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Health Topics
Malaria

This is an infectious disease which is widespread in most tropical and sub-tropical areas. It is also the most imported disease into developed countries. It is transmitted from human to human by a bite from an infected mosquito. It can also be transmitted by blood transfusion from an infected patient or by the use of an infected syringe. Sometimes malaria can be passed from a pregnant woman to her unborn baby.

There are four types of malarial parasites and they can cause various symptoms. The most severe type is malignant malaria which is caused by the Plasmodium Falciparum parasite. The symptoms include altered consciousness and behaviour, irregular fevers, severe organ dysfunction, anaemia, coma, red blood cell destruction and death. This form of malaria will not recur if treated correctly. The symptoms usually appear one to two weeks after infection.

The less severe forms of malaria are called benign types. These are caused by three other parasites. Common symptoms include profuse sweating, high fever, headaches, aches and pains, nausea and shivering. Profuse sweating and exhaustion between bouts of fever are common. Benign types of Malaria have longer incubation periods. They generally take ten to thirty five days after infection to be diagnosed and often recue if not treated properly.
High risk countries for Malaria have been identified and are well documented. The Doctor may well prescribe anti-malarial drugs to be taken before entering the endemic area, during the stay there and after leaving. You should visit the Doctor immediately if you become ill at any time during your travels to endemic areas or after leaving them. Consult your Doctor if there is an increase in temperature, sweating, headaches, aches, pains or nausea.

Prevention of Malaria focuses on avoiding mosquito bites and adhering to prophylactic medications. It is best to avoid being outdoors between dusk and dawn when mosquitoes are actively biting. When outdoors, wear long-sleeved shirts and long trousers. A good insect repellent should be used on exposed skin. The Staff at the Pharmacy will be happy to advise you on effective insect repellents. You may need to reapply repellent after heavy sweating or swimming. Mosquito nets should be used over the bed to avoid mosquito bites. The nets can be sprayed with repellent to make them effective for up to three months. Electric mosquito vapourisers can be plugged into a power point. They help repel mosquitoes by heating a liquid repellent or insecticide mat and releasing fumes into the air.

The medications are not one hundred percent effective against Malaria and so they should always be used along with repellents. May mosquitoes have developed resistance to traditional anti-malarial drugs. The types of resistance vary according to the geographical location. A Doctor with experience in travel medicine will know the most suitable medication for your destination. Common anti-malaria medications include chloroquine, mefloquine (Lariam), doxycycline and atovaquone/proguanil (Malarone) or chloroquine/proguanil combinations. Maloprim, which is a pyrimethamine/dapsone combination is used only for people with epilepsy who cannot take other preparations.

Children are also susceptible to Malaria and need to be well protected from mosquitoes. If possible infants and pregnant women should avoid malaria infected areas. Malaria is a serious threat to pregnant women as it can affect foetal development and cause miscarriage or premature labour.

You can get more information on malaria from the World Health Organisation website: www.who.int/topics/malaria/en/


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Kevin McCormack B.Sc. Pharm. MPSI