1. What is Malaria?
Answer: Malaria is a vector-borne disease caused by Plasmodium parasites. The bite of a female Anopheles mosquito to a healthy person is responsible for transmitting the parasite from one human to another.
Five types of Plasmodium parasites may cause Malaria:

  1. Plasmodium falciparum
  2. Plasmodium vivax
  3. Plasmodium ovale
  4. Plasmodium malariae
  5. Plasmodium knowlesi

Out of these five parasites, the most common parasite responsible for most malaria cases is P.falciparum and P.vivax. In India, urban people suffer from Malaria due to the bite of the female Anopheles stephensi mosquito.

Since mosquitoes breed during the rainy season thus, Malaria is more common in the rainy season. Moreover, geographical regions with warm and humid climates can have Malaria even in the winter season. More than four lakh people died from Malaria in 2019, according to the US Centers for Disease Control and Prevention (CDC). A significant percentage was from the WHO African region.

2. How does Malaria transmit?
Answer: Malaria does not transmit directly from one person to another. It transmits with the help of a vector which is a female Anopheles mosquito.

3. What is the incubation period of Malaria?
Answer: The incubation period is the time range between the bite of a female Anopheles mosquito and the appearance of the first symptom. According to the CDC, USA, the malaria incubation time ranges from seven to thirty days in most cases. The shorter incubation period is mainly observed with the P.falciparum parasite, and the more extended incubation period is marked with the P.malariae parasite.

4. What is the rank of India in cases of Malaria?
Answer: A report published in 2017 in the Lancet Journal ranks India in the fourth position in the list of most malaria cases globally. Out of the 219 million global cases, there were nearly ten million cases of Malaria from India.
However, according to the WHO World Malaria

Report, 2020, India has improved a lot in reducing the burden of Malaria. India declined 17.6% in reported malaria cases in 2019 and has maintained the Annual Parasitic Incidence (API) < 1 since 2012.

5. What are the symptoms of Malaria?
Answer: The symptoms of Malaria include:

  • Severe fever and headache
  • Flu-like illness
  • Body chills ( shaking chills)
  • Severe pain in the muscle and bones
  • Fatigueness and discomfort
  • Jaundice and Anemia in some patients
  • Pain in the abdomen
  • Rapid heart rate and breathing

6. Does Malaria have any risk factors and complications?
Answer: The risk factors of Malaria disease are:

  • People living or visiting places where Malaria is common, e.g., tropical and subtropical countries.
  • Infants and small children
  • Elderly persons
  • Pregnant women
  • Poor people who cannot afford quality healthcare and good living standards.

Malaria, if left undiagnosed and not given proper treatment, can lead to the following complications:

  • Cerebral Malaria ( Malaria that affects the brain)
  • Respiratory Distress (Difficulty in breathing)
  • Dysfunctioning of the kidneys ( Renal failure)
  • Anemia (Damage to the red blood cells)
  • Hypoglycemia ( Low Blood Sugar)
  • Dysfunctioning of the liver
  • Dehydration
  • Swelling of the spleen
  • Jaundice
  • Death of the patient

7. What is the treatment for Malaria?
Answer: The treatment for Malaria depends on four factors:

  1. Type of malaria parasite
  2. The severity of the symptoms
  3. Age of the patient
  4. Whether the female subject is pregnant

Antimalarial drugs that are used to treat Malaria are divided into the following schizonticides (drug that selectively destroys the schizont of sporozoan parasite) categories:

  1. Erythrocytic schizonticides: Chloroquine, Quinine, Mefloquine, Combination of Pyrimethamine and Sulfadoxine, Lumefantrine, and Halofantrine.
  2. Erythrocytic schizonticides+ Gametocides: Artesunate, Artemether, and Arteether
  3. Tissue schizonticides: Primaquine and Bulaquine
  4. Tissue +Erythrocytic schizonticides: Proguanil, Tetracyclines, Doxycycline, and Doxycycline with Primaquine phosphate.

However, certain malaria parasites become resistant to chloroquine and thus do not respond to the treatment. Therefore Artemisinin Combination Treatment (ACT) drugs are used to treat chloroquine-resistant Malaria. Examples of ACT drugs are artemether-lumefantrine and artesunate-mefloquine.

8. Can Malaria cause death?
Answer: Malaria is a deadly disease, and if it is not diagnosed and treated at the right time, it can cause the patient’s death.
Malaria, if not treated, can lead to severe health complications. The malaria parasites present in the red blood cells can travel to the brain and block the blood vessels. This will lead to swelling and brain damage which may cause seizures and coma. Ultimately patient will die due to multiple health complications. Thus it is essential to understand the symptoms and get diagnosed by a registered physician.

9. How is Malaria diagnosed?
Answer: As the first step in diagnosing Malaria, healthcare professionals examine and inquire about the patient’s symptoms and travel history. The patient should inform their healthcare provider about any recent travels or the location of their stay so that the physician can accurately assess the risk, diagnose, and provide effective treatment for treating Malaria.
The different diagnostic tests for Malaria include:

  1. Blood smear stained with Giemsa stain and seen under a microscope ( Gold standard for laboratory diagnosis of Malaria)
  2. Antigen Detection Test or Rapid Diagnostic Tests (RDTs)
  3. Serology Test to detect the presence of specific antibodies against specific malaria parasites.
  4. Molecular Diagnosis using PCR and qPCR ( Less common in use)
  5. Placental Histology Test with the help of laser desorption mass spectrometry (LDMS). ( Reliable diagnostic tool for Diagnosis of Malaria in pregnancy)

10. What are some interesting facts about Malaria?
Answer:
Fact 1: After pneumonia and diarrhea, Malaria is the third leading cause of death in children aged one month to five years.

Fact 2: Malaria means “bad air.” People in the 18th century thought that Malaria was caused by inhaling filthy air in swampy locations. However, in 1880, scientists found this was not the case, but the name malaria lingered.

Fact 3: Malaria can also transmit through pregnancy, blood transfusion, and sharing used needles of malaria patients.

Fact 4: The most popular and efficient strategy to avoid malaria infection is mosquito repellent creams and an insecticide-treated mosquito net while sleeping.

Fact 5: Malaria affects 3.3 billion people in 103 countries worldwide, but Sub-Saharan Africa accounts for 90% of malaria-related deaths. Deaths related to Malaria are more prevalent in the following countries:

  1. Nigeria
  2. The Democratic Republic of Congo
  3. Ghana
  4. Angola
  5. Uganda
  6. Mali
  7. Burkina
  8. Faso
  9. Kenya
  10. Tanzania
  11. Niger
  12. Cameroon
  13. Guinea
  14. Mozambique
  15. Chad

Fact 6: Malaria in pregnancy is a leading cause of death for mothers and young children, claiming the lives of at least 10,000 women and 200,000 infants under the age of one year.

Fact 7: Dr. Alphonse Laveran, a military doctor in the Health Service of the Armed Forces of France, discovered the malaria parasite in 1880.

Fact 8: The first pharmaceutical drug to treat Malaria was Quinine, derived from the bark of Cinchona calisaya.

REFERENCES

  1. Malaria’s Impact Worldwide.
    Accessed at https://www.cdc.gov/malaria/malaria_worldwide/impact.html
  2. Malaria Disease. Accessed at
    https://www.cdc.gov/malaria/about/disease.html
  3. Malaria Fact sheet. Accessed at
    https://dph.georgia.gov/sites/dph.georgia.gov/files/related_files/document/ADES_Malaria_Fact_Sheet.pdf
  4. Malaria transmission cycle. Accessed at
    https://www.mayoclinic.org/diseases-conditions/malaria/multimedia/malaria-transmission-cycle/img-20006373
  5. World Malaria Report 2020. Accessed at
    https://www.pib.gov.in/PressReleasePage.aspx?PRID=1677601
  6. India Ranked Fourth In Global Malaria Cases In 2017, Suggests Lancet Report.
    Accessed at https://swachhindia.ndtv.com/india-ranked-fourth-global-malaria-cases-2017-lancet-report-37926/
  7. Frequently Asked Questions (FAQs) on Malaria. Accessed at
    https://www.cdc.gov/malaria/about/faqs.html
  8. Malaria. Accessed at
    https://www.mayoclinic.org/diseases-conditions/malaria/diagnosis-treatment/drc-20351190
  9. 11 Facts About Malaria. Accessed at https://www.dosomething.org/us/facts/11-facts-about-malaria
  10. Ten things you didn’t know about Malaria. Accessed at
    https://www.unicef.org/press-releases/ten-things-you-didnt-know-about-malaria