Malaria: Symptoms, Blood Tests, Treatment and Prevention

6 min read · Conditions · By the Asthra Health Care team

What is malaria?

Malaria is caused by a parasite called Plasmodium, which is spread by the bite of an infected female Anopheles mosquito. These mosquitoes bite mainly between dusk and dawn. In India, the two most common types are Plasmodium vivax and Plasmodium falciparum. Falciparum malaria is more dangerous and can quickly become severe.

Malaria is more common in the monsoon and after it, in forested, tribal and rural areas, and in places with stagnant water. People who travel to such areas can bring it home to cities. Construction sites, where water collects in pits and tanks, can also become breeding places near towns. Malaria does not spread directly from one person to another through touch or air.

Symptoms of malaria

Symptoms usually appear one to two weeks after the mosquito bite, but vivax malaria can sometimes appear or return months later. Classic malaria causes bouts of fever that come and go, but in many people the fever does not follow a neat pattern.

• Fever with shivering and chills, followed by sweating
• Headache and body ache
• Nausea, vomiting and poor appetite
• Tiredness and weakness
• Sometimes loose motions or cough

Severe malaria

Severe malaria, usually from falciparum, is a medical emergency. It can affect the brain, kidneys, lungs and blood. Signs include confusion, fits, drowsiness, yellow eyes, very dark urine, breathing difficulty and severe weakness. Severe malaria needs hospital care with injectable medicines, so do not wait at home if these signs appear.

Young children, pregnant women, elderly people and people with weak immunity are at higher risk. In pregnancy, malaria can harm both mother and baby, so any fever in a pregnant woman in a malaria area needs prompt testing. Malaria can also cause anaemia, so a doctor may check haemoglobin after recovery.

How malaria is diagnosed

Malaria cannot be diagnosed by symptoms alone, because many fevers look similar. A blood test is needed. A rapid diagnostic test (RDT) from a finger-prick gives a result in minutes and can tell vivax from falciparum. A peripheral blood smear, examined under a microscope, confirms the parasite and shows how many are present.

Testing is available free at government health centres under the national malaria programme. Your doctor may also check a complete blood count, kidney and liver tests and blood sugar, especially if you are very unwell. A negative test early in the illness may need to be repeated if fever continues.

How malaria is treated

Malaria is fully treatable when diagnosed early. The medicine chosen depends on the type of malaria, how severe it is, age and pregnancy. Doctors follow national treatment guidelines, which include artemisinin-based combination therapy for falciparum malaria and chloroquine for vivax malaria in most areas.

Vivax malaria also needs a second medicine, primaquine, to clear the parasite hiding in the liver and prevent relapse. Before giving it, doctors may check for G6PD deficiency. All antimalarial medicines are taken only on a doctor's prescription. Complete the full course even if you feel better, as stopping early can let the infection return.

Care at home during treatment

Rest and drink plenty of fluids. Paracetamol can ease fever and body ache; follow the label or your pharmacist's advice. Eat small, frequent light meals. If you vomit within a short time of taking an antimalarial tablet, tell your doctor, as the dose may need to be repeated. Return for a follow-up test if your doctor asks.

Some antimalarial medicines are best taken with food, and some can cause nausea or dizziness. Ask your pharmacist how to take your medicines and what side effects to expect. Tell the doctor about all other medicines you use, and let them know if you are pregnant or breastfeeding, as this changes the choice of treatment.

Preventing malaria

Sleep under an insecticide-treated bed net, especially children and pregnant women. Use mosquito repellent and wear long sleeves in the evening. Keep windows screened and remove stagnant water near the home. Cooperate with health workers during indoor spraying and fever surveys.

If you are travelling to a high-malaria area, ask your doctor whether preventive medicine is needed. Anyone with fever during or after such travel should get a malaria test. Speak to your doctor or pharmacist for advice before and after travel.

This article is general health information, not medical advice. Do not start, stop or combine medicines on your own — always follow your doctor's prescription and ask your pharmacist if unsure.