Malaria or Paludism

Malaria, also called paludism, is an infection caused by the Plasmodium parasite, transmitted through the bite of an Anopheles mosquito previously infected with the parasite.

Paludism is common in tropical and subtropical countries and rare in temperate regions. Nevertheless, cases are reported worldwide due to the high number of travelers visiting endemic areas.

Malaria is a curable disease, but it presents severe symptoms and, if not treated properly, can be life-threatening.

Symptoms

The incubation period lasts between 10 and 15 days after the mosquito bite, although in infections caused by Plasmodium vivax, it may last for several months. During this time, no symptoms appear. When they do, the most characteristic ones include:

• Fever
• Headache
• Chills
• Profuse sweating
• Severe fatigue
• Jaundice (yellowish discoloration of the skin and eyes)
• Dark or blood-stained urine
• Hemorrhages
• General malaise
• Diarrhea

It is common for fever to occur in cycles that begin with chills and subside with sweating, usually recurring every three or four days.

Causes

Malaria develops when Plasmodium parasites enter the bloodstream through the bite of an Anopheles mosquito. Humans serve as an intermediate host (where asexual reproduction occurs), while mosquitoes are the definitive host, where sexual reproduction takes place.

The species causing malaria are:

• Plasmodium falciparum: causes the most severe infection, which may affect the kidneys and brain. Predominantly found in sub-Saharan Africa.
• Plasmodium vivax: the most common species outside sub-Saharan Africa. Along with P. falciparum, it represents the most frequent form of malaria.
• Plasmodium ovale: found in West Africa, Papua New Guinea, the Philippines, and western Indonesia.
• Plasmodium malariae: typically does not cause acute symptoms or endanger vital organs. Found in sub-Saharan Africa, Asia, and Latin America.
• Plasmodium knowlesi: originates in Southeast Asia, mainly Malaysia. It has a short reproductive cycle, leading to high parasitemia levels (large amounts of parasites in the blood), which can be fatal if untreated.

Risk Factors

Malaria can be contracted when living in or traveling to tropical and subtropical regions, particularly:

• Sub-Saharan Africa
• Central America
• Northern South America
• Southern Asia
• Pacific Islands (Borneo, Java, New Guinea, Sulawesi, Bali, the Philippines)

The risk of severe disease increases in the following cases:

• Infants
• Young children
• Pregnant women
• Travelers from regions where malaria has been eradicated

Complications

Complications are usually associated with Plasmodium falciparum infection, which can spread and cause:

• Seizures
• Anemia
• Hypoglycemia
• Renal failure
• Hepatic insufficiency
• Respiratory distress
• Pulmonary edema
• Cerebral inflammation or brain injury leading to coma

If malaria is not treated properly and in time, it can be fatal.

Prevention

To prevent malaria, it is recommended to:

• Use mosquito repellents containing DEET (a chemical compound acting as a skin barrier).
• Sleep under mosquito nets.
• Wear clothing that covers as much skin as possible, especially at dusk and during nighttime.
• Before traveling to high-risk areas, take prophylactic medication to prevent infection or at least reduce disease severity. The most commonly used drugs include atovaquone, proguanil, doxycycline, and mefloquine.
• The malaria vaccine is recommended for children aged 5 to 36 months in sub-Saharan Africa and other regions with moderate to high transmission.

Which Specialist Treats Malaria?

Malaria is diagnosed and treated in general medicine consultations. In severe or epidemic cases, infectious disease specialists are involved.