Malaria: Causes, Symptoms and Treatment in Nepal

Malaria is a serious and sometimes fatal disease caused by plasmodium parasites that spreads to a human through the bite of Anopheles (female) mosquito.

In general, there are five parasites species of which two of them are considered to pose greater threats to human viz. Plasmodium falciparum and Plasmodium vivax. 

With reference to the World Malaria Report 2018, there were approx. 219 million cases of malaria globally in the year 2017 of which 435000 malaria deaths were recorded. Over a period of eight years (from 2010 to 2018), malaria cases were decreased by 18% all over the world.

Similarly, in Nepal, malaria cases were decreased drastically over a decade (from the year 2008 to 2018) by 87 % i.e. from 5621 to 493 cases (figure 1). 

Key Facts About Malaria

• Malaria is disseminated by Anopheles mosquito that is infected by a parasite. The disease is preventable and curable. 
• Malaria causing parasites breed mostly in warmer climates, where humidity and rainfall are abundant.
• Globally, malaria exists in 103 countries affecting 3.3. billions of people of which higher death rates (90%) have been recorded in sub-Saharan Africa. Among them, the majority are children under five years of age. 
• The incubation period varies from a week to a month. Some rare malarial parasites such as P. malariae remain dormant for long periods and may not show symptoms/illness in the human body up to 4 years. 
• People traveling from areas without malaria often have no immunity and are prone to illness. Prevention is possible if you visit your primary care physician. 
• Malaria is not a contagious disease. A person does not get malaria if he/she comes in contact with infected people. 

How is Malaria Transmitted?

People acquire malaria only when they are bitten by the infected female, Anopheles mosquito. When a mosquito bites an infected person, a little amount of blood is sucked which contains microscopic malarial parasites. After one week, when the mosquito takes its next feed, these parasites mix with the mosquito’s saliva and are injected into the person being bitten.

Malaria can also be transmitted through transfusion, transplant, or the shared use of needles or syringes contaminated with blood as plasmodium is found in red blood cells.

Likewise, malaria can be transmitted from a mother to an unborn infant before or during delivery (congenital malaria).

What are the Clinical Symptoms of Malaria?

Symptoms of malaria include

• Fever
• Chills
• Headache
• Tiredness
• Muscle aches
• Dry cough and flu-like illness.

In some cases, nausea, vomiting, and diarrhea may also occur. Malaria may also cause anemia and jaundice (yellow coloring of the skin and eyes) due to the loss of red blood cells.

Related Articles: Dengue – Causes, Symptoms, and Treatment

For most people, symptoms might be seen from 7 days to 28 days after infection. However, in some cases, an individual may show symptoms even after 28 days up to 1 year. 

It should be treated promptly else the infection can become more severe possibly resulting in renal failure, seizures, confusion, coma, and death.

How can you treat Malaria?

The complex nature of the malaria parasite has a strong capability to evade the human immune system resulting in the failure of vaccine development worldwide.

However, researchers and vaccine developers have been still working on several approaches to test and discover the malaria vaccine. 

What Malaria tablets do you need in Nepal?

Following medication are prescribed for the prevention and treatment of malaria in Nepal: 

Atovaquone/Proguanil (Malarone)

• Adult dose: 1 adult tablet daily.

• Pediatric dose: 5-8 kg: ½ pediatric tablet daily. 8-10 kg: ½ pediatric tablet daily. 10-20 kg: 1 pediatric tablet daily. 20-30 kg: 2 pediatric tablets daily. 30-40 kg 3 pediatric tablets daily. 40 kg and over: 1 adult tablet daily. 

Begin the medication before 1-2 days of travel, every day during travel, and for 7 days after leaving that region.

Chloroquine 

• Adults dose: 300 mg base (500 mg salt), once/week.

• Pediatric dose: 5 mg/kg base (8.3 mg/kg salt) (maximum is adult dose), once/week. 

Begin the medication before 1-2 weeks of travel, once a week during travel, and for 4 weeks after leaving that region. 

Doxycycline 

• Adult dose: 100 mg daily.

• Pediatric dose: ≥8 years old: 2.2 mg/kg (maximum is adult dose) daily. 

Begin the medication before 1-2 days of travel, daily during travel, and for 4 weeks after leaving that region.

Other medicines includes Melfoquine, Primaquine and so on.

What precautions should Malaria Travelers in Nepal take?

When traveling in Nepal, one should avoid mosquito bites to prevent malaria. Travelers may need to take medicine before, during, and after their trip to prevent malaria, depending on their travel plans and destinations. Travelers can have a look on the map that shows the degree of malaria outbreak (high, low, and malaria-free) in various districts of Nepal shown in figure 2. It is commonly found in the area with an altitude of less than 2,000 m (6,562 feet), mostly in tropical (Terai) districts across Nepal. 

By Shital Gautam 
Vaccination In-charge/ Registered Nurse Clinic One
27 May 2020

Need to See a Doctor for Malaria Treatment in Kathmandu?

Call Clinic One Kathmandu at 015400400, 9863393960/61 or Email us at [email protected] to book an appointment.