Anti-Malaria Drugs

Danger

Pregnant women are especially vulnerable to malaria, and this may result in stillbirths, infant mortality and low birth weight. Researchers have demonstrated that pregnant women are twice as attractive to malaria carrying mosquitoes as non-pregnant women and have suggested this is due to a greater volume of exhaled air (21%) and a warmer (0.7° C) skin surface. ref

Contracting Malaria

Malaria is caused by a protozoan parasite transmitted by the female Anopheles mosquito. There are 4 species of malaria parasites,

Plasmodium falciparum - the most deadly species - widespread in tropical areas
Plasmodium vivax - the most prevalent form of human malaria
Plasmodium ovale
Plasmodium malariae

The malaria infection goes through cycles.

The Anopheles mosquito is infected with the parasites by sucking the blood of a person who is already infected. These are then injected into a new person when the mosquito bites again. The Anopheles mosquito can live for several months and infect many people.

The parasites multiply in the liver and mature within one to 4 weeks into a swimming phase and swarm into the blood. These then enter red blood cells and multiply again until the red blood cells rupture releasing more parasites which infect more red blood cells.

Symptoms parallel the destruction of the red blood cells and each cycle causing more and more distress as the parasites increase in numbers.

Symptoms include headaches, muscle aches, diarrhea, fever, chills, vomiting, coughing and abdominal pain. The headaches, generally in the upper neck and back of the head, are severe.

Malaria is extremely dangerous

Anyone returning from a malaria infected region that feels unwell should contact a doctor immediately and have their blood checked for the presence of Plasmodium parasites.

All species of malaria can cause lasting health problems but severe Plasmodium falciparum infections can be fatal in the first cycle, so medical care is urgent. Patients have died within two weeks of infection. If the initial infection is not severe it will get worse with each cycle and can lead to liver failure, kidney failure, convulsions, coma and death.

Every year 300 to 500 million people get malaria and 1.5 to 2.7 million people die from malaria.

Chloroquine resistance

Traditional anti-malaria medicines are based on chloroquine. In many areas, Plasmodium falciparum and Plasmodium vivax have become resistant to chloroquine resulting in the need for new medicines. However, finding a medicine that can prevent or cure malaria without harming the patient has been a challenge.

At the moment Malarone is reported to be the most efficient product with minimum side effects.

Artesunate is a new antimalarial from China that is highly effective against chloquine resistent P. falciparum but is not effective against P. vivax when this parasite has reached the hepatic stage. Artesunate has the least side effects of any effective anti-malaria drug.

Prevention of Malaria

Take active measures to prevent mosquito bites.

Whenever possible wear clothing that covers the arms, legs and ankles. Wear long-sleeved shirts or blouses and long trousers and high socks to protect your arms, legs and ankles, especially from dusk through dawn when mosquitoes are hunting.

Religiously use a mosquito repellent with a high content of DEET (15 to 30%) on exposed skin. Both are available from retail chemists.

Use of repellents on children

Apply repellents on children carefully to keep out of their eyes, nose, mouth, and genitals. Do not apply too much as DEET can be absorbed through the skin and cause side effects. Apply repellent to a child's clothing rather than the skin and wash the child's hands on entering a screened area. If wearing very thin clothing, lightly spray the clothing with repellent because mosquitoes may bite through thin clothing.

Remain in air-conditioned or well-screened rooms to reduce contact with mosquitoes.

Sleep under mosquito netting, preferably netting coated or soaked with permethrin, to avoid being bitten by malaria-carrying mosquitoes.

Use a pyrethrum-containing flying insect spray or mosquito coils to kill mosquitoes in living and sleeping quarters during evening and nighttime hours.