Malaria

Malaria is a disease caused by the plasmodium parasite. The parasite passes to humans through the bites of mosquitoes that carry the parasite when they are feeding on human blood. People who have malaria usually feel very sick, usually with a high fever and shaking chills. The severity of the symptoms depends on the type of infecting parasite, with plasmodium falciparum causing the most severe disease.

In Nigeria, healthcare providers can start treatment after identifying the fever as a symptom and ruling out other serious infections. They generally recommend a group of medicines called artemisinin-combination therapy (ACT). ACTs contain artemisinin and a second medicine that improves its action; combinations include artemether lumefantrine combination (the first medicine combination recommended), artemisinin amodiaquine combination and artemisinin mefloquine, among others. These combinations are used to clear parasites from the blood, remove them from the liver and prevent resistance in the parasite.

The Government and partners emphasize preventing malaria through the use of long lasting insecticide treated nets (LLITNs), insect repellants and the use of intermittent preventive therapy (IPT) in pregnancy, whereby pregnant women are given a full course of antimalarial medicine during routine antenatal care visits. This is aimed at reducing the number of times children, pregnant women and the general population fall ill.

The symptoms of malaria typically develop within 10 days to 4 weeks following the infection. In some cases, symptoms may not develop for several months. Some malarial parasites can enter the body but will not be active for long periods of time.

Common symptoms of malaria include:

• Shaking chills that can range from moderate to severe.
• High fever.
• Excessive sweating
• Headache.
• Feeling like vomiting and actually vomiting.
• Belly pain.
• Loose and watery stools.
• Bloody stools.
• Low levels of iron in the blood (anaemia).
• Muscle pain.
• Uncontrollable shaking.
• Blackout.

Malaria is caused by infection with the parasite, plasmodium falciparum (most common in Nigeria), that is passed onto humans through the bite of an infected mosquito. The parasite moves to the liver to grow and mature and subsequently through the bloodstream causing symptoms.

The biggest risk factor for developing malaria is living in or visiting areas where the disease is common. People at increased risk of malaria include:

• Those who do not sleep under bed nets at night.
• Young children and infants.
• Older people.
• Travelers coming from areas with no malaria.
• Pregnant women and their unborn children.

Poverty, poor housing, lack of knowledge, and little or no access to healthcare also contribute to malaria infections.

Talk to your doctor if you experience a fever while living in or after traveling to a high-risk malaria region. The parasites that cause malaria can remain inactive in your body for up to a year. If you have severe symptoms, seek emergency medical attention immediately.

You can prevent malaria by avoiding mosquito bites. You can do this by sleeping under long-lasting insecticide-treated nets (LLINs), wearing covering clothes, using insect-repellant creams, spraying indoors with residual insecticides, clearing stagnant water (e.g. puddles, containers) from your environment, and preventive medicines (provided in pregnancy and to vulnerable people). Due to side-effects and allergies, giving preventive medicines to a large population is not widely used but can be provided when public health requires it.

Self-care:

• Sleep under a bed net that has been treated with insecticides, like permethrin. These prevent mosquito bites while you are sleeping.
• Wear clothing that covers your skin, such as long-sleeved shirts and long trousers. To be doubly sure, you can tuck in your shirt and tuck pant legs into socks.
• Apply insect repellent to clothing. Sprays containing permethrin are safe to apply to clothing.
• You can apply insect repellent to the skin, but this is not as effective as sleeping under a bed net and covering your skin.

Medical treatment:

Malaria can be life-threatening. Treatment for the disease is typically provided in the community, and when complications appear, you will be treated in a hospital. You will be requested to do a rapid diagnostic test (RDT) for malaria before getting medicines for treatment.

• Treatment usually consists of taking ACT, such as artemether lumefantrine or artemisinin amodiaquine.
• When you suffer from complications, your healthcare provider will admit you for treatment at a healthcare facility.
• If your malaria recurs, your healthcare provider may ask you to take some medicines after being treated with ACT to remove parasites from your liver.
• People living with sickle cell disease must use medicines regularly to prevent a malaria infection (prophylaxis).
• Currently, there is no effective vaccine available against malaria. There is some recent progress with vaccine development, and an effective vaccine may be available in the near future.

Malaria soon resolves after you begin taking medicines, the fever will usually go away by the end of the second day of treatment. There are usually no long term effects of the disease, except those that are due to complications of the disease. You should avoid using medicines for malaria when you do not need them. Ensure you get tested before taking antimalarial medicines.

You may be prescribed medications to prevent the disease. These should be taken before, during and after a trip to an area where malaria is common. Talk to your doctor about long-term malaria prevention if you live in an area where malaria is common. Sleeping under a bed net will prevent being bitten by an infected mosquito. Covering your skin or using bug sprays may also help prevent infection.