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Back to Infectious Diseases
Malaria
Malaria is a disease caused by a protozoal infection with the organism
(plasmodium). The disease course passes through 2 stages:
-
Preerythrocytic (liver) stage: sporozoites (the infective stage)
form micromerozoites which can infect blood.
-
Erythrocytic stage: The red cells become infected with micromerozoites
which mature within the red cells into merozoites form trophozoites (ring
form).
This results in rupture of the red cells and the release of merozoites
in the circulation. The erythrocytic phase may continue for a long period
allowing a few merozoites to develop into the sexual form of the parasite
known as the gametocytes. At this stage the patient is infective.
A mosquito may act as a carrier transmitting infection of sporozoites
from one person to another.
Clinical manifestations
Malaria is characterized by a series of chills, fever,
sweating. Tertian (3rd day) / quartan (4th day) fever.
Hepato-splenomegaly (enlargement of the liver and spleen).
Relapses
Exoerythrocytic (in all types except falciparum):
some merozoites don?t invade RBCs but enter the liver again.
Diagnosis
Malaria blood smears given at 6 to 12 hour intervals confirm the diagnosis.
Treatment
According to the CDC, travelers going to South America, Africa, the Indian
subcontinent, Asia, and the South Pacific should take one of the following
drugs: mefloquine, doxycycline, chloroquine, hydroxychloroquine, or Malarone.
- The adult dose of chloroquine is phosphate 500 mg once a week.
- Take the first dose of chloroquine 1 week before arrival in the
malaria-risk area.
- Take your dose once a week, on the same day of the week, while
in the risk area.
- Take your dose once a week for 4 weeks after leaving the risk
area.
- Chloroquine should be taken on a full stomach to lessen the risk
of nausea and stomach upset.
Malaria, especially Falciparum malaria, is a medical emergency requiring
hospitalization. Chloroquine is the most frequently used anti-malarial medication,
but quinidine or quinine, or the combination of pyrimethamine and sulfadoxine,
are given for chloroquine-resistant infections.
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