Depending on the type of malaria, the presence or absence of complications of the disease, the stage of the development cycle of malarial plasmodium, the presence of resistance (resistance) to antimalarial drugs, individual regimens of etiotropic therapy are developed from the antimalarial drugs presented.
| Drug group | Drug names | Mechanism of action | Efficacy against malaria species | Reception mode |
| Quinolylmethanols | Quinine
(quinine sulfate, quinine hydrochloride and dihydrochloride, quinimax, hexaquin) | Hematoschizotropic antimalarial drugs
effective against plasmodia during the period of erythrocyte schizogony. Prevents the penetration of plasmodia into red blood cells. Gametocidal drug acts on gametocytes (sexual forms), prevents further entry of plasmodium into the mosquito’s body. | All types of plasmodium, including those resistant to chloroquine. | Adults
– 2 g/day. for 3 doses orally, 20-30 mg/kg/day. in 2-3 doses intravenously, 3-7 days. Children – 25 mg/kg in 3 doses, 3-7 days. |
| Chloroquine (delagil, hingamin) | Hematoschisotropic and moderate gametocidal action. | All types of plasmodia. | Adults
– 0.5 g/day. orally, 20-25 mg/kg in 3 injections every 30-32 hours intravenously. Children – 5 mg/kg/day 2-3 days. |
|
| Hydroxychloroquine (plaquenil) | Hematoschisotropic and moderate gametocidal action. | All types of plasmodia. | Adults
– 0.4 g/day. inside 2-3 days. Children – 6.5 mg/kg/ days 2-3 days. |
|
| Mefloquine (lariam) | Hematoschisotropic action | | Adults:
first dose – 0.75, after 12 hours – 0.5 g. Children – first dose – 15 mg/kg, after 12 hours – 10 mg/kg. |
|
| Primaquin | Histoschizotropic drug acts on tissue schizonts of plasmodia, incl. and on hypnozoites (dormant forms). Effective for preventing relapses. Gametocidal action. | Three-day and oval malaria. | Adults:
2.5 mg/kg every 48 hours – 3 doses. Children: 0.5 mg/kg every 48 hours – 3 doses. |
|
| Biguanides | Proguanil (bigumal, paludrin) | Histoschisotropic action . Slow hematoschizotropic action. | Tropical malaria, including those resistant to quinine and chloroquine. | Adults:
0.4 g/day. 3 days. Children: 0.1 – 0.3 g/day. 3 days |
| Diaminopyrimidines | Pyrimethamine (chloridine, Daraprim) | Histoschisotropic action . Slow hematoschizotropic action in combination with sulfadoxine. | Tropical malaria. | Adults:
0.075 g once. Children: 0.0125 – 0.05 g once. |
| Terpene lactones | Artemisinin (artemeter, artesunate) | Hematoschisotropic
action. Reserve drug | All types of malaria. | Adults and children:
first dose – 3.2 mg/kg, then 1.6 mg/kg 1-2 times a day for 5-7 days. |
| Hydroxynaphthoquinones | Atowahon (mepron) | Hematoschisotropic
action. Reserve drug, used in the presence of resistance to other drugs. | All types of malaria. | Adults:
0.5 g 2 times a day for 3 days. Children: 0.125-0.375g 2 times a day for 3 days. |
| Sulfonamides | Sulfadoxine | Hematoschisotropic | Tropical malaria. | Adults:
1.5 g once. Children: 0.25 – 1.0 g once. |
| Sulfones | Dapsone | Hematoschisotropic action in combination with pyrimethamine. | Adults:
0.1 g/day. Children: 1-2 mg/kg/day. |
|
| Tetracyclines | Tetracycline | Hematoschisotropic histoschisotropic action. | Tropical malaria, resistant to the above drugs. | Adults:
0.3 – 0.5 g 4 times a day. Children over 8 years old: 25-50 mg/kg/day. |
| Lincosamides | Clindamycin | Hematoschisotropic
action, low activity, moderate histoschisotropic action. | Tropical malaria, resistant to the above drugs, low activity. | Adults:
0.3 – 0.45 g 4 times/day. Children over 8 years old: 10-25 mg/kg/day. |
Caring for a person with malaria
A person suffering from malaria requires constant and careful care, which will reduce suffering during attacks of fever. During the period of chills, it is necessary to cover the patient; you can put heating pads at the feet. During a fever, it is necessary to open the patient, remove heating pads, but prevent hypothermia and drafts. For headaches, you can put a cold pack on your head. After profuse sweating, change the underwear and give the patient rest.
In the room where the patient is located, it is necessary to prevent the entry of mosquitoes (use of nets, insecticides) in order to prevent the spread of malaria.
If complications of malaria occur, the patient is transferred to a ward or intensive care unit.
Diet for malaria
- Interictal period– no diet is prescribed, common table No. 15 with plenty of drink.
- During an attack of fever – table No. 13 with plenty of drink. Table No. 13 provides for increasing the body's defenses; meals should be frequent and divided.
- low-fat varieties of fish and meat, low-fat broths,
- boiled eggs,
- dairy products,
- mashed rice, buckwheat and semolina porridge,
- boiled vegetables,
- stale wheat bread, crackers,
- ground soft fruits and berries,
- juices, fruit drinks, decoctions,
- honey, sugar.
Prevention of malaria
Prevention of malaria is necessary when living or temporarily staying in countries where malaria is endemic. So, when traveling to a malaria-prone country, you need to prepare in advance. It is advisable for pregnant women, children under 4 years of age and people living with HIV not to travel to countries affected by malaria. Protection against mosquito bites
- Mosquito nets on windows and doorways, you can sleep under a mesh curtain, tucking it under the mattress.
- Repellents – chemical compounds, which repel mosquitoes, but do not kill them, which are applied to human skin or clothing. There are various forms: creams, sprays, aerosols, gels, etc. Used according to the instructions.
- Insecticides– means for killing mosquitoes. It is recommended to treat rooms, nets, and thresholds with an insecticide aerosol. Half an hour after treatment, it is necessary to ventilate the room.
Drug prevention of malaria
Antimalarial drugs are used. It is necessary to clarify the regional resistance of malaria to drugs. Drug prevention does not provide 100% protection, but significantly reduces the risk of disease.Drugs used to prevent malaria(must start 1 week before travel and continue for 4 – 6 weeks after arriving home) :
- Chloroquine (delagil) 0.5 g for adults and 5 mg/kg/day. children once a week.
- Hydroxychloroquine (Plaquenil) 0.4 g for adults and 6.5 mg/kg for children once a week.
- Mefloquine (Lariam) 0.25 g for adults and 0.05 - 0.25 mg for children once a week.
- Primaquin 30 mg for adults and 0.3 mg/kg for children once every 48 hours.
- Proguanil (bigumal) 0.2 g/day. adults and 0.05-0.2 g for children.
- Primethamine (chloridine) 0.0125 g for adults and 0.0025 – 0.0125 g for children in combination with the drug dapsone 0.1 g for adults once a week.
Identifying and effectively treating patients with malaria
It is necessary to promptly examine patients with suspected malaria, and also be sure to examine patients with each hyperthermic syndrome who arrived from places where malaria is endemic for 3 years. Effective treatment helps stop further transmission of the pathogen through mosquitoes.Malaria vaccine
There is currently no official malaria vaccine. However, clinical researches experimental vaccine against tropical malaria. Perhaps, in 2015 - 2017, this vaccine will help cope with the malaria epidemic in the world.
What is lip malaria and how does it manifest?
Malaria on the lips manifests itself in the form of small blisters, located close to each other and filled with clear liquid. The cause of such lesions on the skin is the herpes simplex virus type 1. Therefore, the use of the term “malaria” to refer to this phenomenon is not correct. Also among the common names for the herpes virus on the lips there are such terms as “cold” or “fever on the lips”. This disease manifests itself with local symptoms that develop in accordance with a certain pattern. In addition to local symptoms, patients may also be concerned about some general manifestations of this disease. The stages of manifestation of herpes on the lips are:
- tingling;
- bubble formation;
- formation of ulcers;
- scab formation;
- healing.
initial stage Herpes on the lips is manifested by mild itching. The patient begins to experience a slight tingling sensation in the corners of the mouth, on the inside and outer surface lips Along with tingling, the patient may be bothered by the desire to scratch the areas around the wings of the nose or other parts of the face. Sometimes language can be involved in this process. The duration of this stage most often does not exceed 24 hours. These symptoms may occur due to overheating or hypothermia of the body. Often, herpes on the lips is a harbinger of a cold. In women, this phenomenon can develop during menstruation.
Bubble Formation
At this stage, the inflammatory process begins to develop. The areas where tingling was felt swell and small transparent bubbles form on their surface. The vesicles are located tightly to each other, forming small clusters. These formations are filled with a clear liquid, which becomes more cloudy as they grow. The pressure in the blisters increases and they become very painful. The location of the bubbles is the upper or lower lip, as well as areas under the nose.
Formation of ulcers
After 2–3 days, the bubbles with liquid begin to burst. During this period, the patient is most contagious, since the fluid contains a large number of viruses. An ulcer forms at the site of the burst vesicle.
Formation of scabs
At this stage, the ulcers begin to become covered with a brown crust. All affected areas are involved in the process, and within one day dried scabs form in place of the blisters. When removing the crust, bleeding wounds and a feeling of itching or burning may occur.
Healing
Wound healing and recovery occur within 4–5 days. skin. During the process of the scab falling off, the patient may be bothered by mild peeling and itching, which often provokes patients to peel off the crust of the ulcers on their own. This leads to the healing process being delayed. Such interference can lead to the addition of a bacterial infection.
Common manifestations of herpes on the lips
Along with rashes in the lip area, herpes simplex type 1 can be manifested by a deterioration in general condition, weakness, and headache. Often, patients have enlarged lymph nodes located in the area lower jaw. Body temperature may also rise, muscle pain may develop, and salivation may increase.
What types of malaria are there?
There are four main types of malaria. Each type is caused by a specific type of malarial plasmodium, which determines the specificity of the disease. The types of malaria are:
- tropical malaria;
- three-day malaria;
- malaria ovale;
- quartan.
Tropical or, as it is also called, comatose malaria has the most severe course. It accounts for about 95–97 percent of all deaths. The clinical picture is dominated by severe toxic syndrome. The changes in the phases of “chills,” “heat,” and “sweat,” characteristic of other forms of malaria, are not expressed.
The disease begins with the appearance of fever, diffuse headache and myalgia ( severe muscle pain). After a couple of days, symptoms of toxic syndrome appear - nausea, vomiting, low blood pressure. Tropical malaria is characterized by the appearance of a rash on the body ( allergic exanthema), cough, feeling of suffocation. During the first week, hemolytic anemia develops, which is accompanied by the development of jaundice. Anemia develops due to increased destruction ( hemolysis – hence the name anemia) red blood cells. Enlargement of the liver and spleen is observed only in the second week, which significantly complicates early diagnosis malaria.
Many people with weakened immune systems may develop toxic shock, malarial coma, or acute renal failure already in the first or second week of the disease. Patients who develop a malarial coma become lethargic, sleepy, and apathetic. After a few hours, consciousness becomes confused, inhibited, and convulsions may also appear. This condition has an unfavorable outcome.
Due to massive destruction of red blood cells, acute renal failure most often develops. So, from destroyed red blood cells, hemoglobin enters first into the blood and then into the urine. As a result, the processes of urine formation in the kidneys are disrupted and diuresis decreases ( daily urine). Due to oliguria, metabolic products that are normally excreted in the urine remain in the body. A condition called uremia develops.
Three-day malaria
Three-day malaria is a benign type of malarial invasion. As a rule, it is not accompanied by severe complications and does not lead to death.
Its onset is preceded by a short prodromal period, which is absent in the tropical species. It manifests itself as weakness and muscle pain, after which a sudden fever appears. The difference between three-day malaria is that temperature rises occur every 48 hours, that is, every third day. This is where the name of this type of malaria comes from. During the period of rising temperature, patients are excited, breathing heavily, their skin is hot and dry. Heart rate is sharply increased ( up to 100 – 120 beats per minute), blood pressure drops, and urinary retention develops. The phases of “chills,” “heat,” and “sweat” become more distinct. Average duration the attack varies from 6 to 12 hours. After two to three attacks ( respectively on days 7 – 10) an enlarged liver and spleen appear, and jaundice develops.
However, it can also happen that attacks of fever occur every day. This phenomenon is due to the entry into the blood of several generations of malarial plasmodium at once. Several months after the disease, the patient may continue to have periodic rises in temperature.
Malaria oval
This type of malaria is in many ways similar to tertian malaria, but has a milder course. The difference between malaria ovale is that attacks of fever occur every other day. The temperature rises mainly in the evening hours, which is not typical for previous types of malaria.
Quartan
This type of malaria, like the previous one, belongs to the benign forms of malarial invasion. It develops acutely, without any prodromal phenomena. Fever attacks occur every 72 hours. The temperature rises to 39 - 40 degrees. During attacks, the patient is also in serious condition - consciousness is confused, the skin is dry, the tongue is coated, blood pressure drops sharply.
In addition to the classic types of malaria, there is also a schizont type. It develops as a result of ready-made schizonts entering the human blood ( plasmodia that have undergone an asexual development cycle). Schizont malaria mainly develops as a result of blood transfusions or through the transplacental route. Therefore, this type is also called syringe or graft. Its difference is the absence of the development phase of plasmodium in the liver, and the clinical picture depends entirely on the volume of injected blood.
Mixed malaria also occurs, which develops as a result of infection with several types of malarial plasmodia simultaneously.
What are the features of tropical malaria?
The main features of tropical malaria are the severity of the developing symptoms, the nature of which is similar for all forms of the disease. There are also some differences between the complications, duration and outcome of tropical malaria from other types of disease. Onset of the disease
Malaria is characterized by a prodromal period ( mild course of the disease), which is characterized by general malaise and mild headaches. Typical for this disease are feverish states, followed by periods of calm ( paroxysms), occur after 2–3 days. In tropical malaria, the onset of the disease is more acute. From the first days, patients begin to experience nausea, vomiting, and indigestion in the form of diarrhea. Headaches vary in intensity. These symptoms are accompanied by a persistent fever that can last for several days. Subsequently, the fever acquires an intermittent course with other phases of paroxysms.
Features of tropical malaria from other forms
| All forms of malaria except tropical | Criteria | Tropical malaria |
| The attacks are characterized by a clear change in phases of chills, heat and sweat. The duration of the second stage rarely exceeds 12 hours. After the end of the heat, body temperature drops sharply and increased sweating begins. Seizures occur according to a certain pattern. So, with three-day malaria, paroxysm bothers the patient once every 3 days, with four-day malaria - once every four days. | Paroxysms | The difference between paroxysms in this form is the short duration and weak severity of the first phase ( chills). In some cases, attacks begin to develop from the fever stage, bypassing the chills. In this case, the temperature suddenly reaches high values ( above 40 degrees) and can last all day. There is no specific systematic pattern in the occurrence of attacks. They can occur every other day, daily or twice a day. A decrease in temperature can occur without heavy sweating. |
| The patient may not feel anemia and this sign in most cases it is detected during laboratory testing. Sometimes blood changes are manifested by pale skin and weakness. | Anemia | With tropical malaria, anemia is more pronounced. Blood tests can detect pathologies from the first days of the disease. Patients experience lethargy and apathy due to a reduced amount of hemoglobin. There is a bluish tint to the extremities. |
| The spleen increases in size after several attacks. In this case, the abdomen becomes large and palpation can reveal a twofold increase in this organ. | Enlarged spleen | This form of malaria is characterized by a rapid enlargement of the spleen, which can be detected by ultrasound as early as 2–3 days. In this case, patients complain of pain in the area of the right hypochondrium, which becomes stronger with a deep sigh. |
| With malaria, there is an enlargement of the liver, which entails nausea and pain, which is localized in the right hypochondrium. Liver functions are not significantly impaired, but yellowness of the skin and mucous membranes is present. A change in the size of this organ occurs after the first attacks and leads to a 10–15 percent increase in the total mass of the organ. | Liver enlargement | In tropical malaria, liver enlargement is more progressive. Also, this form is characterized by liver damage, which entails damage to the hepatic lobules ( liver functional units). |
| With malaria infection, there is a decrease in blood pressure during the fever phase and a slight increase during the chills stage. Patients also complain of rapid heartbeat and pain in the heart area, which are stabbing in nature. | Pathologies of the cardiovascular system | Tropical malaria is manifested by severe hypotension ( decreased blood pressure). In addition, there are severe heart pains, murmurs, and tachycardia. |
| During attacks, patients experience headaches and motor agitation. Feverish delirium may occur. In most cases, these symptoms go away as the temperature normalizes. | Violations nervous system | Tropical malaria is characterized by more pronounced damage to the nervous system. Severe headaches, feelings of anxiety and restlessness, convulsions, and confusion are often observed. |
| Malaria may be accompanied by a disorder such as albuminuria ( increased protein excretion in urine). Often, kidney dysfunction provokes edema. Such violations are quite rare - in 2 percent of cases. | Kidney dysfunction | With this form, kidney dysfunction is diagnosed in 22 percent of patients. |
Complications
Severe complications, which often result in the death of the patient, most often develop with tropical malaria.
Complications of tropical malaria are:
- malarial coma– the patient’s unconscious state with a complete lack of reaction to any stimuli;
- algid– toxic-infectious shock, in which the patient retains consciousness, but remains in prostration ( severely depressed and indifferent state);
- hemoglobinuric fever– development of acute renal and liver failure.
The duration of this form of malaria differs from other types of the disease. Thus, the total duration of three-day malaria varies from 2 to 3 years, four-day malaria - from 4 to 5 years, oval malaria - approximately 3 - 4 years. The duration of tropical malaria does not exceed, in most cases, one year.
What are the signs of malaria in adults?
The main symptom of malaria in adults is attacks of fever ( paroxysms) giving way to a state of rest. They are characteristic of all forms of the disease, except tropical malaria. Before the first attack, the patient may experience a headache, painful sensations in muscles and joints, general malaise. Body temperature may also rise to subfebrile levels ( no higher than 38 degrees). This condition continues for 2–3 days, after which febrile paroxysms begin. Malarial attacks are characterized by the presence of phases that develop and replace each other in a certain sequence. At first, the attacks may be irregular in nature, but after a few days a clear pattern of development of this symptom is established. The duration of pauses between attacks depends on the form of the disease. With three-day malaria, the attack repeats once every 3 days, with four-day malaria - once every 4 days. Attacks develop at the same time, most often between 11 and 15 hours. The phases of a malarial attack are:
- chills;
This stage can be manifested by both mild trembling and severe chills, from which the patient’s whole body shakes. At the same time, the patient’s hands, feet and face become cold and acquire a bluish tint. The pulse quickens and breathing becomes shallow. The skin turns pale, becomes rough and takes on a bluish color. Chills can last from half an hour to 2 – 3 hours.
Heat
This phase is accompanied by a sharp increase in temperature, which can reach above 40 degrees. The patient's condition noticeably worsens. The face becomes red, the skin becomes dry and hot to the touch. The patient begins to experience severe headaches, muscle heaviness, and rapid, painful heartbeat. The tongue is covered with a grayish coating and is not sufficiently moist. Often the fever stage is accompanied by vomiting and diarrhea. The patient is in a state of excitement, convulsions and loss of consciousness may occur. The heat provokes an unquenchable thirst. This condition can last from 5 – 6 to 12 hours.
Sweat
The heat stage is replaced by the final phase, which is manifested by profuse sweating. The temperature drops sharply to normal values, sometimes reaching 35 degrees. The patient feels relief, calms down and falls asleep.
Other signs of malaria
Along with seizures among the most characteristic features malaria includes anemia ( anemia), splenomegaly ( enlarged spleen) and hepatomegaly ( liver enlargement). This disease also has a number of symptoms that manifest themselves both on the physical and mental levels.
Signs of malaria include:
- anemia;
- splenomegaly;
- hepatomegaly;
- urinary disorders;
- dysfunction of the cardiovascular system;
- icteric staining of the skin and mucous membranes;
- skin hemorrhages;
- herpetic rashes ( manifestations of herpes);
- nervous disorders.
Patients with malaria rapidly develop anemia, which is characterized by a deficiency of hemoglobin and red blood cells. It develops due to massive destruction of red blood cells due to the presence of malarial plasmodium in them ( so-called hemolytic anemia). Signs of anemia are most obvious between attacks. However, anemia may still persist long time after recovery. The patient's skin becomes yellowish or sallow in color, weakness and increased fatigue are noted. With anemia, body tissues experience severe oxygen deficiency, because hemoglobin is an oxygen carrier.
Splenomegaly
An enlarged spleen is observed after 3–4 attacks of fever and persists for a long time. In tropical malaria, the spleen may enlarge immediately after the first paroxysm. Along with the increase, pain in this organ is observed. The spleen becomes denser, which is determined by palpation. In the absence of adequate treatment, the spleen enlarges so much that it begins to occupy the entire left side belly.
Hepatomegaly
The enlargement of the liver occurs faster than the change in the spleen. In this case, the edge of the liver drops below the costal arch and becomes denser and more painful. The patient complains of painful discomfort in the area of the right hypochondrium.
Urinary disorders
Against the background of ongoing processes in the body, during attacks during chills, patients experience frequent urination. In this case, the urine has an almost transparent color. With the onset of fever, the volume of urine becomes more scanty, and the color becomes darker.
Dysfunction of the cardiovascular system
The most severe disturbances of the cardiovascular system are expressed during malarial paroxysms. Characteristic signs of this disease are an increase in blood pressure during chills and a drop during fever.
Jaundice staining of the skin and mucous membranes
It is an early sign of malaria in adults. When red blood cells are destroyed, not only hemoglobin is released from them, but also bilirubin ( bile pigment). It gives the yellow color to the skin and mucous membranes. In people with dark color It is sometimes difficult to identify icteric staining of the skin. Their jaundice is determined by the color of the visible mucous membranes, namely the sclera ( outer shell of the eye). A yellowish color of the sclera or their icterus may appear long before the icteric discoloration of the skin, therefore it is important diagnostic sign.
Skin hemorrhages
Due to vascular spasms, a hemorrhagic rash forms on the patient’s body ( subcutaneous hemorrhages). The rash has no specific localization and spreads unevenly throughout the body. Externally, this sign looks like star-shaped spots of blue, red or purple.
Herpetic rashes
If a patient with malaria is a carrier of the herpes virus, it worsens during a febrile state. Bubbles with clear liquid characteristic of the virus appear on the lips, wings of the nose, and less often on other areas of the face.
Nervous disorders
The most obvious disorders of the nervous system are manifested in three-day and tropical malaria. Patients experience constant headaches, insomnia, and lethargy in the morning and throughout the day. The psyche of patients undergoes negative changes during attacks. They are depressed, have poor orientation, and answer questions asked in a confused manner. Often during a fever, patients become delirious and experience hallucinations. Tropical malaria is characterized by a violent state of the patient, which can continue even after an attack.
What are the signs of malaria in children?
In children, the signs of malaria vary widely, depending on the child’s age and immune system. Signs of malaria in children include:
- fever;
- anemia;
- rash;
- disorders of the gastrointestinal tract;
- disorders of the nervous system;
- convulsions;
- enlargement of the spleen and liver.
It is the main symptom of childhood malaria. It can be either constant or in the form of attacks. Classic attacks, which are typical for adults, are rare. Such attacks occur in several stages. The first stage is chills; the second is heat ( heat); the third is pouring sweat. Children are characterized by high temperature rises of up to 40 degrees or more. The younger the child, the stronger the fever. During the second stage, children are excited, they experience rapid breathing, dry and red skin. A drop in temperature is accompanied by heavy sweating and severe, debilitating weakness. Such classic seizures are rare in children. More often, the temperature is variable, and in 10–15 percent of children, malaria occurs without fever at all. Infants often experience constant fever, drowsiness, and lethargy. The equivalent of an attack in infants is a sharp pallor of the skin, turning into cyanosis ( bluish discoloration of the skin). In this case, the skin becomes sharply cold, and tremors of the limbs are observed.
Anemia
As a rule, malaria in children occurs with severe anemia. It appears from the first days of the disease and is often an early diagnostic sign. It develops due to massive destruction of red blood cells. The number of red blood cells sometimes drops to 30–40 percent of normal.
A distinctive sign of malarial invasion in children is changes in the blood not only in red blood cells and hemoglobin, but also in other blood elements. Yes, it is very often noted general decline leukocytes ( leukopenia), platelets. At the same time, the erythrocyte sedimentation rate increases. Despite severe anemia, jaundice in children with malaria is observed only in 15 to 20 percent of cases.
Rash
The rash is especially common in young children. It first appears on the stomach, then spreads to chest and other parts of the body. The nature of the rash can be very diverse - petechial, macular, hemorrhagic. The development of the rash is caused by a decrease in the number of platelets and increased permeability of the vascular wall.
Gastrointestinal disorders
Disorders of the digestive system are almost always observed. The younger the child, the more varied these disorders are. They manifest themselves in the form of diarrhea, repeated vomiting, and nausea. Often noted loose stool with an admixture of mucus, which is accompanied by bloating and pain. In infants, this may be the first sign of malarial infestation. Repeated vomiting also occurs, which does not bring relief.
Nervous system disorders
They can appear both at the height of febrile attacks and during the temperature-free period. These disorders manifest themselves in the form of meningeal symptoms, which are characteristic of all types of malaria. Photophobia, stiff neck, and vomiting appear. Such symptoms disappear simultaneously with a drop in temperature. Motor agitation, delirium, and confusion may also occur. This variety of nervous system disorders is explained by the effect of malaria toxin on nerve cells.
Convulsions
Seizures or convulsions are also very common in children with malaria. Basically, cramps appear at the height of fever. They can be clonic or tonic. Their appearance is explained by high temperature, and not by the presence of any disease. These seizures fall under the category of febrile seizures, which are characteristic of childhood. How younger age child, the more likely he is to have seizures.
Enlarged spleen and liver
It is a common but inconsistent symptom. The spleen and liver enlarge only after several repeated attacks of fever.
A separate type of malarial infection in children is congenital malaria. In this case, malarial plasmodium enters the child's body in utero through the placenta. This malaria is extremely severe and often ends in death. Children with congenital malaria are born prematurely, with low weight and abnormalities internal organs. The skin of such children is pale, with a waxy or jaundiced tint, and a hemorrhagic rash is often observed. The spleen and liver are sharply enlarged. When born, children do not make their first cry, they are usually lethargic, with reduced muscle tone.
Why is malaria dangerous during pregnancy?
The danger of malaria during pregnancy is the increased risk of developing malignant forms diseases. Physiological changes that accompany the process of bearing a child make a woman more susceptible to infection. The nature of the consequences is determined by the stage of pregnancy at which malaria infection occurred. The outcome of the disease is also influenced by the condition of the woman’s body and the timing at which treatment was started. Infectious agents can have a negative impact both on the pregnant woman and directly on the fetus itself. Consequences of malaria for women
The infection poses the greatest danger when it is contracted on early stages bearing a child. The most common consequence is spontaneous abortion. Termination of pregnancy occurs due to irreversible changes that have occurred in a woman’s body under the influence of malarial plasmodia. If pregnancy continues, children are often born prematurely, of which 15 percent die during childbirth and 42 percent die in the first days after birth. Among full-term children born to women infected with malaria, the percentage of stillbirths is an order of magnitude higher than among other mothers. Often, children of patients with malaria are born with low birth weight and are often ill during the first years of life.
Complications of malaria during pregnancy are:
- anemia (there is anemia among the people);
- nephropathy (a form of late toxicosis caused by kidney dysfunction);
- eclampsia (critical complications due to brain damage);
- hypoglycemia (decreased blood sugar).
Lack of hemoglobin in the blood provokes multiple pathological processes in a woman's body. The liver stops producing the necessary amount of protein to form new cells, which can result in intrauterine developmental delay of the embryo. Toxins are no longer excreted in full, which can lead to insufficient oxygen supply to the fetus.
Other consequences of malaria due to anemia are:
- premature placental abruption;
- stillbirth;
- weakness of labor.
Nephropathy develops after the 20th week of pregnancy and is manifested by increased blood pressure, swelling of the hands and face, insomnia and headaches. Laboratory tests for this disorder detect increased levels of protein and uric acid in the urine. The consequences of nephropathy may be a delay intrauterine development, fading pregnancy, fetal death.
Eclampsia
This disorder develops against the background of damage to brain cells, which is provoked by a malaria infection. Eclampsia manifests itself as convulsive seizures, after which the patient falls into a coma. After some time, the patient returns to consciousness. In some cases, a prolonged coma may develop, from which the woman cannot emerge. Vascular spasms that occur during seizures can lead to asphyxia ( suffocation) or hypoxia ( oxygen starvation) embryo. Eclampsia often causes intrauterine fetal death. In a pregnant woman this complication malaria can cause stroke, heart or lung failure, liver or kidney dysfunction. Often, against the background of this disorder, premature placental abruption occurs. All these pathologies can lead to the death of both the fetus and the woman herself.
Hypoglycemia
This syndrome can develop in pregnant women infected with tropical malaria. Hypoglycemia manifests itself in attacks, the repeated repetition of which can harm both the fetus and the expectant mother. The lack of the required amount of glucose can cause heartbeat disturbances or retardation in physical and mental development in the embryo. For women this state is fraught with depression of cognitive functions, depressed state, and attention disorder.
Also, the consequences of congenital malaria include:
- jaundice;
- epileptic seizures;
- anemia ( often in severe form);
- enlarged liver and/or spleen;
- increased susceptibility to infections.
What drugs are there against malaria?
Against malaria, there is a wide range of different drugs that act on different stages of the development of Plasmodium falciparum. First of all, etiotropic drugs are used, the action of which is aimed at destroying the malarial plasmodium from the body. Drugs whose action is aimed at eliminating symptoms ( symptomatic treatment).There are the following main groups of drugs against malaria:
- drugs that act on malarial plasmodia in the liver and that prevent their further penetration into red blood cells - proguanil, primaquine;
- drugs that act on erythrocyte forms of plasmodium, that is, those that are already in erythrocytes - quinine, mefloquine, atovaquone;
- drugs that act on the sexual forms of Plasmodium falciparum - chloroquine;
- drugs to prevent relapses of malaria - primaquine;
- drugs used to prevent malaria - plasmocide, bigumal.
- drugs that are used to both treat and prevent malaria are antifolates.
Main drugs used in the treatment and prevention of malaria
| A drug | Characteristic |
| Chloroquine | Mainly used for the prevention of all types of malaria. The drug should be taken a week before entering an endemic zone ( country or region with a high incidence of malaria). |
| Mefloquine | Used to prevent malaria in cases where chloroquine is ineffective. |
| Quinine | It is used in the treatment of malignant forms of malaria, for example, in the tropical form. The drug may be contraindicated due to individual intolerance. |
| Proguanil | Used in the treatment of malaria in combination with other drugs, such as atovaquone. Also used for prevention. |
| Pyrimethamine | Possesses wide range action and is effective against malarial plasmodium and toxoplasma. Rarely used in monotherapy, as it quickly causes resistance. |
| Atovaquone | Used in the treatment of malaria, but not registered in most CIS countries. Highly effective against all types of malaria, used in the treatment of malaria in AIDS patients. |
| Galfan | It is a reserve drug and is used in extreme cases for forms of malaria resistant to other drugs. It also has great cardiotoxicity. |
There are other drugs used in the treatment of malaria:
- antihistamines – clemastine, loratadine;
- diuretics – furosemide, diacarb, mannitol;
- colloidal and crystalloid solutions - refortan, 20 and 40% glucose solution;
- cardiotonic drugs – dopamine, dobutamine;
- glucocorticoids – Avamis, beclazone;
What anti-malaria pills are there?
There are different malaria pills depending on the underlying active substance.| Name of tablets | Characteristic | ||||||
| Quinine sulfate | Take 1 - 2 grams per day, lasting 4 - 7 days. They can be found in the form of 0.25 gram and 0.5 gram tablets. The daily dose is divided into 2 – 3 doses. The tablets should be taken with acidified water. It is best to use water with lemon juice. The dose and duration of taking the tablets depends on the type of malaria. Children's doses depend on age. |
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| Chloroquine | Adults are prescribed 0.5 grams per day. On the first day, the daily dose was increased to 1.5 grams in two doses - 1.0 and 0.5 grams. Children's doses are 5 – 7.5 milligrams per kilogram. Treatment with chloroquine lasts 3 days. |
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| Hydroxychloroquine | Adults are prescribed 0.4 grams per day. On the first day, the daily dose was increased to 1.2 grams in two doses - 0.8 and 0.4 grams. Children's doses are 6.5 milligrams per kilogram. Treatment with hydroxychloroquine tablets lasts 3 days. |
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| Primaquin | Available in 3 and 9 milligrams. They are taken at 27 milligrams per day for two weeks. The daily dose is divided into 2 – 3 doses. Proguanil is prescribed not only for therapy, but also for the prevention of malaria. The dosage depends on the type of malaria. On average, daily therapeutic dose is 0.4 grams, and the prophylactic dose is 0.2 grams. Treatment lasts 3 days, and prophylaxis lasts the entire period of stay in an area with a high risk of infection, plus another 4 weeks. Children's doses do not exceed 0.3 grams per day. Diaminopyrimidine group of drugs Sulfanilamide group of drugs Sulfones Tetracycline group of drugs and lincosamides
What tests for malaria need to be taken? For malaria it is necessary to take a general urine test, as well as general and specific tests blood, which will help diagnose this disease. General urine analysis Hemoleukogram All blood tests begin with a hemoleukogram. During malaria, red blood cells are destroyed in large numbers, which leads to shifts in the overall ratio of cellular elements in the blood. The main deviations in the hemoleukogram in malaria are:
For malaria, it is also necessary to take a biochemical blood test, which confirms the active destruction of red blood cells in the vascular bed. Immunological blood test Polymerase chain reaction based on a drop of blood What are the stages of malaria? The clinical picture of malaria is divided into several stages. The stages of malaria are:
The incubation period is the period of time from the moment the malarial plasmodium enters the body until the first symptoms appear. The duration of this period depends on the type of malarial plasmodium. The duration of the incubation period depending on the type of malaria The length of the incubation period may vary if inadequate prophylaxis has previously been taken. Stage of primary manifestations During periods of no fever, symptoms such as muscle pain, headaches, weakness, and nausea persist. If malaria develops in children, then during this period symptoms of gastrointestinal disorders predominate. These symptoms are vomiting, diarrhea, and bloating. As the liver enlarges, it increases Blunt pain in the right hypochondrium and jaundice develops, as a result of which the patients’ skin acquires a jaundiced tint. One of the most formidable symptoms of this period is the rapid developing anemia (decrease in the number of red blood cells and hemoglobin in the blood). Its development is caused by the destruction of red blood cells by the malarial plasmodium. Red blood cells are destroyed, and hemoglobin comes out of them ( which subsequently appears in the urine) and bilirubin, which gives the skin its yellow color. Anemia, in turn, leads to other complications. This is, firstly, oxygen deficiency that the body experiences. Secondly, hemoglobin released from red blood cells enters the kidneys, disrupting their functionality. Therefore, acute renal failure is a common complication of this period. It is also the main cause of death from malaria. This stage characterizes the main clinical picture of malaria. In case of untimely diagnosis and treatment, conditions such as malarial coma, toxic shock, and hemorrhagic syndrome develop. Toxic syndrome at this stage is moderate, complications are rare. As in the stage of early manifestations, anemia develops, the liver and spleen are moderately enlarged. Recovery stage Sometimes a latent stage may occur between the periods of early and late relapses ( complete absence of symptoms). It can last from two to ten months and is mainly characteristic of three-day malaria and malaria ovale. What are the consequences of malaria? There are multiple consequences of malaria. They can occur both in the acute period of the disease ( that is, in the stage of early manifestations), and after. The consequences of malaria are:
As a rule, it is a complication of tropical malaria, but can also be a consequence of other forms of malarial invasion. This complication is characterized by a staged, but at the same time, rapid course. Initially, patients complain of severe headache, repeated vomiting, and dizziness. They experience lethargy, apathy and severe drowsiness. Over the course of several hours, drowsiness worsens and a soporous state develops. During this period, convulsions are sometimes observed, meningeal symptoms (photophobia and muscle stiffness), consciousness becomes confused. If there is no treatment, it develops deep coma, during which blood pressure drops, reflexes disappear, breathing becomes arrhythmic. During a coma, there is no reaction to external stimuli, vascular tone changes and temperature regulation is disrupted. This condition is critical and requires resuscitation measures. Toxic shock Also with toxic shock, damage to the nervous system occurs, which is manifested by confusion, psychomotor agitation, temperature increase ( due to a violation of temperature regulation). Acute renal failure Symptoms of acute renal failure are rapid deterioration, decreased diuresis, and dark urine. In the blood there is a disturbance in the water-electrolyte balance, a shift in the alkaline balance, and an increase in the number of leukocytes. Acute massive hemolysis Hemorrhagic syndrome
These blood clots are formed due to enhanced thrombocytopoiesis, which, in turn, is activated due to the destruction of red blood cells. Thus, a vicious circle is formed. As a result of hemolysis of red blood cells, numerous breakdown products are formed, which enhance the formation of blood clots. The more intense the hemolysis, the stronger the hemorrhagic and DIC syndrome. Is there a vaccine against malaria? A vaccine against malaria exists, but it is not currently universal. Its routine use is not approved in European countries. The first malaria vaccine was created in 2014 in the UK pharmaceutical company GlaxoSmithKline. British scientists have created the drug mosquirix ( moskirix), which is intended to vaccinate populations most at risk of contracting malaria. Since 2015, this vaccine has been used to vaccinate children in many countries in Africa, where malaria is most common. Moskirix vaccination is given to children from one and a half months to two years. It is at this age that African children are most susceptible to malaria. According to scientists, as a result of vaccination, not all children developed immunity against malaria. In children aged 5 to 17 months, the disease was prevented in 56 percent of cases, but in children under 3 months it was prevented in only 31 percent of cases. Thus, the currently created malaria vaccine has a number of negative qualities, which suspends its large-scale use. New developments are currently underway to create a more universal malaria vaccine. According to scientists, the first mass vaccinations should appear by 2017. |
An infectious disease caused by a mosquito bite is called. Signs of malaria in adults manifest themselves in the form of prolonged fever, and the disease is often accompanied by relapses.
This disease has spread throughout the world, but places with a humid climate are most often susceptible to infection. Such conditions are favorable for malaria mosquitoes; here they can reproduce much faster.
Residents of African countries especially often suffer from this disease. According to world statistics, the disease annually claimed the lives of more than 200 million people.
However, through intensified control starting in 2000, rates have now improved and deaths have been halved.
How to identify the disease? It is necessary to know how Plasmodium falciparum manifests itself in an adult.
The causative agents of the disease are the protozoa Plasmodium. They get to a person after being bitten by a mosquito, the female of which injects them into the blood. Incubation period, can be different until the first manifestations. A person may not feel any discomfort, therefore, do not consult a doctor.
Depending on the type of sporozoites, the length of the incubation period varies:
- From 10 to 21 days, with slow development, for 1 year. This type is called three-day malaria;
- 11-16 days, with a slow course of the disease, more than 1 year, this variety is called malaria ovale;
- 25-42 days, development of four-day malaria occurs;
- Tropical malaria develops within 10-20 days.
The first symptoms of malaria after a mosquito bite are observed: headaches, joint pain, chills. Most often, this condition lasts more than 3 days.
Features of the course of the disease:
- With three-day malaria, short-term attacks occur, mainly during the day or in the morning;
- With malaria oval, attacks are observed in the afternoon. The disease proceeds without visible complications;
- With four-day malaria, relapses rarely occur;
- With tropical malaria, a strong fever occurs, the patient feels weak, and in the absence of timely help, leads to death. Seizures occur frequently.
Typically, malaria mosquitoes are active at night. In areas prone to this disease, the epidemic begins during periods of prolonged rain.
At-risk groups
There are several factors that influence infection:
- insect lifespan;
- external environment;
- human immunity.
People living locally at high risk develop immunity to the disease over the years. That is why children under 5 years of age are most often susceptible to infection.
People who move from another region are also more likely to contract malaria. This increases the risk of death from the disease.
Patients infected with malaria can pose a danger to others, so they must be isolated from society during treatment. Humans also run the risk of becoming a source of infection for mosquitoes.
Thus, having become infected while traveling in one region, a patient can easily spread the disease to another region upon returning.
How to diagnose the disease
The main reasons for diagnosis are attacks that recur every 48 or 72 hours. The liver enlarges, jaundice and sclerosis appear.
Sometimes these signs are not enough to make a diagnosis because the symptoms are similar to other infectious diseases.
Signs of tropical malaria can be confused with diseases of the central nervous system.
To do this, it is necessary to find out whether the patient has had similar problems before.
General blood test of the patient:
- hemoglobin is below normal;
- red blood cells are below normal;
- leukocytes are exceeded;
- platelets are higher than normal.
Analyzing data on diagnoses made at the first symptoms of malaria, doctors most often diagnosed ARVI, influenza, and meningitis. This simplifies the procedure, and is sometimes done to hide the fact that the patient was in the area of the disease epidemic.
Taking tests
Of fundamental importance laboratory diagnostics. The main method is to test the patient's blood. For analysis it is necessary blood from finger.
The core of plasmodium becomes dark red. For any form of the disease, except tropical malaria, a blood test can detect all stages of the development of plasmodium.
In addition, a general Analysis of urine. To detect hidden blood and urobilin, which increases during disease.
Based on the results of all studies, it is possible to determine what type of symptoms are observed, which will help select treatment.
Symptoms
Each of the 4 forms of the disease has its own characteristics, but the symptoms are common: febrile attacks; anemia, enlarged spleen.
During the course of the disease, several periods are observed:
- primary, hidden;
- primary manifestations of symptoms;
- hidden secondary period;
- period of complications.
Towards the end of the incubation period, the first symptoms begin to appear in the form of chills and pain.
Periods of the disease
The acute period is the most difficult. Now the patient has an increase in body temperature, but at the same time he freezes, blood pressure exceeds normal, and the pulse rate increases. Depending on the form of the disease, this condition can last up to 3 hours.
This is followed by a febrile period when the body temperature reaches 40 °C. The face becomes red and the patient feels hot. In this state, patients experience anxiety and their consciousness becomes confused. Headaches intensify, and in some cases, convulsions occur.
At the end of this period, profuse sweating appears, body temperature decreases, and the person begins to fall asleep. The attacks will be repeated in accordance with the frequency corresponding to the type of disease.
It is necessary to carefully monitor emerging symptoms, because malarial plasmodium has a destructive effect on all systems of the body, but most negatively on the nervous system, genitourinary, and cardiovascular.
Consequences
If the disease is not treated correctly, relapses may occur after some time.
The following complications are observed:
- coma;
- severe swelling;
- profuse hemorrhage;
- neurological disorders;
- liver and kidney pathologies;
- rupture of the spleen.
During attacks, some patients experience a decrease in the amount of urine produced, leading to kidney failure and death.
Treatment and prevention for adults
The latest treatment methods help fight the disease even in its most advanced forms.
IMPORTANT! Drug treatment should be carried out immediately after diagnosis of the disease, in a hospital setting.
Treatment has the following goals:
Depending on the form of malaria, symptoms and treatment will differ. Medicines used in therapy:
- quinine;
- tetracycline antibiotics;
- biguanides;
- lincosamides.
Patients require daily care and a special diet. It is necessary to include boiled vegetables and fresh fruits in the diet.
Summary
The risk of getting this disease exists not only in Africa, but also in some countries in Asia and Latin America.
Susceptible to infection:
- Women during pregnancy. If infected, there is a risk of miscarriage, as well as death of the mother and fetus;
- HIV – infected and sick with AIDS;
- People who are not immune to the disease.
The most effective measures to combat the disease is the destruction of malaria mosquitoes. Indoors must be sprayed with a special agent, and a mosquito net must be installed on the windows.
In addition, before going outside, it is advisable to lubricate the skin with a protective cream. If possible, avoid wearing revealing clothing.
In contact with
Malaria is a disease that in our latitudes is usually confused with influenza and other acute respiratory viral infections. This is especially widespread in the winter: at this time of year, people often go on vacation to tropical countries, where malaria feels at home, because the tropics are the habitat of malaria pathogens.
What is malaria?
Difference between the Anopheles mosquito and other species
Getting infected with malaria in our latitudes, as in any others, is possible if a person infected with plasmodia is bitten by a mosquito of the genus Anopheles (only this one). The mosquito drank a certain amount of infected blood, after which, driven away, it flew to another poor fellow, to whom it had already transferred the brutal plasmodia along with its saliva. Or when injecting two people with the same syringe (as with HIV, hepatitis). There are no other ways of transmitting malaria. Also, if you caught Plasmodium in the tropics, it means that it was transmitted to you by a mosquito from some person with malaria. Malaria is not transmitted by airborne droplets or in any other way!
There are 5 types of malaria, each of which differs in the degree of danger:
Immunity to malaria occurs only partially, after a large number of infections over several years. It occurs only for a specific type (strain) of malaria and intensifies with each new time. Symptoms become weaker over time, and the possibility of death is practically reduced to a minimum. There is no vaccine for malaria! Development and clinical trials of a vaccine against the tropical form are underway, but it will not protect you from all types of plasmodiasis at once. However, it showed weak efficiency (about 35%).
Symptoms of malaria
When I traveled to Papua New Guinea, I was, of course, well aware that this region is very rich not only in natural resources, but also in Plasmodium falciparum. And before going to such a wilderness, I stocked up on a good anti-malarial drug. Those. I was prepared for this disease, I knew its symptoms and knew how to treat it. But theory is theory, but in practice everything often turns out to be completely different, because it is impossible to foresee everything.
When I first felt the symptoms of fever and chills, the first thing I immediately thought of was malaria and nothing else. Local residents in this endemic region get sick very often and malaria in New Guinea is the most common disease. I went to the local hospital to get a rapid test for malaria. The test showed a negative result. I asked the doctor what should I do about my symptoms, to which the doctor replied that I needed to take Panadol (Paracetamol) two tablets every 6 hours. Those. usual, classic therapy for acute respiratory viral infections - just remove unpleasant symptoms(temperature) with paracetamol and wait until the immune system It will cure you of viruses itself. In addition, I also took the antibiotic amoxicillin, believing that cold symptoms could be caused by bacteria, i.e. I drank just in case, having no idea of the realities.
Possible symptoms of malaria
- Fever- temporary increase in body temperature due to intoxication of the body with waste products of plasmodium. Fever has a cyclical appearance. As a rule, the temperature rises sharply, reaches its peak value (38-40°) and drops, down to normal body temperature (36.6-37°). Cycles can be 4 days, 3 days or permanent. The temperature can change several times within one day, even with three-day malaria (all types);
- Chills- feeling of cold when the temperature rises in the first stage of fever (all types);
- Heat- feeling of heat when the temperature drops, redness of the skin, after chills, the second stage of fever (all types);
- Sweating- during heat transfer, the third stage of fever (all types);
- Tingling in the skin- unpleasant sensations similar to weak mosquito bites (all types);
- Cramps, muscle tremors- if the temperature rises to 39-40° and above. The body begins to shake, the muscles contract. This arises from the fact that the body, feeling cold, begins to contract muscles (as in real cold, frost) in order to thereby release the necessary heat to warm the internal organs (all types);
- Dry cough- a frequent occurrence;
- Joint pain- not all types of malaria ( P. falciparum);
- Nausea, vomiting- sometimes, against the background of elevated temperature as a side effect;
- Diarrhea- sometimes with blood ( P. falciparum);
- Headache- does not always appear (mostly P. falciparum);
- Anemia- decreased hemoglobin in the blood, pale skin, does not appear immediately (all types);
- Low sugar in blood- does not appear immediately;
- Hemoglobin in urine- does not appear immediately;
- Hepatosplenomegaly- enlargement of the spleen and liver in advanced forms (all types);
- Hepatitis nephroso-nephritis- renal-liver failure, jaundice ( P. falciparum);
- Hemorrhagic syndrome- bleeding of mucous membranes, leads to death ( P. falciparum);
- Coma- when the form is neglected, leads to death ( P. falciparum);
- Paralysis- rarely, with advanced form ( P. falciparum).
- Brain edema- manifests itself rarely; if the disease progresses lightning fast in the early stages, it can lead to death ( P. vivax);
Not all symptoms appear immediately and not in all forms of malaria. Main symptoms - fever, headache, anemia, enlarged liver and spleen. Death most often occurs from overheating when the temperature rises above 42°, as well as from encephalopathy - coma or cerebral edema. Malaria during pregnancy can cause fetal death, P. falciparum And P. vivax. The most susceptible to the disease are post-infant children (from 1 year to 5 years), pregnant women and adults who have not previously been ill (for example, tourists).
So I just lived, taking paracetamol when symptoms occurred. And the symptoms continued constantly. The temperature dropped and then rose again - cyclically. Then one day in Bangkok, instead of 2 paracetamol tablets, I took 1 - and then I started shaking! I didn’t have a thermometer, but I’m sure it was over 40 degrees, and I had a strong fever, with cramps, like after cold water.
Then I came home and lived at home for another week with these symptoms, which appeared and disappeared. I took paracetamol while taking them off. I would like to say that daily dose paracetamol is 1 g, but I took 3 g per day, i.e. 6 tablets (2 at a time). Sometimes 4. Why didn’t I see a doctor immediately upon arriving home? Because I thought that after constantly taking antibiotics, my immune system was slightly weakened, and therefore my body fought the flu virus more slowly.
P. falciparum under a microscope (Gametocyte)
Red blood cell infected with P. vivax
I would like to note that in such situations, many people attribute these symptoms to ARVI and exclude the possibility of malaria. Even when they go to the doctor, doctors often also make a diagnosis of ARVI, while sarcastically mocking ignorant patients. Even when they hint to them: maybe I have malaria?! However, whoever is ignorant here, this still needs to be established! It is not uncommon for such patients to die after an incorrect diagnosis by would-be therapists! People are treated for colds and end up dying from malaria when their body is no longer able to resist a huge number malarial plasmodia, which during this time greatly multiplied in their body.
About 100 years ago, malaria was used to treat syphilis. Patients with syphilis were specially infected with malaria in order to cause an increase in body temperature to 41-42°, at which the causative agent of syphilis dies. Malaria was then treated traditionally - with quinine.
And then one day, when I again felt a strong fever with shaking (muscle tremors), in which I could not even get out of bed, I realized that things were bad, and it was most likely not a cold. As soon as I felt better, I took my temperature: it was 40.2°. This is despite the fact that it was already on the decline, in accordance with its cycle. This means that during the tremors she was obviously higher. I decided to call an ambulance so that she would take me to the infectious diseases department of our city hospital (I had already been there), and there they could accurately diagnose me, without my ignorant amateur fortune-tellers, and I could receive appropriate therapy.
Bursting red blood cells release a new generation of plasmodia
I was admitted to the hospital with a preliminary diagnosis, which was made by ambulance workers - "Fever of unknown origin". This is the most adequate diagnosis for similar symptoms in a similar situation (the patient arrived from an endemic region), there was no talk of any ARVI or typhoid fever (often confused with malaria). The hospital took everything necessary tests, ruled out the presence of pneumonia, tuberculosis, and, of course, a cold. Before the first results of the blood test were ready, there were two versions of my diagnosis: sepsis (blood poisoning) and malaria. After the sterility test (for sepsis) and the “Thick Drop” were ready, the exact diagnosis was established - malaria. That means I was wrong, that means the rapid test was wrong, and I still have malaria. However, some test strips can only detect antigens (proteins) of the causative agent of tropical malaria and not the other three types. So, perhaps I came across just such a test, for the tropical form.
Test strip: 1 - absence of plasmodium; 2 - P. falciparum; 3 - combined; 4,5 - spoiled test.
Treatment of malaria
was found in my blood Plasmodiumvivax - the causative agent of three-day malaria. Adequate therapy is to take drugs like Quinine. Quinine is a drug that is obtained from the bark of the cinchona tree. People have been treating malaria with this substance since time immemorial. In Russia, Chloroquine is used, which is produced under various names, the most popular is - Delagil. I also informed the doctors that I have Quinine purchased abroad. I drank it too, taking 4 tablets even before taking Delagil. After which I felt a clear improvement in my health, a drop in temperature - it no longer rose.
Treatment of malaria in Russia: Chloroquine (Delagil / Immard / Plaquenil)
- 4 days (P. malariae) - 1st day: 1.5 gr, 2nd day: 0.5 gr, 3rd day: 0.5 gr;
- 3 days (P. vivax, P. ovale) - 1st day: 1.5 gr, 2nd day: 0.5 , 3rd day: 0.5 , 4th day and onwards (within 2 weeks) + Primaquin(to prevent relapse);
- Tropical (P. falciparum) - 1st day: 1.5 gr, 2nd day: 0.5 gr, 3rd day: 0.5 gr, 4th day: 0.5 gr, 5th day: 0.5 gr, next + Primaquin. -
For treatment tropical malaria this therapy outdated due to the emergence of resistance in some strains P. falciparum to chloroquine!
Other drugs (adult dose)
- Fansidar(Sulfadoxine + Pirematamine) - once, 3 tablets;
- Primaquin- 3 tablets/day, for 2 weeks;
- Quinine- 500-700 mg, every 7-8 hours, for 7-10 days;
- Lariam(Mefloquine) - 1 g once;
- Coartem(Artemether + Lumefantrine) - 4 tablets, morning and evening, for 3 days;
- Malaron(Atovaquone + Proguanil) - 4 tablets per day, for 3 days.
- Bigumal(Proguanil) - 1.5 g for 4-5 days
- Quinocid- 300 mg, 1-2 times a day
For treatment tropical malaria (p. falciparum) most often used: Lariam, Coartem and Malarone.
The World Health Organization recommends treating all types of malaria with artemisinin combination therapy (ACT). Artemisinin(or its derivatives) + Primaquin(for the treatment of relapses). Artemisinin is not a quinine derivative; it is isolated from Artemisia annua ( Artemisia annua). WHO.
The use of delagil for tropical malaria is now practically useless! As far as I know (the doctors themselves told me this), in our hospitals, except for Delagil, there are no more antimalarial drugs, but they can be purchased separately in city pharmacies. For example, the same Quinine is available in a form together with analgin, but the quinine content is very low. Chloroquine (Delagil), Primaquine are less harmful drugs than Quinine, but due to resistance Plasmodium falciparum to Chloroquine, Quinine, which kills all types of plasmodium, began to be used again. Primaquine is used to prevent relapses of malaria after primary recovery. Popular in Africa Coartem, which copes well with tropical malaria, which is widespread there.
IMPORTANT! In the Russian Federation, as well as in the CIS countries, you can only buy Delagil, Fansidar, Analgin with quinine among antimalarial drugs. Other drugs must either be ordered from abroad or brought with you from countries where malaria is endemic.
Typically, two types of drugs are used to treat malaria. First one, then the other (for example, first delagil, then primaquine). The fact is that they can live in our blood different shapes Plasmodium, sexual and asexual. By killing some forms, we do not kill others, and the person still remains infected, which can lead to recurrence and infection of other people during the mosquito active season (summer).
In my case, for three-day malaria, delagil is a completely adequate medicine. After taking Delagil they started giving me an antibiotic doxycycline(in conjunction with suprastin), it is also possible to take tetracycline or clindamycin. In addition, I took one quinine tablet each while in Papua New Guinea and Bangkok - at the time of high fever, just in case. I believed in the test results and believed that it was not malaria, but the flu, complicated due to a weakened immune system, but just in case I took quinine. Why one tablet? Because I gave this medicine to local residents, and they always only needed one tablet, after which they said that they felt good. However, the locals are less susceptible to the disease than I, a newbie! They have a partial immune response, antibodies to this type of plasmodium.
Relapses of malaria
Malarial plasmodia can go into “hibernation” and remain in the human body for many years, after which symptoms of the disease may appear again. For the prevention of exoerythrocytic distant relapses, it is prescribed Primaquin or Quinocid. The catch is that it is impossible to buy primaquine and quinocide in the Russian Federation - they are not certified drugs. They can, for example, be brought from abroad. Therefore, it turns out that to prevent relapses, our doctors try the use of antibiotics doxycycline, tetracycline, etc. However, this therapy does not always show a positive effect, without killing the “dormant” forms of plasmodium.
Alternatively, you can use complex therapy Quinine/Chloroquine (elimination of erythrocyte, blood forms) + fansidar(elimination of non-erythrocyte forms), it does not guarantee elimination of relapses, but can be used. Without the use of appropriate medications, there is a high risk of more and more new clinical manifestations of the disease occurring months and even years later. P. vivax, P. ovale can lie dormant in the body for up to 3 years, P. malariae- dozens.
I had a relapse after 2 months from the end of treatment. The temperature rose, chills, fever, sweating, pain in the left side, tingling on the skin, like weak mosquito bites. I didn’t even have my blood tested, but immediately started taking delagil - it’s easy to buy in pharmacies.
Prevention of malaria
If you go traveling to the tropical wilderness, be sure to stock up on anti-malarial drugs in advance in the large cities that you will pass through. Take time, go to the pharmacy and buy a couple of packages of the drug. Tropical malaria is very common in Africa and India, so do not take delagil there, but stock up on quinine. If you don’t know how to use a particular drug, then drink according to maximum 0.5 g per day, do not drink any more because it may cause side effects.
In 2015, about 214 million people had malaria, of whom 438,000 died. 90% of them were in Africa. WHO
To prevent malaria, you can use all the same drugs as to treat it. But it is worth remembering that if you do get malaria, despite taking medications, you need to use a different type of medicine to treat it. For prophylaxis, the same quinine, primaquine, Lariam (mefloquine), malarone, etc. are used.
However, despite small doses of the drug taken as preventive measures ( 2 once a week, starting at 2 weeks before the trip, and 2 after), the drugs still have a harmful effect on the body due to side effects. It is best to treat malaria after it appears. You should start taking it immediately, at the first symptoms. As soon as you feel an increase in temperature, feel free to take your treasured tablets according to the previously selected dosage.
Life cycle of Plasmodium falciparum
Malaria is one of the most dangerous human diseases. Plasmodium parasites are transmitted to humans through the bites of infected Anopheles mosquitoes. Plasmodium vivax causes tertian malaria, Plasmodium malariae causes tertian malaria, Plasmodium ovale causes tertian malaria, and Plasmodium falciparum causes tropical malaria. Each form of the disease has its own characteristics, but symptoms of malaria such as fever attacks, anemia and hepatosplenomegaly are common to all.
Life cycle The development of malarial plasmodium consists of 2 stages that occur in the body of the mosquito and the human body. In the human body clinical manifestations diseases are associated only with erythrocyte schizogony. Malaria is a polycyclic infection. During the course of the disease, there is an incubation period (primary and secondary), a period of primary acute manifestations, a secondary latent period and a period of relapse. If the infection occurred naturally (through), they speak of a sporozoite infection. If the disease develops when a donor's blood containing plasmodia is introduced into the human body or as a result of vaccination, they speak of schizont malaria.
Rice. 1. The malaria mosquito is a carrier of malarial plasmodia.
Rice. 2. Plasmodium parasites are the cause of malaria.
Incubation period
When a mosquito bites, sporozoites penetrate into the blood, where they move freely for 10 to 30 minutes, and then settle in hepatocytes (liver cells). Some sporozoites of Pl. ovale and Pl. vivax hibernate, another part of them and Pl. falciparum and Pl. malaria immediately begins hepatic (exoerythrocytic) schizogony, during which from 1 sporozoite is formed from 10 to 50 thousand hepatic merozoites. Having destroyed the liver cells, merozoites are released into the blood. The entire process lasts from 1 to 6 weeks. This ends the incubation period of malaria and begins the period of erythrocyte schizogony - the period of clinical manifestations.
Different types of pathogens have their own duration of the incubation period of malaria:
- With Plasmodium vivax, the short incubation period is 10 - 21 days, long incubation - 8 - 14 months.
- With Plasmodium malariae - 25 - 42 days (in some cases more).
- With Plasmodium falciparum - 7 - 16 days.
- For Plasmodium ovale - from 11 to 16 days.
The duration of the incubation period for malaria increases with inadequate chemotherapy.
Before an attack of malaria at the end of the incubation period with Plasmodium vivax and Plasmodium falciparum, a prodromal period is recorded: symptoms of intoxication and asthenia, headache, muscle and joint pain, general weakness, fatigue, and chilling appear.
Rice. 3. Malaria is common in more than 100 countries in Africa, Asia and South America.
Signs and symptoms of malaria during a febrile attack
Pathogenesis of fever in malaria
While in red blood cells, plasmodia absorb hemoglobin, but not completely. Its remains turn into dark brown pigment grains that accumulate in the cytoplasm of young schizonts.
When an erythrocyte ruptures, foreign proteins, hemoglobin, malarial pigment, potassium salts, and red blood cell residues enter the blood along with the merozoites. They are foreign to the body. By affecting the thermoregulation center, these substances cause a pyrogenic reaction.
Malaria in more cases occurs with characteristic febrile attacks. Rarely, the disease occurs with persistent fever lasting from 6 to 8 days and only then febrile paroxysms appear.
Rice. 4. Up to 30 thousand cases of “imported” malaria are registered annually, 3 thousand of which are fatal. In 2016, 100 cases of imported malaria were registered in the Russian Federation.
Development of a fever attack
- During the initial period of fever paroxysm The patient develops chills lasting from 30 minutes to 2-3 hours, often severe, the skin and mucous membranes become pale in color, and goose bumps appear. The patient is freezing and wraps himself in a blanket over his head.
Rice. 5. A rise in temperature during infectious diseases is always accompanied by chills.
- Feverish attack most often occurs around 11 am. Body temperature rises to 40°C or more, quickly, nausea, vomiting and dizziness occur. In severe cases of malaria, convulsions, delirium and confusion occur. The patient is excited, the skin is hyperemic, hot and dry to the touch, and herpes rashes often appear on the lips. The tongue is coated with a brownish coating. Tachycardia, shortness of breath and urinary retention are noted, and blood pressure drops. The patient becomes hot. He is tormented by thirst.
Rice. 6. An attack of malaria in a woman (India).
- After 6 - 8 hours, and with tropical malaria towards the end first day, body temperature decreases. The patient develops profuse sweating. Symptoms of intoxication gradually disappear. The patient calms down and falls asleep. After half a day, the patient’s condition becomes satisfactory.
Rice. 7. A decrease in temperature is accompanied by profuse sweating.
- Repeated attacks of fever occur after 2 days for 3-day, oval and tropical malaria or after 3 days for 4-day malaria.
- Secondary latency period occurs after 10 - 12 attacks of fever.
- With inadequate treatment weeks (sometimes months) later, short-term (up to 3 months) or distant (6-9 months) relapses occur.
After several attacks, patients' liver and spleen enlarge, anemia develops, the cardiovascular and nervous systems suffer, symptoms of nephritis appear, and hematopoiesis suffers. After the cessation of febrile attacks, anemia and hepatosplenomegaly persist for quite a long time.
Rice. 8. Temperature curve for malaria.
Signs and symptoms of malaria affecting internal organs
Causes of damage to internal organs
In case of insufficient treatment various organs malaria patient are detected pathological changes, the causes of which are:
- pathological substances circulating in the blood, leading to hyperplasia of the lymphoid and reticuloendothelial elements of the spleen and liver,
- sensitization of the body by foreign proteins, often accompanied by autoimmunopathological reactions of the hyperergic type,
- breakdown of red blood cells, leading to damage to internal organs, the development of anemia and thrombocytopenia, impaired blood circulation in the capillaries and the development of intravascular thrombus formation,
- disturbance of water-electrolyte balance.
Plasmodium, while in red blood cells, absorbs hemoglobin, but does not completely assimilate it. As a result, its remains gradually accumulate in the cytoplasm of young schizonts. When merozoites are formed, the pigment enters the blood and is further captured by macrophages of the liver, lymph nodes, spleen and bone marrow, which acquire a characteristic smoky or brown color. Over a long period of time, the pigment in the interstitial tissue forms massive accumulations. Its processing and disposal is slow. The specific coloring of the internal organs persists for a long time after treatment.
Foreign substances circulating in the blood irritate reticular cells spleen, liver, cause their hyperplasia, and with a long course - proliferation of connective tissue. Increased blood supply to these organs leads to their enlargement and pain.
Lack of appetite, nausea and a feeling of fullness in the epigastric region, often diarrhea are the main signs of liver damage in malaria. The liver and spleen gradually begin to enlarge. By the 12th day, yellowness of the skin and sclera appears.
The liver and spleen are enlarged and dense in malaria. The spleen can rupture with minor trauma. Its weight often exceeds 1 kg, sometimes the weight reaches 5 - 6 kg or more.
Rice. 10. A liver specimen affected by plasmodia.
Rice. 11. Enlarged liver and spleen in patients with malaria.
Bone marrow damage
Anemia due to malaria
The breakdown of red blood cells during the period of erythrocyte schizogony, increased phagocytosis and hemolysis caused by the formation of autoantibodies are the main causes of anemia in malaria. The degree of anemia is influenced by the type of plasmodium. Iron and folic acid deficiency in residents of several developing countries in Africa aggravates the disease.
Gametocytes of plasmodium of 3-day, 4-day malaria and malaria oval develop in the erythrocytes of peripheral capillaries for 2 - 3 days and after maturation die after a few hours, therefore anemia in these types of malaria often reaches a significant degree. Blood regeneration slows down significantly during three-day malaria, since plasmodia settle mainly in young red blood cells - reticulocytes. In addition, Plasmodium vivax causes ineffective bone marrow erythropoiesis. Anemia due to malaria is exacerbated by the destruction of healthy (uninfected) red blood cells.
The degree of anemia is related to the size of the spleen. The spleen in the human body is the only blood filtering organ. Its increase is a hallmark of malaria infections. When benign red blood cells are damaged in the spleen, extramedullary hematopoiesis starts to work, compensating for the losses.
Characteristic changes in the blood during malaria appear from 6 to 8 days of illness. And by the 12th day, hypochromic anemia, significant leukopenia, thrombocytopenia are registered, and ESR is significantly accelerated.
Rice. 12. Red blood cells become deformed when infected with Plasmodium vivax and Plasmodium ovale. When infected with Plasmodium malariae and Plasmodium falciparum, the shape and size of red blood cells do not change.
Rice. 13. Destruction of red blood cells when merozoites are released into the blood is one of the causes of anemia in the disease.
Signs and symptoms of malaria affecting the heart
The functioning of the heart is affected by toxic substances and anemia. Expansion of the borders of the heart to the left, muffled sounds at the apex and a slight systolic murmur at the apex are the first signs of organ damage in malaria. Long-term malaria negatively affects the functioning of the cardiovascular system. The patient begins to experience swelling in the feet and legs.
Signs and symptoms of malaria affecting the nervous system
Malaria affects the autonomic nervous system. Irritability, headache, and fatigue are the main symptoms of malaria when the nervous system is affected in long-term patients.
Rice. 14. Brain damage due to malaria. Multiple hemorrhages are visible in the brain tissue.
Relapses of malaria
The cause of early relapses that occur during the first 3 months after the expected recovery is the surviving schizonts, which, when the immune system is weakened, actively reproduce again.
The course of relapses is usually benign. General toxic syndrome is moderately expressed. Malarial paroxysms occur rhythmically. Anemia, an enlarged spleen and liver are the main signs of recurrent malaria.
The duration of the disease caused by Plasmodium vivax lasts 1.5 - 3 years, Plasmodium ovale - from 1 to 4 years.
Rice. 15. Children with malaria.
Complications of malaria
Malaria causes complications that are closely related to the pathogenesis of the disease. These include severe anemia, persistent enlargement of the spleen and its cirrhosis, cirrhosis and melanosis of the liver, nephrosonephritis, encephalopathy with development mental disorders and hemoglobinuric fever.
At acute diffuse nephrosonephritis Patients develop edema, protein and red blood cells in the urine, and in some cases arterial hypertension develops. Symptoms that are under the influence of adequate treatment and diet.
At malarial hepatitis yellowness of the sclera and skin appears, the liver enlarges, its pain is noted on palpation, bilirubin in the blood increases, and liver function tests are distorted.
Available splenic rupture with minor injury.
Hemoglobinuric fever is the most severe complication of tropical malaria, rarely found in other types of disease. With the disease, acute hemolysis of red blood cells develops, a flood of hemoglobin in the blood and its excretion in the urine, which occurs under the influence of medicinal product quinine. The patient develops a jaundiced coloration of the sclera and skin, and the liver and spleen become enlarged.
Acute pulmonary edema develops in tropical malaria. The trigger mechanism is an increase in vascular permeability as a result of exposure to toxins. The problem is aggravated by the increased introduction of fluid into the patient's body.
Hypoglycemia develops mainly in tropical malaria. Its cause is a violation of glucogenesis in the liver, an increase in glucose consumption by plasmodia and stimulation of insulin secretion by the pancreas. When the disease occurs, a large amount of lactic acid accumulates in the patient’s tissues. Developed acidosis is often the cause of death.
Timely detection and adequate treatment of malaria always results in recovery. With late detection and inadequate treatment, tropical malaria always ends fatal. The other three types of malaria are benign infections.
Rice. 17. Yellowness of the sclera and skin indicates liver damage
Malaria in pregnant women
Malaria adversely affects the course of pregnancy and its outcome. It can cause abortion, miscarriage and premature birth. Fetal developmental delay and death are often observed. Malaria is often the cause of eclampsia in pregnant women and death. Pregnant women living in areas where malaria is endemic are the most endangered population. Late diagnosis and inadequate treatment quickly lead to the development of “malignant malaria.” The development of hypoglycemia, which often causes death, is especially dangerous in pregnant women.
Rice. 18. Placenta infected with malarial plasmoids.
Malaria in children
The most vulnerable age is children from 6 months to 4 - 5 years. Malaria is especially dangerous for young children.
In malaria-endemic regions, the disease in children is one of the causes of high mortality. Children under 6 months of age born from immune mothers do not develop malaria.
Types of malaria in children
Malaria in children can be congenital or acquired.
Malaria in children often develops a fulminant course. Severe anemia may develop within a few days and cerebral form diseases. Malaria in children often occurs in a peculiar way:
- the skin is pale, often with an earthy tint, yellowness and waxiness persist for a long time, despite treatment;
- malarial paroxysms (fever attacks) are often absent;
- symptoms such as cramps, diarrhea, regurgitation, vomiting and abdominal pain come to the fore;
- during attacks of malaria there are often no chills at first, and at the end of an attack of fever there is often no sweating;
- a rash in the form of hemorrhages and spotty elements often appears on the skin;
- anemia increases quickly;
- with congenital malaria, the spleen is significantly enlarged, the liver - to a lesser extent.
Symptoms of malaria in older children
In older children, the disease progresses as in adults. During the interictal period, the children's condition remains satisfactory. The fulminant form of three-day malaria is rare, and malarial coma is extremely rare.
Differential diagnosis
Malaria in children should be distinguished from hemolytic disease of the newborn, sepsis, septic endocarditis, miliary tuberculosis, pyelonephritis, hemolytic anemia, typhus, brucellosis, food poisoning, leishmaniasis in children living in the tropics.
Rice. 19. Up to 90% of malaria cases and deaths from it occur in countries of the African continent.
Rice. 20. About 1 million children die from malaria every year.
Malaria is a group of vector-borne diseases that are transmitted by the bite of a malarial mosquito. The disease is widespread in Africa and the Caucasus countries. Children under 5 years of age are most susceptible to the disease. More than 1 million deaths are recorded every year. But, with timely treatment, the disease proceeds without serious complications.
Etiology
There are three ways of contracting tropical malaria:
- transmission type(through the bite of a malarial mosquito);
- parenteral(through unprocessed medical supplies);
- transplacental(mixed type).
The first route of infection is the most common.
General symptoms
The first and most sure sign of infection with the disease is fever. It begins as soon as the malaria pathogen has penetrated and reached critical level. In general, the symptoms of malaria are:
- periodic fever;
- significant enlargement of the spleen;
- Possible liver hardening.
The general list may be supplemented with other signs, depending on the period of development and form of the disease.
Forms of malaria
In modern medicine, the disease is classified into four forms:
- three-day form;
- four-day;
- tropical infectious form;
- ovale malaria.
Each of these forms has its own characteristic, pronounced symptoms and requires an individual course of treatment.
Three-day form
Three-day malaria has a very favorable prognosis compared to other forms of the disease. The incubation period can last from 2 to 8 months from the moment of the mosquito bite.
The symptoms of malaria of this subform correspond to the list described above. In the absence of correct treatment or if the immune system is too weakened, complications such as nephritis or malarial hepatitis may occur. In the most complex clinical cases, peripheral nephritis may develop. But in general, three-day malaria occurs without significant complications.
Quartan
Just like three-day malaria, with correct and timely treatment it occurs without significant complications. General symptoms of the disease can be supplemented by the following signs:
- daily fever;
- There is practically no increase in internal organs.
It is worth noting that attacks of fever can be easily stopped if antimalarial drugs are used in a timely manner. However, relapse of the disease can occur even after 10–15 years.
In rare cases, a complication may develop in the form of renal failure.
Ovale malaria
In its symptoms and course, this form is similar to the three-day form of the disease. The incubation period can last on average up to 11 days.
Tropical malaria
Tropical malaria is the most common form of the disease. Harbingers of the development of the disease may be the following:
- sharply increased temperature;
- chills;
- weakness, malaise;
- muscle pain.
Unlike three-day malaria, this form of pathology is characterized by a severe course. Without appropriate treatment, even death can occur. The virus is transmitted from a sick person to a healthy person, or through a mosquito bite.
Periods of disease development
Since the disease is classified as a polycyclic infectious disease, its course is usually divided into four periods:
- latent (incubation period);
- primary acute period;
- secondary period;
- relapse of infection.
Clinical picture of periods
The initial period, that is, the incubation period, practically does not manifest itself at all. As we move into acute stage, the patient may exhibit the following signs of the disease:
- a sharp change from a period of chills to fever;
- increased sweating;
- partial cyanosis of the extremities;
- rapid pulse, heavy breathing.
At the end of the attack, the patient’s temperature can rise to 40 degrees, the skin becomes dry and red. In some cases there may be a violation mental state- a person is either in an excited state or falls into unconsciousness. Convulsions may occur.
During the transition to the secondary period of development of the pathology, the patient calms down, his condition improves somewhat, and he can sleep peacefully. This condition is observed until the next attack of fever. It is worth noting that each attack and the development of a new period of the disease is accompanied by profuse sweating.
Against the background of such attacks, an enlarged condition of the liver or spleen is observed. In general, the incubation period includes up to 10–12 such typical attacks. After this, the symptoms become less pronounced and the secondary period of the disease begins.
Without treatment, relapse almost always occurs and death cannot be ruled out.
Diagnostics
Diagnosis of this disease is not particularly difficult, due to its specific symptoms. To clarify the diagnosis and prescribe the correct course of treatment, a laboratory blood test is performed (allows us to identify the pathogen).
With timely treatment, malaria proceeds without significant complications. In this case, any traditional methods or dubious pills purchased independently from a pharmacy are unacceptable. Delay can result not only in relapse of the disease and complications in the form of other diseases, but also in death.
The most effective is drug treatment. In this case, the patient must be hospitalized, since treatment should be carried out only inpatiently and under the constant supervision of medical specialists.
At initial period, as a rule, they get by with just tablets. The most commonly used is Hingamin. The doctor calculates the dosage and frequency of administration individually based on the general health condition, weight and age of the patient.
If you didn't bring the pills desired result, and the condition of the infected patient has not improved, drugs are prescribed that are administered intravenously.
Other tablets based on artemisinin can also be used to treat the disease. But drugs based on this substance are very expensive, so clinical practice They have not found widespread use for the treatment of malaria infection. However, such tablets are most effective for treating even late stages development of the pathological process.
Possible complications
Unfortunately, malaria in any form can affect the condition of any organ or system in the human body. The disease most often affects the liver, spleen and cardiovascular system. Also, against the background of malaria, diseases of the nervous system, genitourinary and vascular systems can occur.
As medical practice shows, the disease is most difficult and fatal in southern countries where there is no access to good drugs. Cheap pills can only temporarily stop attacks, but the infectious agent does not die from this. As a consequence of this, the transition to the last period of development of the disease begins and death occurs.
Prevention
Prevention of malaria requires taking special tablets. You should start taking them 2 weeks before your intended departure to the risk zone. An infectious disease doctor can prescribe them. It is worth continuing to take the prescribed pills after arrival (for 1–2 weeks).
In addition, to prevent the spread of infection in countries where the disease is not uncommon, measures are being taken to destroy malaria mosquitoes. The windows of the buildings are protected by special nets.
If you are planning to go to such a dangerous zone, you should get special protective clothing and do not forget to take preventive pills.
Such preventive measures almost completely eliminate infection with this dangerous disease. If you experience at least a few of the symptoms described above, you should immediately contact an infectious disease specialist. Timely treatment will allow you to almost completely get rid of the disease and prevent the development of complications.
