MALARIA TIPS

2008-12-08T06:26:00.000-08:00

DEFINITION
Malaria is a serious, infectious disease spread by certain kinds of mosquitoes. It is common in tropical climates and is characterized by chills, fevers, and an enlarged spleen. These symptoms reappear again and again. The disease can be treated with medication, but it tends to come back even after being cured. Malaria is endemic in many developing countries. An endemic disease is one that occurs frequently in a particular location. Isolated, limited outbreaks of malaria sometimes occur in the United States.
Malaria is pestilential heat attacking the Liver, Spleen, and other organs.
Its origin is outside the body, yet it attacks organs deep within the body.It is considered half interior, half exterior in nature.
Scientists have discovered that the Chinese herb, qing hao (artemesia), long used for malarial disorders, works far better than currently used anti-malarials. To better profit from this herb, drug companies have produced a marketable extract called artemisinin.
Yet there is no evidence that artemisinin works any better than does cooking the whole herb or using a simple water extract of the herb. There is also no evidence that artemisia in any form works better taken alone than it does taken in combination with other herbs, as is done in Traditional Chinese Medicine. In fact, we believe that the following formula will prove a better approach to malaria than simple artimisinin.

DESCRIPTION
Malaria is not a serious problem in the United States. Over the past ten years, only about 1,200 cases have been reported each year in this country. In most cases, a person was infected outside the United States while traveling on business or on vacation.
Malaria is a far more serious problem in other parts of the world. Between 300 million and 500 million people in Africa, India, Southeast Asia, the Middle East, the South Pacific, and Central and South America have the disease. About two million people die of the disease every year. Most of these deaths occur in southern Africa.
A person can have malaria more than once. In some parts of Africa, people have up to forty bouts of malaria during their lifetime. Malaria is becoming a more serious problem because the organisms that cause the disease are growing resistant to the drugs used to treat it.
CAUSES
Malaria is caused by four different kinds of parasites belonging to the plasmodium family. A parasite is an organism that lives off another organism. Animals can also get malaria, but malaria cannot be passed from humans to animals or from animals to humans.
Malaria is transmitted by female mosquitoes that carry the parasite in their bodies. When the mosquito bites a human, it injects a small amount of its saliva into the human's bloodstream. The saliva contains parasites that travel through the person's bloodstream to his or her liver. There, the parasites reproduce. Eventually, they leave the liver and travel back into the bloodstream. Once in the bloodstream, they begin to cause the symptoms of malaria.
Malaria cannot be passed directly from one human to another. It can be transmitted by a mosquito. A mosquito may bite a person infected with the malaria parasite. When it sucks the person's blood, it takes in some of the parasites. If the same mosquito bites a second person, it may transfer those parasites to the uninfected person.
Malaria can also be transmitted through blood transfusions. If an infected person donates blood, the blood will contain malaria parasites. If the blood is put into another person's body, the parasites will also flow into his or her bloodstream. For this reason, blood donors are often screened for the malaria parasite before they are allowed to give blood.
The incubation period for malaria varies considerably. An incubation period is the time between the mosquito bite and the time symptoms of malaria begin to appear. The incubation period differs depending on the kind of parasite involved. For the most serious form of malaria, the incubation period is eight to twelve days. In some rare forms of malaria, the incubation period can be as long as ten months.
Malaria: Words to Know
Artemisinin:
An antimalarial herb used for many years in China under the name qiinghaosu.
Chloroquine:
An antimalarial drug first used in the 1940s as a substitute for quinine, and still widely used in Africa because of its relatively low cost.
Mefloquine:
An antimalarial drug developed by the U.S. Army in the early 1980s.
Quinine:
One of the first successful treatments for malaria, derived from the bark of the cinchona tree.
Sulfadoxine/pyrimethamine (trade name Fansidar):
An antimalarial drug developed in the 1960s, often used in areas where quinine and chloroquine are no longer effective.
SYMPTOMS
A person infected with malaria passes through three stages of very distinctive symptoms. The first stage is characterized by uncontrollable shivering for an hour or two. In the next stage, the patient's temperature rises quickly. It may reach 106°F (41°C) for a period of up to six hours. In the third stage, the patient begins to sweat profusely, and his or her temperature drops rapidly.
Diagram of mosquito biting a human, transmitting malaria. (Reproduced by permission of
Hans and Cassady
)
Other symptoms may accompany these stages. They include fatigue, severe headache, nausea, and vomiting. After the third stage, the patient often falls asleep from exhaustion.
The three stages are often repeated the following day, two days later, or at some later time. In many cases, a person experiences a repetition of the stages again and again during their lifetime. Some people go many years before the symptoms repeat.
The most serious forms of malaria can result in death in a matter of hours. The parasites attack a person's red blood cells and change their structure. The cells become very sticky and begin to clump together. As they do, they may block blood vessels in vital organs, such as the kidneys and spleen. These organs may no longer be able to function properly, and the patient may fall into a coma and die.
DIAGNOSIS
Malaria can be diagnosed with a blood test. A sample of a patient's blood is taken and studied under a microscope to detect the presence of parasites. Blood tests sometimes need to be repeated after a seventy-two-hour period to confirm the diagnosis.
The three stages of malaria can also be used to diagnose the disease. A person who lives in an area where malaria is common and who has chills, fever, and a very high temperature should have a blood test as quickly as possible.
Malaria is sometimes misdiagnosed in North America. The disease is not very common in this part of the world, and its symptoms are similar to those of the flu (see influenza entry). A doctor may think that a person has the flu when he or she really has malaria. This kind of misdiagnosis can result in the patient's death if he or she has a severe case of malaria.
AN ANCIENT ILLNESS
Malaria has been a known disease for centuries and was described in medical records from ancient China, India, and Greece. Doctors first believed that malaria was caused by poisonous vapors in the air. People who lived around swamps, bogs, and other wetlands were especially likely to get the disease. Therefore, it was presumed that it must be the "bad gases" given off by these watery regions. In fact, the name of the disease comes from two Italian words for "bad air": mal- ("bad") and -aria ("air").
The Romans are credited with one of the most successful attempts to eliminate malaria. They drained large areas of swampy land around the city, believing that they were cutting off the supply of "bad gases." In fact, they were destroying the wet areas in which malaria carriers (the mosquitoes) lived and bred.
TREATMENT
Malaria can be treated with drugs. However, treatment is complicated by a number of factors. First, each type of malaria requires a different drug. Second, the treatment depends on the region of the world in which the person was infected. The kinds of parasites living in different parts of the world respond in different ways to different drugs.
The classic treatment for malaria is quinine. Quinine is still effective in treating some forms of malaria in some parts of the world, but other parasites have developed a resistance to quinine.
If quinine is not effective, a variety of antibiotics can be tried. These include tetracycline (pronounced tet -ruh-SIE-kleen), clindamycin (pronounced klin-duh-MY-suhn, trade name Cleocin), mefloquine (pronounced MEF-luhkwine, trade name Lariam), or sulfadoxine/pyrimethamine (pronounced sullfuh-DOK-seen/pi-ruh-METH-uh-meen, trade name Fansidar). A modified form of quinine known as chloroquine (pronounced KLOR-uh-kween) can also be used. In some parts of the world, the parasite that causes the most serious form of malaria is resistant to all known drugs.
Blood cells infected with the parasite that causes malaria. (©1993
NMSB
. Reproduced by permission of
Custom Medical Stock Photo
.)
Patients with very serious cases of malaria may require hospitalization and special treatments. These treatments may include intravenous fluids (fluids injected into the patient's bloodstream), blood transfusions, kidney dialysis, and oxygen therapy to help him or her breathe.
Alternative Treatment
The Chinese herb qinghao (known as artemesia in the West) has long been used to treat malaria. However, it is not approved for use in the United States and other parts of the developed world. Researchers are still concerned about the herb's possibly dangerous side effects.
Some practitioners suggest using certain herbs to protect against malaria and to strengthen the liver. These herbs include wormwood, goldenseal, Chinese goldenthread, and milk thistle.
PROGNOSIS
If treated in its early stages, malaria can be cured. Cures are more difficult for people who live in areas where malaria is endemic. These people may be bitten by mosquitoes and exposed to malaria parasites again and again and may never fully recover from the disease.
PREVENTION
Malaria can be prevented in one of two ways. First, a person can avoid being bitten by a mosquito carrying the malaria parasite. The World Health Organization (WHO) has been working to eliminate malaria for more than thirty years. Its approach has been to kill as many of the mosquitoes that cause malaria as possible. For some years, WHO was quite successful in this effort. It used DDT and other pesticides to kill mosquitoes. Unfortunately, mosquitoes have slowly become resistant to many pesticides. It has become more and more difficult to kill mosquitoes with the pesticides now available.
The second method for avoiding malaria is to take drugs that protect against the disease. These drugs kill parasites as soon as they enter the bloodstream. The problem is that antimalarial drugs are expensive. Most people in Africa, Asia, and other areas where malaria is common cannot afford them.
Scientists have long hoped to find a vaccine for malaria. With a vaccine, a person could be protected for a lifetime with one or a few shots. So far, however, researchers have had no success in producing such a vaccine.
People who travel in areas where malaria is common can protect themselves by wearing mosquito repellent. The compound known as DEET is one of the most effective repellents, but it can have harmful side effects, especially in children. It should be used only with caution.
Certain other preventive measures can also be followed, including:
Staying indoors in well-screened areas between dusk and dawn
Sleeping inside mosquito nets that have been soaked with mosquito repellent
Wearing clothes that cover the entire body
People who plan trips to areas in which malaria is endemic should take antimalarial drugs as a preventive against contracting the disease. The drugs usually prescribed are chloroquine or mefloquine. A person starts taking the drugs a few days before leaving on the trip. He or she continues to take the drugs while on the trip and for at least four weeks after they return home.
.
Treatment of malaria
Last updated: Tuesday, October 31, 2006
The choice of which drug to use to treat malaria depends on where the patient acquired malaria (i.e. whether chloroquine resistance is common or not), whether prophylaxis was taken, and what form of malaria the patient has.

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If the patient has P. vivax, P ovale, P. malariae, or has been in an area where there is no chloroquine resistance in P. falciparum, chloroquine is the best drug to use to treat malaria.
If the patient is infected with P. vivax or P. ovale, primaquine needs to be given as well. This drug is able to kill the liver stages of the parasites, unlike chloroquine. If primaquine is not used, the chloroquine will cure the acute attack, but the dormant liver stages will be able to cause recurrences in the future.
In cases where chloroquine resistant P. falciparum is suspected, either quinine, mefloquine, halofantrine or the artemesinins can be used. Parasites that are resistant to mefloquine are also often resistant to halofantrine. Mefloquine is also not licensed for use as treatment in South Africa. Halofantrine has been associated with cardiac side effects, and should not be used for routine treatment. Quinine was the first drug used to successfully treat malaria, and with increasing chloroquine resistance, it is making something of a “comeback”. It is thought to be the best available agent for treating complicated chloroquine resistant falciparum malaria. Unfortunately, resistance to this drug is also being described.
A new class of drug is the artemesinin derivatives. This drug has been known for centuries in China and is derived from the wormwood plant. It shows great potential in being able to treat resistant falciparum malaria, and has been used often in SE Asia. Unfortunately, resistance to this agent is also being described. When these drugs are used to treat malaria, they should be combined with a second agent to try and reduce the development of resistance.
In South Africa, treatment is usually with either an artemesinin derivative called artemether in combination with lumefantrine (Coartem), or with quinine combined with doxycycline. The artemether/lumefantrine combination has been used since 2001 in Kwazulu Natal with good results. It can be used for uncomplicated malaria if the patient is able to take medication orally. For severe or complicated malaria, quinine given intravenously is still the recommended treatment in South Africa