Malaria In Pakistan

Overview

Malaria is caused by a parasite calledPlasmodium, which is transmitted via the bites of infected mosquitoes. In thehuman body, the parasites multiply in the liver, and then infect red bloodcells. Symptoms of malaria include fever, headache, and vomiting, and usuallyappear between 10 and 15 days after the mosquito bite. If not treated, malariacan quickly become life-threatening by disrupting the blood supply to vitalorgans. In many parts of the world, the parasites have developed resistance toa number of malaria medicines. Key interventions to control malaria include:prompt and effective treatment with artemisinin-based combination therapies;use of insecticidal nets by people at risk; and indoor residual spraying withinsecticide to control the vector mosquitoes.

Transmission of Malaria

We get malaria by being bitten by an infectedfemale Anopheles mosquito. Only Anophelesmosquitoes can transmit malaria and they must have been infected through aprevious blood meal taken on an infected person. When a mosquito bites, a smallamount of blood is taken in which contains the microscopic malaria parasites.The parasite grows and matures in the mosquito’s gut for a week or more, thentravels to the mosquito’s salivary glands. When the mosquito next takes a bloodmeal, these parasites mix with the saliva and are injected into the bite. Oncein the blood, the parasites travel to the liver and enter liver cells to growand multiply. During this “incubation period”, the infected personhas no symptoms. After as few as 8 days or as long as several months, theparasites leave the liver cells and enter red blood cells. Once in the cells,they continue to grow and multiply. After they mature, the infected red bloodcells rupture, freeing the parasites to attack and enter other red blood cells.Toxins released when the red cells burst are what cause the typical fever,chills, and flu-like malaria symptoms. If a mosquito bites this infected personand ingests certain types of malaria parasites (“gametocytes”), the cycle of transmissioncontinues.

Because the malaria parasite is found in redblood cells, malaria can also be transmitted through blood transfusion, organtransplant, or the shared use of needles or syringes contaminated with blood.Malaria may also be transmitted from a mother to her fetus before or duringdelivery (“congenital” malaria).

Malaria is not transmitted from person to personlike a cold or the flu. You cannot get malaria from casual contact withmalaria-infected people. 

Prevention from Malaria

You andyour family can prevent malaria by

Keeping mosquitoes from biting you, especially at night

Taking anti malarial drugs to kill the parasites (as perregistered medical practitioner advice)

Eliminating places around your home where mosquitoes breed

Spraying insecticides on your home’s walls to kill adultmosquitoes that come inside

Sleeping under bed nets – especially effective if they havebeen treated with insecticide, and

Wearing insect repellent and long-sleeved clothing if out ofdoors at night
Symptom sand Diagnosis

Symptoms of malariainclude fever and flu-like illness, including shaking chills, headache, muscleaches, and tiredness. Nausea, vomiting, and diarrhea may also occur. Malariamay cause anemia and jaundice (yellow coloring of the skin and eyes) because ofthe loss of red blood cells. Infection with one type of malaria, Plasmodiumfalciparum, if not promptly treated, may cause kidney failure, seizures,mental confusion, coma, and death.

For most people, symptoms begin 10 days to 4weeks after infection, although a person may feel ill as early as 7 days or aslate as 1 year later. Two kinds of malaria, P. vivax and P. ovale,can relapse. In P. vivax and P. ovaleinfections, someparasites can remain dormant in the liver for several months up to about 4years after a person is bitten by an infected mosquito. When these parasitescome out of hibernation and begin invading red blood cells (“relapse”), theperson will become sick.

Most people, at the beginning of the disease,have fever, sweats, chills, headaches, malaise, muscles aches, nausea andvomiting. Malaria can very rapidly become a severe and life-threateningdisease. The surest way for you and your health-care provider to know whetheryou have malaria is to have a diagnostic test where a drop of your blood isexamined under the microscope for the presence of malaria parasites. If youare sick and there is any suspicion of malaria (for example, if you haverecently traveled in a malaria-risk area) the test should be performed withoutdelay.

Malaria Drugs

Once diagnosed as malaria, either on aclinical or parasitological basis, the patient should be treated early with asafe and effective antimalarial medicine, the Roll Back Malaria goal beingeffective treatment within 24 hours of the onset of symptoms. This is because adelay in treatment of uncomplicated malaria, specially in the non-immunepatient could result in progression to severe disease which is associated witha high case fatality rate.

The management of clinical malariaincludes treatment with an antimalarial medicine which should be consistentwith the national treatment policy, and also supportive therapy, and referralto appropriate health facilities.

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