Malaria is a serious and sometimes fatal disease. People who become infected with it tend to have severe symptoms, including chills, fever, and flu-like conditions. Malaria has a high mortality rate. However, timely and proper treatment can prevent this. The causative agent of malaria is Plasmodium, which lives in the body of a certain type of mosquito that feeds on human blood. This issue will be considered in more detail below. You will find information about the treatment and prevention of the disease in this publication.
History
The symptoms of malaria have been described in ancient Chinese medical writings. Several characteristic signs of the disease, which was later called malaria, are found in the work of the imperial doctor Nei Jing "Canons of Medicine". This disease was widely known in Greece already in the 4th century BC, at that time it caused a high mortality of the population. The main symptoms were noted by Hippocrates and other philosophers and doctors of antiquity. The Hindu physician Susruta, a thinker and follower of Ayurveda, in his treatise also mentioned the symptoms of malaria and toldabout their appearance after the bites of certain insects. Some Roman writers associated malaria with swamps.
The inquisitive minds of mankind have always been looking for ways to cure all sorts of ailments. What methods were not resorted to for the treatment of malaria in ancient times: bloodletting, amputation of a bitten limb, the use of opium drugs … Even astrologers were attracted, who associated the frequency of occurrence of malaria fevers with astronomical phenomena and the position of stars in the sky. Many turned to witchcraft. Scientist Albert Magnus, a Dominican, proposed treating malaria by eating small buns made from the flour and urine of a sick person, as well as drinking a drink that included cognac, the blood of an infected person and pepper.
The ancient Greek physician Galen, who worked in Rome, suggested that vomiting that occurs with malaria is an attempt by the body to expel poisons out, and bloodletting speeds up the cure. These principles have dominated medicine for fifteen hundred years. Countless malaria patients were subjected to bloodletting and forced cleansing of the stomach and intestines by means of enemas and vomiting. This had disastrous results, with people dying of anemia and dehydration, as well as the devastating symptoms of malaria, in even shorter timeframes.
In China in the 2nd century BC. in the writings of physicians, the plant artemisia, or sweet wormwood, was described, which was used as a remedy for malaria. Interestingly, in 1971, Chinese scientists isolated the active ingredient from it - artemisin. During the Vietnam War, active work was carried out to study the antimalarial properties of sweet wormwood. The plant extract was fed to laboratory mice and rats infected with malaria strains. Artemisinin proved to be quite effective, just like quinine and chloroquine. Derivatives of this substance are now part of powerful and effective antimalarial drugs.
The type of Plasmodium that causes the development of malaria was first discovered by the French physician and scientist Laveran at the end of the 19th century. Russian researchers have made a huge contribution to the study of the disease and the development of methods for its elimination. Among these scientists, it is worth noting E. I. Martsinovsky, V. A. Danilevsky, S. P. Botkin. During the periods of the First and Second World Wars, there were surges in the incidence of malaria.
Out of the two hundred existing species of parasitic protozoa of the genus Plasmodium, at least ten cause malaria. Among them are P. ovalecurtisi, P. wallikeri, P. vivax, P. malariae, P. knowlesi. The most severe and lethal malaria is caused by P. knowlesi and P. falciparumand. The infection leading to the development of the disease is transmitted exclusively by mosquitoes of the Anopheles genus. Malaria becomes more likely to occur during active travel around the world, especially to remote endemic areas of the planet, as well as through human interaction with wild animals.
Facts
Malaria is a disease caused by the parasitic protozoan Plasmodium, which infects an average of 200 million people a year around the globe. As a result, 500,000deaths. The causative agent of malaria enters the body through the bites of malarial mosquitoes. What happens next? The malaria parasite goes through a complex life cycle in the body of a mosquito and then in the body of an infected person. The cycle repeats if a mosquito bites a person who is already infected and has a parasite in his blood that causes the disease "malaria". A photo of the pathogen is shown below.
The areas with the highest mortality from this disease are Africa, Asia, Central and South America. Malaria is a disease that affects a very large number of people visiting these areas. In sub-Saharan Africa, the majority of cases (86%) are children under 5 years of age. About 40% of the world's population is at risk of infection. The incubation period is from one to three weeks. Some people can become carriers of so-called sleeper parasites. In this case, the activation of the infection may occur several months or even years after the malaria plasmodia enter the body.
Signs
Malaria is a disease whose symptoms include chills, fever, headaches and muscle pain. Some patients experience nausea, vomiting, cough and diarrhea. The state of fever recurs every one, two or three days - this is the most typical manifestation of malaria. Shivering and feeling cold are followed by the so-called hot stage, which is characterized by high fever, convulsions, headaches and vomiting.
Complications are often signs of such a form of illness as tropical malaria. Due to the destruction of the redblood cells and liver cells may experience jaundice of the skin and whites of the eyes, as well as diarrhea and cough. In more rare cases, a rash appears on the body in the form of itchy reddish papules. Malaria is defined as such. A photo of the carrier of the disease is presented above.
Severe forms, such as when Plasmodium falciparum is the causative agent of malaria, are accompanied by problems such as:
- bleeding;
- liver and kidney failure;
- shock and coma;
- damage to the central nervous system.
Without timely treatment, these symptoms often lead to death.
How is it transmitted?
So, let's take a closer look at how the malaria pathogen enters the body and develops in it. The life cycle of the malaria parasite Plasmodium is complex, the microorganism has two hosts - a human and a malarial mosquito. As mentioned above, the disease is transmitted through an insect bite, in which the parasite enters directly into the bloodstream.
Sporozoites (immature Plasmodium) travel through the human bloodstream and enter the liver. There they mature and infect red blood cells - erythrocytes, inside which they develop until the patient is again bitten by the malaria vector - a mosquito. Getting into the body of an insect, plasmodia penetrate into its salivary glands, and with the next bite in the form of sporozoites, they begin their life cycle in human blood again.
The developmental processes of species such as P. ovale and P. vivax can be even more complex andinclude the formation of inactive forms - hypnozoites, which often remain inactive for several weeks and even years. In the body of the malarial mosquito, Plasmodium go through the sexual period of its life cycle, and in the human body, the pathogen is in the asexual phase, which is also called schizogony. Therefore, the development cycle of plasmodium in red blood cells is called erythrocyte schizogony.
How is the infection transmitted? Its sources are female malarial mosquitoes and an infected person (both sick and carrier). It is worth noting that malaria is a disease that is not transmitted among people either by household or airborne droplets. Infection can occur only if the patient's blood enters the body of a he althy person.
Diagnostic features
When the above symptoms appear, especially after travel, it is recommended to be tested for the presence of malarial plasmodium. The manifestations of many diseases can resemble those of malaria. These are, for example, yellow fever, typhoid fever, influenza, cholera, measles and tuberculosis. Therefore, the doctor must know the travel history of the sick person in order to schedule the necessary tests.
Diagnosing malaria primarily involves the classic and most commonly used test, the blood smear on a glass slide, which uses a stain indicator to indicate the presence of parasites inside the red blood cells. Although this test is considered quite simple,the correctness of the results depends largely on the technical skill of the laboratory assistant who prepares and examines blood products under a microscope.
Other tests that can help diagnose the disease:
- immunological tests;
- polymerase chain reaction.
Treatment
Features of therapy depend on several factors:
- kind of Plasmodium ingested;
- the clinical situation of the patient, for example, the treatment will be different for an adult, a child and a pregnant woman, for severe and mild forms of the disease;
- Drug sensitivity of pathogen.
The last factor depends on the geographic area in which the infection was received. The fact is that different parts of the world have different types of malarial plasmodia that are resistant to certain drugs. Malaria remedies can be selected correctly by a doctor who is familiar with information from malaria treatment protocols around the world. People infected with P. falciparum can die without prompt treatment, so therapeutic measures must be taken immediately.
Mild forms of malaria are treated with oral medications. Complex symptoms such as severe anemia, altered consciousness, coma, pulmonary edema, renal failure, acute respiratory syndrome, disseminated intravascular coagulation, spontaneous bleeding, acidosis, hemoglobin in the urine, jaundice, and generalized seizures requireintravenous drug administration.
How to get rid of malaria with medication? Treatment of the disease with drugs is not always successful. The Aralen remedy is effective against all Plasmodium, with the exception of parasite strains resistant to its active active ingredient, for example, Plasmodium ovale. The following drug treatment options can be used to control chloroquine-resistant malaria:
- Quinine sulfate in combination with antibiotics "Doxycycline" or "Tetracycline".
- Preparations "Clindamycin" or "Maralon".
Treatment of malaria in most cases is based on template schemes adopted for a particular region. For example, P. falciparum, acquired in the Middle East, is sensitive to chloroquine, but if the infection of the same type of malaria occurred in Africa, then this substance may not bring positive results in treatment.
Modern scientists have developed treatment regimens based on the combination of drugs with derivatives of the active antimalarial compound - artemisin. Examples of combination medicines:
- Artesunate-Amodiachin.
- Artesunate-Mefloquine.
- Dihydroartemisin-Piperakhine.
The development of new treatments for malaria is ongoing, due to the increase in the number of drug-resistant strains of Plasmodium. One of the promising compounds in the creation of effective drugs for malaria isspiroindolone, which has been shown to be effective against P. falciparum in a number of experiments.
Primaquine can be used to treat forms of malaria, the pathogens of which have been inactive in the liver for a long time. This can prevent severe recurrences of the disease. Pregnant women should not take Primaquine. This drug is also contraindicated in people who suffer from a deficiency of glucose-6-phosphate dehydrogenase. For this reason, the remedy is not prescribed until a diagnostic screening test has ruled out the problem. In some countries, suppositories are used in addition to oral and injectable forms of medicines.
Disease during childbearing
Malaria is a serious threat to the pregnant woman and fetus. Infection greatly increases the risk of preterm birth and stillbirth. Statistics show that in sub-Saharan Africa, up to 30% of children die from malaria every year. Therefore, all pregnant women who live in dangerous areas or are planning a trip there should definitely consult a doctor and take the drugs prescribed by him, for example, Sulfadoxine-pyrimethamine. This is essential malaria prevention to avoid infection.
Treatment of the disease in women who are expecting a baby is carried out according to the standard scheme discussed above. However, drugs such as Primaquine, Tetracycline, Doxycycline and Halofantrine are not recommended due to the potential risk to the fetus.
Disease in children
Malaria prevention is mandatory for all children, including infants, living or temporarily staying in areas where the disease is prevalent. The following means can act as preventive agents: Chloroquine and Mefloquine.
It is very important to use the correct dosage for the child, which depends on their age and weight. Before traveling with a baby to countries at risk, all parents should consult with a specialist in the field of childhood infectious diseases regarding the treatment and prevention of the disease in question. Since an overdose of an antimalarial drug can be fatal, all medicines should be kept out of the reach of children, such as in tightly sealed containers.
Infection prevention
If a person intends to travel to areas where malaria is common, first of all he must find out what drugs and in what dosages should be taken to prevent infection. At the same time, it is recommended to start taking these drugs two weeks before the intended trip, during your stay in the country and for a month after returning from a trip. There is currently no vaccine for malaria, but intensive research is underway and a vaccine is under development.
If possible, avoid visiting countries with a high percentage of infected people, otherwise malaria prophylaxis is a must - it can save your he alth and save lives. If you are a traveler, try to always be aware of the places wherecurrent outbreaks. The malaria vector can land on a person's skin at any time of the day, but most bites occur at night. Insects are also most active at dawn and dusk. Avoid being outdoors during these hours. Prevention of infection is very important, given that the malaria vaccine has not been created.
Wear appropriate clothing - wear trousers, long sleeve shirts, high closed shoes instead of open sandals, and hats. Tuck your clothes into your trousers. Use insecticidal repellents, for example, Permethrin, which is used to treat clothing and equipment, can be recommended. Remember that good products contain up to fifty percent diethyltoluamide. Mosquito nets are especially necessary when the room is not ventilated, for example, there is no air conditioning. Treat them with aerosol repellents. Mosquito coils are also recommended.
Vaccine
There are currently no vaccines available for malaria. However, over the past few years, researchers have made good progress with experimental vaccines. The latest large clinical trial in children from eight African countries, sponsored by the Bill Gates Foundation, showed that the study drug was effective in half of the cases. Many other experiments have also become successful and predict reliable protection against the described disease in the near future. Experts say that a malaria vaccine will appear within 3-10 years. The intended action is based on interrupting the parasite's life cycle with a protein preparation that produces antibodies against it.
Types of disease
The main types of pathogens of the disease were named above. The course of the disease may also differ. Let's name the main types of malaria:
- tropical;
- three-day;
- four-day;
- malaria-ovale.
Four-day malaria is manifested by six to ten hour bouts of fever that usually begin in the morning or afternoon. Severe consequences rarely develop, the incubation period can be up to 5 months. Tropical malaria is characterized by a high concentration of parasites in the blood, fever is not clearly expressed, often there are symptoms such as diarrhea, vomiting, lesions of the central nervous system, kidney failure. Complications often develop. Three-day malaria presents with severe fever, including chills, increased sweating and fever, but indistinct alternation with periods of remission.
Folk remedies
Medicines are the backbone of malaria treatment. But many sources point to the benefits of some natural remedies in the treatment of the disease caused by plasmodia. Here we publish only some of them, and in no case should these recipes and recommendations be considered as the main means of treatment.
Lime and lemon are good for four day fever. About three grams of chalk is dissolved in 60 ml of water and the juice of one lemon or lime is added. This compositionmust drink before the fever starts.
Alum is also being considered as a supportive treatment for malaria. They are fried in a hot frying pan and ground into powder. Inside, take a teaspoon of the remedy four hours before the alleged fever and half a teaspoon two hours after it.
