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.

Malaria Treatments

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QUESTION

What are the of different types of antimalaria drugs?

ANSWER

Most drugs used in treatment are active against the parasite forms in the blood (the form that causes disease) and include:

  • chloroquine
  • atovaquone-proguanil (Malarone®)
  • artemether-lumefantrine (Coartem®)
  • artesunate-pyronaridine (Pyramax®)
  • dihydroartemisinin-piperaquine (Duo-Cotecxin®)
  • mefloquine (Lariam®)
  • quinine (given intravenously, this is recommended first-line treatment for severe, complicated malaria)
  • quinidine
  • doxycycline (used in combination with quinine)
  • clindamycin (used in combination with quinine)

All of the treatments above which combine an artemisinin-derivative (such as artemether, artesunate or dihydroartemisinin) in combination with another anti-malarial are called the artemisinin-based combination therapies (ACTs) and are collectively recommended by the World Health Organisation as the first line medication against uncomplicated malaria.

In addition, primaquine is active against the dormant parasite liver forms (hypnozoites) and prevents relapses. Primaquine should not be taken by pregnant women or by people who are deficient in G6PD (glucose-6-phosphate dehydrogenase). Patients should not take primaquine until a screening test has excluded G6PD deficiency.

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.