An in depth guide to malaria
What is malaria?
Carried and spread by mosquitos, this tropical disease can be fatal if left undiagnosed and untreated.
Mosquitoes can carry a parasite, known as a plasmodium, in their saliva, which can pass from the insect into your bloodstream if they bite into your skin.
There are, in fact, many different types of plasmodium but only five of them cause malaria in humans.
Once the parasites are in the blood stream, they make their way to the liver. Here they begin to duplicate until the point when they’re released back into the blood stream in significantly higher numbers.
They can then invade the red blood cells and, once inside, continue to multiply until the cells explode. This releases more parasites into the blood stream.
Not only does the parasite infect humans, but any mosquito that bites a human infected with the parasite can then spread the disease further.
The types of malaria
There are five different types of malaria which depend on the parasite the mosquito is carrying:
- Plasmodium vivax – This is a milder form of the disease. While it is generally not fatal, treatment is needed as it can cause various health issues. It is common in India.
- Plasmodium malariae – This is also a milder form but requires treatment. This parasite can stay in the blood for several decades.
- Plasmodium ovale – Another mild version which can remain in the body for years without symptoms. However, without treatment it can relapse.
- Plasmodium falciparum – This is the most serious form. While it is especially common in Africa, some cases have been reported in areas where it was thought to have been eradicated.
- Plasmodium knowlesi – This causes malaria in macaques but has also been known to infect humans.
Symptoms of malaria
Malaria symptoms tend to start appearing around 10 days after infection as the parasites multiply throughout the body.
However, you might not notice symptoms for up to a year after contraction. In even rarer cases, the parasite can remain dormant in the liver for decades. Once awakened from their dormant state, the parasites will start duplicating.
The main symptoms are:
- Flu-like illness
- Nausea, vomiting, and diarrhoea
Other symptoms are:
- Kidney failure
- Mental confusion
Malaria is most prevalent in warmer, humid countries, where mosquitos thrive. They are most common in tropical and subtropical countries.
Warmth is a critical factor in the spread of this disease, since mosquitos need it to survive and parasites need a warm environment to multiply inside the mosquito.
Malaria is prevalent in over 100 countries, especially those in:
- South Asia
- Parts of Central and South America
- The Caribbean
- Southeast Asia
- The Middle East
- Oceania (Fiji, Polynesia etc)
Facts about malaria
- Only female Anopheles mosquitoes spread malaria
- The females predominantly bite at night
- In rare cases, malaria has been transmitted through blood transfusion, organ transplant and shared needles
- It can also be transmitted to an unborn baby from an infected mother
In 2020, there were an estimated 241 million cases of malaria worldwide. The estimated number of malaria deaths stood at 627 000 in 2020.
The WHO African Region carries a disproportionately high share of the global malaria burden. In 2020, the region was home to 95% of malaria cases and 96% of malaria deaths. Children under five accounted for an estimated 80% of all malaria deaths in the region.
Since October 2021, WHO also recommends broad use of the RTS,S/AS01 malaria vaccine among children living in regions with moderate to high P. falciparum malaria transmission. The vaccine has been shown to significantly reduce malaria, and deadly severe malaria, among young children.
Well-known malaria victims
While the majority of people suffering from malaria are from poorer backgrounds, it’s a disease that can affect anyone.
A number of high-profile celebrities have been infected by the disease including Chelsea team mates Didier Drogba and Michael Essien. Former X-Factor judge and Girls Aloud member, Cheryl Cole was diagnosed with the disease in 2010; it is believed she contracted malaria in Tanzania, although claimed to have been taking anti-malaria tablets at the time.
David Attenborough, who has spent many years travelling to exotic locations, has also suffered from malaria. He picked it up in the 1990s while filming in Niger.
There are a number of ways to avoid contracting malaria but the best way to remember them is to follow the ABCD.
A: Be aware of the risk of malaria if travelling to a foreign country. Check with your local GP or the Fit for Travel website to check if malaria is a problem in the area.
B: Avoid mosquito bites by taking appropriate measures. This could include wearing insect repellent and spraying it in your room, wearing long sleeve tops and trousers, using mosquito nets above beds and staying indoors at dawn and dusk when mosquitos are more abundant.
C: Check whether you need to take antimalarial pills and make sure you are taking them consistently and for the full period recommended. Remember, these can take time to become effective so make sure to visit your GP at least 4 weeks before travel.
D: Early diagnosis of malaria if symptoms manifest following travel to a malarias region is vital. Malaria can be fatal but early diagnosis and treatment is usually 100% effective.
There are a number of malaria tablets available. As there is no vaccine against the disease, it is highly recommended that travellers take the tablets.
When used together with DEET and other methods to prevent mosquito bites, malaria tablets are 90-100% effective. However, if they are used incorrectly, you may not be protected at all.
While some of the products have side effects, they are considerably less serious and harmful than malaria itself. Side effects could include stomach pain, dizziness, headache, nausea, diarrhoea, coughing, mouth ulcers and vivid dreams.
The tablets are often taken daily and are to be taken for the full length of your travels. Some have to be taken in advice and many can be taken for up to a year if you’re travelling for an extended period of time. They will then need to be taken for a period of time after you return.