Malarial plasmodium disease. Malaria - symptoms and treatment. World Malaria Day

Part 1

Identifying symptoms of malaria

Severe chills. Another main symptom of malaria is severe, shaking chills, alternating with periods of sweating. Shaky chills are characteristic of many other infectious diseases, but with malaria they are usually more pronounced and intense. The chills are so intense that they cause teeth to chatter and even interfere with sleep. If the chills are particularly severe, it can be confused with a seizure. Typically, chills due to malaria are not relieved by wrapping yourself in a blanket or warm clothing.

Vomiting and diarrhea. Another common secondary symptom of malaria is vomiting and diarrhea, which occurs many times throughout the day. They often accompany each other, which resembles the initial symptoms of food poisoning, as well as some bacterial infections. The main difference is that with food poisoning, vomiting and diarrhea go away after a few days, while with malaria it can last several weeks (depending on treatment).

Recognize late symptoms. If, after the appearance of primary and secondary symptoms, the patient does not seek medical help and does not receive appropriate treatment, which is not always available in developing countries, then the disease progresses and leads to significant damage to the body. In this case, late symptoms of malaria appear and the risk of complications and death increases significantly.

Confusion, multiple convulsions, coma and neurological disorders indicate swelling and damage to the brain.
Severe anemia, abnormal bleeding, difficulty in deep breathing and respiratory failure indicate severe blood poisoning and infection in the lungs.
Jaundice (yellowish skin and eyes) indicates liver damage and dysfunction.
Kidney failure.
Liver failure.
Shock (very low blood pressure).
Enlarged spleen.

Part 2

Risk factors

Be very careful when visiting underdeveloped tropical regions. Those who live or visit countries where the disease is common are at greatest risk of contracting malaria. The risk is especially high when visiting poor and underdeveloped tropical countries because they lack the money for mosquito control and other malaria preventive measures.

Take preventive measures when traveling to high-risk areas. To protect yourself from mosquito bites Anopheles, do not stay outside for too long; wear long sleeve shirts, trousers and cover as much skin as possible with clothing; apply an insect repellent containing diethyltoluamide (N,N-diethylmethylbenzamide) or picaridin; spend time in rooms with windows protected by mosquito nets or with air conditioning; sleep on a bed with a mosquito net treated with an insecticide (such as permethrin). Also, talk to your doctor about taking an anti-malarial drug.

Malaria should be considered a deadly disease. If you suspect you have malaria, contact your doctor immediately.
The symptoms of malaria are similar to those of many other diseases. It is important to tell your doctor that you have recently returned from an area where there is a risk of malaria, otherwise he may not initially think of it as a possible cause of your symptoms and may not make a diagnosis in time.

Malaria is an acute infectious disease caused by a representative of the class of protozoa Plasmodium malaria, transmitted to humans by the bite of infected mosquitoes of the genus Anopheles, occurring with attacks of fever that occur at certain intervals corresponding to the development cycle of the pathogen.

Malaria is one of the most dangerous human diseases. Because of it, entire nations died, it led to the decline of great powers and decided the results of wars. Alexander the Great, King of the Huns Attila, Genghis Khan, the poet Dante, St. Augustine, Christopher Columbus, Oliver Cromwell and many others died from it.

Rice. 1. It is believed that Alexander the Great died of malaria.

Rice. 2. Genghis Khan, King of the Huns Attila, Christopher Columbus, Alexander the Great, the poet Dante, St. Augustine, Oliver Cromwell and many others died from malaria.

Historical information

Malaria has been known since ancient times. In the 18th century, the Italian Lencisi put forward a theory of the origin of malaria as a result of harmful fumes from swamps (swamp fever is its second name). The causative agent of malaria, Plasmodium, was first discovered and described in 1880 by C. Laveran (Algeria). Thanks to the staining method using methylene blue and eosin developed in 1891 by D. L. Romanovsky (Russia), the structure of the malarial plasmodium was carefully studied. In 1898, R. Rost (England) studied the development cycle of plasmodium in the body of a mosquito and proved the role of mosquitoes of the genus Anopheles in the transmission of the disease. In 1948 - 1954, it was established that in addition to the forms of plasmodium developing inside erythrocytes, there is also a tissue form. For the first time in 1926, plasmokhin was synthesized, and then akrikhin, bigumal and quinricide, used in the treatment of malaria.

Prevalence of malaria in the world

Tropical malaria (Plasmodium falciparum) is probably native to West Africa, and three-day malaria (Plasmodium vivax) is probably native to Central Africa.

The disease is now common in more than 100 countries in Africa, Asia and South America.
More than 3.2 billion people, or half of the total population, live on Earth under conditions of increased risk of malaria infection.
In 2014, 214 million cases of the disease were registered, 480 thousand of which were fatal. As before, about 90% of cases of illness and death occur in countries of the African continent located south of the Sahara, where the most severe form of the disease, tropical malaria, is recorded. Of the remaining 10% of cases, 70% are reported in India, Sri Lanka, Brazil, Vietnam, Colombia and the Solomon Islands.
About 1 million children die from malaria every year. In tropical Africa, this disease is one of the leading causes of child mortality.
Every year, 30 thousand cases of “imported” malaria are registered, 3 thousand of which are fatal.

Rice. 3. Prevalence of malaria in the world.

Prevalence of malaria in Russia

Before the First World War, 3.5 million cases of malaria were registered in Russia. In the former USSR, malaria was practically eliminated and occurred only in isolated cases. Currently, outbreaks have intensified in Azerbaijan and Tajikistan. More and more cases of “imported” malaria are being registered in Russia. Some malaria patients die due to late or incorrect diagnosis of the disease.

Since the beginning of this year 2017, 3 deaths as a result of the disease have been registered in the Russian Federation: in the Ulyanovsk, Samara and Sverdlovsk regions. The importation of malaria was reported from Goa, a state in India.

In 2016, 100 cases of the disease were registered (33 regions of Russia), in 2015 - 99 cases. 99% of cases were “imported” malaria. 18 cases of “imported” malaria were registered in persons arriving from India, 10 cases from Congo, 7 cases from Angola, 9 cases from Afghanistan, Guyana and Oceania.

84% of cases were men. Among the sick were 2 children (3 in 2015).

The Krasnoyarsk and Perm regions, Yakutia, Belgorod, Volgograd, Vladimir, Kursk, Omsk and Novosibirsk regions, as well as St. Petersburg, are unable to cope with the early diagnosis of malaria.

Rice. 4. About 90% of cases of illness and death occur in countries of the African continent.

Epidemiology of malaria

Cause of malaria In humans there are 4 types of plasmodia:

When infected with Plasmodium vivax, three-day malaria develops.
When infected with Plasmodium malariae, quartan malaria develops.
When infected with Plasmodium falciparum, tropical malaria develops.
When infected with Plasmodium ovale, malaria similar to tertian malaria develops.

Carrier of malarial plasmodia are mosquitoes of the genus Anopheles. During wintering, the sporozoites in the female's body die. For it to become infected, a new infection from a sick person will be required.

Summer and autumn are the main ones periods of the year favorable for transmission of infection in areas with temperate and subtropical climates. The period of transmission of infection in them lasts 2 - 7 months. In the tropics this period reaches 8 - 10 months, in the equatorial countries of Africa - all year round.

Susceptibility to malaria universal. And only representatives of the Negroid race are immune to Plasmodium vivax - three-day malaria.

Rice. 5. In the photo on the left is a mosquito of the genus Anopheles (they are carriers of 4 types of malarial plasmodia, Japanese encephalitis and one type of Brugia). In the photo on the right is a mosquito of the genus Culex (they are carriers of Japanese encephalitis and 2 types of filariae of Japanese encephalitis).

Transmission of infection

Malaria is transmitted through the bites of female Anopheles mosquitoes, of which 400 species only 30 transmit the infection. Each species of mosquito prefers its own aquatic habitat: accumulations of fresh water in puddles, in animal hoofprints, wetlands, etc. The number and survival of Anopheles is affected by environmental temperature, precipitation distribution and humidity. If the air temperature drops below 16 o C (for Plasmodium vivax) and below 18 o C (for other species), then the development of pathogens in the mosquito’s body stops. Mosquitoes bite at dawn and dusk.

Rice. 7. Malaria is transmitted through the bites of female Anopheles mosquitoes. A distinctive feature is the raised rear part of the abdomen.

Stages of malaria

In the body of an infected person, plasmodia go through 2 stages: hepatic (preclinical) and erythrocyte (clinical).

Rice. 8. The figure shows the stages of development of plasmodia. In the upper part, the process of development of plasmodium in the body of a mosquito. In the lower part - in the human body (on the right - in liver cells, on the left - in red blood cells).

Hepatic (exoerythrocytic, preclinical) stage of malaria

When infected with Plasmodium vivax, schizonts first enter the bloodstream after 10 months. from the moment of infection.
When infected with Plasmodium malariae or Plasmodium falciparum, the liver stage ends here.
When infected with Plasmodium ovale, some schizonts (hypnoschizonts) remain in the liver cells for a long time (“dormant” liver stages) and only after several months and even years they become active and cause relapses of the disease.

Erythrocyte (clinical) stage of malaria

Once released into the blood, merozoites attach to red blood cells. Receptors on the surface of erythrocytes that serve as targets for merozoites are different for different types of Plasmodium. While in red blood cells, schizonts begin to divide. From one schizont, from 8 to 24 blood merozoites are formed, which, after maturation, destroy red blood cells and enter the blood. Some of the merozoites re-enter the erythrocytes, the other part goes through the gametogony cycle (transformation into gamonts - immature female and male reproductive cells). The duration of the erythrocyte schizogony phase is 72 hours in P. malariae, and 48 hours in other Plasmodium species.

Gamonts, entering the stomach of a mosquito when biting a sick person, turn into gametes (mature sex cells). After the fertilization process, a zygote is formed, which is sent to the wall of the stomach, where it divides many times, forming thousands of sporozoites.

When red blood cells are destroyed and merozoites are released into the plasma, febrile attacks and anemia develop. When liver cells are destroyed, hepatitis develops. Foreign protein formed as a result of the disintegration of mobile forms of merozoites, malarial pigment, hemoglobin, potassium salts and remnants of red blood cells change the specific reactivity of the body and affect the heat-regulating center, causing a temperature reaction (malarial fever).

The development of a fever attack is influenced by the dose of the pathogen and the reactivity of the body. The duration and cyclicity of erythrocyte schizogony (repeated attacks) depend on the type of pathogen.

Rice. 10. Feverish attacks and hepatitis are the main symptoms of malaria.

Malaria, also known as swamp fever, intermittent fever, and paroxysmal malaria, is an acute infectious disease caused by several species of protozoa of the genus Plasmodium and transmitted by the bite of an Anopheles mosquito. Malaria is characterized by repeated attacks of severe chills, high fever and profuse sweating.

It is widespread in warm and humid regions with an average annual temperature of 16 ° C and above, it is also found in zones of more temperate climates and is completely absent in the polar regions. The disease causes serious economic damage to countries with tropical and subtropical climates, leading among all diseases as the main cause of disability and mortality.

At the beginning of the 21st century, the incidence was 350-500 million cases per year, of which 1.3-3 million resulted in death. The death rate was expected to double over the next 20 years. According to the latest WHO estimates, there are from 124 to 283 million cases of infection with malarial plasmodia per year and from 367 to 755 thousand deaths from the disease. From 2000 to 2013, global malaria mortality rates fell by 47% and in the WHO African Region by 54%.

85-90% of cases of infection occur in sub-Saharan Africa; the vast majority of infections occur in children under 5 years of age.

How can you get infected?

The causative agent of malaria is Plasmodium falciparum. It belongs to the class of protozoa. The causative agents can be 5 types of plasmodia (although there are more than 60 species in nature):

The life cycle of malarial plasmodia includes a successive change of several stages. At the same time, a change of owners occurs. At the stage of schizogony, pathogens are found in the human body. This is the stage of asexual development, it is replaced by the sporogony stage. It is characterized by sexual development and occurs in the body of a female mosquito, which is the carrier of the infection. The causative mosquitoes belong to the genus Anopheles.

Penetration of malarial plasmodia into the human body can occur at different stages in different ways:

When bitten by a mosquito, infection occurs at the sporozontal stage. Penetrated plasmodia after 15-45 minutes end up in the liver, where their intensive reproduction begins.
Penetration of plasmodiums of the erythrocyte cycle at the schizont stage occurs directly into the blood, bypassing the liver. This route is realized when donated blood is administered or when using non-sterile syringes that can be contaminated with plasmodia. At this stage of development, it passes from mother to child in utero (vertical route of infection). This is the danger of malaria for pregnant women.

In typical cases, division of plasmodia that enter the body through a mosquito bite occurs in the liver. Their number is increasing many times over. At this time, there are no clinical manifestations (incubation period). The duration of this stage varies depending on the type of pathogen. It is minimal in P. falciparum (from 6 to 8 days) and maximum in P. malariae (14-16 days).

Malaria on the lips

Malaria appears on the lips in the form of small blisters located close to each other and filled with a clear liquid. The cause of such lesions on the skin is the herpes simplex virus type 1. Therefore, using the term “malaria” to refer to this phenomenon is not correct.

Also among the popular designations for the herpes virus on the lips there are such terms as “cold” or “fever on the lips”. This disease manifests itself with local symptoms that develop in accordance with a certain pattern. In addition to local symptoms, patients may also be concerned about some general manifestations of this disease.

Symptoms of malaria in humans

Characteristic symptoms of malaria include fever, chills, joint pain, vomiting, decreased hemoglobin in the blood, detection of hemoglobin in the urine, and convulsions. In some cases, patients note tingling of the skin; this symptom is especially common with malaria caused by P. Falciparum. Upon examination, the doctor notes an enlarged spleen, the patient is bothered by a very severe headache, and the blood supply to the brain is disrupted. Malaria can be fatal and affects children and pregnant women the most.

Modern research methods include special diagnostic tests, which are based on immunochemical reactions. Such a study is one of the fastest (5–15 minutes), accurate and at the same time the most expensive methods.

Complications

In weakened or untreated patients, as well as in case of treatment errors, the following complications may develop:

malarial coma;
edema syndrome;
extensive hemorrhages (hemorrhages);
different types of psychoses;
renal and liver failure;
infectious complications;
splenic rupture.

A separate complication of malaria is hemoglobinuric fever. It develops against the background of massive proliferation of plasmodia, during treatment with medications, due to the destruction of red blood cells (hemolysis). In severe cases of this complication, a progressive decrease in urine production is added to the general symptoms and complaints of an attack of malaria. Fulminant renal failure develops, often with early death.

Diagnostics

For the diagnosis of P. falciparum, monoclonal antibody test strips to histidine-rich protein-2 can be used at the bedside, which have an accuracy comparable to a blood spot and require less effort than microscopy. PCR and other tests are informative, but they are not widely used. Serological tests may reflect previous infection but do not diagnose acute infection.

How to treat malaria?

All patients with malaria are hospitalized in an infectious diseases hospital.

Etiotropic treatment of malaria:

"Quinine" is a fast-acting antimalarial drug that affects all strains of Plasmodium. The drug is administered intravenously. This is necessary to create a high concentration of the drug in the blood serum. The duration of treatment with Quinine is 7-10 days. If intravenous administration of the drug becomes impossible, it is administered intramuscularly or orally. Treatment with Quinine alone is often insufficient. In such cases, its use is combined with the use of antibiotics from the group of tetracyclines or other antimalarials.
"Chloridine" is a drug that has a damaging effect on various forms of plasmodium. This drug is quite effective, but acts more slowly than Hingamin. In severe cases, they are recommended to be taken simultaneously.
"Hingamin" is a widely used antimalarial drug that causes the death of plasmodium. The tablets are prescribed to patients with malaria and are used to prevent infection. They should be taken after meals for 5 days. In severe cases, the drug is administered intravenously. For children, Khingamin is prescribed as intramuscular injections twice with an interval of 6 hours. To speed up and enhance the therapeutic effect of the drug, it is prescribed together with anti-inflammatory and hormonal drugs.

In addition to etiotropic therapy, symptomatic and pathogenetic treatment is carried out, including detoxification measures, restoration of microcirculation, decongestant therapy, and the fight against hypoxia.

Colloidal, crystalloid, complex salt solutions, “Reopoliglyukin”, isotonic saline solution, “Hemodez” are administered intravenously. Patients are prescribed Furosemide, Mannitol, Eufillin, and undergo oxygen therapy, hemosorption, and hemodialysis.

To treat complications of malaria, glucocorticosteroids are used - intravenous Prednisolone, Dexamethasone. According to indications, plasma or red blood cells are transfused.

Prevention

Prevention of malaria requires taking special tablets. You should start taking them 2 weeks before your intended departure to the risk zone. An infectious disease doctor can prescribe them. It is worth continuing to take the prescribed pills after arrival (for 1–2 weeks).

In addition, to prevent the spread of infection in countries where the disease is not uncommon, measures are being taken to destroy malaria mosquitoes. The windows of the buildings are protected by special nets. If you are planning to go to such a dangerous zone, you should get special protective clothing and do not forget to take preventive pills.

Such preventive measures almost completely eliminate infection with this dangerous disease. If you experience at least a few of the symptoms described above, you should immediately contact an infectious disease specialist. Timely treatment will allow you to almost completely get rid of the disease and prevent the development of complications.

Development of malaria vaccines

Development and clinical trials of various malaria vaccines are underway.

In July 2015, the European Medicines Agency issued a positive opinion on the Plasmodium falciparum vaccine Mosquirix, also commonly known as RTS,S/AS01, developed by the British pharmaceutical company GlaxoSmithKline and tested in more than 15 thousand children. The vaccine showed an effectiveness of about 30-40% when administered four times (at 0, 1, 2 and 20 months).

The publication by the European agency will contribute to obtaining approvals for use in African countries. The World Health Organization will study how safe the vaccine is for children, who are most susceptible to the disease, and use of the vaccine in individual countries is expected in 2017. The vaccine could likely complement the many efforts being taken to combat malaria.

Malaria is a group of vector-borne diseases that are transmitted by the bite of a malarial mosquito. The disease is widespread in Africa and the Caucasus countries. Children under 5 years of age are most susceptible to the disease. More than 1 million deaths are recorded every year. But, with timely treatment, the disease proceeds without serious complications.

Etiology

There are three ways of contracting tropical malaria:

transmission type(through the bite of a malarial mosquito);
parenteral(through unprocessed medical supplies);
transplacental(mixed type).

The first route of infection is the most common.

General symptoms

The first and most sure sign of infection with the disease is fever. It begins as soon as the malaria pathogen has penetrated and reached a critical level. In general, the symptoms of malaria are:

periodic fever;
significant enlargement of the spleen;
Possible liver hardening.

The general list may be supplemented with other signs, depending on the period of development and form of the disease.

Forms of malaria

In modern medicine, the disease is classified into four forms:

three-day form;
four-day;
tropical infectious form;
ovale malaria.

Each of these forms has its own characteristic, pronounced symptoms and requires an individual course of treatment.

Three-day form

Three-day malaria has a very favorable prognosis compared to other forms of the disease. The incubation period can last from 2 to 8 months from the moment of the mosquito bite.

The symptoms of malaria of this subform correspond to the list described above. In the absence of correct treatment or if the immune system is too weakened, complications such as nephritis or malarial hepatitis may occur. In the most complex clinical cases, peripheral nephritis may develop. But in general, three-day malaria occurs without significant complications.

Quartan

Just like three-day malaria, with correct and timely treatment it occurs without significant complications. General symptoms of the disease can be supplemented by the following signs:

daily fever;
There is practically no increase in internal organs.

It is worth noting that attacks of fever can be easily stopped if antimalarial drugs are used in a timely manner. However, relapse of the disease can occur even after 10–15 years.

In rare cases, a complication may develop in the form of renal failure.

Ovale malaria

In its symptoms and course, this form is similar to the three-day form of the disease. The incubation period can last on average up to 11 days.

Tropical malaria

Tropical malaria is the most common form of the disease. Harbingers of the development of the disease may be the following:

sharply increased temperature;
chills;
weakness, malaise;
muscle pain.

Unlike three-day malaria, this form of pathology is characterized by a severe course. Without appropriate treatment, even death can occur. The virus is transmitted from a sick person to a healthy person, or through a mosquito bite.

Periods of disease development

Since the disease is classified as a polycyclic infectious disease, its course is usually divided into four periods:

latent (incubation period);
primary acute period;
secondary period;
relapse of infection.

Clinical picture of periods

The initial period, that is, the incubation period, practically does not manifest itself at all. As the patient progresses to the acute stage, the following signs of the disease may appear:

a sharp change from a period of chills to fever;
increased sweating;
partial cyanosis of the extremities;
rapid pulse, heavy breathing.

At the end of the attack, the patient’s temperature can rise to 40 degrees, the skin becomes dry and red. In some cases, a mental state disorder may be observed - the person is either in an excited state or falls into unconsciousness. Convulsions may occur.

During the transition to the secondary period of development of the pathology, the patient calms down, his condition improves somewhat, and he can sleep peacefully. This condition is observed until the next attack of fever. It is worth noting that each attack and the development of a new period of the disease is accompanied by profuse sweating.

Against the background of such attacks, an enlarged condition of the liver or spleen is observed. In general, the incubation period includes up to 10–12 such typical attacks. After this, the symptoms become less pronounced and the secondary period of the disease begins.

Without treatment, relapse almost always occurs and death cannot be ruled out.

Diagnostics

Diagnosis of this disease is not particularly difficult, due to its specific symptoms. To clarify the diagnosis and prescribe the correct course of treatment, a laboratory blood test is performed (allows us to identify the pathogen).

With timely treatment, malaria proceeds without significant complications. In this case, any traditional methods or dubious pills purchased independently from a pharmacy are unacceptable. Delay can result not only in relapse of the disease and complications in the form of other diseases, but also in death.

The most effective is drug treatment. In this case, the patient must be hospitalized, since treatment should be carried out only inpatiently and under the constant supervision of medical specialists.

In the initial period, as a rule, they get by with tablets alone. The most commonly used is Hingamin. The doctor calculates the dosage and frequency of administration individually based on the general health condition, weight and age of the patient.

If the tablets do not bring the desired result and the condition of the infected patient does not improve, drugs are prescribed that are administered intravenously.

Other tablets based on artemisinin can also be used to treat the disease. But drugs based on this substance are very expensive, so they have not found widespread use in clinical practice for the treatment of malaria infection. However, such tablets are most effective for treatment even in the later stages of the development of the pathological process.

Possible complications

Unfortunately, malaria in any form can affect the condition of any organ or system in the human body. The disease most often affects the liver, spleen and cardiovascular system. Also, against the background of malaria, diseases of the nervous system, genitourinary and vascular systems can occur.

As medical practice shows, the disease is most difficult and fatal in southern countries, where there is no access to good drugs. Cheap pills can only temporarily stop attacks, but this does not kill the infectious agent. As a consequence of this, the transition to the last period of development of the disease begins and death occurs.

Prevention

If you are planning to go to such a dangerous zone, you should get special protective clothing and do not forget to take preventive pills.

Almost 100 countries with tropical and subtropical climates consider malaria to be the most serious health problem. The disease poses a danger both to residents of endemic risk zones and to tourists who come on vacation to hot countries.

What kind of disease is this

The most frequently reported cases of infection are in Africa, Southeast Asia, and the Eastern Mediterranean. Any of these regions is dangerous for people with immunodeficiency, the elderly, pregnant women, and young children. All of them suffer from a severe form of the disease and, due to malaria, face an increased risk of death, miscarriage, and stillbirth.

The causative agent of the disease is a simple unicellular organism of the genus Plasmodium. It comes in 4 types. In this regard, experts distinguish 4 forms of the disease:

Ovale malaria. This is a relatively rare disease. It is found in West Africa. Oval malaria accounts for about 1% of cases. The causative agent is Plasmodium ovale.
Four-day form. It is considered rare (up to 7% of cases). It is caused by Plasmodium malariae.
Three-day form. It is caused by Plasmodium vivax. The disease caused by this pathogen is widespread in the world (up to 43% of cases).
Tropical malaria. This form is the most common (up to 50% of cases). Its causative agent is Plasmodium falciparum.

How is malaria transmitted?

The disease can occur in almost any person living or who has visited endemic risk areas. There are just a few features:

indigenous people of West Africa exhibit congenital immunity to Plasmodium vivax;
People with sickle cell anemia easily tolerate the tropical form of the disease, which is considered the most dangerous, rapidly progressing if left untreated.

Malaria is caused by female Anopheles mosquitoes. They act as carriers of plasmodia. Insects transmit pathogens from sick people to healthy people through bites. In the past, several isolated cases of human infection with zoonotic species of Plasmodium (Plasmodium knowlesi and Plasmodium cynomolgi) have been reported. These pathogens were transmitted to humans by mosquitoes after being bitten by sick monkeys.

With malaria, the incubation period depends on the type of plasmodium that has entered the body. The most rapid development of the disease is observed in the tropical form. The first symptoms appear after 8-16 days. The incubation period for the four-day form ranges from 3 to 6 weeks. Pathogens such as Plasmodium vivax and Plasmodium ovale are characterized by the preservation of dormant hypnozoites in the liver. The period from infection to activation can range from 6-8 months to 3 years.

First signs and main symptoms

Fever, chills, headache, muscle pain, muscle weakness, cough, vomiting, abdominal pain, diarrhea are possible clinical signs. In the absence of treatment, a negative progression of malaria is observed, the disease leads to manifestations of failure of individual organs (acute renal failure, pulmonary edema). Coma and death may occur.

Of all the symptoms, fever deserves special attention. If it occurs for unknown reasons 7 days or more after the first possible contact with the pathogen, you should immediately consult a doctor. It is advisable to visit a specialist no later than 24 hours after the onset of symptoms indicating malaria, because treatment started in a timely manner will reduce or eliminate the likelihood of death.

An important feature of the disease is its paroxysmal course. In the first days, the fever is of the wrong type (temperature fluctuations are observed throughout the day without patterns). It lasts 1-3 days for three-day and oval malaria and 5-6 days for tropical malaria. After this period, the clinical picture takes on the appearance of typical paroxysms (attacks). They clearly have 3 phases - chills, fever, sweating. The duration of attacks varies from 1-2 hours to 12 hours.

Paroxysms are repeated either after 48 hours (with tropical, three-day and oval malaria), or after 72 hours (with the four-day form of the disease). Between attacks, the condition of sick people is satisfactory. After 2-3 temperature paroxysms, the liver and spleen increase in size. Anemia develops from the second week of the disease.

Diagnosis and treatment

Medicine for malaria is prescribed after confirmation of the presence of the disease. Diagnosis includes anamnesis and clinical examination. Laboratory methods are a mandatory part of it. One of them is microscopic. During its use, blood products prepared by the “thin smear” and “thick drop” method and stained according to Romanovsky-Giemsa are examined. The microscopic method allows you to confirm or exclude the disease, determine the type of pathogen, and the severity of the infectious process.

After confirming the diagnosis, the doctor thinks about how to rid the patient of malaria. Treatment begins in a hospital setting. It includes:

use of etiotropic drugs (Daraprim, Delagil, etc.);
conducting pathogenetic therapy (prescribed drugs - Prednisolone, Korglykon, ascorbic acid, multivitamins).

Prognosis and prevention

The prognosis is favorable with timely diagnosis and treatment of uncomplicated malaria. Full recovery occurs quickly. The most dangerous are malignant forms of the disease. The mortality rate caused by them is 1%. For example, in the cerebral (comatose) form, multiple hemorrhages are observed in the brain tissue and meninges. The disease is manifested by intense headache, nausea, repeated or repeated vomiting, disturbances and loss of consciousness. Death occurs due to increasing cardiac and respiratory failure.

It is possible to avoid the disease and its negative consequences, because malaria prevention has been developed. One of the effective measures is the use of drugs prescribed for treatment. It is recommended that you first consult with your doctor regarding such prophylaxis. Medicines are prescribed to those people who are going to travel to endemic areas. When drawing up a prevention plan, the specialist takes into account:

malariological situation in the region, malaria season, period of disease transmission (part of the year during which pathogens can be transferred from mosquitoes to humans);
planned duration of stay in the endemic territory;
the presence of individual intolerance to drugs.

In order to reduce the likelihood of developing malaria, prevention also includes the use of personal protective equipment (mosquito nets, repellents). An important role is played by chemical, physical, biological and hydraulic measures carried out by countries at the state level (bringing water sources to proper sanitary and technical condition, leveling the banks, clearing vegetation, etc.). A vaccine is also being developed that could protect 100% from infection.