Malaria - Symptoms, Treatment, Types & causes

Malaria is a protozoan disease transmitted by female Anopheles mosquitoes which is a definitive host of the protozoan. Humans act as an Intermediate host and the malaria parasite can enter human body in the the form of sporozoites (Infective form to humans) from the saliva of mosquito after bite. However the infective form to the mosquito is called as Gametocyte. There has been heavy investment done by the countries to increase the resources to diagnose, treat and prevent the disease. 25^th of April is called as World Malaria Day whereas June is called as Malaria month in India.

Malaria Causes

• Most of the tropical areas around the world are infected by malaria. P.falciparum predominantly involves the Africa, New Guinea , dominican Republic and Haiti whereas Asian and South american regions are infected by P.vivax.  
• As mentioned earlier, the humans get infected by malaria upon bitten by female anopheles mosquito. The mosquito resides on the standing water in unhygienic places and these kind of places can also act as breeding grounds for the mosquito.

Also Read: Valley Fever: Causes, Symptoms, Risk Factors, Diagnosis, Treatment, Prevention and Complications

Malaria Symptoms

The initial symptoms of malaria are non-specific which includes headache, muscle aches, fatigue followed by fever. The temperature of non immune individuals and children can spike above 40 deg C.

Generally Patients infected with P.Vivax, P.Falciparum and P.Ovale get fever every 3 days( Tertian) whereas P.Malariae can cause fever every 4^th day( Quartan).

• Benign malaria - It can present as Febrile paroxysms in which there is Cold phase( Chills and Shivering) and Hot Phase(Fever). Whenever schizonts in RBC burst there will be fever.
• Malignant malaria - It is also called as Cerebral Malaria( caused by P.Falciparum). Patient will present as fever, headache, nausea and Hepatosplenomegaly. It can get more aggressive and can lead to confusion, paralysis and coma.
• Chronic malaria can present as Tropical splenomegaly.
• RBC breakdown/Intravascular hemolysis can lead to Hemoglobinuria which is called as Black water malaria.

LIFE CYCLE OF MALARIA PARASITE

Also Read: Bedbugs: Causes, Symptoms, Risk Factors, Diagnosis, Treatment and Prevention

Malaria Risk Factors

• Biggest risk factor for developing malaria is to reside in the mosquito prevalent area.
• Traveling to the area where disease is very common (Asian subcontinent and African countries).
• Poor socioeconomic conditions
• Natural disasters like flood and heavy rain fall areas.
• Blood Transfusion, needle stick injury and organ transplantation.

Also Read: Trichomycosis: Causes, Symptoms, Risk Factors, Diagnosis, Treatment and Prevention

Malaria Complications

• Cerebral malaria
• Hypoglycemia
• Acidosis
• Non Cardiogenic Pulmonary Edema
• Renal Impairment
• Hematologic abnormalities
• Liver dysfunction
• Malaria in early pregnancy can cause Fetal loss.
• Majority of deaths caused by Falciparum malaria include the young african children population.
• Burkitt lymphoma and EBV Infection.

Also Read: Legionnaires: Causes, Symptoms, Transmission, Risk Factors, Diagnosis, Treatment, Prevention and Complications

Malaria Diagnosis

• Light microscopy is considered as Gold standard test for Malaria. Stains used are Romanowsky stain and JSB( Jaswant Singh & Bhattacharya staining). JSB is preferred as per National malaria program. Different species presents uniquely on microscopic examination -
  • P.vivax- Schuffner’s dots
  • P.falciparum- Maurer’s cleft
  • P.malarie- Ziemann’s dots
  • P.ovale- James dots

• Fluorescent microscopy
• Microhematocrit method( Quantitative buffy coat)
• Rapid Diagnostic test
• PCR ( Most Sensitive Test)

Also Read: Escherichia Coli: Causes, Symptoms, Risk Factors, Diagnosis, Treatment, Prevention and Complications

Malaria Prevention

• Insecticides can be used to kill mosquito vectors effectively. However these can be used judiciously to avoid insecticide resistance.
• Measures should be taken to avoid exposure to mosquitoes at their peak feeding times like usage of insect repellents, suitable clothings covering most of the body parts and Insecticide treated bed nets.
• Do not allow water to settle during rainy season.
• Travelers to malaria endemic region should take antimalarial drugs(mefloquine) 2days to 2 weeks before departure. Keep on taking drug during the stay and also 2-3 weeks after arrival back to home.
• Pregnant women should be informed about complications of malaria.

Also Read: Clostridium Difficile: Causes, Symptoms, Risk Factors, Diagnosis, Treatment, Prevention and Complications

Malaria Treatment

Treatment of malaria and prescription of antimalarial drugs requires knowledge of local patterns of drug sensitivity and resistance. Patient should be screened for G6PD deficiency before prescribing them anti-malarial treatment.

• Chloroquine phosphate ( Can be given to patients located in Chloroquine sensitive regions)
• Atovaquone-Proguanil ( Given as a prophylaxis in areas with CLQ or Mefloquine resistant areas).
• Doxycycline
• Hydroxychloroquine 
• Mefloquine
• Primaquine( For prevention of malaria in areas with mainly P.vivax)

Also Read: Giardiasis: Causes, Symptoms, Risk Factors, Diagnosis, Treatment, Prevention and Complications

Malaria (Protozoa) Types

• P.Vivax- It is a benign form and can cause fever every 3 days( Tertian).
• P.Falciparum- Malignant and aggressive form (Tertian). It affects the young african adults mainly and has a high mortality rate.
• P.Malariae- It is a benign form and cause fever every 4^th day ( Quartan).
• P.Ovale- It is a benign form that cause fever every 3 days(Tertian).
• P.Knowlesi- It is a benign form that cause fever every 24 hours ( Quotidian). It is not found in India.

Also Read: Staphylococcus Aureus: Transmission, Symptoms, Risk Factors, Diagnosis and Treatment

Download the PrepLadder app now and unlock a 24-hour FREE trial of premium high-yield content. Access Video Lectures, digital notes, QBank, and Mock Tests for FREE to ace your NEET PG preparation. Elevate your study experience and gear up for success. Start your journey with PrepLadder today!