Malaria

About Malaria

Malaria is a parasitic disease caused by Plasmodium parasites transmitted by Anopheles mosquitoes. WHO estimated about 282 million cases and 610,000 deaths in 2024, mostly among children under 5 in sub Saharan Africa. Five species infect humans: P falciparum most severe, P vivax, P ovale, P malariae, and P knowlesi. Symptoms typically begin 1 to 4 weeks after infection. Classic malaria presents with cyclical fevers, roughly 48 hour tertian cycles for P vivax and P ovale and 72 hour quartan cycles for P malariae, while P falciparum fevers are often irregular, corresponding to the parasite life cycle rupture of red blood cells. Each fever episode has three stages: cold shivering, hot fever up to 41C, and sweating stages. Other symptoms include headache, nausea, vomiting, diarrhea, muscle aches, and jaundice from red blood cell destruction. Severe P falciparum malaria can cause cerebral malaria seizures, coma, severe anemia, acute kidney injury, ARDS, and hypoglycemia. Cerebral malaria has high mortality even with treatment. Fever during or after travel to a malaria area needs urgent medical assessment, and severe malaria is a medical emergency. Diagnosis is made through blood smear microscopy showing parasites within red blood cells, or rapid diagnostic tests RDTs detecting parasite antigens. Treatment depends on species and severity. Artemisinin based combination therapy ACT such as artemether lumefantrine Coartem is the standard treatment for uncomplicated P falciparum. Severe malaria is treated in hospital with intravenous artesunate, which reduces mortality compared to quinine. Prevention includes insecticide treated bed nets, indoor residual spraying, and preventive medications such as atovaquone proguanil Malarone, doxycycline, or mefloquine prescribed for travelers. WHO recommended the RTS S Mosquirix vaccine in 2021 and the R21 Matrix M vaccine in 2023 for children in endemic areas.