Malaria Explained From A Layman’s Perspective

Introducing Malaria

[Image source: Wikimedia commons. Author: CDC/James Gathany]

Malaria is a life-threatening disease caused by a Plasmodium parasite and spread through the bite of an infected Anopheles mosquito. Once infected, the parasite reproduces in the liver and then enter the blood where it destroys red blood cells. This way, malaria kills many people each year.

It is very common in hot, tropical areas.

Prevention, early diagnosis and proper treatment are the three ways to protect one’s self from malaria. Although a vaccine is being produced in Europe, there is no globally licensed vaccine available.

What Causes Malaria?

The parasite that causes malaria is called 'Plasmodium'. There are over 100 types of the Plasmodium parasite, five of which can infect humans. These are:

P. vivax
P. falciparum
Plasmodium vivax
Plasmodium ovale
Plasmodium malariae

How Does Plasmodium Enter The Human Body?

Plasmodium is transmitted through the bite of an infected Anopheles mosquito. The Plasmodium resides in the mosquito’s special saliva. When an infected mosquito bites someone, this saliva is secreted. The saliva prevents the person’s blood from clotting by injecting an anticoagulant. The person gets Plasmodium just as the anticoagulant is injected. It is through this process that Plasmodium typically enters the human body.

It all begins when the infected mosquito bites a person. The parasite enters the body and stays dormant within the liver for an average of 10 to 15 days. During this period, the malaria parasite will begin multiplying without any visible sign to the host. After this period, the newly produced parasites will enter the bloodstream and infect the red blood cells and multiply further. This continues until it is treated or the patient dies.

If the infected person is bitten by an uninfected mosquito, the mosquito becomes infected and passes the infection when it bites an uninfected person.

Sometimes, some of the parasites might remain in the liver, explaining why malaria may reoccur after treatment.

Note that only the female mosquito transmits malaria. This is because only the female mosquito feeds on blood. The male mosquito feeds on nectar of flowers.

There are four other ways by which a person can get infected.

A child can get it from it mother while in the womb.
People can get infected through blood transfusion although this rarely happens.
By using a needle already used by an infected person.
People can also get it through received an infected donated organ. (This rarely ever happens)

The Spread of Malaria

Wikipedia estimates that 40% of people live in a place where there is malaria. (Mostly Africa)

Between 300 to 700 million people get infected by malaria each year with about one to two million of them dying from it. 90% of malaria death worldwide is reported to occur in sub-Saharan Africa, most of which are children.

Pregnant women and children suffer most when infected by malaria

The spread of malaria is more pronounced in developing countries. Its prevalence is aided by the lack of medicine and/or effective mosquito control.

Symptoms

Malaria symptoms are divided into two major categorises: severe and uncomplicated malaria

Severe Malaria

In severe malaria, there are clinical signs of vital organ dysfunction. Severe malaria can affect vital organs such as the brain and kidney

Symptoms include

Fever and chills
Respiratory problems
Adopting a prone position
Convulsions
Impaired consciousness
Anemia
Abnormal bleeding
Jaundice
Laboratory evidence of vital organ dysfunction

Severe malaria can lead to death if not treated.

Uncomplicated malaria

In this case, the symptoms of malaria are present but there are no signs of vital organ dysfunction.

However, this can easily degenerate to sever malaria if it is left untreated.

Symptoms include cold with shivering, fever, vomiting, headaches, irritability, drowsiness, body pains, nausea and poor appetite.

These symptoms typically last 6 to 10 hours and reoccur every second day.

This kind of malaria can be treated with over the counter drugs

Diagnosis

Early diagnosis is important for a victim’s recovery.

Malaria is usually suspected based on the symptoms. A blood sample is then taken for microscopic laboratory testing.

In malaria-endemic countries, doctors often administer treatment for malaria without getting laboratory evidence to prove the person has malaria. This is especially when the person has a fever with no obvious cause

Treatment

The aim of malaria treatment is to use anti-malaria drugs to eliminate the Plasmodium parasite from the patient’s bloodstream.

The anti-malaria drugs are administrable by mouth, by injection or intravenously. Depending on the severity and doctor’s assessment, a person may be treated as an out-patient or admitted and treated with IV medicine.

The WHO recommends Artemisinin-based combination therapy (ACT) to treat uncomplicated malaria.

Artemisnin is gotten from a plant called Artemisia annua, also known as Sweet Wormwood. It is proven to rapidly reduce the amount of Plasmodium in the bloodstream. Its role in the ACT is to reduce the concentration of parasites within the first 3 days of infection, while the partner drug eliminate the rest.

For severe malaria, the patient is advised to seek help from a qualified medical doctor.

Prevention

There are many ways to prevent malaria

Vector Control

The idea here to to kill the mosquito before it comes infected and spread malaria. Pesticide are usually employed to carry out the task. Pesticides include DDT, malathion and bendiocarb.

Vaccination

There is currently no globally licensed vaccine for malaria although research is currently ongoing. There is one, however, that is being circulated to Europe.

Other Preventive Measures

People who are residing in or travelling to places where that experience high numbers of reported malaria cases should take precaution. This include sleeping in trousers and long sleeve dresses, using mosquito net, insect repellent, insecticides, pre-treated bed nets, and appropriate clothing.