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Malaria deaths, causes, symptoms, prevention and awareness

Malaria is the most common disease caused by mosquito bites and is a major public health threat across the globe. This life-threatening infectious disease is caused due to the bite of female Anopheles mosquito. Malaria is a widespread vector-borne fever in tropical and subtropical areas. In 2016 only, 216 million cases of malaria were reported around the world. The estimated deaths were between 445,000 and 731,000. The most affected regions were from the African continent. It is generally associated with less developed and poor nations and is also one of the causes of poor economic development and prosperity. We will try to understand key points about malaria, it is spread and control through below questions and answers.

How Malaria is caused?

Malaria is caused by Plasmodium parasite. These are microorganisms and there are more than 100 species of Plasmodium parasites. Through mosquito bites, parasites enter into the body. The female Anopheles mosquito becomes infected when it bites another infected person (Also known as night-biting mosquitoes). There are five types of Plasmodium parasites which can cause the illness(P.Falciparum, P.Malariae, P.Vivax, P.Ovale, and P.Knowlesi).

The most dangerous and life taking parasite is Plasmodium Falciparum which can lead to severe organ failures. Vivax malaria is mild but sometimes it can also lead to death. When mosquito bites, parasites enter into the bloodstream, then they go from bloodstream to liver. The parasites in liver grow and multiply before they re-enter into the bloodstream. Parasites infect the red blood cells. The red blood cells burst regularly in the interval of 48-72 hours and cause symptoms like shivering, high fever, and sweating. 

Malaria parasites can also be transmitted through blood transfusion, organ transplant, and used needles. The transmission of malaria can also occur to newborn baby from an infected mother. Certainly, malaria is not a contagious illness. It cannot spread from casual contact. It cannot be transmitted sexually.

What are common signs or symptoms of malaria?

Generally, it takes 10 days to 4 weeks to appear symptoms after mosquito bite but sometimes the person may feel ill in one week or it may take 1 year of time. In the case of p.falciparum parasite the symptoms can appear in 9-14 days. The symptoms of malaria are shivering, high fever, sweating, vomiting, tiredness, headache, muscle pain and diarrhea. There may be many cycles of chills, shivering and sweating.

Two types of malaria, P.Vivax and P.Ovale can emerge again. These parasites may remain dormant in the liver even up to 4 years and can re-enter red blood cells. Such reoccurrence of malaria is called relapsing.

How anopheles mosquito does look like?

The Anopheles mosquitoes have blackish to dark brown color. They can be identified by buzzing sounds they have. Their eggs float in the water and they have itchy bites. The female Anopheles mosquito bites at 45 degrees of angle from the skin. They have mouthpart palps which have the same length as a proboscis.

What is the life cycle of Anopheles mosquito? 

Anopheles has four stages in their life cycle:-egg, larva, pupa and imago. The first three stages are aquatic and together they last for 5-14 days. In their adult stage, they act as a malaria vector. The female mosquito can live up to a maximum of a month.

What are favorable habitats for Anopheles mosquitoes?

The rainy season is favorable for their growth. They can lay their egg in tyres, buckets, bottles, well, ponds, paddy fields, drains, canals, construction sites, and water tanks. They can lay eggs in stagnating and slow flowing water. People should be made aware about breeding grounds of the mosquitoes so that they can help in destroying these habitats.

What the impacts are of severe malaria?

If not treated on time illness can develop severe complications. Due to the loss of red blood cells anemia and jaundice can develop. It may develop into cerebral malaria a condition in which the brain can swell. The severe brain disorder like permanent damage or coma can occur.

Other complications like liver and kidney failure, spleen and lungs damage may occur. The pregnant women can have premature births, miscarriage and newborn baby with low weight. Sometimes it can cause the death of a mother.

Severe malaria can also develop acute respiratory distress syndrome (ARDS), Hypoglycemia,  Hyperparasitemia, and Metabolic acidosis.

What is Malaria Relapses?

The patient recovered from infection of P.vivax and P.ovale parasites can have several additional attacks without symptoms even after months or years. Relapses occur because they (P.vivax and P.ovale) have dormant liver stage parasites which can reactivate.

Who is at high risk due to malaria infection?   

Human groups like infants, children (below the age of 5 years), and pregnant women, patients with HIV/AIDS illness, travelers and refugees are more prone to malaria infection. Poor people with lack of proper health care facilities are at greater risk. 

Is vaccine available to prevent illness?

So far we don’t have an effective vaccine for malaria prevention. A lot of efforts are being made in this direction. RTS, S is the only approved vaccine but unfortunately, it is not effective and cannot prevent infection completely. Because of low performance WHO doesn’t recommend its use in babies between six to twelve weeks. PfSPZ is another promising vaccine for malaria prevention. It is going under many clinical trials to measure its efficacy.

What is the incubation period for malaria infection?

The time between to appear the first sign or symptom after a mosquito bite is called incubation period. It varies between 7 days to 30 days. Generally, it is shorter in case of P.faciparum and longer in P.malaride. If travelers to high transmission regions take anti-malarial drugs then the symptoms may be delayed by weeks or months.

How long does it take to recover from Malaria?

Malaria is treatable disease and all parasites can be eliminated from the body if the right kind of treatment is taken. The recovery depends on the severity of infection and the type of parasite, detection, and treatment. Normally it takes two weeks of time to recover from it but in some cases, replases of malaria may develop.

How malaria is diagnosed and treated?

WHO recommends that suspected malaria patients should be diagnosed with microscopy or rapid diagnostic test (RDT) before antimalarial treatment is given. Blood tests are conducted to confirm the presence of the parasite. These tests are helpful in finding vital information like which type of parasite is causing illness, whether the parasite is drug resistant or not and other serious complications. The treatment without tests should be started only if diagnostic facilities are not available within 2 hours of reporting of the patient. The treatment depends on the type of parasite, the condition of the patient, drug resistance behavior, pregnancy, and other complexities or allergies. For non-complicated malaria caused by P.falciparum parasite, artemisinin-based combination therapy (ACT) should be given. The ACT is nothing but a combination of more than two drugs. These are the first line of drugs against malaria. The examples of ACTs are Artemether-Lumefantrine and Artesunate-Amodiaquine.

Patient with the severe case who can’t take oral drugs should be given inject-able treatment(artesunate) for 24 hours followed by a complete 3-day course of ACT(oral medicines) once he is in position to take them.

What are the drugs used for malaria treatment?

The common effective drugs used against malaria parasite are Quinine, Quinidine, Doxycycline, Clindamycin, Atovaquone-proguanil, Artemether-lumefantrine, chloroquine, mefloquine, and artesunate.

Although primaquine is effective and active against dormant parasite liver forms and prevents relapses, it should not be given to pregnant women. Mefloquine, doxycycline, proguanil should not be given during pregnancy.

What are home and traditional remedies for malaria?

Traditional herbs are used to treat malaria for many centuries. They are a good source of ingredients used in modern anti-malarial drugs. Artemisinin and quinine are extracted from plants and herbs. It is estimated that around 1200 plant species are used as herbal remedies to cure malaria. The home remedies which can be used in the daily diet to cure and prevent malaria are orange juice, cinnamon, ginger, turmeric, mustard oil, grapes, apple cider vinegar. They boost immunity and are anti-inflammatory,anti-bacterial and anti-oxidant.

Why Malaria is the illness of poverty?

Malaria kills 1 million people in one year in the Sub Saharan region of the African continent. In the absence of proper awareness and treatment on time people die. All the factors associated with poverty like illiteracy, sanitation, poor health infrastructure, economic backwardness, and poor governance have a major impact on the spread and control of the illness. The high mortality rate due to malaria is seen in nations with extreme poverty. This disease is also one of the major causes behind the poverty. This disease causes loss of productive hours and hard earned money.

Where does malaria commonly occur?   

The regions with the hot and humid climate in tropical and subtropical are ideal habitats for Anopheles mosquito to thrive. The regions include African continent, South East Asia, Central, and South America, the Middle East and Oceania. The high temperature and humid environment provide habitats for growth and maturity.

The economic activities like mining, plantation, subsistence farming, forestry, constructions, and unplanned urbanization are responsible for the uncontrolled population of mosquitoes.

How Malaria does impacts travelers?

Many people from the US and Europe travel to warm regions where they get malaria infection. The travelers to sub-Saharan regions should take precautionary measures. Annually, around 1700 returned travelers are diagnosed with malaria. If there is a sign of malaria the person should immediately seek medical treatment. It is recommended that they should carry appropriate drugs when they visit high-risk areas so that they can get treatment on time. Travelers should carry malaria drugs, insect repellent, long-sleeved clothes, sprays and bed nets.    

What is anti-malarial drug resistance?

Anti-malarial drug resistance is the major concern for fighting against this deadly illness. Resistance to P. falciparum has been observed in 4 countries of South East Asia (Myanmar, Cambodia, Thailand, and Vietnam).

It is also reported that in almost 64 nations the mosquito has become resistant to at least one pesticide used in mosquito control.

How does malaria affect children or babies?

Most of the children killed by malaria are under the age of five. The newborn babies and infants less than 12 months of age are most vulnerable to malaria infection. In high malaria transmission or an endemic area around 3 months of age, babies become vulnerable to malaria because immunity acquired from mother starts to diminish. They are more prone to severe anemia and death. 

Since half of the global population is at risk due to Malaria, its eradication from the world has become a priority. The global burden of malaria is huge and it can only be reduced by taking appropriate preventative and curative actions. Poor people are more affected and they can’t afford costly insecticides nets, therefore, these nets should be distributed freely to them. To reduce maternal and infant mortality due to malaria intermittent preventive treatment should be promoted in highly affected regions. Use of intermittent preventive treatment has been effective in addressing the problem related to malaria and low birth weight.   

The local communities and international travelers should be made aware of symptoms, incubation period, treatment and precautionary measures. The travelers traveling in the high-risk area should be careful and should immediately seek the help of doctors if they see any kind of malaria symptoms. They can take anti-malarial drugs with them after consulting with appropriate doctors. People around the globe, NGOs, health organizations and governments should make every effort to control the spread and eliminate this deadly vector-borne disease completely from the earth.

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