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Malaria

Author: Rajendran.T, Pharmacist

What is Malaria?

Malaria is a serious, infectious disease spread by certain kinds of mosquitoes. It is common in tropical climates and is characterized by chills, fevers, and an enlarged spleen. These symptoms reappear again and again. The disease can be treated with medication, but it tends to come back even after being cured. Malaria is endemic in many countries. An endemic disease is the one that occurs frequently in a particular location. Isolated, limited outbreaks of malaria sometimes occur in even developed countries like United States.

Description of Malaria Infection
Malaria is a serious problem in developing countries. Between 300 to 500 million people in Africa, India, South East Asia, The Middle East, The South Pacific, Central and South America have the disease. About 2 million people die of the disease every year. Most of these deaths occur in Africa. A person can have malaria more than once. In some parts of Africa, people have upto forty bouts of malaria during their lifetime. Malaria is becoming a more serious problem because the organism that causes the disease is developing resistance to the drugs used to treat it.

Malaria as an Ancient Illness
Malaria has been a known disease for centuries and was described in medical records from ancient China, India and Greece. Doctors first believed that malaria was caused by poisonous vapors in the air. People, who lived around swamps, bogs, and other wetlands, were especially likely to get the disease. In fact the name of the disease comes from two Italian words for BAD AIR: ‘mal’ – (bad) and ‘aria’ – (air).
The Romans are credited with one of the most successful attempts to eliminate malaria. They drained large areas of swampy land around the city, believing that they were cutting off the supply of ‘bad gases’. In fact, they were destroying the wet areas in which malaria carriers (the mosquitoes) lived and bread.

Causes of Malaria
Malaria is caused by four different kinds of parasites belonging to the Plasmodium family. A parasite is an organism that lives off another organism. Malaria is transmitted by female mosquitoes that carry the parasites in their blood. When the mosquito bites a human, it injects a small amount of its saliva into the human’s bloodstream. The saliva contains parasites that travel through the person’s bloodstream to his or her liver. There, the parasites reproduce. Eventually they leave the liver and travel back into the bloodstream. Once in the bloodstream, they begin to cause the symptoms of malaria.
Malaria cannot be passed directly from one human to another. It can be transmitted by a mosquito. A mosquito may bite a person infected with the malaria parasite. When it sucks the person’s blood, it takes in some of the parasites. If the same mosquito bites a second person, it may transfer those parasites to the uninfected person.
Malaria can also be transmitted through blood transfusions. If an infected person donates blood, the blood will contain malaria parasites. If the blood is put into another person’s body, the parasites will also flow into his or her blood stream. For this reason, blood donors are often screened for the malaria parasite before they are allowed to give blood.
The incubation period for malaria varies considerably. An incubation period is the time between the mosquito bite and the time symptoms of malaria begin to appear. The incubation period differs depending on the kind of parasite involved. For the most serious form of malaria, the incubation period is eight to twelve days. In some rare forms of malaria, the incubation period can be as long as ten months.

Symptoms of Malaria
A person infected with malaria passes through three stages of very distinctive symptoms. The first stage is characterized by uncontrollable shivering for an hour or two. In the next stage, the patient’s reach 106ºF (41ºC) for a period of up to six hours. In the third stage, the patient begins to sweat profusely, and his or her temperature drops rapidly.
Other symptoms may accompany these stages. They include fatigue, severe headache, nausea and vomiting.
The most serious form of malaria can result in death in a matter of hours. The parasites attach a person’s red blood cells and change their structure. The cells become very sticky and begin to clump together. As they do, they block blood vessels in vital organs, such as the kidney and spleen. These organs may no longer be able to function properly, and the patient may fall into a coma and die.

Diagnosis of Malaria
Malaria can be diagnosed with a blood test.
The three stages of malaria can also be used to diagnose the disease. A person who lives in an area where malaria is common and who has chills, fever, and a very high temperature should have a blood test as quick as possible.

Treatment of Malaria
Malaria can be treated with drugs. However, treatment is complicated by a number of factors. First, each type of malaria requires a different drug. Second, the treatment depends on the region of the world in which the person was infected.
The classic treatment for malaria is quinine. Quinine is still effective in treating some forms of malaria, but other parasites have developed resistance to quinine.

Prognosis of Malaria
If treated in its early stages, malaria can be cured. Cures are more difficult for people who live in areas where malaria is endemic. These people may be bitten by mosquitoes and exposed to malaria parasites again and again and may never fully recover from the disease.

Prevention of Malaria
Malaria can be prevented in one of two ways. First, a person can avoid being bitten by a mosquito carrying the malaria parasite. The second method for avoiding malaria is to take drugs that protect against the disease.

Who is most vulnerable?
Young children - who have to develop immunity to malaria.
Pregnant women, whose immunity is decreased by pregnancy.
Travelers coming from areas of little malaria transmission.