Malaria Symptoms, Causes, Prevention, and Treatment

Malaria Overview

Malaria is a mosquito-borne disease. When an infected mosquito Anopheles bite human, it injects the Plasmodium parasite into the bloodstream.

Once the parasite enters the human body, within a span of 2 days it starts multiplying inside the red blood cells (RBC’s), causing the parasite to break out in the human body.

Once the parasite enters the human body, it went through several stages of development, like multiplying the parasite load and spreading into the bloodstream which causes a wide range of symptoms.

Malaria is the one of the most common disease of humans, and almost all countries are affected by Malaria so far, The death toll due to malaria each year rises up to 3 million every year.

Although, governments of developed countries claim that malaria has been eliminated from nation such as the United States, Canada, Russia, and Europe but despite the government’s enormous efforts, malaria has been seen raising up in these countries & other developing countries like Africa, India, etc.

Every year, World Health Organization and national health bodies launch new measures to control malaria but malaria has been around the world for decades and still affects humans and is one of the major causes of human death.

What causes malaria in humans?

Malaria in humans is caused by a single-cell parasite of the genus Plasmodium. This single-cell parasite is transmitted to the human body by mosquito bites.

How do mosquitoes transmit parasites to the human body?

There are 5 stages that are responsible for the mosquito transmission cycle.

Initial Stage: – When any uninfected mosquito becomes infected after biting any person who is already suffering from malaria.
Transfer of parasite: – When a mosquito becomes infected in the previous stage, it carries the parasite. Now when this mosquito bites a human, it transfers the parasite to another human body which results in developing malaria in the human body.
Inside the liver: – Once the parasites enter the human body. It travels to the liver and multiplies itself to increase the parasite load.
Into the bloodstream: – Once the parasite matures in the liver it bursts out into the bloodstream and damages the red blood cells. At this stage, symptoms of malaria are visible
Transfer of parasite to another Person: – Now if any uninfected mosquito bites the infected person it carries the same parasite stream inside it and that parasite stream can be transmitted to other people upon biting.

More overview of the Malaria Life cycle and stages of Malaria is discussed below –

How do humans get infected by malaria?

Humans get infected by Malaria due to mosquito bites. The parasite is loaded into the blood streams which starts multiplying itself after a span of 24 hours and bursts into red blood cells (RBC’s)

Malaria Life Cycle and Stages of Malaria

As we know, malaria is a mosquito-borne infectious disease. There are several stages of malaria where the disease progress:

Transmission: – Human infection begins when a female anopheline mosquito inoculates plasmodial sporozoites from its salivary gland during a blood meal. During the bite, the female mosquito injects sporozoites, which cause infection into the bloodstream.

Liver Stage (Hepatic Stage): – Once parasites enter the human body, it grows and multiply themselves first in liver cells. Once the liver is infected, it grows and starts multiplying in the red blood cells. In blood parasite load increases and destroys the red blood cells, which release daughter parasites known as “merozoites” and they play a major role in invading the other red cells.

Blood Stage (Erythrocytic Stage): – The “merozoites” which are born in the previous stage are released from the liver cells after damaging them and enters the bloodstream. Once merozoites enter the bloodstream they infect the red blood cells (Erythrocytes). They start growing up and start multiply and transform into trophozoites. Trophozoites feed themselves with hemoglobin which causes reduced hemoglobin in the human body. Hemoglobin is an oxygen transport protein found in red cells.Once the red blood cells are infected, symptoms of malaria start showing up like high fever, chills, and anemia.

Gametocyte Stage: – In the bloodstream, certain blood stage parasites develop into sexual forms called gametocytes, which are taken up by female Anopheles mosquito during blood feeding, this gametocyte matures inside and goes under sexual reproduction, resulting in supplying parasite to the female mosquito, which can be transferred to another human being when mosquito bites again.

Hypnozoite Stage: – Sometimes, after the person is recovered from malaria still some species of Plasmodium called hypnozoite can persist in liver. They can become active again after months or years and can cause malaria again even without mosquito bites.

Malaria Symptoms

The symptom of malaria depends upon the severity of the infection. The most common symptoms of malaria are: –

High Fever – Individuals affected by malaria experience high fever which is cyclic, fever may come and go. A person can also experience chills and sweat along with a fever
Fatigue – Fatigue is the most common symptom of malaria. A person may experience weakness, and tiredness even after taking plenty of rest.
Severe Headache – Malaria can cause serious headache episodes, which can be very high and may be episodic troubling continuous for weeks.
Muscle and Joint pain – A person may experience pain in the whole body, especially in muscles and joints. Due to weakness, even a slight movement becomes a heavy task for the body.
Nausea and vomiting – Nausea and vomiting are the common symptoms of malaria in children.
Anemia
Enlarged Spleen – Due to an increase in infection in red blood cells, the spleen becomes enlarged which results in pain and discomfort in the left upper abdomen.
Jaundice – The skin and eyes of an infected person from malaria turn in to yellow. This is one of the early signs of malaria.
Sweating
Chills
Chest pain
Cough

Malaria Diagnosis

Malaria can be easily diagnosed by your healthcare experts. The Doctor will check your symptoms, and travel history (if you have travelled to any tropical region which is affected by Malaria). However please note clinical evaluation is not enough to diagnose malaria because malaria symptoms are similar to another viral disease, so laboratory test confirmation is required to rule out the possibility.

Below are the methods to diagnose malaria: –

Clinical Evaluation: – Your medical expert will examine the early signs of malaria-like Jaundice, fever, nausea, vomiting, etc. A doctor will also do some blood tests & laboratory tests to determine if you have an enlarged spleen or liver.
Blood Smear Microscopy: – This is the best method to diagnose malaria. An infected person’s blood sample is collected, and a thick blood smear is prepared from it. This thick blood smear is stained with special dyes and examined under a high-resolution digital microscope. This method is able to detect the presence of malaria parasites and the severity of malaria infection.
Rapid Diagnostic Tests (RDTs): – These tests are carried out at small facilities. They are simple and quick, RDTs uses small blood samples and are able to detect specific malaria antigen in blood. The results are out in 15 – 20 minutes, however, RDTs have some limitations in specificity and other tests are required for confirmation in a few cases.
Molecular Methods: – PCR( Polymerase chain reaction) is a very highly sensitive and specific method to detect and identify malaria parasites in the bloodstream. PCR methods are used in laboratories or research centers to produce accurate results.

What are the life-threatening complications of malaria?

If malaria is untreated or not managed properly, it can be life-threatening. Some of the potential risks and complications of malaria are: –

Cerebral Malaria: – If not treated on time, malaria can turn into cerebral malaria. Cerebral malaria is the most severe form of malaria. It affects the brain and neurological function. Common symptoms are confusion, short-term memory loss, altered mental status, seizures and coma. Cerebral malaria can damage the neurological functions permanently and can lead to death.
Severe Anemia:- Malaria infects the red blood cells and mass destruction of RBC can lead to anemia ( decrease in red blood cells), red blood cells are responsible for carrying oxygen to the whole body. Once the red blood cell count decrease, a person starts experiencing fatigue, weakness, shortness of breath and other health complication in children & pregnant women like nausea, vomiting, pain, headache, etc.
Organ Failure: – Malaria can infect several organs like the liver, kidneys, and spleen. These organs are either dysfunctional or a failure. Organ failure leads to serious complications like jaundice, kidney failure, rupture of the spleen, and liver damage.
Metabolic Complications: – Malaria disturbs the metabolic function of the human body. It may lead to low blood sugar (hypoglycemia), building up acid in the blood (metabolic acidosis), and other metabolic processes. If not managed properly they can add complications and can be life-threatening.
Pregnancy complications: – Pregnant women who are affected by malaria pose a high risk of maternal and fetal complications if not properly managed. They can develop severe anemia, and cerebral malaria which can result in miscarriage, stillbirth, preterm birth, and low birth weight.

Malaria Treatment

As we know, treating malaria on time is very essential because it can be life-threatening. As parasites enters the human body and after multiplying in liver and bloodstream it starts damaging red blood cells and internal organs.

Treatment of malaria should be done under qualified health care experts. The choice of malaria treatment depends upon several factors like age group, the severity of disease, species of malaria parasite that has caused the infection, weight, and other complications. The primary goal of medical experts is to clear the parasite from the bloodstream and eliminate the symptoms from which individuals are suffering: –

Below are the common medicines used to treat malaria: –

Artemisinin-based Combination Therapy(ACT): – The most effective treatment for uncomplicated malaria caused by Plasmodium falciparum, the deadliest variety of malaria parasite, is artemisinin-based combination therapy (ACT). ACT commonly combines an artemisinin derivative that quickly lowers the blood parasite count with a longer-acting antimalarial medication that eliminates the remaining parasites.

Chloroquine : – Chloroquine is an antimalarial medication that was formerly frequently used to treat malaria brought on by Plasmodium vivax and Plasmodium ovale. Chloroquine is no longer effective in many areas due to rising drug resistance, and other medications have taken its position as the first-line therapy.

Quinine: – Quinine is an antimalarial treatment that has been used for a long time and is still used in some situations, such as when severe malaria is present or when other medications are unavailable or ineffective. Quinine should only be used when strictly supervised by a doctor because it is frequently combined with other medications and has the potential to cause negative effects.

Primaquine: – Primaquine is an antimalarial medicine used for treating P. vivax and P. ovale malaria as well as for preventing relapses brought on by these species. Primaquine is used in conjunction with other antimalarial medications, and before delivery, it must be carefully checked for a deficiency in the enzyme glucose-6-phosphate dehydrogenase (G6PD), as this condition might result in severe side effects.

Doxycycline(Doxy-100, Monodox, Oracea)

Mefloquine

Atovaquone-proguanil

It is very important to follow the prescribed medicine course by the health experts and complete the full course, In many case, person stops taking medications once the symptoms are improved but be noted if the parasite is not completely cleaned out of the body it can again cause malaria.

Side effects of medications for treating Malaria

There are several side effects of medications used to treat malaria. It is important to tell your healthcare expert if you are already using any other medicines for other disease. Antimalarial drugs can cause issues when combined with other drugs. The side effects varies in the individual depending upon their age, type of medication, dosage, duration of treatment, etc.

Nausea and Vomiting: – Vomiting and nausea are two gastrointestinal adverse effects that can be brought on by several antimalarial medications. Majority of the time, taking the drug with food or modifying the dosage can help control these adverse effects, which are typically moderate.
Diarrhea:- Certain antimalarial drugs may cause diarrhea as a side effect, particularly if taken on an empty stomach. This side effect may be lessened by drinking plenty of water and changing the medication’s kind or dosage. Eating foods which are rich in fluids will be beneficial for the patients.
Headache:- Antimalarial drugs may cause severe headaches as a side effect. The management of minor headaches may benefit from over-the-counter painkillers.
Dizziness: – Medications used to treat malaria might make you feel lightheaded or dizzy. While rising up or performing other activities that call for attention, it’s crucial to use caution, especially if you’re feeling dizzy.
Sleep disturbances or Sleep disorder: – Few antimalarial drugs can cause Vivid dreams, nightmares, or insomnia, such as mefloquine. If you experience the same, let your health care expert know about these symptoms to treat them.
Skin rash: – Few antimalarial medications may cause skin rash or itching as a side effect. If a rash appears, it is crucial to let your doctor know right away because it can be an indication of an allergic reaction or a more severe side effect.
Eye problems: – In a few rare instances, antimalarial medications like chloroquine and hydroxychloroquine, which can induce visual abnormalities or retinal damage, may cause eye issues. During the course of treatment with these drugs, routine eye checkup is recommended.

How to prevent malaria?

If you are living in an area or plan to travel in an area where Malaria is a common disease, talk to your healthcare provider. They will suggest you to medications to prevent malaria.
You may need to take your drugs before, during, and after the travel. However please note, these medications can help you to prevent malaria but if you are infected with malaria these medications will be of no use and you need to undergo proper treatment for malaria.

The most important step is to lower the chances or eliminate the risk of mosquito bites. To get reed of mosquitoes follow the below steps: –

Use insecticide-treated beds nets: – Sleeping inside the insecticide-treated bed nets makes a physical barrier between the mosquitos and human skin. Malaria mosquitos are very active at night and insecticide-treated beds can be very effective to stop mosquitos from reaching out to you.
Applying mosquito repellents over the exposed skin. Repellents have DEET, picaridin, or any other ingredients which are effective in repelling mosquitos should be apply over the skin.
Always wear protective clothes if you are living or traveling to areas where malaria is a common disease. Try to wear light colored cloths as mosquitos are more attracted towards the dark color cloths.
Take antimalarial drugs in advance after consulting your medical experts if you are traveling to the areas affected by malaria.
Keep your surroundings clean, eliminate mosquito breeding sites where water is logged, empty the flower pots, change water at regular interval of time, close the water tanks properly, clean your water tanks regularly.
If you are affected by malaria, seek early diagnosis and treatment with expert healthcare doctors.

It is important to note that Treating malaria differs in individuals based on their age, severity of disease, type of infection, other complications etc. However early diagnosis leads to effective treatment against malaria.

Frequently Asked Questions

Q1. What are the stages of malaria?

Stages of malaria involves two phases: –

a. Human Host phase – In this stage infected mosquito bites the healthy person and injects the Plasmodium parasite into bloodstream. The parasite travels to the liver and start multiplying itself causing damage to the liver. Thousands of new parasites are produced known as merozoites.

These merozoites enter the bloodstream and start damaging the red blood cells, causing severe effects on the human body. Person start showing symptoms like high fever, headache, chills, vomiting, nausea, etc.

b. Mosquito Vector phase – When an infected mosquito bites a person with malaria, it ingests the Plasmodium parasites along with the person’s blood.

Inside the mosquito guts, parasites involve in sexual reproduction and release thousand of parasites that can be transferred to a healthy body during mosquito bites.

Q2. What are the common symptoms of malaria?

Most common symptoms of malaria are: –

Fever
Headache
Fatigue
Muscle and joint pain
Nausea and vomiting
Sweating
Cough, sore throat and running nose
Splenomegaly

Q3. How to prevent malaria?

Malaria can be prevented if you eliminate the risk of mosquito bites. If you need to travel to an area which is affected by malaria take certain drugs after consulting your Doctor to prevent the malaria.

Q4. What are the types of malaria?

There are 5 different types of malaria depending upon the species of Plasmodium parasites, Most common types of malaria by which humans get diagnosed are: –

Plasmodium falciparum
Plasmodium vivax
Plasmodium malaria
Plasmodium ovale
Plasmodium knowlesi

Q5. What blood tests detect malaria?

Below are the blood tests which can detect malaria: –

Microscopic examination of blood smears
Rapid diagnostic tests (RDTs)
Polymerase chain reaction (PCR)
Quantitative buffy coat (QBC) test

Q6. Which injection is best for treating malaria?

Commonly used Injections for treating malaria are: –
Artesunate – Artesunate is a highly efficient antimalarial medication that is advised as the initial course of treatment for severe malaria brought on by Plasmodium falciparum, the most dangerous type of the disease.

Quinine – Quinine is still in use as an antimalarial drug in some areas where other antimalarial drugs are not available or can’t be used due to resistance or contraindications.

Artemether – Artemether is given with a combination of other antimalarial drugs for treating severe malaria caused by Plasmodium falciparum

Q7. How long malaria lasts in the human body?

The duration of malaria in the human body depends upon the type of malaria, the severity of the disease, diagnosis & treatment. If malaria is not treated it can last up to several weeks and can cause death.

Q8. Why does RBC decrease in malaria?

Hemolysis, or the breakdown of red blood cells (RBCs), is a frequent occurrence in malaria. When the virus or parasite infects into the bloodstream and starts multiplying in the red blood cells, they infect the red blood cells and release new parasites. This repeated cycle leads to the damage of a large number of red cells.

Q9. How to increase red blood cells(rbc) in malaria?

In malaria, the destruction of red blood cells is very high. It is very important to treat malaria and start to increase the number of red blood cells(RBC).
The most effective ways to increase the red blood cells during and after malaria are: –

Diagnose & Treatment of malaria at an early stage, which in turn does the fewer damage to red blood cells during malaria.
Blood transfusions – In severe conditions, it is necessary to replace the lost red blood cells to stabilize the patient’s condition.
Nutritional Support – Eat foods that are high in nutrition and vitamins, such as red meat, eggs, fish, beans, lentils, green leafy vegetables etc. High-nutrition foods helps to increase the development of reb blood cells.
Iron Supplementation – Eat foods which are rich in iron. Also take iron supplements under the supervision of your health care expert

Rest & recovery – take proper sleep and rest to get fast recovery.