Complete Guide to Malaria Medication

Mar 29, 2022 Malaria

Complete Guide to Malaria Medication 

Malaria is a serious disease that is spread to humans through mosquito bites. Malaria is most often found in tropical countries. 

It is not a viral or a bacterial disease but is caused by a parasite. 

The disease causes fevers, vomiting, diarrhoea, and muscle pain, and if it is not treated it can be fatal. 

There are preventative measures (eg. mosquito nets) and antimalarial tablets to fight the disease, but there is currently no vaccine. 

 

How Does Malaria Spread?

It is caused by the protozoan parasite that is transferred by mosquito bites. This occurs mainly during dusk or at night time. 

Female mosquitos spread malaria by passing on a parasite when they suck the blood of a human.  Male mosquitoes do not bite (males just feed on plant nectar) so the female is more deadly than the male. 

There are four types of malarial parasites that can cause infection.

The only mosquito that spreads Malaria is the female Anopheles genus variety.  They carry the Plasmodium parasite which causes the disease

If you are bitten by an infected insect you will probably contract malaria.

 

Which Countries Have Malaria 

It is important that you are aware of which countries are high risk before you travel. The following parts of the world are high-risk areas: 

• Africa
• Asia
• Central and South America
• Haiti and the Dominican Republic
• parts of the Middle East; and
• some Pacific Islands.

As you can see these places are much warmer and ideal habitats for mosquitoes than European countries.

Malaria occurs in 100 countries with a hot and tropical climates.  The USA eliminated malaria in 1951 but still have cases caused by people who have returned to the country infected by the disease.

Malaria has been eradicated in the UK. 

 

Symptoms of Malaria 

Malaria cells multiply in the liver and the red blood cells eventually resulting in the body shutting down.

Symptoms include:

• chills
• headache
• fever
• vomiting
• diarrhoea
• painful
• muscles
• seizures

Severe cases of malaria can lead to brain damage or death if you don’t take precautions.

No one knows how seriously they will be affected by the condition so preventative treatments are required.

 

How Long Before Symptoms Appear?

The disease has a long incubation period resulting in diagnosis delay or misdiagnosis. People don’t associate symptoms with their travels because they manifest themselves months and years later. 

Sometimes the symptoms of malaria don’t manifest themselves for a while after you return. Symptoms usually appear within 17 days but it may take up to a year. If this is the case, contact your doctor immediately. 

 

How Dangerous is Malaria?

Malaria kills nearly 600,000 people a year.  Children are affected the most.

Malaria affects 198 million cases every year across the world. 1,586 people were diagnosed with the condition in the UK in 2014.

 

Does Malaria Cause Brain Injury?

In some cases malaria can affect the brain, causing damage or causing the sufferer to fall into a coma.  There are two problems related to malaria to be aware of:

Severe Anaemia — This is when your red blood cells are unable to carry sufficient oxygen around the body causing the sufferer to be drowsy and weak all over.

Cerebral Malaria — As the name suggests this rare version of Malaria is very serious.  In this version the small blood vessels in the brain become blocked, preventing blood from circulating around the brain.  This can cause; seizures, brain damage and in the worst cases a coma.

 

How Is Malaria Treated?

There is no malaria vaccine. Instead, you have to take medication before and after you travel. These come in the form of antimalarial tablets, of which there are multiple types. 

 

When to Take Malaria Medication 

Whichever brand you decide to take you will have to take tablets before you go away, during your holiday and when you come back. These will reduce your chance of being infected with malaria. 

What if you didn’t take the antimalarials before travel, or you were just unlucky, and you get malaria anyway?

As well as preventing the disease, antimalarials are also the treatment for patients who already have malaria. However, you must discuss with a doctor which antimalarial to take in this situation. 

 

Do You Have To Take Malaria Medication?

There are no laws that require the consumption of malaria medication.

However, let’s not beat around the bush here - if you don’t take malaria medication you might die.  If the brain damage or stroke doesn’t kill you it will leave you a shadow of the person you used to be.  You can go into shock, have liver damage, develop severe anaemia, have kidney failure, ruptured spleen, and acute respiratory distress syndrome. 

Although nobody can force you to take anti-malaria treatment, the question is - why would you take the risk?

 

Types of Malaria Medication 

There are three main treatments for malaria; Doxycycline, Atovaquone/Proguanil, and Malarone. 

Although their purpose is the same, they vary significantly in terms of cost, dosage and side effects.

Malaria treatment is not free on the NHS because it is not considered a danger to the public if it is brought into the country.

Doxycycline 

Part of the tetracycline antibiotics family, doxycycline is fairly cheap and only needs to be taken two days before your trip.  You continue to take it during your holiday and for four weeks when you return.  Some people may suffer photosensitive skin reactions, which can cause issues if you are travelling somewhere hot and sunny.  It is not recommended for pregnant women or children under twelve.  If you use the contraceptive pill as a means of birth control it can reduce its effectiveness.

Atovaquone/ Proguanil and Malarone 

Are antimalarials,  which produce fewer side effects than older malaria treatments.  It only has to be taken two days before travelling.  It is to be taken while on holiday and for seven days when you get back.  Side effects are very similar to most medications including; a headache, feeling sick, stomach pain and diarrhoea. Most people won’t even suffer any adverse reactions.

 

Which Types of Malaria Medication Should You Take? 

As with all medications, Malarone and Doxycycline are suitable for different types of people. Only after a thorough consultation with a doctor will you be able to choose the right medication. It is important that you are completely honest about any medical conditions or mental health issues you may have because your holiday could be a nightmare instead of the dream that you hoped it would be.

 

History of Malaria Medication 

Traditional treatment involves Tetracycline antibiotics which are a cheap effective way to prevent Malaria.  Modern versions of this treatment are much more user-friendly and avoid some of the more distressing side effects suffered in the past. Antimalarials containing Malarone and the most up to date treatments.  There are hardly any side effects and they are very easy to take.

 

Side Effects of Malaria Medication 

Often people are concerned about the side effects of the treatment and question if they are necessary.  This is because treatments have been known to cause hallucinations and depression.

Thankfully, the side effects of malaria treatments are much less harsh than in the past making taking them much more palatable. 

 

Precautions Against Malaria 

Bite Prevention 

The best way to avoid catching malaria is not to get bitten in the first place.  Here are ways to reduce your chances of getting bitten:

• Wear insect repellent on all exposed skin.
• Cover up with light clothing.
• Sleep under a mosquito net.
• Close windows and doors.
• Stay somewhere with air conditioning, so you can close the doors and windows.
• Use insecticides in the form of; mats, sprays, and plugins.
• Burning citronella candles

 

Antimalarial tablets 

Antimalarial tablets are both the treatment for the disease and a preventative measure so that you do not get it in the first place. That is why it is advised that tablets are taken before, during and after travel to a high-risk country. 

You can find out more facts about Malaria on the World Health Organisation (WHO) website here. 

 

Will Malaria be More or Less of a Risk in the Future?

 

Climate Change and Malaria 

As already mentioned, areas, where malaria infections are rife, are much warmer, as this is the ideal habitat for mosquitoes.

Climate change is a very real issue that is already affecting temperatures around the world.  When we consider global warming we only think about the big effects such as; flooding, melting ice caps and general temperature rises.  Diseases thrive in warm climates so it makes sense to consider the implication of global warming on malaria.

If global warming was to continue then more countries are likely to develop the right conditions to encourage mosquitoes to breed.

The Independent reports that studies have shown that as the temperature rises mosquitoes migrate to higher altitudes. This means that areas that were once malaria-free are starting to be affected by the disease.  Highland areas in the tropics have a much greater population due to increased rainfall.  Evidence shows that Malaria is spreading already due to climate change.  Mosquitoes who carry malarial parasites thrive in warmer climates. 

People who live at higher altitudes have avoided infection due to the cooler temperature being a hostile environment for mosquitoes.  Now, this is changing and malaria is more prevalent in these areas.   The World Health Organisation has also noted that climate change has a great impact on malaria.  Monsoons and increased rainfall provide the perfect breeding ground for mosquitoes.

 

The Possibility of a Malaria Vaccine 

Malaria is a pretty resilient infection and up to now has evaded doctors’ attempts to produce a vaccine.

It seems that its effect on red blood cells may provide the solution to preventing Malaria. People with Sickle Cell anaemia are resilient to Malaria which is the disease's only redeeming feature. Sickle cell anaemia changes the haemoglobin in the blood making catching malaria impossible.  People with Sickle Cell Anaemia are really bad hosts because their blood is not good enough to allow the parasite to multiply. (Source: WHO). Is the answer to the problem of malaria in our haemoglobin?

Sickle Cell Anaemia is a genetic condition affecting the haemoglobin in the blood. It causes the red blood cells to be a sickle shape which blocks blood vessels causing organ damage and pain.  The sickle shape affects the way oxygen interacts with different organs in the body. This results in organ damage and disability in the sufferer. Symptoms include; anaemia, fatigue, pain, inflammation, infections, lung and heart damage, leg ulcers, impaired vision and bone reduction. 

People who have Sickle Cell Anaemia have a shorter lifespan than those without. At the moment doctors can only treat the symptoms of anaemia and provide pain management.  People who have sickle cell anaemia in their families can access genetic counselling to prevent passing on the disease to their offspring. The only benefit of having Sickle Cell Anaemia is its resistance to Malaria. The sickle-shaped cells are not a good host for a parasite to multiply in so it dies pretty quickly.  (Source: MedicineNet.com) At the moment people with Sickle Cell Disease are the only ones immune to Malaria but it is a possibility that scientists will be able to use the information to produce a vaccine.

At the moment developing a vaccine and treating malaria is a challenging process.  Scientists know what causes the condition and how it is possible to destroy it but they have many factors that make producing a vaccine difficult.  First of all the parasite becomes resistant to antibiotics, secondly, the treatment that stays in the red blood cells is expensive and very temporary. Eliminating the condition is certainly a huge challenge for scientists who have restricted budgets, large populations of people and pesky mosquitos to deal with.  At the moment and for the foreseeable future traditional ways to prevent Malaria are the only way we can fight the disease.

 

More About Mosquitos

This is the life cycle of a mosquito:

• Eggs are laid either directly into water or on leaves floating on the water. The eggs hatch when exposed to water.

• The larva is known as, ‘wigglers’, swim in the water while they grow and eat food provided by the mother.  They go to the service of the water to breathe.

• Pupa or, ‘tumbler’, stage.  This is similar to being in a cocoon and no food is consumed during this time.

• The adult emerges from the pupa and is able to fly.  Once the body has dried the mosquitos are ready to ruin people’s holidays.