Malaria: Causes, Risk Factors, Symptoms, Diagnosis, Treatment, Complications and Prevention

It is a disease caused by a parasite, transmitted by the bite of an infected mosquito.

Malaria causes recurrent attacks of chills and fever.
When the female mosquito bites the individual, the parasite enters the body and infects the red blood cells.
It can cause serious and sometimes life-threatening illness, but it can be prevented and treated.
About half of the world’s population lives in places where malaria is present.

Causes and risk factors

People who live or travel to countries where the disease is present such as: Africa, especially those countries south of the Sahara desert, are more likely to contract malaria or malaria.
This disease is also present in other areas, including Central and South America, Asia, the Middle East, and part of the Pacific Islands.
Some groups are more susceptible to malaria than others, such as:
  • Babies and children under five years of age.
  • Pregnant women.
  • People with HIV or AIDS.
  • People who travel to countries where the disease is.
  • Malaria is caused by a parasite called Plasmodium sp.
There are five types of Plasmodium that infect humans. Of these, two cause malaria in most cases.
Plasmodium falciparum causes the most severe form of malaria and most deaths, and is the most common malaria in Africa. About seven out of 10 people who contract malaria are infected with P. falciparum.
Plasmodium vivax can remain in the body for many months, so symptoms may not develop until later.

Symptoms of malaria

Symptoms usually begin within a month of becoming infected with P. falciparum.
If the individual has been infected with P. vivax, symptoms usually begin within three months of the bite, although symptoms can also develop up to a year later.
The first symptoms are often like having the flu, but they can be mild and not very specific.
This can sometimes make malaria difficult to diagnose.
The most common symptoms are:
  • Fever, sweat, or chills, causing shaking and shaking.
  • Very bad headache.
  • Muscle and joint pain
  • Lack of energy and tiredness.
  • Belly pain, perhaps with the appearance of diarrhea and vomiting.
If malaria is not treated, you can develop other more serious symptoms, such as seizures, being confused or very sleepy, and having trouble breathing.
If you are sick, have a fever, and have traveled to a region with malaria in the last year, always consult your GP.
Make sure they are aware of your travel history. Symptoms of malaria can get worse very quickly, so it is important to get immediate treatment.
The duration of the onset of symptoms can also vary depending on whether you have taken any medicines to prevent malaria.
You can still get the disease even if you have taken antimalarial drugs correctly.
If you have a fever at any time while in a malaria country, seek medical help as soon as possible.
If you are traveling to an area where it is unlikely that you will be able to get medical attention quickly, your GP may suggest that you bring emergency treatment for malaria, just in case.
You can use it if you have a fever and cannot reach a doctor within 24 hours.
Your GP should give you written instructions, explaining how and when to take it, and any side effects you may have.
It is important to see a doctor as soon as you can after taking this emergency treatment.

Malaria diagnosis

If you have symptoms of malaria, it is important to get medical help quickly.
To learn more about how to prevent malaria, you should talk to your doctor, ideally several weeks before traveling.
If you are born in an area where there is malaria, you can develop some immunity to the infection.
However, if the person leaves and moves to a country that is not endemic to malaria, they will quickly lose immunity, therefore they will need to take antimalarial drugs if they travel to an area with malaria again.
The diagnosis of malaria is made with the help of a microscopic examination of blood samples. The symptoms of malaria may resemble other viral fevers, therefore a careful evaluation is needed to diagnose malaria.
A differential diagnosis should be made by reviewing conditions that mimic malaria and should be ruled out before a malaria diagnosis, these include:
  • Hepatitis viral A, B o C.
  • Typhoid fever.
  • Dengue.
  • Influenza.
  • Viral fevers.
  • HIV infection.
  • Meningitis or encephalitis brain infections.
To make the diagnosis of malaria, the detailed history of travel to endemic areas should be reported to the doctor, even brief stopovers should be recorded.
Early diagnosis is important to ensure adequate, presumptive, and accurate treatment and to reduce the risk of life-threatening complications and death. A blood sample is usually taken for diagnosis.
Thick and thin blood smears are taken on a glass slide.
Smears show a better confirmatory diagnosis when the parasite is present in the peripheral bloodstream.
Smears on glass slides are stained with Giemsa stain.
When the blood sample is negative, at least two additional samples must be obtained within the next 48 hours before ruling out malaria.
A negative blood sample does not mean that the individual does not have malaria, in pregnancy, for example, the parasites remain in the placenta and their detection is not easy.
Rapid diagnostic tests are also used for easy detection and take about 2 to 15 minutes. These tests detect parasite antigens.
The polymerase chain reaction is the most sophisticated method of diagnosing malaria, although it is very expensive and less available in endemic areas.
Nucleic acids from parasites are detected by the polymerase chain reaction and used to confirm the species of parasite that causes malaria, once the disease has been diagnosed by smear microscopy.
Serology can also be used to detect antibodies to malaria parasites.
This can be done using indirect immunofluorescence or enzyme-linked immunosorbent assay.
Serology does not detect current infection, but measures past exposure.
In addition to detecting the parasite, other tests are ordered. These include complete blood counts that reveal anemia, low platelet counts, and, rarely, high white blood cell counts.
The activity of G6PD is observed to prevent the side effects of some antimalarial drugs such as primaquine.
Liver and kidney functions are evaluated to rule out organ damage.
Urea and electrolytes are tested for acidosis and low levels of sodium and creatinine.
Blood glucose is tested since hypoglycemia is common with falciparum malaria.
Other tests include evaluation of blood gases, blood cultures, blood coagulation studies, chest x-rays, urine and stool cultures, and examination of cerebrospinal fluid by lumbar puncture.

Treatment for malaria

Malaria is a medical emergency and must be treated as soon as possible.
If you develop the disease, you can go from having no symptoms to having serious complications in a day or two.
Malaria can be successfully treated with medicine. These get rid of all parasites from the blood.
The medications used will depend on the type of malaria you have, the severity of the disease, and whether the malaria is resistant to treatment.
Certain medications do not work for malaria in some parts of the world.
When you have P. falciparum malaria, you will likely receive hospital treatment, whereas if you have other types of malaria, you will probably be able to continue your treatment at home after your initial evaluation.
If the patient has severe malaria or complications, they may need to be cared for in an intensive care unit.
In the treatment of P. falciparum malaria, drugs such as:
  • Artemisinin combination therapy: Used for uncomplicated malaria.
  • Atovaquone-proguanil: used for uncomplicated malaria.
  • Quinine: Used for uncomplicated malaria and severe malaria, where it can be given directly into a vein rather than as tablets. You can also take doxycycline or clindamycin with quinine.
  • Artesunate : Used for malaria with complications and is given directly into a vein. You can also take doxycycline or clindamycin with quinine.
It usually takes three to seven days of treatment to get rid of all the parasites.
A blood test should be done every day while taking medications to check how well they are working.
Other types of malaria are usually treated with chloroquine. If you have malaria caused by P. vivax or P. ovale, you will need treatment to prevent the infection from coming back.
This is because the parasites can remain in the liver. To get rid of these, you need to take primaquine after you finish taking chloroquine.
Most people with malaria recover quickly and completely once treatment is started.
Sometimes malaria can come back if treatment hasn’t worked, so if you have symptoms again in the future, you should always see your doctor right away.

Antimalarial medicine and G6PD deficiency

Glucose-6-phosphate dehydrogenase deficiency is a genetic disorder.
It is possible to have it and not know it, it affects their red blood cells and the individual is more likely to have the disease if they are of African, Asian or Mediterranean origin.
If you are deficient in glucose-6-phosphate dehydrogenase, you should not take primaquine, as it can lead to anemia and other serious health problems.
If primaquine is prescribed, the doctor should perform a blood test for glucose-6-phosphate dehydrogenase deficiency.

Complications of malaria

Complications are more likely to develop if you have the P. falciparum type of malaria, rather than other types of malaria.
These complications include:
  • Seizures (convulsions) and a change in the level of consciousness.
  • Kidney problems
  • Anemia.
  • Trouble breathing or fluid in the lungs.
  • Very low blood sugar levels.
  • Blood clotting problems
  • Organ failure.
  • Blood poisoning (sepsis).

Malaria prevention

There are many things that can be done to lower your chance of getting malaria.
A good way to remember what to do to prevent malaria is to:

Risk awareness

Find out about malaria, how it is acquired, and if you are at risk in the area where you plan to travel.

Sting prevention

Malaria is transmitted by the bite of the Anopheles mosquito, which is most active from dusk to dawn.
Bites can be prevented by using insect repellent, mosquito nets, and long-sleeved pants and shirts.
Chemoprophylaxis (or similar drugs to prevent infection)
Your GP can give you the correct medications to take, depending on where you are traveling.
It is important that they are taken as prescribed, which also means that they should continue to be taken when you return home or leave the area.
Make sure to carry medicines from their place of origin with you, as preventive medicines in some countries can be of poor quality.

Malaria and pregnancy

If you are pregnant, the safest option is not to travel to an area where there is malaria.
This is because the person is more likely to get malaria and more likely to have serious complications.
Malaria can also cause serious harm to the unborn baby.
Miscarriage or stillbirth is more likely, and the baby is very likely to be born premature and underweight.
It can be particularly serious if you get malaria in the last three months of pregnancy (third trimester).
If you get malaria when you are pregnant, you can pass it on to your unborn baby, but this is very rare.
If this happens, the baby would be born with the disease, this is called congenital malaria. The baby would have symptoms of malaria such as fever, feeding problems, and jaundice (yellow skin and whites of the eyes) or anemia.
If you have to travel to an area where there is malaria, you should always take antimalarial medicine and do everything you can to prevent mosquito bites.
The doctor must be notified when you are pregnant, how many weeks you will be traveling. This is for your doctor to prescribe the necessary medications.
Not all medicines to prevent malaria are safe at specific times during pregnancy.