Approximately 300 million people worldwide are affected by malaria and between 1 and 1.5 million people die from it every year. Previously extremely widespread, the malaria is now mainly confined to Africa, Asia and Latin America. The problems of controlling malaria in these countries are aggravated by inadequate health structures and poor socioeconomic conditions. The situation has become even more complex over the last few years with the increase in resistance to the drugs normally used to combat the parasite that causes the disease.

TYPES OF MALARIA :

Malaria in man is caused by 4 distinct species of malaria parasite -

1. Plasmodium vivax
2. Plasmodium falciparum
3. Plasmodium malariae
4. Plasmodium ovale

(1) Plasmodium vivax -
It has the widest geographic distribution throughout the world and causes much debilitating disease.
In India, about 60% of the infections are due to P. vivax.

(2) Plasmodium falciparum -
It is also wide spread, results in the most severe infections and is responsible for nearly all malaria-related deaths.
40% of infection is due to P. falciparum.

(3) Plasmodium malariae -
It has restricted distribution and is said to be responsible for less than 1% of infections in India.

(4) Plasmodium ovale -
It is very rare parasite of man, mostly confined to tropical Africa.
In highly endemic areas, the patient may become infected with one, two or even more species of the malarial parasite.
In India, 4-8% is due to mixed infection.

CAUSES OF MALARIA:

Malaria parasites are transmitted from one person to another by the female anopheline mosquito. The males do not transmit the disease as they feed only on plant juices. There are about 380 species of anopheline mosquito, but only 60 or so are able to transmit the parasite.

Like all other mosquitos, the anophelines breed in water, each species having its preferred breeding grounds, feeding patterns and resting place. Their sensitivity to insecticides is also highly variable.
Plasmodium develops in the gut of the mosquito and is passed on in the saliva of an infected insect each time it takes a new blood meal. The parasites are then carried by the blood in the victim's liver where they invade the cells and multiply:

Blood transfusion
Needle- stick injury
Sharing of needle by infected drug addicts
Organ transplantation

SYMPTOMS:

Malarial attacks present over 4 to 6 hours with shaking chills, high fever, and sweating, and are often associated with fatigue, headache, dizziness, nausea, vomiting, abdominal cramps, dry cough, muscle or joint pain, and back ache. The attacks may occur every other day or every third day.
Cerebral malaria and death can occur, sometimes within 24 hours, if the infection is caused by plasmodium falciparum.
Fever or other symptoms can develop in malaria as early as 8 days or as late as 60 days after exposure or stopping prophylaxis. For plasmodium vivax in temperate areas, the delay may be up to one year.

MEDICINE & DOSAGE:

(1) Chloroquine

(2) Sulphadoxine + Pyrimethamine

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