Malaria Patient Information Leaflet
What is Malaria?
Malaria is a potentially life-threatening infection caused by a parasite which is transmitted to humans by mosquito bites.
What causes Malaria?
- The Malaria parasite (Plasmodium) is carried by the Anopheles mosquito
- When the mosquito bites a human, the parasite passes from the mosquito’s mouth-parts into the person’s bloodstream, soon making its way to their liver
- After 1-2 weeks in the liver (the duration depends on the strain of Malaria parasite), it re-enters the bloodstream, invades red blood cells, multiplies and bursts out of them, thus continuing the cycle
- It usually takes 1-4 weeks for symptoms of Malaria to appear. Again, this depends on the strain of Malaria parasite
What are the symptoms of Malaria?
Symptoms of Malaria may include:
- Fever
- Chills & sweats
- Aches & pains
- Headaches
- Nausea or vomiting
- Abdominal pain
- Diarrhoea
Life-threatening complications of the more severe form of Malaria (Plasmodium falciparum) infection include:
- Jaundice (yellow discoloration of the eyes & skin)
- Abnormalities in blood clotting
- Kidney Failure
- Liver Failure
- Haemolytic Anaemia (a low blood count due to breakdown of red blood cells)
- Rupture of the spleen
- Shock (a dangerous drop in blood pressure leading to poor blood circulation)
- Pulmonary Oedema (fluid in the lungs)
- Confusion and coma (caused by cerebral malaria- i.e inflammation of the brain)
Symptoms of Malaria can appear up to a year after travel to an area in which Malaria is present!
Which countries have Malaria?
- Australia was declared free of Malaria in 1981, but a few hundred cases occur here every year, in people returning from travel abroad
- There have also been some cases of Malaria in the Torres Strait Islands
- Malaria is widespread in large parts of Africa, Asia, South America, the Pacific Islands and other places
Assessing the risk of Malaria
The risk of Malaria varies between countries and the type of trip or activities involved. Urban areas may have lower risk for Malaria than rural areas of a country. The main type of Malaria parasite and the resistance to antimalarial medication also varies in different regions. You can check the risk of Malaria at your destination on the following websites:
https://www.cdc.gov/malaria/travelers/country_table/a.html
http://www.fitfortravel.nhs.uk/destinations
All travellers to Malarial regions should properly inform themselves, and take appropriate preventive measures.
How can you prevent Malaria?
It is extremely important to reduce the risk of mosquito bites in the first place, via simple methods including:
- Trying to stay indoors at times of the day when mosquitoes are most active (generally in the evening)
- Ideally, staying in an air-conditioned room with insect screens, and/or sleeping under a mosquito net that’s been treated with Permethrin or another insect repellent.
- Applying appropriate mosquito repellent to your body and spraying it on your clothing too
- Wearing long sleeves and trousers, particularly at times when mosquitoes are active
- Burning mosquito coils in outdoor areas
Antimalarial medication (also known as “ Malaria prophylaxis”) significantly reduces the risk of getting Malaria, though does not provide 100% protection.
Antimalarial medications
- The choice of antimalarial medication depends on the species of Malaria that is present in the country you are travelling to.
- Some forms of Malaria are resistant to particular medications (so if you choose the wrong medication, you won’t be protected).
- Malaria risk in different regions can change over time, and drug resistance patterns can also vary.
- Therefore it is important to get up-to-date advice about your travel destination and any resistance to antimalarial medications that exists in that area. The following websites are regularly updated:
https://www.cdc.gov/malaria/travelers/country_table/a.html
http://www.fitfortravel.nhs.uk/destinations
- All antimalarial medications must be started before entering the Malaria area, so it is important to plan your travel with this in mind. They also need to be taken after leaving the Malaria area for anything between 1-4 weeks depending on the medication in question. Commonly recommended Antimalarial medications include Malarone/Promozio and Doxycycline:
Malarone/Promozio (Atovaquone plus Proguanil)
This medication is taken once daily, and is usually started at least 2 days before entering the Malaria area, continued once daily while there, and taken for 7 more days after leaving the Malaria area.
Common side effects include nausea, vomiting, abdominal pain, diarrhoea, increased liver enzyme levels and headaches.
It is not recommended for use in breastfeeding or pregnancy.
Doxycycline
This medication is taken once daily and is usually started at least 2 days before entering the Malaria area, continued once daily while there, and taken for 4 more weeks after leaving the Malaria area.
Common side effects include abdominal discomfort, oesophageal ulceration, vaginal candidiasis, photosensitivity and renal (kidney) impairment
It is contraindicated during pregnancy or breastfeeding and not recommended in children under the age of 12.
Antimalarial medication in pregnancy
Malaria infection in pregnant women may be more severe than in non-pregnant women.
Travel to Malaria risk areas should be avoided if possible. Some antimalarials may be used, but it is best to seek specialist advice if travel to a Malaria area is unavoidable.
Antimalarial medication in children
The indications for prophylaxis are identical to those described for adults and the same medications can be used, except for Doxycycline is not recommended for children less than 12 years of age.
However, the dose needs to be calculated carefully according to the individual body-weight of the child. It is best to get specialist advice.
