What to know about Malaria disease

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Malaria is a protozoa disease that is transmitted predominantly by mosquitoes, causing illness, health complications and death. It is a major human parasitic disease with outcome of periodic episodes of chills, fever, pain and sweating especially in children under 5 years and pregnant women.

The plasmodium parasite is mainly spread by female Anopheles mosquitoes, which are night-biting mosquitoes. When an infected mosquito bites, it injects the parasites into the body. In the human body, the parasites multiply in the liver and attack the red blood cells.

Residents of a malaria region may be exposed to the disease so frequently that they acquire partial immunity, which can lessen the severity of malaria symptoms. However, this partial immunity can disappear if they move to a country where they are less exposed to the parasite. It’s important you know that good health is durable wealth. Know and promptly report features of malaria for early treatment that interrupts the outcome of the disease.

THE DISEASE CALLED MALARIA

Malaria is an infectious disease caused by a parasite, Plasmodium, which infects the red blood cells. It is a mosquito-borne disease, affecting humans and other animals; and it is of wide public health importance. In simple terms, malaria is caused by a microscopic parasite called plasmodium, which is transmitted via the bites of infected mosquitoes. There are many different types of plasmodia parasites, but only five cause malaria in humans. The infection begins with a bite from an infected female Anopheles mosquito (the definitive host) which introduces a motile infective form called the sporozoite through saliva into the human circulatory system. A single mosquito bite is all it takes for someone to become infected.

THE EFFECTS OF MALARIA IN HIGH RISK AREAS

Malaria is widespread in tropical and subtropical regions of Sub-Saharan Africa, Asia and the Americas. It’s prevalence in tropical and subtropical regions are because of rainfall, warm temperatures and stagnant waters which provide favourable habitats for mosquito larvae.

The recent World Malaria report, states that there were about 219 million cases of malaria globally, resulting to an estimated 940,000 deaths (90% in the African region). The World Health Organization (WHO) estimates that a child dies of malaria every 30 seconds and malaria kills an estimated 1 million people (especially the under 5 years and pregnant women) annually on a global scale. Poverty, lack of knowledge and little or no access to healthcare contribute to malaria deaths globally.

HEALTH HAZARDS AND COMPLICATIONS OF MALARIA

There are several important health hazards and complications following malaria attack. In most cases, malaria deaths are related to one or more of these serious complications and hazards which include:

  • Cerebral malaria. If parasite-filled blood cells block small blood vessels to the brain, swelling of brain or brain damage may occur. Cerebral malaria may cause seizures and coma. Malaria causes direct brain damage and widespread anemia during the period of rapid brain development. This neurologic damage results from cerebral malaria to which children are more vulnerable. Some survivors of cerebral malaria have an increased risk of neurological and cognitive deficits, behavioural disorders and epilepsy.
  • Respiratory distress. Malaria can cause fluid to accumulated in the lungs (pulmonary edema) making it difficult to breathe.
  • Organ failure. Malaria can cause kidneys or liver to fail or spleen to rupture. Any of these conditions can be life-threatening.
  • Severe anemia. Malaria weakens and damages the red blood cells, which can result in severe anemia. This is manifested when the red blood cells are unable to carry enough oxygen around the body, leading to drowsiness and weakness.
  • Low blood sugar. Severe forms of malaria can cause very low blood sugar which may result to coma or death.
  • Birth problems. Malaria in pregnant women is an important cause of stillbirths, infant mortality and low birth weight.

SIGNS AND SYMPTOMS OF MALARIA

The signs and symptoms of severe or uncomplicated malaria typically begin 8–25 days following infection. However, some types of malaria parasites can lie dormant in the body for months or even years without obvious signs and symptoms. However, signs and symptoms may occur later in those who have taken antimalaria drugs as prevention.

Generally the signs and symptoms of malaria include headache, joints pain, nausea, vomiting, jaundice, retinal damage and two or more convulsions within the periods of malaria attack. There are presentations of  high temperature (fever) of 380C (100.40F) or above, moderate to severe shaking chills, profuse sweating that repeat every 1-3 days as body temperature fluctuates, muscle pains, diarrhoea and coughing that can persist for days.

Other signs and symptoms of malaria are blurring of vision, dizziness, decreased consciousness, significant weakness that impair movement, inability to feed (loss of appetite)  and  coma that lasts longer than 30 minutes after a seizure.  Low blood pressure (less than 70 mmHg in adults and 50 mmHg in children), breathing problems and circulatory shock are common. There may be kidney failure or hemoglobin in the urine, bleeding problems or hemoglobin value of less than 5 g/dL, pulmonary edema, blood glucose of less than 40 mg/dL and acidosis or lactate levels of greater than 5 mmol/L.

POSSIBLE CONTROL MEASURES AGAINST MALARIA

People should avoid delayed treatment that can cause death due to none reporting or ignoring malaria signs and symptoms. Avoid traveling to or through countries where malaria is endemic if possible. If people must go to areas where malaria is rampant, they should carefully take all the prescribed preventive drugs. It is important to avoid contaminated blood transfusions, inadequate or ineffective treatment especially due to self-medication, and collection of stagnant water. Exposure to female mosquitoes that feed on blood particularly during the peak hours of dawn and dusk should be avoided.

Do a pre-travel consultation for every overseas trip even if you have previously visited the country of interest.  If you are going to travel to a location where malaria is common, talk to your doctor a few months ahead of time about drugs to take that can help protect you from malaria parasites before, during and after the trip.  Community participation and health education strategies that promote awareness of malaria and the importance of control measures have been successfully used to reduce the incidence of malaria in some malaria-endemic areas.

 PREVENTION OF MALARIA

  • Spraying the home. Use Indoor Residual Spraying (IRS) with insecticide to control the vector mosquitoes. Treating home’s walls with insecticide can help kill adult mosquitoes that hide inside dark corners.
  • Sleeping under net. Bed nets, particularly those treated with insecticide (permethrin) are especially recommended for pregnant women and young children essentially to provide protection and reduce discomfort caused by mosquito bite and noise. Permethrin will be effective for several months if the bed net is not washed. If bed nets do not reach the floor, they should be tucked under mattresses.
  • Covering the skin. During active mosquito times, usually from dusk to dawn, minimize body exposure by wearing long-sleeved shirts, long pants, boots and hats or caps. Tucking in shirts; and wearing socks and closed shoes are also important and helpful.
  • Apply mosquito repellents or insecticides on clothing and skin. Sprays containing permethrin are safe to use on clothing, while sprays containing 50% DEET (N,N-diethyl-m-toluamide), which is the most effective mosquito repellent for adults and children over 2 months of age, can be used on skin for added protection.
  • Use door and window nets; and close doors to your bedroom especially from 6pm to 7am.
  • Use of oil or kerosene. Cover stagnant water with oil or kerosene to check mosquito breeding and disallow dirty water collections in vessels or pits in your environment.

TREATMENT OF MALARIA

Despite the need, no effective malaria vaccine currently exists, although there are ongoing efforts to develop one. Several medications are available to prevent malaria in travelers to malaria-endemic regions. A variety of antimalaria medications are available. When properly treated, people with malaria usually enjoy a complete recovery. However, severe malaria can progress extremely rapidly and cause death within hours or days.

Your doctor needs to know where you will be traveling to so that he or she can prescribe the drug that will work best on the type of malaria parasite most prevalent in that region. Check whether you need to take malaria prevention tablets: if you do, ensure you finish the prescribed course of antimalaria drug(s).

The key to the timely treatment and other relevant medical interventions in the malaria cases are: recognizing symptoms and signs; and prompt reporting to appropriate healthcare professionals in the early stages.  Therefore, report any experience of malaria for effective treatment that will prevent complications and stop malaria disease from becoming fatal.

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