Malaria is an vector borne parasitic infectious disease that can be fatal sometimes prevalent in tropical and sub tropical countries spread by mosquitoes called female Anopheles mosquito with characteristic feature of fever, chills, sweating and others caused by parasite called plasmodium

 

Symptoms usually appear with in 10 to 15 days of the mosquito bite and if not treated, malaria can quickly become life-threatening by disrupting the blood supply to vital organs. Infection with one type of malaria, Plasmodium falciparum, if not promptly treated, may cause kidney failure, seizures, mental confusion, coma, and death.

Symptoms:

• Fever and flu like illness
• Shaking chills
• Headache
• Muscle aches and tiredness
• Nausea and vomiting
• Diarrhea, increase respiratory rate may also occur
• Malaria may cause anemia and jaundice, yellow coloring of the skin and eyes because of the loss of red blood cells
• Abnormalities in blood coagulation and thrombocytopenia

Infection with one type of malaria, Plasmodium falciparum, if not promptly treated, may cause Kidney failure

• Seizures
• Mental confusion
• Coma and death
• Severe anemia
• Hemoglobulinuria
• Cardiovascular collapse and shock
• Trouble with movements, speech difficulties, deafness and blindness
• In pregnancy premature  delivery of baby and low birth weight baby
• Nephrotic syndrome features and other infections

Tests and Diagnosis:

• History of travel to malaria prone areas and examination
• Complete blood count and Urine routine
• Blood smear with Giemsa stain
• Rapid diagnostic tests
• Serology tests for detection of antigen and antibody
• Polymerase chain reaction for QT-NASBA

Treatment:

Medications

• Chloroquine
• Quinine sulfate
• Hydroxy chloroquine
• Combination of sulfadoxine and pyrimethamine (Fansidar)
• Mefloquine
• Combination of atovaquone and proguanil
• Doxycycline
• Artemisinins-derived medications.
• Halofantrine
• Primaquine

Hospitalization and treatment with intravenous fluids, oral fluids and antipyretics

In complicated malaria that is cerebral malaria the following treatment options are followed

• Chemotherapy primarily involves the use of quinine and chloroquine
• Artemisinins clear parasitemia and fever faster than quinine or chloroquine
• The two most widely used anti malarial drugs are artesunate and artemether

Supportive Treatment:

• Anti-pyretics: Paracetamol to reduce fever
• Anti-convulsants: Phenobarbital sodium for seizures.
• Osmotic diuretics are used to reduce intracranial pressure 
• Hypoglycemia correction using hypertonic glucose
• Exchange transfusion generally when peripheral parasitemia exceeds 10% of circulating erythrocytes
• Anti-Inflammatories: Corticosteroids
• Desferrioxamine: An iron-chelating adjuvant agent with anti malarial properties reduces formation of reactive oxygen species by reducing amount of free iron.
• Microcirculatory Flow ­Pentoxifylline reduces red cell deformability and blood viscosity, decreases systemic vascular resistance, and impairs platelet aggregation, thus improving microcirculatory flow.