Malaria is a serious infectious illness acquired from mosquitoes. If not diagnosed and treated promptly, it can be life-threatening. Most of the victims are children. It is one of the prevalent causes of child lethality. In 2017, one in 12 children died of malaria. However, there are several ways of preventing malaria-mortality and this is why it is important you educate yourself about this threatening disease.
The cause of malaria is a bite from an infected mosquito. The first symptoms (fever, headache, chills) usually appear 10-15 days after being bitten by an infectious mosquito and can be mild and difficult to recognize as malaria. If not treated immediately it can result in lethality.
Read more below on how to spot the first symptoms of malaria and what to do in order to prevent and treat this dangerous infection. The good news is that the World Health Organisation has established goals to completely eliminate malaria by 2030 and about that read just below.
Overview
Malaria is a disease caused by parasites.1 The parasite is transmitted to humans through the bite of an infected mosquito. People with malaria usually become very sick with high fever and chills.1
Although the disease is rare in temperate climates, malaria remains endemic in tropical and subtropical countries. About 290 million people become infected with malaria each year, and more than 400,000 die.2 To reduce malaria transmission, global health programs distribute mosquito nets treated with preventive drugs and insecticides to keep mosquitos away.2 The World Health Organisation recommends malaria vaccines for children living in countries with a high incidence (in sub-Saharan Africa and other regions) of malaria cases. The recommendations are based on the results of ongoing pilot programs in Ghana, Kenya and Malawi, which have reached more than 1 million children since 2019.2,5,6
Protective clothing, mosquito nets, and insecticides can help protect you while travelling. You can also take preventive drugs before, during, and after travel to risk areas. Many malaria parasites have acquired resistance to common drugs used to treat the disease.1,2
Causes of malaria
Malaria is an acute febrile disease caused by Plasmodium parasites that are transmitted to humans through the bite of infected female Anopheles mosquitoes.2,3 There are 5 parasite species that cause malaria in humans, two of them, Plasmodium falciparum and Plasmodium vivax, pose the greatest threat. Plasmodium falciparum is the deadliest malaria parasite and the most prevalent on the African continent. Plasmodium Vivax is the predominant malaria parasite in most countries outside sub-Saharan Africa.2,3,6
The first symptoms (fever, headache, chills) usually appear 10-15 days after being bitten by an infectious mosquito and can be mild and difficult to recognise as malaria. Untreated, Plasmodium falciparum can cause severe illness and death within 24 hours.2,3
Other transmission modes:1,4
Because the parasite that causes malaria affects red blood cells, malaria can also be acquired through exposure to infected blood, such as:
- Mother to foetus
- Through blood transfusion
- By sharing needles used to inject drugs
Signs and symptoms of malaria
Malaria can be divided into two disease presentations: uncomplicated and severe.7 WHO defines uncomplicated malaria as the presence of symptoms without clinical or laboratory signs suggestive of severe or critical organ dysfunction. Symptoms are generally nonspecific, including fever, chills, myalgia (muscle aches and pain) headache, anorexia, and cough, making the clinical diagnosis unreliable.7 Signs of serious illness usually appear 3 to 7 days after the nonspecific symptoms listed above, butinclude rapid deterioration, failure to regain consciousness after and non- immune patients dying within 24 hours of their first symptom manifestation.7
Malaria can be difficult to detect, but symptoms may include:
- High temperature, sweating, chills
- Headache and confusion
- Extreme fatigue and sleepiness (especially in children)
- Nausea and vomiting, abdominal pain and diarrhoea
- Loss of appetite
- Muscle pain
- Yellow skin or whites of the eyes
- Sore throat, cough, difficulty breathing
Some people with malaria experience cycles of malaria "attacks".1,4 Attacks usually begin with shivering and chills, followed by a high fever, followed by sweating and normal body temperature.4 These symptoms usually appear 7 to 18 days after being bitten by an infected mosquito. However, symptoms may be absent for months or, in rare cases, years after travel.1,4
Management and treatment for malaria
Malaria is an emergency that requires prompt treatment. Treated with antimalarial drugs. Some people are hospitalised for specialist care and treatment. Malaria may recur and may need to be treated again if it recurs.4
Early diagnosis and treatment of malaria can help reduce illness, prevent death, and reduce transmission. WHO recommends that all suspected cases of malaria be confirmed by parasite-based diagnostic tests (microscopy or rapid diagnostic tests). Diagnostic tests allow healthcare providers to quickly distinguish between malarial and non-malarial fevers, facilitating appropriate treatment.
The best available treatment, especially for Plasmodium falciparum, is artemisinin-based combination therapy (ACT).3 The main goal of treatment is the rapid and complete elimination of the malaria parasite to prevent uncomplicated malaria cases from progressing to serious illness and death.
FAQs
How is malaria diagnosed?
To diagnose malaria, your doctor will likely look at your medical history and recent travel, perform a physical exam and order blood tests. Blood tests can:
- Show the presence of parasites in the blood confirms that you have malaria
- Determines the type of malaria parasite that caused your symptoms
- Determines if your infection is resistant to certain drugs
- Show whether the disease will cause severe complications
Some blood tests take days, while others give results in as little as 15 minutes. Depending on your symptoms, your doctor may order additional diagnostic tests to evaluate potential complications.
How can I prevent malaria?
To avoid malaria these steps should be followed when planning on travelling to the area where malaria is found:
- If you are travelling to an area where malaria is endemic, consult your GP, nurse, pharmacist, or travel clinic before travelling
- This is best done at least 4-6 weeks before your trip, but you can get last minute advice if needed
- Malaria tablets may be prescribed to reduce the risk of malaria and instructions on how to avoid mosquito bites
When arriving at the area where malaria is found follow these precautions:
- Take prescribed antimalarial drugs. It should usually start a few days or weeks before departure and continue for several weeks after returning home
- Use insect repellent on your skin, make sure it's 50% DEET-based (the concentration of DEET in a product indicates how long the product will be effective — higher concentrations will last longer)
- Sleep under an insecticide-treated mosquito net
- Wear long sleeves and pants that cover your arms and legs in the evening when mosquitoes are most active
Who is at risk of malaria?
Anyone can get malaria. However, malaria is not transmitted from person to person like the common cold or the flu nor is it sexually transmitted. You cannot get malaria through casual contact with someone who has malaria. It is especially important to seek advice before travelling if you are at high risk of developing serious malaria.
This includes:
- If you are pregnant
- Young children
- Adults over 65 years old
- Weaken immune system
- If you have no spleen
This infection is very common in certain parts of the world.
Found in tropical regions including:
- Vast regions of Africa and Asia
- Central and South America
- Dominican Republic and Haiti
- Parts of the middle east
- Some pacific islands
How common is malaria?
As identified by the World Health Organisation (WHO), in 2021, there were an estimated 247 million cases of malaria worldwide. The estimated death toll from malaria in 2021 was 619,000. By 2021, the region will account for 95% of malaria cases and 96% of malaria deaths. Children under the age of five accounts for about 80% of malaria deaths in the region.
When should I see a doctor?
If you develop a fever during or after travelling to areas with a high malaria risk, consult your doctor. If symptoms are severe, seek emergency medical care.
Summary
With proper treatment, people with malaria can usually expect a full recovery. In addition, The World Health Organisation have built a strategy and goals towards eliminating malaria where the main targets are set as:
- Reduce malaria cases by at least 90% by 2030
- Reduce malaria mortality by at least 90% by 2030
- To end malaria in at least 35 countries by 2030
- Prevent malaria recurrence in all malaria-free countries
Therefore, there have been promising steps in order to eliminate malaria and thus make the world safer for people.
References
- NHS. (2022, February 18). Malaria. NHS choices. Retrieved February 21, 2023, from https://www.nhs.uk/conditions/malaria/
- World Health Organization. (2022, December 8). Fact sheet about malaria. World Health Organization. Retrieved February 21, 2023, from https://www.who.int/news-room/fact-sheets/detail/malaria
- Centers for Disease Control and Prevention. (2022, March 22). CDC - malaria - about malaria - disease. Centers for Disease Control and Prevention. Retrieved February 20, 2023, from https://www.cdc.gov/malaria/about/disease.html
- Mayo Foundation for Medical Education and Research. (2023, February 9). Malaria. Mayo Clinic. Retrieved February 22, 2023, from https://www.mayoclinic.org/diseases-conditions/malaria/symptoms-causes/syc-20351184
- Walk, J., de Bree, L. C., Graumans, W., Stoter, R., van Gemert, G.-J., van de Vegte-Bolmer, M., Teelen, K., Hermsen, C. C., Arts, R. J., Behet, M. C., Keramati, F., Moorlag, S. J., Yang, A. S., van Crevel, R., Aaby, P., de Mast, Q., van der Ven, A. J., Stabell Benn, C., Netea, M. G., & Sauerwein, R. W. (2019). Outcomes of controlled human malaria infection after BCG vaccination. Nature Communications, 10(1). https://doi.org/10.1038/s41467-019-08659-3
- Duffy, P. E., & Patrick Gorres, J. (2020). Malaria vaccines since 2000: Progress, priorities, products. Npj Vaccines, 5(1). https://doi.org/10.1038/s41541-020-0196-3
- Ashley, E. A., Pyae Phyo, A., & Woodrow, C. J. (2018). Malaria. The Lancet, 391(10130), 1608–1621. https://doi.org/10.1016/s0140-6736(18)30324-6