Short and Long Term Effects of Malaria

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QUESTION

What are the short term and long term effects of malaria?

 

ANSWER

In the short term, malaria can cause a variety of symptoms including shaking chills, headache, muscle aches, and tiredness. Nausea, vomiting, and diarrhea. Malaria may also cause anemia and jaundice (yellow coloring of the skin and eyes) because of the loss of red blood cells.   Once treated, most people return to normal.  However, in severe cases of malaria, especially in children, those that survive may suffer from  cognitive, motor , behavior problems and even epilepsy.

 

Signs of Malaria

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QUESTION

I don’t like taking drugs, but since the past one month I’ve been very down with fever. My eyes have changed to yelllow, joint pain, I’ve severe pains in my ear, I have stomach and abdominal pain,  I have seizure undere my feet, sores on my tongue, throat pain, heart burn, and cough. Please are these malaria signs?

ANSWER

Thanks for your question. Malaria is often tricky because there are so many different symptoms. Here is a link to our webpage which lists some of the common symptoms of malaria. However, if you suspect you might have malaria, it is really important to get a proper diagnosis from a clinic or hospital, usually through a blood test. It is only with a proper medical diagnosis that you can be sure you are receiving the right medication for your illness, whether it is malaria or something else.

Can Malaria Penetrate the Brain

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QUESTION

Can malaria penetrate the brain?

 

ANSWER

Approximately 1% of people with malaria will develop a severe form, and in these cases the brain can be affected.  When the brain is affected, the condition is called cerebral malaria.  Functional changes to the blood-brain barrier occur in cerebral malaria, possibly as a result of the binding of parasitized red blood cells to cerebral endothelial cells,  although scientists do not really understand the mechanism.  However, people suffering from cerebral malaria can have seizures, fall into a coma, or show other neurological problems.

Without treatment, cerebral malaria generally leads to death.  Among children with cerebral malaria who received treatment and survived, it has been found that about a quarter (25%) have long-term problems with thought processes, motor function or have behavior impairments and  10% develop epilepsy.

Symptoms of Malaria but Tests Negative

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QUESTION

My sister has been suffering from fever from past 22 days temperature varying from 102-106 with chills shivering, headache, body pain,nausea and muscle ache but tested negative for malaria. She also tested negative for dengue, swine flu, hiv, and many others.  So out of frustration we gave her mefloc 250 and she seems to be responding. She is still having fever that is after 12 hrs of medication but the temprature is ranging between 98-100 and there is no headache and no chills and shivers.  Now we are confused how to confirm that it is really malaria and when will the fever stop completely. Should we shift her to a some other hospital at present she is in Pune.

ANSWER

The diagnosis of malaria is confirmed by observing parasites on a blood smear.  There are also Rapid Diagnostic Tests (RDT) that can be done with a pin prick of blood, but the blood smear is the definitive test. It is possible, that in your sister’s case,  a proper malaria test was not done or not interpreted correctly, and she does have malaria and it is responding to the medicine.   Alternatively it could be that your sister does not have malaria, but suffers from another problem that coincidentally is resolving itself at the same time the anti-malarial medicine is given.  It is hard to determine exactly what is wrong, but the good news is that she is getting better.

Sometimes medicine is given on presumption of illness which is what happened in your sister’s case. However, if someone has uncomplicated falciparum malaria, (most prevalent in India)  WHO recommends Artemisimin Combined Therapy (ACT), which uses an artemisinin compound with another anti malarial, such as mefloquine, not mefloquine alone.  If your sister’s fever returns, make sure to have a blood smear taken to see if it is malaria or not, and if so what kind of malaria it is, to better tailor her medicine.

Falciparum Long-term Outcomes

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QUESTION

My husband was admitted to ICU for 22% falciparum parasite load (with some mild kidney and liver failure, as well as low blood pressure) after being overseas two weeks earlier.

They treated him with IV artesunate and oral Malarone and an exchange transfusion, and discharged him after a week, as his kidneys had improved and so had his blood pressure, and he wasn’t yellow anymore. He never went unconscious.

He’s still quite short of breath and having a challenging time climbing stairs which hasn’t really improved over the past week. It’s not outright respiratory distress, as he was having this in the hospital as well and never actually needed oxygen. He’s also still feeling warm (though no documented fevers).

I am wondering about: a) Whether testing for recrudescence is useful almost two weeks after symptoms started b) how long this shortness of breath is anticipated to last (and is it secondary to a mild transfusion reaction, as his chest Xrays were always normal in the hospital) and c) will there be long-term sequelae I should be aware of (as I can’t find anything except for “falciparum infection has poor prognosis if not treated promptly’) and d) what are his risks of becoming this sick again?

ANSWER

It sounds as if your husband received good care and that you are very well informed which is excellent.  Recrudescence can occur up to 28 days after initial infection but it isn’t common if the above treatment was given.  One of the side effects of malaria is anemia, and this can cause fatigue and breathlessness.  My hunch is that he probably is anemic and should be eating iron rich foods (meats, greens) and taking an iron supplement. It is best to check with your primary care physician who can order a simple blood test to check for anemia and advise you on supplements and nutrition.  There shouldn’t be a poor prognosis in the long term for people treated and recovered from falciparum malaria. I hope this helps.

Time Allowed for Malaria Treatment

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QUESTION

How long does a person have to get to a doctor if they suspect they may have malaria?

ANSWER

Once you suspect you have malaria (symptoms include very high fever, chills, head and body ache etc) you should seek care and have a blood smear done to identify the parasite. If not treated, malaria can quickly become life-threatening by disrupting the blood supply to vital organs. If not promptly treated, infection with one type of malaria, Plasmodium falciparum, may cause kidney failure, seizures, mental confusion, coma, and death.  It is best to prevent malaria, but once you have it it is essential to recognize the signs and symptoms of the disease in order to get early and appropriate treatment.

Symptoms of Malaria

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QUESTION

What are the symptoms of malaria?

ANSWER

This is a frequently asked question.  Please see Malaria Symptoms and Causes for more information. The most common symptoms of malaria include fever and flu-like illness, including shaking chills, headache, muscle aches, and tiredness.  If you think you may have malaria because you have these symptoms you should seek help including a blood test to identify the malarial parasite.

Can my 14 day old daughter have malaria?

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QUESTION

My 14 day old daughter has a body temperature of about 38.3 C and breathes a bit rapidly.  Can it be a sign of malaria?

ANSWER

In newborns, it is sometimes difficult to tell exactly what is wrong.   The majority of newborns who get sick after delivery,  get an infection (from bacteria, not malaria).  WHO and UNICEF have identified the following “danger signs.” If the baby has  one or more of the following signs, take the baby to a hospital with qualified personnel and drugs immediately. Once there, the staff can treat the baby and test for malaria if indicated.

 

  1. Not feeding since birth or stopped feeding
  2. Convulsions
  3. Respiratory rate of 60 or more
  4. Severe chest indrawing
  5. Temperature ≥ 37.5 C
  6. Temperature ≤ 35.5 C
  7. Only moves when stimulated, or not even when stimulated

or        Yellow soles (sign of jaundice)

Signs of local infection:

  1. Umbilicus red or draining pus, skin boils, or eyes draining pus

All newborns, infants and young children in malarial areas  need to be protected from malaria and should sleep under an long acting, insecticide treated bed net.

 

Malaria Symptoms and Diagnosis

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QUESTION

My husband is currently working in Mozambique, and is sick with a fever, headache, and pain in his joints. Can this be malaria?

ANSWER

It could be. Your husband should go to the clinic and get tested.  The standard diagnosis for malaria  depends on the demonstration of parasites on a blood smear examined under a microscope.  In some settings, where microscopic examination is not possible, or as a quick response,  clinics can use an RDT or rapid diagnostic test on a drop of blood.  If your husband is in a place without any available testing methods, the health worker may treat him on his symptoms alone (this is called presumptive treatment). It is important to seek care early because if it is malaria it can get serious very quickly.

URGENT HELP ON MALARIA

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QUESTION

I 25 yr old male from Lagos, Nigeria. I have been having frequent malaria since 2006 till present. My symptoms are always weakness of the body, feeling cold sometimes not always and also my mouth got better most cases. I have been to the hospital several times and the doctor told me my frequent malaria is because my blood genotype is AA and also am having a malaria parasites. I was given drugs and injection in most cases. It got to a stage I had to stop consulting the doctor and start making use of self description because the malaria goes and comes back and its cost me much money in going to the hospital every time.

The weakness is always my problem because will be restless and unable to study well even during my exams. I remember there was a period I sat down in front of my house and started crying cos I was fed up on getting weak during Xmas period while my mates were having fun. I also remember cases where I walked into one of the biggest pharmacy in my area and ask the guy which malaria drugs is the most expensive cos I was thinking the most expensive should be the most effective. He brought out some drugs which I paid some money.

I was free from malaria for the past 4 months not of recent I started having heavily symptoms mentioned above. I have taken several drugs like chloroquine 2-2-1 and Combisunate(arthmeter and lumefactrine),still yet no positive response.The Cold had stopped but my body is till getting weaker. I am just confuses don’t know what to do. I even thought of going for a HIV test soon cos I believe am not the only AA that stays in House. Others, I mean some of my family and neigbours do have often and it disappears immediately after taking some drugs.

I am fed up seriously and really don’t know what to do again.I hope you can help.

ANSWER

Thanks for your question. Getting infected with malaria doesn’t have anything to do with whether you are blood type A or O or anything else. Some people do have natural resistance to some types of malaria—for example a lot of people in sub-Saharan Africa are “Duffy negative” which means they are resistant to Plasmodium vivax malaria; other people carry the sickle cell gene, which also provides some protection.

However, it is not common to have so many repeated attacks of malaria. The first thing to do is to make sure you are protecting yourself sufficiently from mosquito bites. You can’t get malaria if you aren’t bitten by mosquitoes, and the type of mosquitoes that transmit malaria usually bite at night. As such, it is crucial to sleep every night under a long-lasting insecticide treated bednet. If you have one, it might need to be re-dipped in insecticide to make sure it keeps working effectively. Also, you should make sure all your windows and doors are properly screened to prevent mosquitoes from coming in; many people also do something called “indoor residual spraying” where they spray insecticide on the walls inside their house to kill any mosquitoes which might come in. If you live in an urban area, this might not be necessary if you can get good screens, or indeed if you have air conditioning (mosquitoes do not like cooler environments). Finally, you should try to wear long-sleeved clothing in the evenings and at night, again to stop mosquitoes from biting.

Finally, I think it is important to make sure that you are diagnosed properly. In many places I have been to, hospitals don’t do a proper check, but if someone has even a few of the symptoms of malaria, they just give them treatment. This is not good—you need a proper diagnosis, both to see what kind of malaria you have (so you can get appropriate treatment) and also to make sure you actually have malaria, and not something else which is being ignored because they think you have malaria!

In fact, your symptoms of fatigue, weakness and cold are not very typical of malaria, which is usually characterized by very high fever interspersed with chills, nausea and body aches. As such I think you might want to talk to a doctor about other possible explanations for your symptoms, especially since they are so persistent.

Finally, in Nigeria, you should NOT be given chloroquine to treat malaria, unless your case is confirmed as not being caused by Plasmodium falciparum. Virtually all the Plasmodium falciparum in Africa is resistant to chloroquine, and so it is no longer an effective treatment. Instead, first-line treatment for malaria is recommended as an artemisinin-based combination therapy, such as Combisunate which you mention above.