World Malaria Day 2024: Uncomplicated vs Severe Malaria - All You Need To Know About Symptoms And Treatment

Malaria is an infection caused by a plasmodium parasite and does not spread from person to person. It spreads to humans by infected female Anopheles mosquitoes' bite. Treatment of malaria depends on the severity but early intervention is key, especially for severe malaria.

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World Malaria Day is observed on May 25 every year globally and the day aims to raise awareness about malaria and acknowledge the efforts taken to control the disease. Mostly found in tropical countries, malaria can be a life-threatening disease that spreads to humans by some types of mosquitoes - to be specific, infected female Anopheles mosquitoes. The infection is caused by a plasmodium parasite and does not spread from person to person.

While malaria is completely curable, timely diagnosis and treatment is very much essential. Malaria can also become complicated, and even turn fatal. According to the World Health Organization website, "globally in 2022, there were an estimated 249 million malaria cases and 608,000 malaria deaths in 85 countries." While a large number of these cases emerge from the African region, malaria is also not uncommon in India, a tropical nation.

Complicate vs Uncomplicated Malaria

Dr Seema Dhir, Senior Consultant, Internal Medicine at Artemis Hospital Gurugram, shares the difference between complicated and uncomplicated malaria and how the treatment differs in both cases. "Uncomplicated malaria and severe malaria differ in terms of levels of severity and accordingly, their treatments also vary. It is important to understand the differences between the two for effective management and treatment of malaria."

Uncomplicated Malaria

Uncomplicated malaria is the typical presentation of the disease, and the common symptoms include fever, chills, headache, fatigue, muscle and joint pain, nausea, and vomiting, says Dr Dhir. She adds, "Although these symptoms can sometimes prove to debilitating, they do not indicate the presence of severe complications. These types of uncomplicated malaria can generally be managed on an outpatient basis, and the prognosis is generally good with immediate and effective treatment," adds Dr Dhir.

Treatment Of Uncomplicated Malaria

The treatment of uncomplicated malaria typically involves the use of antimalarial medications, which target the Plasmodium parasites that cause infection, according to Dr Dhir. "The choice of antimalarial medication depends on various factors, like the species of Plasmodium involved and the drug resistance patterns in the region where the infection was acquired," the doctor adds. Commonly used antimalarial drugs include:

1. Artemisinin-based Combination Therapies (ACTs): For uncomplicated malaria, in several regions where the disease is endemic, ACTs are considered to be the first-line treatment. These combination therapies generally include an artemisinin derivative, which instantly reduces the parasite load. They are combined with a longer-acting partner drug that helps clear the remaining parasites.

2. Chloroquine: In areas where Plasmodium falciparum malaria is susceptible to chloroquine, this drug is generally used as a first-line treatment for uncomplicated cases.

3. Other antimalarial medications: In places where people show resistance to artemisinin or other antimalarial drugs, other medications like mefloquine, atovaquone-proguanil, or quinine may be used for the treatment of uncomplicated malaria.

The doctor highlights the fact that the duration of treatment and specific dosing regimens vary depending on the medication used and the severity of the infection. "Apart from antimalarial drugs, supportive care measures like rest, hydration, and symptomatic relief of fever and pain may be recommended to help alleviate symptoms and promote recovery," says Dr Dhir.

Severe Malaria

If the malaria is severe, then it is a medical emergency that requires urgent intervention, says Dr Dhir, failing which there can be life-threatening complications. "Symptoms of severe malaria may include impaired consciousness, seizures, respiratory distress, severe anaemia, jaundice, renal failure, and circulatory collapse. If not treated immediately, severe malaria can progress to multiple organ failure and death at a very fast pace."

Treatment of Severe Malaria

Rigorous management to address both the underlying infection as well as associated complications is key in the treatment of severe malaria. Dr Seema Dhir breaks down the key components of the treatment:

1. Intravenous Antimalarial Therapy: Oral medications may not be sufficient if a patient has severe malaria because of impaired absorption or inability to tolerate oral intake, says Dr Dhir. She adds that therefore, intravenous (IV) administration of antimalarial drugs like artesunate or quinine is generally recommended as the first-line treatment.

2. Supportive Care: Patients with severe malaria require intensive supportive care to manage complications and maintain vital organ function. "This generally includes measures like fluid resuscitation, oxygen therapy, blood transfusion for severe anaemia, and management of electrolyte imbalances," says Dr Dhir.

3. Monitoring And Close Observation: "Patients with severe malaria need to be closely monitored for signs of clinical deterioration, including changes in consciousness, respiratory distress, and hemodynamic instability," says Dr Dhir. She adds that time-to-time clinical assessments, laboratory testing, and vital sign monitoring are necessary to guide treatment decisions and optimize patient outcomes.

4. Critical Care Interventions: In severe cases complicated by respiratory failure, acute kidney injury, or cerebral malaria, patients may need admission to an intensive care unit (ICU) for advanced monitoring and interventions like mechanical ventilation, renal replacement therapy, or intracranial pressure management.