Malaria: Causes, Symptoms, Diagnosis, and Treatment

Malaria is a disease that can be life threatening. Malaria is transmitted by the bite of an infected Anopheles mosquito. Infected mosquitoes carry the Plasmodium parasite. When these mosquitoes bite you, parasites are released into your bloodstream.

What is Malaria?

Malaria is a serious disease caused by parasites whose symptoms are similar to flu, which is high fever and cold. When the parasite is in the body, the parasite will go to the liver where to breed.

After a few days, adult parasites enter the bloodstream and start infecting red blood cells. Within 48 to 72 hours, the parasites in the red blood cells multiply, causing the infected cells to open.

There are three important aspects in the malaria life cycle:

  • The Anopheles mosquito carries the parasite and is where the parasite starts its life cycle.
  • Parasites (Plasmodium) have many subspecies, each of which causes different severity of symptoms and responds to various treatments.
  • Parasites first move to the human heart to grow and multiply. Then it moves in the bloodstream and infects and destroys red blood cells.

In Indonesia alone, based on the Ministry of Health’s record, the number of malaria cases in 2017, 90 percent came from Papua, West Papua and NTT. This indicates that around 73.7 million Indonesians live in malaria endemic areas.

In addition, the data revealed, out of 514 districts/cities in Indonesia, 266 (52%) were malaria-free areas, 172 districts/cities (33%) were low endemic, 37 districts/cities (7%) were intermediate endemic, and 39 districts/cities (8%) are high endemic.

Causes of Malaria

Mosquitoes infected with parasites are the main cause of malaria. This parasite is transmitted to humans through mosquito bites. P. falciparum parasites cause a more severe form of the disease and a person affected by this type of malaria has a higher risk of death

How to Spread Malaria

Also, be aware, because the parasite that causes malaria affects red blood cells, someone who can get malaria when exposed to infected blood, such as:

  • From mother to unborn child.
  • Through blood transfusion.
  • Sharing needles used to inject drugs.

Malaria type

Until now there are more than 100 types of Plasmodium, but scientists have identified five types of Plasmodium that are specifically capable of infecting humans, including:

1. Malaria P. falciparum

The parasites that cause malaria are worldwide, but the majority are in Africa. An estimated 1 million people die from this parasite each year. This type of parasite can multiply rapidly into severe malaria, for example to attack the brain. However, this parasite does not cause recurrence.

2. Malaria P. vivax

These parasites are generally located in Latin America, Africa and Asia (most in Asia). This type of parasite has an active stage that can activate and attack blood after months or years.

3. Malaria P. ovale

Parasites are generally located in West Africa, which is biologically and morphologically very similar to P. vivax. This parasite is capable of attacking Duffy’s negative blood group, which is a group in the majority of sub-Saharan African populations. This explains that the prevalence of this parasite (not P. vivax) is mostly in Africa.

4. Malaria P. malariae

Located throughout the world and the only malaria parasite that is active every 3 days. If left untreated, P. malariae can cause chronic infections that can last a lifetime.

5. Malaria P. knowlesi

Located in Southeast Asia and is known to have a 24 hour cycle. Because these parasites can multiply rapidly, severe effects on the body are often reported.

After knowing the various types of malaria parasites as above, the important thing to know is when an infected mosquito bites you, there are about 7 to 30 days before symptoms appear (incubation period).

The incubation period for P. vivax is usually 10-17 days but can also be longer. Whereas P. falciparum usually has a short incubation period (10-14 days). Other Plasmodium species that cause malaria have an incubation period similar to P. vivax.

Symptoms of Malaria

Symptoms of malaria usually develop within 10 days to 4 weeks after infection. In some cases, symptoms may not develop for several months. Some malaria parasites can enter the body but will be inactive for a long time.

The following are the most common symptoms of malaria, including:

  • High fever.
  • Sweating a lot.
  • Headache.
  • Nausea.
  • Gag.
  • Stomach ache.
  • Diarrhea.
  • Anemia.
  • Muscle ache.
  • Convulsions.
  • Coma.
  • Bloody stool.

Some people who experience malaria experience a ‘attack’ cycle of malaria. The attack usually starts with chills and cold, followed by high fever and sweating, then returns to normal temperature.

Although the characteristics of malaria usually appear within a few weeks after being bitten by an infected mosquito, some types of malaria parasites can be inactive in the body for up to one year.

Things to Do When Traveling to the Endemic District of Malaria

Once you know the symptoms of malaria as above, the following are steps that can be taken as a precautionary measure if in an area there are high cases of malaria, including:

  • Consult with your doctor about what drugs are used to prevent infection in the region.
  • Get antimalarial drugs at trusted pharmacies before you travel to areas that are difficult to get drugs. This method is also useful to avoid the risk of buying fake drugs.
  • Consider traveling if you are pregnant, with an elderly person, or children.
  • Prepare special tools to prevent mosquito bites.

If possible, avoid situations that increase your being bitten by mosquitoes such as choosing a place to stay that has air conditioning and does not camp near stagnant water,

When is the Right Time to See a Doctor?

Because the parasite that causes malaria can remain in the body for up to one year, consult a doctor if you have a fever while staying or after traveling to high-risk areas of malaria. If you have severe symptoms, seek emergency medical help immediately.

Malaria diagnosis

Diagnosis of malaria that can be done by a doctor is by reviewing your medical history, doing a physical examination, and doing a blood test. Meanwhile a blood test can help the doctor to show:

  • The presence of parasites in the blood.
  • Which type of malaria parasite causes symptoms.
  • If the infection is caused by a parasite that is resistant to certain drugs.

Other blood tests help determine whether the disease causes serious complications. Here are some of the symptoms of malaria that cause complications, including:

  • Swelling of the brain blood vessels.
  • Accumulation of fluid in the lungs that causes respiratory problems.
  • kidney, liver, or spleen organ failure.
  • Causes anemia due to damage to red blood cells.
  • Low blood sugar.

Treatment of Malaria

Malaria can be a life-threatening condition, especially if you are infected with the P. falciparum parasite. Treatment for malaria is usually provided at a hospital. The doctor will prescribe drugs based on the type of parasite that attacks.

In some cases, the prescribed malaria drug may not eliminate the infection due to parasitic resistance to the drug. If this happens, the doctor may need to use more than one drug or change the medicine to treat the condition.

In addition, some types of malaria parasites, such as P. vivax and P. ovale, can survive in the body for a long time and can be active later in life which causes recurrence of infection.

If one of these types of malaria parasites is found in your body, you will be given two medicines to prevent future recurrences.

Eventually, the types of drugs and duration of treatment will vary depending on:

  • The type of malaria parasite that is owned.
  • Severity of symptoms.
  • Age.
  • Are you pregnant?

The following are the most commonly used malaria medicines, including:

  • Artemisinin-based combination therapies (ACTs). This is the first treatment for malaria. There are several types of ACT, for example artemether-lumefantrine and artesunate-amodiaquine. ACT is a combination of two or more drugs that work against malaria parasites in different ways.
  • Chloroquine phosphate. Chloroquine is the preferred treatment for all drug-sensitive parasites. However, in some countries, this parasite causes malaria to be resistant to chloroquine, so this drug is no longer an effective treatment.

Other malaria medications include:

  • A combination of atovaquone and proguanil.
  • Quinine sulfate with doxycycline.
  • Mefloquine.
  • Primaquine phosphate.

Additional factors such as age, weight, and pregnancy status can limit the choices available for malaria treatment.

Prevention of Malaria

At present there is no effective vaccine against malaria. Consult a doctor if you travel where malaria is common or live in the area. You will usually be given prescription drugs to prevent disease.

Considering that there is no effective drug to prevent malaria, therefore prevention of mosquito bites is something very important. Preventive steps that can be done are

  • Sleeping with a Mosquito Net. This is the most effective way to prevent malaria. If possible cover all areas of the bed to the floor so that mosquitoes can not enter
  • Clothes closed. If you wear closed clothes it will reduce the risk of mosquito bites. In addition, you can also use socks and apply mosquito repellent to prevent further mosquito bites.


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