are often seen with P. falciparum malaria infection, particularly if not promptly diagnosed and treated. This is because the P. falciparum parasite infects a red blood cell, it changes the surface of the cell and makes it “sticky”; when the red blood cell then tries to pass through the small blood vessels that lead into the body’s organs, it becomes stuck. This process is known as “sequestration”. If enough red blood cells become sequestered in the organs, it can reduce blood flow to the organ, resulting in oxygen deprivation. When this happens in the blood vessels in the brain, the patient may experience impaired consciousness, confusion and even coma and death—this manifestation is known as “cerebral malaria.”

Is malaria possible years after bite?

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QUESTION

My child had a fever for 40 days after returning from a cruise 3 years ago. I begged the pediatrician to test for malaria because she got bit by something in Mexico but they laughed at me. She has had swollen lymph nodes on both sides of her neck for 3 years and all the docs tell me you can have swollen lymph nodes forever but now she has them in her groin and under arm on left side. She is pale and tired all the time. I took her back to the pediatrician and her cbc was normal so the dr is blowing it off. Malaria and Lymphoma are on my mind. My question is, Can malaria live in the body that long without it killing you?

ANSWER

Malaria can certainly survive in the body for a long time, but usually would present as recurring episodes of fever rather than enlarged lymph nodes (the malaria parasites reside dormant in the liver). There are two types of malaria that can reside in the body for extended periods: Plasmodium vivax and P. ovale. The former is found in parts Mexico, but cases of malaria are rare, especially in coastal areas. Unfortunately, malaria can only be detected when it enters the blood again – this occurs during the fever episodes. So, if your daughter does have a fever again, it might be worth asking for a malaria test, and specifically to look for P. vivax. If positive, there is a drug, primaquine, which can be taken to kill the remaining liver stages of malaria and prevent further relapses. However, overall, your daughter’s case doesn’t sound like malaria. What was your daughter’s Hb level? Anemia could explain the pallor and lethargy, though your pediatrician should have spotted that on the blood tests.

Teen Has Anaemia, Mom Had Malaria

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QUESTION

I am concerned that my 22 yr old daughter has anaemia (tired & sleepy), possibly caused by Malaria (Katima Mulilo, Namibia), which I contracted just before returning to Cape Town.

I fell pregnant at that time. I was treated at the local hospital before returning home. Could it have affected the unborn fetus? My daughter has a low red blood count.

ANSWER

Congenital malaria occurs when a foetus is infected with malaria from the mother, either through transmission across the placenta or during childbirth. It can cause serious complications for the foetus, including spontaneous abortion, low birth weight and anaemia.

However, I don’t think there is any evidence that anaemia persists later into life—usually congenital malaria only affects newborns a few weeks after birth.

One of our maternal/child health experts says that she knows of one study (mentioned in the Tanzania Journal of Health Research) which suggests that immune priming due to congenital malaria could result in longer term effects in infancy and childhood—however, anaemia is not mentioned specifically and the article emphasises that more study is required to confirm this hypothesis.

Our advisory expert also says that anaemia is common in teenage and pubescent girls, and it is important to confirm the anaemia with a haemaglobin blood test, and get advice regarding improving her diet and perhaps taking iron supplements if indeed she is anaemic.

Malaria and Anemia

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QUESTION

How does malaria cause anemia?

ANSWER

Anemia is the result of a decrease in the number of red blood cells in the blood. Malaria specifically attacks red blood cells, invading them and then undergoing multiple cycles of reproduction inside them. Once replication has been completed, the malaria parasites burst out of the red blood cell, destroying it in the process. Over the course of an infection, this can destroy many red blood cells, resulting in anemia in the patient.

Malaria and Blood Cells

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QUESTION

What effect does malaria have on blood cells?

ANSWER

Malaria survives by invading red blood cells (erythrocytes), then replicating within them several times (the exact number and timing of replication depends on the species of malaria), then, once done with replication, bursts from inside the red blood cells, destroying it in the process. As such, malaria infection decreases the number of red blood cells in a patient’s blood, which can lead to anaemia. Moreover, the most severe species of malaria, Plasmodium falciparum, forces red blood cells to stick to the insides of tiny blood vessels deep within major organs such as the kidneys and even brain. This process is called sequestration.

Infection with malaria is also often associated with a decrease in the overall number of white blood cells, but elevated numbers of monocytes can sometimes be observed.