Deadly Malaria: Treatment & Complications

Malaria is an infection caused by a parasite known as Plasmodium that is carried in mosquitos and transmitted to and between humans through the bite of an infected mosquito. Once bitten and injected with the parasite, the liver followed by the red blood cells become the site of multiplication and spread in the human body. Malaria occurs most commonly in tropical regions like Africa, Central America, South America and southern Asia.

What are the causes of the disorder?

There are different types of Plasmodium parasites but five of those can cause malaria in human beings. These Plasmodium parasites can live inside mosquitos, and it is the bite of an infected Anopheles mosquito that transfers the Plasmodium parasite into the blood of a healthy human. Mosquitos pick up the parasite upon drawing blood from an already infected human, and transmit it to another healthy human during a subsequent bite. The Anopheles mosquito generally bites at night.

Another way of malaria transmission could be through sharing of needles or during blood transfusions, though these are rare possibilities.

What one needs to know about symptoms or signs?

Symptoms of malaria first appear between seven to eighteen days after the mosquito bite. These include:

  • High fever
  • Chills
  • Sweating
  • Headaches, muscle pain
  • Vomiting
  • Diarrhoea

Which specialist should be consulted in case of signs and symptoms?

At first signs of high fever and chills, a general physician should be consulted who will run diagnostic tests and further refer the patient to a specialist in infectious diseases.

What are the screening tests and investigations done to confirm or rule out the disorder?

Early diagnosis of malaria is key to managing the infection effectively. In malaria-endemic countries like India, screening and surveillance programmes are routine, especially during peak transmission seasons like monsoons.

Malaria diagnosis is carried out through microscopy and malaria rapid diagnostic test (RDT). A blood test is done to look for malarial parasite and results are generally made available on the same day.

Treatment is started immediately upon confirmation, but confirming a positive case before treatment is essential to avoid the spread of drug resistance.

What treatment modalities are available for management of the disorder?

Treatment begins as soon as malaria is confirmed. Type of medication and its duration may depend on the causal parasite, severity of infection, whether a woman is pregnant and if a person has had a course of preventive anti-malarial dose.

The drug of choice is Artemisinin Combination Therapy (ACT) for malaria caused by Plasmodium falciparum, along with primaquine. The National Programme in India recommends artesunate, sulfadoxine and pyrimethamine as part of ACT.  Malaria caused by P. vivax is treated with Chloroquine.

What are the known complications in management of the disorder?

The infection can worsen and become fatal if not treated immediately. Complication include:

  • Anaemia – Once red blood cells become ineffective in carrying oxygen, it leads to weakness and drowsiness.
  • Cerebral malaria – A small number of cases may show blockage in the blood vessels leading to the brain, which can cause seizures, brain damage and coma.
  • Complications in pregnant women The effects of malaria infection are more severe in pregnant women.

How can the disorder be prevented from happening or recurring?

  • Prevention of mosquito bites through insect repellents, nets
  • Antimalarial preventive tablets
  • Early diagnosis

 


Sources:

“Malaria,” CDC.gov, Centers for Disease Control and Prevention, http://www.cdc.gov/malaria/

“Malaria,”NHS.uk, http://www.nhs.uk/Conditions/malaria/Pages/Introduction.aspx

“Malaria,” WHO.int, World Health Organisation, http://www.who.int/topics/malaria/en/

“Malaria,” WebMD.com, http://www.webmd.com/a-to-z-guides/malaria-topic-overview

http://www.who.int/malaria/publications/country-profiles/profile_ind_en.pdf?ua=1

http://www.apiindia.org/medicine_update_2013/chap02.pdf

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