Malaria

Overview of malaria

The rise and spread of communicable diseases have posed a major threat to life and health. In the recent decade, the scenario has been very grave in the low and middle-income countries that lack the minimum conditions for maintaining a healthy and hygienic lifestyle. In many of these countries, the temperature and weather conditions are ideal for microbial growth and propagation, which makes the inhabitants more vulnerable. Malaria is one such disease that has led to unnumbered epidemic outbreaks in the past.

The statistics of the UNICEF show that nearly 1 million people worldwide die from the disease every year. Nearly 90% of these incidences occur in Sub-Saharan Africa and affect mainly children below the age of 5. The World Health Organisation reports that nearly 200 million people suffer from malaria annually. The global health organizations have collaborated to spread awareness related to Malaria and other mosquito-borne diseases.

What is Malaria?

Malaria is a common mosquito-borne disease mediated by a class of parasitic protozoans that belong to the Plasmodium family.

The disease affects humans and other animals. But the manifestations occur mainly in the human hosts.The disease spreads mainly through the bites of the Anopheles mosquito.

It is mainly characterized by high fever, vomiting, fatigue, and headache.In many cases, the parasite remains in a dormant state within the host’s body and may cause recurrent malaria at some point in time. In extreme cases or after a few recurrent malaria instances, the patient may eventually die from the disease.

What causes Malaria?

In the human hosts, Malaria is mainly caused by the parasites belonging to the Plasmodium family. The common species are-

• Plasmodium falciparum
• Plasmodium malariae
• Plasmodium ovale
• Plasmodium vivax
• Plasmodium knowlesi

Most of the cases are caused by the Plasmodium falciparum and Plasmodium vivax, which lead to most of the fatalities as well.

The female Anopheles mosquito is usually the carrier of the parasite.

When an infected Anopheles mosquito bites a human host, it transmits the sporozoite (a motile form of the parasite) into the human body.

The sporozoite migrates via the blood vessels to the hepatocytes (liver cells) where it multiplies and produces innumerable merozoites. The infected red blood cells henceforth undergo a number of multiplication cycles, producing new infective merozoites. Eventually, these cells burst and the infective cycle occurs from the beginning.

The remaining merozoites transform into immature gametocytes. As a fertilized mosquito bites an infected human, the gametocytes are transferred into the mosquito’s body through the blood and they progressively mature inside the mosquito’s gut. A fertilized motile zygote results, which is called ookinete. These zygotes thereby develop into new sporozoites that finally migrate to the mosquito’s salivary glands and are ready to infect a new human host. When a mosquito bites a healthy human host, the sporozoites are injected into the skin.

Phases of Malaria

The Malaria infection develops through two distinct phases namely- the erythrocytic phase (occurs in the red blood cells) and the exoerythrocytic phase (occurs in the liver cells). During a blood meal, the sporozoites transmit from the mosquito’s saliva into the bloodstream of the person, where they multiply for 8-30 days.

Symptoms of Malaria

The symptoms of Malaria usually manifest themselves around 8-25 days after the primary infection. The disease begins with flu-like symptoms and gradually leads to gastrointestinal symptoms and other complications. The commonly observed symptoms are listed below-

Itching of hands due to a mosquito bite

• A headache, fever and shivering (occur in a cyclic order)
• Bouts of vomiting
• Episodes of acute joint pain
• Hemolytic anemia
• Presence of hemoglobin in urine
• Jaundice
• Fits and convulsions
• Damage to retina
• Loss of consciousness
• Feebleness
• Inability to carry out normal joint movements
• Loss of appetite
• Extremely low blood pressure (less than 70 mm Hg in adults and 50 mm Hg in children)
• Respiratory problems
• Problems in blood circulation (the patient may need blood supply in extreme cases)
• Impaired kidney functions
• Bleeding problems
• Pulmonary edema
• Drop in blood glucose level (less than 40mg/dL)
• Acidosis (lactate concentration higher than 5 mmol/L)

Types of Malaria

According to the part of the body affected, the causative pathogen and the resulting complications, Malaria can be classified into the following categories-

• Algid malaria: It is caused by the Plasmodium falciparum and affects mainly the gut and other abdominal viscera. It is of two types- gastric algid malaria and dysenteric algid malaria. Gastric malaria leads to persistent vomiting and dysenteric malaria leads to bloody diarrhea. A large number of infected red blood cells are found in the stool in this case. The patients may also experience persistent chills, circulatory shocks and cardiovascular ailments.
• Bilious malaria: Triggered by Plasmodium falciparum, this type mainly affects the liver and leads to jaundice-like symptoms and vomiting.
• Cerebral malaria: This is also mediated by Plasmodium falciparum and affects the cerebrum. The patients may experience hypoglycemia, seizure and even coma.
• Congenital malaria: As the name implies, it is present in the child at the time of birth. It is usually transmitted to the neonate through maternal-fetal circulation.
• Quartan malaria: This is triggered by Plasmodium malariae. It is marked by paroxysms (spasms) every fourth day. 

Diagnosis

Proper diagnosis is essential to accurately detect malaria and enable effective treatment. The following diagnostic tests are usually carried out-

• Antigen-based rapid diagnostic tests
• Platelet count
• Bilirubin level check
• Checking of spleen size

The common drugs recommended for Malaria are- Quinine, Chloroquine, Mefloquine, Doxycycline or a combination of Malarone and Atovaquone. Before administering the drugs, the symptoms of Malaria should be crosschecked with that of other diseases in order to avoid misdiagnosis and wrong treatments.

Treatment & Prevention

The main aim of effective malaria treatment is to remove the pathogen, Plasmodium parasite from the body of the patient.

In case of uncomplicated malaria (mild symptoms and no impact on organ functioning), ACT or Artemisinin-based combination therapy is used.

It is usually administered along with an additional drug; the combined effect of both helps in eliminating pathogens from the body.

There are no formal vaccinations for malaria till date.

The best and most effective way to prevent malaria is to avoid mosquito bites at all costs.  Sleeping under mosquito nets and regular use of insecticides will help in the prevention of malaria. When visiting regions prone to malaria, one should wear clothing that covers the entire body without exposing much skin area and take anti-malarial drugs. One can also spray insecticides on clothes. Additionally, use insect repellent lotions every time you step outside. Don’t allow water to stagnate.

Malaria is an extremely life-threatening disease and leads to innumerable fatalities if not detected in the earliest stages. The health units in the tropical and subtropical countries are warning people about the sites in and around the residences that promote the breeding of mosquitoes. Mosquito control sprays are being used to curb the growth of the disease. Self-awareness and preventive measures like the use of mosquito nets and repellents is the first and foremost step towards preventing and controlling the disease.

Malaria home remedies

The following home remedies can be safely employed in addition to the usual medicines prescribed by the doctor for treating malarial symptoms:

• Add crushed cinnamon and pepper to warm water along with honey and drink this mixture 2-3 times a day. This herbal remedy has anti-microbial, anti-inflammatory, and antioxidant properties that will help in reducing the symptoms of malaria.
• Drinking turmeric milk will help in flushing out toxins from your body.
• Orange juice is high in vitamin C. Drinking 2-3 glasses of orange juice every day will help in building a strong immune system against the malaria parasite.
• To get quick relief from the fever and body ache, drink a concoction of ginger and warm water. This will also help fight the infection.
• Soak fenugreek seeds overnight in water and drink this mixture the next day. It will restore your body’s strength and boost energy levels.

TL;DR?

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