Malaria
It had been a rough week for Mary, for the last three days she had been feeling weaker than usual and it seemed like her whole body was being repeatedly hit with a stick because her muscles hurt! No matter what she did, she just couldn’t get comfortable; one second she was burning up with sweat pouring down her face and the instant she took off her sweater, she was freezing so bad the shivers made her teeth chatter. She couldn’t wait to get home and crawl beneath the sheets…
We, at least most Africans, can identify with Mary. I remember the look of wonder and awe I got from my professor and classmates when I mentioned once in class that I had gotten malaria multiple times. We are so familiar with the symptoms of malaria that pretty much anyone can make a correct diagnosis of this disease on sight. As April celebrates World Malaria day, I felt an article on this common foe would be appropriate. Even though Malaria is a common disease to most Africans, there are still some myths surrounding the disease that should be cleared up. I.e. using antibiotics to treat and thinking every symptom of fever is malaria. I hope this article enlightens us on this disease, its characteristics and what we can do about it.
What is Malaria and how is it contracted?
Malaria is a disease transmitted by any Anopheles mosquito carrying any of the strains of the Plasmodium parasites.
*Myth 1: there is only one type of malaria….
Plasmodium parasite has 4 different strains and the symptoms and severity of the malaria you get is dependent on this. The 4 strains are:
1. Plasmodium falciparum: This is the one you want to avoid at all costs! The one you “see” on one side of the street and rush to cross to the other side. (Ok, excuse the dry joke LOL). P. falciparum is the one strain of malaria that is life threatening and can actually kill its victim after a few days of infection. Another bad thing about it is that it is resistant to common medicine that cures the other strains.
2. P. vivax, P. malariae, P. ovale: These are the less life threatening and more common ones. They come, beat you up for a week or so and then leave. Without treatment, it is very possible to get over malaria of these strains and it is less likely to claim a life. The downside of these strains is that it is possible for them to hibernate (chill out) in the liver only to wait for a couple of months to years and then reappear.
*Myth 2: Since I got bitten by a mosquito, I will definitely get Malaria…
Fortunately for us, the bite of a mosquito does not automatically mean malaria. As I mentioned earlier, malaria is only transmitted by an infected anopheles mosquito (the ONLY mosquito that carries malaria) and not all mosquitoes are infected. A mosquito itself gets infected by sucking the blood of someone already carrying a plasmodium strain and after picking up the parasite, the biting of anyone else after this guarantees malaria.
Another reason that might prevent you from getting malaria even though you’ve been bitten is the gift of immunity. People who live in areas of high malaria incidence and have had malaria multiple times can develop immunity (resistance/temporary protection…get the picture?) to certain strains. For example, if a person has had P. ovale strain malaria 20 times, the next time this person is bitten by a mosquito carrying the same strain, their immunity might kick in and prevent symptoms. Please be aware that this does not mean that if they are bitten by a P. vivax strain carrying mosquito, they will also be protected.
OK, I got bitten…what’s next?
After a person is bitten, it can take as little as 9 to as much as 40 days before the symptoms occur. Once introduced into your system, the parasite travels to the liver where it rents out apartments in your liver cells in order to reproduce ( Ok, I will stop with the dry jokes…) After reproducing, the parasites cause the cells to burst open and then move on to other cells to repeat the same cycle again. Ever notice that your urine is darker when you have malaria? It’s because all the blood cells that die during this process are excreted through the urine.
*Myth 3- I live in the United States/England and contracted malaria…
The cases of Malaria in the western world are very low because the Anopheles mosquito is not indigenous to (i.e. does not live in) many of these countries. As a matter of fact the number of Malaria cases in the US is so low that doctors are required to report EVERY case to the state department of health! Most cases seen on this side of the world are due to people traveling to endemic places, getting infected but not seeing symptoms till they get back to their homes. In other cases, hibernating Plasmodium strains in the body re-infect the patient and aren’t actual new infections.
In most African countries, doctors can diagnose Malaria just based on the symptoms and general appearance of the patient but in western countries, especially where the occurrence of malaria is really low, there are certain tests done to diagnose malaria.
They include:
• Blood smears-A sample of blood is spread on a thin slide to detect the presence of the parasite.
• Liver Function tests- remember I mentioned the parasite loves to live and replicate in the liver cells, like a bad tenant they destroy the place as they leave; causing liver damage which can be detected by doing certain liver tests. After the diagnosis is made, treatment is based on the strain of plasmodium causing the malaria.
• Chloroquine- Is the most common drug used in combating malaria in most African countries and has proven very effective. If traveling to an endemic region, it is recommended to start using this drug 2 weeks before you leave and for 4 weeks after you come back. Unfortunately, there are areas that carry “Chloroquine- resistant” strains of malaria and other drugs have to be used.
• Mefloquine, Doxycycline, Quinidine- are drugs used with chloroquine resistant strains of malaria and are equally effective.
*Myth 4- I can use antibiotics to treat my malaria…
Did you notice that not even one antibiotic was listed above? Antibiotics CAN NOT work against malaria. Malaria is caused by a parasite and since antibiotics work on bacteria, they are not effective in malaria treatment. Besides the drugs listed above, symptomatic drug treatment is also prescribed i.e. drugs to reduce the accompanying symptoms of malaria such as fever and muscle pain.
How do I reduce my risks of getting malaria?
For people who live in endemic areas; there are steps that can reduce the risk of contracting malaria. They include
• The use of bed nets
• Insect repellants
• Limiting time outside between dusk and dawn (time most mosquitoes are rampant)
Malaria is a disease that unfortunately is still fatal in most African countries; with proper knowledge of both preventative and treatment side of this disease, it is possible to combat this disease in order to live a healthier life.
Stay Blessed
T
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