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Malaria

Malaria

Definition

Malaria is an infection marked by fever and shaking chills that is caused by one of four different species of the Plasmodium parasite.

What is going on in the body?

Malaria occurs mainly in the tropical areas of the world, including Africa, Asia, and Central and South America. Humans acquire malaria through the bite of a mosquito. There are 4 species of Plasmodium that cause infection.
When an infected mosquito bites a person, the parasite travels through the bloodstream to the liver. The parasite multiplies in the liver. Then it goes back into the bloodstream and attacks the red blood cells. As the red blood cells are destroyed, symptoms begin in the body.

Risks

What are the causes and risks of the infection?

The Plasmodium parasite causes malaria. The bite of the Anopheles mosquito transmits the parasite from person to person.
When a mosquito bites a person who has malaria, the parasite multiplies in the mosquito. If the mosquito then bites another person, it can inject the parasite into another person.
The infection can also be spread from an infected pregnant woman to her unborn child across the placenta.

Prevention

What can be done to prevent the infection?

People who travel to an area where malaria exists should take antimalarial medications. The exact medication depends on the area and the type of Plasmodium there.
Travelers can also help prevent mosquito bites by doing the following:
  • wearing protective clothing
  • avoiding the outdoors from dusk until dawn
  • using mosquito netting while sleeping
  • using insect repellents

Diagnosed

How is the infection diagnosed?

A healthcare professional may suspect malaria after examining the person. The parasite causing the malaria can be determined by examining a blood smear under a microscope. The best time to obtain these blood samples is during a fever. A complete blood count, or CBC, will be ordered to look for low numbers of red blood cells and signs of infection.

Long Term Effects

What are the long-term effects of the infection?

Long-term effects that may result if malaria is untreated are as follows:
  • very low blood count and bleeding
  • respiratory failure (rare in children)
  • kidney failure
  • jaundice, or yellowing of the skin
  • low blood glucose
Infection in the central nervous system may cause the following:
  • confusion
  • decreased consciousness (coma)
  • seizures
  • possibly death
Some types of Plasmodium can cause chronic infection in the liver. This can cause a relapse many years after the first infection.

Other Risks

What are the risks to others?

Malaria is not spread directly from person to person. But if a mosquito bites an infected person, the mosquito can spread the disease to the next person it bites. Malaria may pass through the placenta of a pregnant woman and infect her unborn child.

Treatments

What are the treatments for the infection?

Antimalarial medications are used to treat malaria. The choice of medication depends on the following factors:
  • the species of malaria, and whether it is likely to be resistant to medications
  • the age of the infected person
  • the extent of symptoms
Medications commonly used to treat malaria include:
  • quinine sulfate (usually combined with another antimicrobial)
  • quinidine
  • chloroquine (i.e., Aralen)
  • primaquine
  • a combination of atovaquone and proguanil (i.e., Malarone)
  • mefloquine (i.e., Lariam)
Hospitalization and intravenous medications may also be necessary.

Side Effects

What are the side effects of the treatments?

Medications used to treat malaria may cause stomach upset or allergic reactions.

After Treatment

What happens after treatment for the infection?

For mild symptoms, bed rest, adequate nutrition, and medications may be enough. Recovery from more serious complications of malaria may take more time.

Monitor

How is the infection monitored?

Any new or worsening symptoms should be reported to the healthcare professional.

Sources

Harrison's Principles of Internal Medicine, 1998, Fauci et al. Complete Guide to Symptoms, Illness, and Surgery, 2000, Griffith. www.cdc.gov/travel/malinfo.htm.

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