It is a disease caused by five different species of Plasmodium parasite (P.falciparum, P.vivax, P.ovale, P.malariae, P.knowlesi). P. falciparum and P. vivax pose the greatest threat. But all species can cause serious illness and death. How Is Malaria Transmitted? What Are the Symptoms of Malaria? What are Malaria Diagnosis and Treatment Methods? What are Malaria Prevention Methods?
How Is Malaria Transmitted?
The disease is transmitted to humans by the bite of the female anopheles mosquito infected with the parasite. Anopheles mosquitoes bite mostly between sunset and sunrise. Sometimes, transmission occurs through blood transfusion, organ transplant, needle (syringe) sharing, or from mother to fetus.
What Are the Symptoms of Malaria?
Malaria; It is an acute febrile illness with an average incubation period of 7 days. Although the symptoms are seen at the earliest 7 days (usually within 7-30 days) of going to the malaria-endemic area, they can also be seen a few months (rarely up to 1 year) after leaving the malaria-endemic area. Therefore, febrile illness within the first week following a possible mosquito bite is most likely not malaria.
- Muscle pain
- It is characterized by flu-like symptoms such as malaise.
- These symptoms may occur intermittently. If left untreated, seizures, confusion, renal failure, acute respiratory distress syndrome, hepatosplenomegaly, coma and death may occur.
Malaria, particularly P. falciparum malaria, is a medical condition that can cause rapid and unexpected deterioration in clinical status and requires immediate attention. It is estimated that approximately 1% of patients with P.falciparum malaria die from this disease.
Pregnant women and young children are more susceptible to falciparum malaria. malaria in pregnant women; increases the risk of serious illness, maternal death, miscarriage, low birth weight infant and neonatal death.
What are Malaria Diagnosis and Treatment Methods?
Travelers with signs of malaria should undergo a medical evaluation as soon as possible. Malaria should be considered in patients with fever who have recently returned from a malaria-endemic country.
Definitive diagnosis of malaria is made by microbiological examination. The most widely used method in microbiological diagnosis all over the world is the examination of the preparations prepared by spreading and staining the blood taken from the fingertip of the patient under the light microscope. In this examination, which is defined as thick drop and thin smear, the diagnosis is made by seeing plasmodiums. While the presence of parasites is investigated with a thick drop, the species causing the infection is determined with a thin smear. If parasites are not detected in the first blood sample and clinical suspicion or symptoms persist, the examination should be repeated by taking 12-24 new blood samples at 2-3 hour intervals. In addition, there are various rapid blood tests to detect antigens obtained from malaria parasites and show the result in as little as 2-15 minutes.
Early diagnosis and appropriate treatment can save lives. Falciparum malaria, in particular, can lead to death if treatment is delayed for more than 24 hours.
In the treatment of patients diagnosed with malaria, various malaria drugs are applied according to the condition of the disease.
Malaria vaccine studies have been going on for a long time, and a vaccine that is 2% effective in children under the age of 40 has only been developed in certain regions until now.
Risk for Passengers
Malaria occurs in large areas in Africa, Central and South America, part of the Caribbean, Asia (including South Asia, Southeast Asia and the Middle East), Eastern Europe, and the Southern and Western Pacific region. In 2017, 92% of malaria cases and 93% of malaria deaths occurred in the African region.
There are 200-300 million cases of malaria worldwide each year, and more than 400 people die from malaria. 61% of these deaths occur in children under 5 years old.
Every year, many international travelers contract malaria in countries where the disease occurs and become ill after returning home.
In regions where malaria is common, travelers exposed to mosquito bites, especially at night, during the transmission season are at risk of malaria. The disease mostly occurs in travelers due to not complying with antimalarial drug regimens or using inappropriate antimalarial drugs, not using fly repellent repellant, long-lasting insecticide-impregnated nets.
Young children, pregnant women and elderly passengers are at greater risk. Travelers to countries where the prevalence of malaria varies in different regions should be informed about the specific malaria risk of their destination. In rural areas, the risk is very high for travelers who sleep outside at night.
What are Malaria Prevention Methods?
Prevention from malaria; It consists of the combination of measures to be taken against mosquito bites and anti-malarial drugs. Since the drugs recommended against malaria are not 100% protective, they should be used in conjunction with mosquito protection measures (such as insect repellents, long sleeved clothing, long pants, sleeping in a mosquito-free area, or using medicated mosquito nets). Malaria preventive drug administration should be started before traveling to the area where malaria is seen, and should be continued during and after travel. The purpose of initiating medication before travel is to ensure that antimalarial agents are mixed into the bloodstream before travelers are exposed to malaria parasites.
A specific risk assessment needs to be made for each individual, taking into account not only the traveler's destination, but also the itinerary, specific cities, type of accommodation, season, and type of travel in detail. In addition, conditions such as pregnancy and resistance to an antimalarial drug at the destination may affect the risk assessment.
Even if you have had malaria before, preventive measures should always be applied sensitively by travelers, as there is a possibility of re-infecting the disease because full immunity is not formed.
The Anopheles mosquito feeds at night. For this reason, the spread of malaria mostly occurs between dusk and dawn. Contact with mosquitoes can be minimized by staying in well-protected areas, using mosquito nets (medicated mosquito nets are recommended), applying insect sprays containing pyrethroids in areas where you will be staying in the evening and overnight, and wearing body-containing clothing. Mosquito repellents should be applied to open parts of the body that may be exposed to mosquitoes. If sunscreen is to be used, sunscreen should be applied to the skin first, followed by mosquito repellents. Additional protection against mosquitoes can be provided by applying insect repellents containing permethrin to mosquito nets and clothing, avoiding direct skin contact.
Return Travel Recommendations
Malaria is always a serious and potentially fatal disease. While traveling in an area with malaria risk, or having a history of traveling to such an area in the past 1 year, they should seek medical help immediately and inform their doctor about their travel history when they show fever or flu-like symptoms.
Further spread of the disease should be prevented by ensuring that the malaria patient is protected from mosquito bites.