Duration of Malaria Symptoms

QUESTION

If untreated how long will a person suffer symptoms caused by Malaria?

ANSWER

The answer to that depends a lot on what type of malaria they have as well as their own immune status, and particularly if they have been infected with malaria before. So, for example, P. falciparum is the most severe and deadly kind of malaria, and without treatment, many people who do not have acquired immunity (from previous infections) are likely to die within just a few days. This is the type of malaria that causes the most deaths, and explains why most of the fatalities occur in young children, who have not had the chance to acquire immunity.

In contrast, other kinds of malaria are less severe, and so symptoms can persist before the malaria parasite is naturally cleared by the parasite, usually within 1-2 weeks. In extreme cases, this can last much longer; Plasmodium malariae is the slowest replicating form of malaria, and so frequently causes mild infections which can last weeks, if not months. In some cases, people are infected with low levels of P. malariae for years without even experiencing symptoms, since their own immune system is able to keep levels of the parasite low enough so that they don’t cause noticeable disease.

Malarone and Mefloquine for Malaria

QUESTION

Which drug is better for kids for anti-malaria – Malarone or Mefloquine. I have heard about lot of side-effects of Mefloquine. So, which is a safer drug out of these two or is there any other drug with no side-effects? Is it important to take anti-malaria pills keeping in mind the side-effects?

ANSWER

Both drugs are considered safe for children, though Malarone (atovaquone-proguanil) should not be given to pregnant women or those nursing a child under 5kg. Malarone is also available in a pediatric form in some places, where the dose is reduced specifically for prescription to children under 40kg in weight. Personally, I took both Malarone and mefloquine (as Lariam) when I was a child, and experienced no side effects from either, though certainly many more people do report side effects from mefloquine, including disturbed sleep and hallucinations, or increased anxiety, and it is therefore not recommended for people with a history of psychiatric illness or disorders.

If this does not apply to you or your children, then it really is a matter of preference, cost and practicality. Malarone is generally more expensive than Lariam, needs to be taken every day, but only needs to be taken a few days before departing for the malarial area and for only one week after you return. Lariam, on the other hand, is only taken weekly (which can be an advantage with small children), but needs to be started 2 weeks before travel and for 4 weeks afterwards, which can make it less convenient for short trips.

The other thing to consider, finally, is where you are going—some forms of malaria found in south-east Asia are resistant to mefloquine, meaning it is not a suitable anti-malarial for travel in those areas, so Malarone would be a better choice in that circumstance. Both mefloquine and Malarone are suitable for travel in all other malarial areas.