Malaria

Malaria
Malaria
• Malaria is a serious, life-threatening, and sometimes

fatal, disease spread by female Anopheles mosquitoes
and caused by a Plasmodium parasites.
• The parasites are spread to people through the bites of
infected female Anopheles mosquitoes, called
"malaria vectors."
Malaria
• Malaria is caused by a parasite called Plasmodium. There are 5
species of Plasmodium which infect humans:
• Plasmodium vivax
• Plasmodium falciparum
• Plasmodium malariae
• Plasmodium ovale
• Plasmodium knowlesi which is less common.
Plasmodium falciparum infection is the most severe and can cause

death in up to 10% of cases.
It can be rapidly fatal. Pregnant women and children are
especially at risk.
Symptoms
Malaria symptoms divided into two categories: -
Uncomplicated and severe malaria.
Uncomplicated malaria
•This form can become severe malaria without treatment, or if the
host has poor or no immunity.
•Symptoms typically last 6 to 10 hours and recur every second day.
•symptoms progress as follows, through cold, hot, and sweating
stages:
•a sensation of cold with shivering
•fever, headaches, and vomiting
•seizures sometimes occur in younger people with the disease
•sweats, followed by a return to normal temperature, with tiredness
Symptoms
Severe malaria
•clinical or laboratory evidence shows signs of vital organ
dysfunction.
•Symptoms of severe malaria include:
•fever and chills
•impaired consciousness
•prostration, or adopting a prone position
•multiple convulsions
•deep breathing and respiratory distress
•abnormal bleeding and signs of anemia
•clinical jaundice and evidence of vital organ dysfunction
Malaria Transmission
• Only Anopheles mosquitoes can transmit malaria and they must have
been infected through a previous blood meal taken from an infected
person.
• When a mosquito bites an infected person, a small amount of blood is
taken in which contains microscopic malaria parasites.
• These parasites mix with the mosquito’s saliva and are injected into
the person being bitten.
• In humans, the parasites grow and multiply first in the liver cells and
then in the red cells of the blood.
• In the blood, successive broods of parasites grow inside the red cells
and destroy them, releasing daughter parasites (“merozoites”) that
continue the cycle by invading other red cells.
•
Malaria Transmission
• Because the malaria parasite is found in red blood
cells of an infected person, malaria can also be
transmitted through blood transfusion, organ
transplant, or the shared use of needles or syringes
contaminated with blood.
• Malaria may also be transmitted from a mother to her
unborn infant before or during delivery (“congenital”
malaria).
Risk
• Travelers going to malaria endemic areas in Africa,

South America, and Asia are at high risk.
• Persons originally exposed to malaria in endemic
areas who go back to their home country to visit
friends and relatives are also at risk due to waning
immunity.
• Although partial immunity is developed during years
of exposure to parasites, no one becomes fully
immune to malaria.
Malaria endemic countries in Asia
Diagnosis
• Diagnosis is made by a blood test – sometimes it is necessary
to repeat the test a number of times, as the parasites can be
difficult to detect.
• Incubation period (time between becoming infected and
developing symptoms)
• Varies with the type:
• P. falciparum: 9 to 14 days
• P . vivax: 12 to18 days but some strains may have an
incubation period of 8 to 10 months or longer
• P. ovale: 12 to 18 days
• P. malariae: 18 to 40 days
• P. knowlesi 9 to 12 days.
• These periods are approximate and may be longer if the person
has been taking drugs taken to prevent infection.
Diagnosis
• Infectious period (time during which an infected person can
infect others)
• Direct person-to-person spread does not occur.
• A person remains infectious to mosquitoes as long as the
parasites are present in the blood.
• This may be several years if adequate treatment is not given.
Parasites disappear from the blood within a few days of
commencing appropriate treatment.
• Mosquitoes remain infected for life.
Management &Treatment
• The aims of malaria treatment are to alleviate
symptoms and to prevent relapses and spread of
disease.
• All patients diagnosed of malaria or suspected
malaria should be admitted.
• Anti malarial medication
• IV Therapy if patient unable to take and retain oral
fluids.
• The treatment should follow treatment guideline
given by WHO.
Malaria precautions
• Malaria risk is present throughout the year in Sabah and Sarawak.
• In these areas the risk is not high enough to warrant antimalarial
tablets for most travellers, however, it may be considered for
certain groups who may be at higher risk (see below under Low
risk with additional advice).
• There is low to no risk in all other areas including Kuala Lumpur,
other urban/suburban areas and coastal areas.
• Malaria precautions are essential. Avoid mosquito bites by
covering up with clothing such as long sleeves and long trousers
especially after sunset, using insect repellents on exposed skin
and, when necessary, sleeping under a mosquito net.
• Check with your doctor or nurse about suitable antimalarial
tablets.
Malaria precautions
• Low risk with additional advice: antimalarial tablets are not
usually advised, however, they can be considered for certain
travellers who may be at higher risk e.g. longer stay in rural
areas, visiting friends or relatives, those with medical
conditions, immunosuppression or those without a spleen.
Atovaquone/proguanil OR doxycycline OR mefloquine is
advised for those at risk.
• Low to no risk: antimalarial tablets are not usually advised .
• If you have been travelling in a malarious area and develop a
fever seek medical attention promptly.
• Remember malaria can develop even up to one year after
exposure.
• If travelling to an area remote from medical facilities, carrying
standby emergency treatment for malaria may be considered.
Thank you

Malaria

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Malaria

• Malaria is a serious, life-threatening, and sometimes

Plasmodium falciparum infection is the most severe and can cause

• Travelers going to malaria endemic areas in Africa,

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