Malaria Disease: Symptoms, Diagnosis & Treatment

Written by Medicover Team and Medically Reviewed by Dr Vamsi Krishna Kedarisetti , General Medicine

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Malaria is a deadly disease caused by the Plasmodium parasite and spread by female Anopheles mosquitoes. While five species infect humans, P. falciparum is the most lethal, dominating Africa, though India also sees 2 million cases annually.

If untreated, it can cause organ failure or death, especially in children and pregnant women. The World Health Organisation (WHO) recommends vaccines for children in high-risk areas to prevent malaria fevers.

What Are the Symptoms of Malaria?

The signs of Malaria generally show ten to four weeks after the infection. In some circumstances, they may not appear for several months. Most commonly recognized symptoms of malaria are:

High fever
Chills and shivering
Profuse sweating
Headache
Fatigue and weakness
Muscle and joint pain
Back pain
Nausea and vomiting
Abdominal pain
Dry cough
Loss of appetite
Enlarged spleen
Confusion or seizures (in severe malaria)
Difficulty breathing (in severe cases)
Bloody stools (rare, severe cases)

What Are the Causes of Malaria?

The major cause of malaria is the Plasmodium parasites, which are transmitted to humans (bloodstream) through the bite of an infected female Anopheles mosquito.

The five different kinds of malaria parasites that can infect humans are:

Plasmodium falciparum
Plasmodium vivax
Plasmodium malariae
Plasmodium ovale
Plasmodium knowlesi

During the bite, the mosquito injects Plasmodium parasites into the bloodstream. The parasites travel to the liver, multiply, and later infect red blood cells, leading to malaria.

What Is the Life Cycle of Malaria?

Malaria Transmission: Malaria is transmitted to humans through the bite of an infected female Anopheles mosquito. The mosquito injects sporozoites, a form of the malaria parasite, into the bloodstream during a blood meal.
Liver Stage (Exoerythrocytic Stage): Once in the bloodstream, the sporozoites travel to the liver, where they infect hepatocytes (liver cells). Inside the hepatocytes, the sporozoites mature into schizonts, which then multiply asexually, producing thousands of merozoites.
Blood Stage (Erythrocytic Stage): Merozoites are released from the liver cells and enter the bloodstream, where they infect red blood cells (erythrocytes). Inside the red blood cells, the merozoites multiply and develop into trophozoites, which then mature into schizonts. The schizonts rupture the red blood cells, releasing more merozoites into the bloodstream.
Clinical Symptoms: The release of merozoites and the destruction of red blood cells lead to the characteristic symptoms of malaria, including fever, chills, headache, muscle aches, and fatigue.
Transmission to Mosquitoes: Some of the merozoites develop into male and female gametocytes, which are ingested by mosquitoes during a blood meal. In the mosquito's gut, the gametocytes undergo sexual reproduction, forming zygotes.
Sporogonic Cycle: The zygotes develop into ookinetes, which penetrate the wall of the mosquito's gut and form oocysts. Inside the oocysts, sporozoites develop and eventually rupture the oocyst, releasing sporozoites into the mosquito's body. The sporozoites migrate to the mosquito's salivary glands, ready to be transmitted to another human host during a subsequent blood meal.

In rare cases, malaria can also be passed from an infected pregnant woman to her unborn baby. Less commonly, the infection may spread through contaminated blood transfusions, organ transplants, shared needles, or accidental exposure to infected blood. Malaria does not spread through casual person-to-person contact.

When to See a Doctor for Malaria?

Malaria can become severe and life-threatening if left untreated, so it is important to seek medical care as soon as symptoms appear. Consult a general physician immediately if you develop severe symptoms, especially after living in or travelling to a malaria-endemic area.

Pregnant women, young children, older adults, and people with weakened immune systems are at a higher risk of severe malaria and should receive prompt medical evaluation if they develop symptoms. Malaria signs may appear several weeks or even months after exposure, so be sure to inform your doctor about any recent or past travel to malaria-prone regions.

Early diagnosis and timely treatment can help prevent serious complications and improve recovery.

What Are the Complications of Malaria?

Malaria may be lethal, mainly when it is caused by Plasmodium species that are common in Africa. Malaria deaths are frequently linked to one or more significant complications of malaria, such as:

Cerebral malaria: Cerebral malaria occurs when parasite-filled blood cells block tiny blood arteries in the brain, resulting in brain swelling or damage. Seizures and coma are possible side effects of cerebral malaria.
Breathing problems: Fluid buildup in the lungs (pulmonary oedema) can make it difficult to breathe.
Organ failure: Malaria can induce organ failure by causing damage to the kidneys, liver, and spleen, as well as causing the spleen to burst. Any of these disorders can put their life in jeopardy.
Anemia: Malaria can cause anemia, which means people don't have enough red blood cells to get enough oxygen to the body's tissues (anemia).
Low blood sugar: Severe types of malaria, as well as quinine, a major malaria treatment, can produce low blood sugar (hypoglycemia). Low blood sugar levels might lead to unconsciousness or death.

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How Is Malaria Diagnosed?

A doctor will review your medical history, recent travel history, and symptoms before performing a physical examination. To confirm malaria, they may recommend blood tests such as a microscopic blood smear or a rapid diagnostic test (RDT) to detect the presence of Plasmodium parasites.

Blood tests help determine:

Whether Plasmodium parasites are present in the blood, confirming malaria.
The specific species of the malaria parasite causing the infection.
The severity of the infection and the number of parasites in the blood.
Whether the parasite is resistant to certain antimalarial medicines.
Whether the infection has affected organs such as the liver, kidneys, or blood cells.

Depending on your condition and symptoms, your doctor may recommend additional laboratory tests to assess complications and guide the most appropriate treatment plan.

What Is the Treatment and Medication for Malaria?

Treatment for malaria depends on the type of Plasmodium parasite, the severity of the infection, where the infection was acquired, and the patient's age, pregnancy status, and overall health.

Early diagnosis and prompt treatment are essential to prevent serious complications.

Common medications used to treat malaria include:

Artemisinin-based Combination Therapy (ACT): The preferred treatment for most cases of uncomplicated malaria caused by Plasmodium falciparum.
Chloroquine or Hydroxychloroquine: Used only in areas where the malaria parasite remains sensitive to chloroquine.
Atovaquone-Proguanil: An effective treatment option for uncomplicated malaria and commonly prescribed for both treatment and prevention in certain regions.
Artemether-Lumefantrine: A widely used ACT that treats uncomplicated malaria caused by susceptible parasites.
Mefloquine: May be recommended in selected cases when other treatment options are not suitable, depending on the patient's medical history.
Intravenous Artesunate: Recommended for severe malaria and typically followed by an oral antimalarial medicine once the patient's condition improves.

Patients with severe malaria may require hospitalization for close monitoring and supportive care, including intravenous fluids, oxygen therapy, blood transfusions, or other treatments to manage complications.

Your doctor will recommend the most appropriate treatment based on your condition and current clinical guidelines.

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How Can Malaria Be Prevented?

Although malaria cannot always be prevented, the risk of infection can be greatly reduced by avoiding mosquito bites, taking preventive medicines when recommended, and seeking prompt medical care if symptoms develop. The ABCD approach is an easy way to remember key malaria prevention measures.

Awareness of Risk: Before travelling, check whether your destination is a malaria-endemic area and learn about the local risk of infection.
Bite Prevention: Protect yourself from mosquito bites by using insect repellent, wearing long-sleeved clothing and long pants, sleeping under insecticide-treated mosquito nets, and staying in screened or air-conditioned rooms whenever possible.
Home Safety Tips: Remove standing water around homes to reduce mosquito breeding. Use mosquito coils or indoor insecticide sprays when appropriate. And keep doors and windows screened to prevent mosquitoes from entering.
Diagnosis: Seek immediate medical attention if you develop fever, chills, or flu-like symptoms during or after visiting a malaria-endemic region. Early diagnosis and treatment can prevent serious complications.
Chemoprophylaxis (Preventive Medication): If recommended by your doctor, take antimalarial medicines exactly as prescribed before, during, and after travel to malaria-risk areas.

Lifestyle Changes and Self-Care for Malaria Recovery

Antimalarial medicines are the primary treatment for malaria. Along with following your doctor's treatment plan, healthy lifestyle habits can support recovery, improve strength, and reduce the risk of dehydration and complications.

Complete your prescribed medication: Take all antimalarial medicines exactly as directed, even if you start feeling better before the course is finished.
Stay well hydrated: Drink plenty of water, oral rehydration solutions, coconut water, soups, or other fluids to replace fluids lost through fever and sweating.
Eat a balanced diet: Choose easily digestible meals that include fruits, vegetables, whole grains, and lean protein sources such as eggs, fish, chicken, pulses, and legumes to support recovery.
Get adequate rest: Rest allows your body to recover while your immune system fights the infection.
Manage fever safely: Follow your doctor's advice and maintain adequate fluid intake.
Prevent mosquito bites: Continue using mosquito repellents and insecticide-treated bed nets to avoid spreading the infection to mosquitoes and reducing further transmission.
Attend follow-up appointments: Keep scheduled follow-up visits if recommended to ensure the infection has cleared completely.

Seek immediate medical attention if you experience persistent high fever, difficulty breathing, repeated vomiting, confusion, seizures, or worsening symptoms during treatment.

Dos and Don'ts

Malaria in adults, infants, and youngsters is curable and manageable if they get the necessary treatment on time. However, following the prescribed dos and don'ts can help you avoid the disease's negative consequences. Some guidelines are as follows:

Do's	Don'ts
Apply mosquito repellents frequently.	Travel to areas with a malaria outbreak.
Use mosquito nets over the bed.	Ignore the symptoms indicating malaria.
Eat healthy meals and stay hydrated.	Eat fatty, spicy foods during malaria.
Include protein in your daily meals.	Eat high-fibre foods and caffeinated drinks during malaria.

Malaria is not a fatal condition if caught and treated early. By following precautions, we can avoid its serious repercussions.

Citations

https://www.nhs.uk/conditions/malaria/
https://www.cdc.gov/parasites/malaria/index.html
https://www.who.int/news-room/fact-sheets/detail/malaria
https://en.wikipedia.org/wiki/Malaria

Frequently Asked Questions

1. When do symptoms begin if you're infected with malaria?

Symptoms of malaria can start within a few weeks after infection, but in some types, the parasite stays hidden in your body and symptoms might not appear for months or even years.

2. Is there a vaccine against malaria?

Yes, there are two approved vaccines that help prevent malaria. They are mainly used in young children in regions where malaria is common, helping lower the risk of severe disease.

3. Is malaria a contagious disease?

Malaria is not directly contagious from person to person. It is primarily transmitted through the bite of infected female Anopheles mosquitoes. However, in rare cases, it can be transmitted through organ transplantation, blood transfusion, or from an infected mother to her baby during childbirth or breastfeeding.

4. How do I know if I have malaria for sure?

To confirm a malaria infection, you need a blood test. Malaria diagnosis typically involves examining a blood sample under a microscope to identify the presence of malaria parasites. Rapid diagnostic tests (RDTs) are also used in many areas for quick and reliable diagnosis.

5. How long can you carry malaria?

Malaria does not remain in the body indefinitely. The duration of the infection varies depending on the type of malaria parasite, the effectiveness of treatment, and individual factors. With proper treatment, most malaria infections are cleared within a few weeks. However, some individuals may carry the parasites for an extended period if not treated promptly.