Malaria Health Article

Signs and tests

During a physical examination, the doctor may identify an enlarged liver or an enlarged spleen. Malaria blood smears taken at 6 to 12 hour intervals confirm the diagnosis.

Treatment

Malaria, especially Falciparum malaria, is a medical emergency requiring hospitalization. Chloroquine is a frequently used anti-malarial medication, but quinidine or quinine plus doxycycline, tetracycline, or clindamycin; or atovaquone plus proguanil (Malarone); or mefloquine or artesunate; or the combination of pyrimethamine and sulfadoxine, are given for chloroquine-resistant infections. The choice of medication depends in part on where you were when you were infected.

Aggressive supportive medical care, including intravenous (IV) fluids and other medications and breathing (respiratory) support may be needed.

Expectations (prognosis)

The outcome is expected to be good in most cases of malaria with treatment, but poor in Falciparum infection with complications.

Complications

• Destruction of blood cells (hemolytic anemia)
• Liver failure and kidney failure
• Meningitis
• Respiratory failure from fluid in the lungs (pulmonary edema)
• Rupture of the spleen leading to massive internal bleeding (hemorrhage)

Calling your health care provider

Call your health care provider if you develop fever and headache after visiting the tropics.

Prevention

Most people living in areas where malaria is common have acquired some immunity to the disease. Visitors will not have immunity, and should take preventive medications. It is important to see your health care provider well before your trip, because treatment may begin is long as 2 weeks before travel to the area, and continue for a month after you leave the area. The types of anti-malarial medications prescribed will depend on the area you visit. According to the CDC, travelers to South America, Africa, the Indian subcontinent, Asia, and the South Pacific should take one of the following drugs: mefloquine, doxycycline, choroquine, hydroxychoroquine, or Malarone.

Even pregnant women should take preventive medications because the risk to the fetus from the medication is less than the risk of acquiring a congenital infection.

People on anti-malarial medications may still become infected. Avoid mosquito bites by wearing protective clothing over the arms and legs, using screens on windows, and using insect repellent.

Chloroquine has been the drug of choice for protection from malaria. But because of resistance, it is now only suggested for use in areas where Plasmodium vivax, P. oval, and P. malariae are present. Falciparum malaria is becoming increasingly resistant to anti-malarial medications.

For travelers going to areas where Falciparum malaria is known to occur, there are several options for malaria prevention, including mefloquine, atovaquone/Proguanil (Malarone), and doxycycline.

Travelers can call the CDC for information on types of malaria in a given geographical area, preventive drugs, and times of the year to avoid travel. See: www.cdc.gov