Malarial Fever

Malaria remains one of the most dangerous infectious diseases globally, especially in tropical and subtropical regions. Though preventable and curable, it continues to pose a major public health challenge. Malarial fever, often referred to simply as malaria, is caused by protozoan parasites of the genus Plasmodium, which are transmitted to humans via the bite of an infected female Anopheles mosquito.

The disease is characterised by cyclic episodes of fever, chills, and sweating. If not treated properly, malaria can lead to severe complications and even death. However, with timely diagnosis, appropriate medical intervention, and preventive strategies, it can be effectively managed and often avoided altogether.

Malarial fever is an acute febrile illness caused by Plasmodium parasites, which infect and destroy red blood cells. There are five main species that cause malaria in humans:

1. Plasmodium falciparum (most severe and prevalent in Africa)
2. Plasmodium vivax (common in Asia and Latin America)
3. Plasmodium ovale
4. Plasmodium malariae
5. Plasmodium knowlesi (zoonotic, found in Southeast Asia)

Each species causes a slightly different clinical picture, but all involve recurrent bouts of fever, chills, and anaemia.

Malaria affects hundreds of millions globally each year. According to the World Health Organization (WHO), there were an estimated 249 million malaria cases worldwide in 2022, with 608,000 deaths.

In India, malaria remains endemic in many states, especially in tribal, rural, and forested regions. According to India’s National Center for Vector Borne Diseases Control (NCVBDC), approximately 170,000 malaria cases and 83 deaths were reported in 2022.

Malaria is classified based on the infecting species:

1. Uncomplicated Malaria: Symptoms are present but without signs of severe disease.
2. Severe Malaria: Life-threatening, often caused by P. falciparum, involving complications like cerebral malaria, organ failure, and severe anaemia.
3. Recurrent Malaria: Especially caused by P. vivax and P. ovale due to dormant liver stages.
4. Imported Malaria: Cases contracted abroad and diagnosed domestically.
5. Congenital Malaria: Passed from mother to child during pregnancy.

Malaria is caused by infection with Plasmodium parasites, which are transmitted by:

• Mosquito bites: From infected female Anopheles mosquitoes.
• Blood transfusions: In rare cases, from infected donors.
• Organ transplants
• Shared needles
• Congenital transmission: From mother to baby during childbirth.

Factors like poor sanitation, stagnant water, lack of mosquito nets, and warm climates contribute to the spread of the disease.

The symptoms typically appear 10-15 days after the mosquito bite. Common signs include:

• High-grade fever (often periodic)
• Chills and shivering
• Sweating
• Headache
• Nausea and vomiting
• Fatigue
• Muscle and joint pain
• Anaemia
• Jaundice (yellowing of skin and eyes)
• Abdominal pain and diarrhoea (sometimes)

In severe malaria, additional symptoms may include seizures, confusion, low blood pressure, difficulty breathing, and coma.

Timely diagnosis is critical to preventing complications. Common diagnostic methods include:

1. Microscopy: Blood smear examination to detect parasites.
2. Rapid Diagnostic Tests (RDTs): Detect specific malaria antigens.
3. Polymerase Chain Reaction (PCR): Confirms parasite species (usually in research settings).
4. Complete Blood Count (CBC): May show anaemia and low platelet count.

Treatment depends on the type and severity of malaria, and local drug resistance patterns:

1. Uncomplicated Malaria:
   
   • P. vivax & P. ovale: Chloroquine and Primaquine (Falcin Syrup and Nivaquine Forte Tablet)
   • P. falciparum: Artemisinin-based Combination Therapies (ACTs)
2. Severe Malaria:
   
   • Intravenous Artesunate or Quinine
   • Hospitalisation for supportive care (fluids, oxygen, blood transfusion)

Adherence to prescribed treatment is crucial to prevent recurrence and resistance.

Alternative therapies are not a substitute for standard treatment but may provide supportive relief:

• Herbal Remedies: Neem, Tulsi (Holy Basil), and other Ayurvedic preparations (under supervision)
• Homeopathy: Used as complementary therapy, though not evidence-backed
• Nutritional Support: Iron and folic acid supplements to combat anaemia

Always consult a healthcare professional before considering alternative treatments.

Certain groups are more vulnerable to malarial infection:

• Infants and young children
• Pregnant women
• Travellers to endemic areas
• Individuals with weakened immunity

People living in poor, overcrowded areas with mosquito breeding sites

If untreated or improperly treated, malaria can lead to severe health issues:

• Cerebral malaria (brain swelling and coma)
• Severe anaemia
• Organ failure (kidneys, liver)
• Hypoglycaemia
• Pulmonary oedema
• Death (especially from P. falciparum)

Pregnant women may suffer from miscarriage, stillbirth, or low birth weight in newborns.

• Seek medical care immediately when symptoms appear
• Complete the full course of treatment
• Stay hydrated and get plenty of rest
• Maintain a nutritious diet to recover from anaemia
• Monitor for recurrence of symptoms
• Educate family members about prevention

• Myth: You can catch malaria from someone else.
  
  
  • Fact: Malaria is not contagious and cannot spread through casual contact.
     
• Myth: Malaria only happens during the rainy season.
  
  
  • Fact: While cases rise in rainy seasons, malaria can occur year-round in endemic areas.
     
• Myth: Once treated, you can never get malaria again.
  
  
  • Fact: Reinfection is possible, especially with P. vivax and P. ovale.
     

Immediate medical attention is necessary if you experience:

• High fever with chills
• Severe headache
• Persistent vomiting
• Confusion or seizures
• Jaundice or pale skin
• Shortness of breath

Delaying treatment can lead to complications or death.

• What type of malaria do I have?
• What treatment do I need?
• How can I prevent reinfection?
• Should my family members also get tested?
• Are there any side effects of the medications?
• What should I do if symptoms return?

• Encourage them to complete their treatment
• Help with meals, hydration, and medication schedules
• Reduce mosquito exposure in the home
• Provide emotional support and reassurance
• Assist in arranging follow-up care

Malarial fever remains a significant but preventable and treatable disease. Understanding its causes, recognising the symptoms early, and accessing timely medical care are essential steps toward reducing its burden. With increased awareness, community participation, and robust healthcare systems, malaria can be controlled and eventually eliminated. Individuals, families, and governments must work together to fight this disease and protect future generations.