Types, Causes and Treatment Of Malaria

Malaria is a life-threatening disease prevalent in countries with tropical climates. About 500 million people are said to be infected with malaria yearly.

Effective treatments has been shown to reduce the annual mortality and morbidity rates. As of 2020, a vaccine, RTS,S/AS01 (RTS,S) has been reported to decrease malaria risk by about 40% in African children. In this article, you’ll get to know more about the types of malaria and their treatments.

Types, Causes and Treatment Of Malaria

There are five species of plasmodium parasites which infects humans. They are:

(a) Plasmodium falciparum (P. falciparum)

(b) Plasmodium vivax (P. vivax)

(c) Plasmodium malariae (P. malariae)

(d) Plasmodium ovale (P. ovale)

(e) Plasmodium knowlesi (P. knowlesi)

1. Plasmodium falciparum

Considered the most fatal, Plasmodium falciparum is accountable for several malarial deaths. The World Health Organization World Malaria Report 2019 reported 228 million cases of malaria worldwide with a resultive deaths of 405,000 in 2018.

Caused by the female Anopheles mosquito, P. falciparum is mostly prevalent in Africa. Children under the age of 5 years are most prone to this disease. Also, pregnant women are susceptible to severe malaria.

Susceptibility is reduced in subsequent pregnancies. The clinical features of falciparum malaria include chills, fever, headaches, sweating, dizziness, vomiting, dry cough amongst others.

According to 2010 WHO guidelines, artemisinin-based combination therapies (ACTs) are the primary antimalarial treatments for uncomplicated P. falciparum malaria. WHO recommends a variety of combinations such as artemether/lumefantrine, artesunate/mefloquine, artesunate/amodiaquine, artesunate/sulfadoxine-pyrimethamine, and dihydroartemisinin/piperaquine.

In cases where initial treatment fails, second-line antimalarial treatment is recommended, for example, artesunate and doxycycline or tetracycline or clindamycin; aquinine and doxycycline or tetracycline or clindamycin. Any of these combinations should be administered for 7 days.

2. Plasmodium vivax

Though it’s less virulent than P. falciparum, P. vivax is the leading cause of severe disease and death due to enlarged spleen.

P. vivax is prevalent in Latin America, Asia and a few parts of Africa. This disease exhibit symptoms like loss of taste, hiccups, pain while swallowing, urinary discomfort and cough.

In cases of severe malaria, intravenous (IV) and intramuscular (IM) artesunate is recommended for adults. Chloroquine is highly recommended for treating vivax malaria.

In the presence of Chloroquine resistance, artesunate becomes the most preferred drug of choice. Artemisinin-based combination therapy in combination with primaquine can also be used for treating P. vivax malaria.

3. Plasmodium malariae

Due to its low prevalence and milder clinical features, P. malariae is one of the least studied species.

Widely spread across Sub-saharan Africa, Southeast Asia, islands of the western Pacific and Indonesia, P. malariae leads to a chronic infection which can last a lifetime in some cases.

A distinguishing feature of P. malariae is bouts of fever which exhibits quartan periodicity. Other symptoms associated with this condition include nausea, chills, nephrotic syndrome and edema. Chloroquine is mostly used for therapy.

4. Plasmodium ovale

Primarily concentrated in the Sub-Saharan region and islands in the Western Pacific, P. ovale is a rare malarial infection and less deadly than P. falciparum.

There are about 15 million cases of P. ovale infection annually. Characterised by the tertian fever, symptoms usually occurs between 12 to 20 days in human.

In rare cases, P. ovale may occur 4 years after initial infection. Typical treatment is simultaneous treatment with chloroquine and primaquine.

In circumstances where patients are resistant to Chloroquine, the combination atovaquone-proguanil may be used.

5. Plasmodium knowlesi

Plasmodium knowlesi is a rare form of malaria that affects humans. Prevalent in Southeast Asia, P. knowlesi is recognised as a major health burden in Malaysia.

P. knowlesi can result to uncomplicated and severe malaria in humans. People with uncomplicated P. knowlesi most times display symptoms like loss of appetite, headaches, joint pain.

Few infected persons exhibit abdominal pain, coughing, nausea and vomiting. In contrast to other human malarias, people infected with P. knowlesi experience daily fever spikes.

Due to socio-economic and lifestyle, males are more prone to P. knowlesi malaria than females; adults are more affected than children.

For patients suffering from uncomplicated malaria, the World Health Organization approves treatment with artemisinin-based combination therapy (ACT) or chloroquine.

For those with severe malaria, the World Health Organization approves the use of intravenous artesunate for at least 24 hours, followed by ACT treatment.

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