What is malaria?
Malaria is an infectious disease caused by a parasite, Plasmodium, which infects red blood cells. Malaria is characterized by cycles of chills, fever, pain, and sweating. Historical records suggest malaria has infected humans since the beginning of mankind. The name "mal aria" (meaning "bad air" in Italian) was first used in English in 1740 by H. Walpole when describing the disease. The term was shortened to "malaria" in the 20th century. C. Laveran in 1880 was the first to identify the parasites in human blood. In 1889, R. Ross discovered that mosquitoes transmitted malaria. Of the four common species that cause malaria, the most serious type is Plasmodium falciparum malaria. It can be life-threatening. However, another relatively new species, Plasmodium knowlesi, is also a dangerous species that is typically found only in long-tailed and pigtail macaque monkeys. Like P. falciparum, P. knowlesi may be deadly to anyone infected. The other three common species of malaria (P. vivax, P. malariae, and P. ovale) are generally less serious and are usually not life-threatening. It is possible to be infected with more than one species of Plasmodium at the same time.
Currently, about 2 million deaths per year worldwide are due to Plasmodium infections. The majority occur in children under 5 years of age in sub-Saharan African countries. There are about 400 million new cases per year worldwide. Most people diagnosed in the U.S. obtained their infection outside of the country, usually while living or traveling through an area where malaria is endemic.
What are malaria symptoms and signs?
The symptoms characteristic of malaria include flulike illness with fever, chills, muscle aches, and headache. Some patients develop nausea, vomiting, cough, and diarrhea. Cycles of chills, fever, and sweating that repeat every one, two, or three days are typical. There can sometimes be vomiting, diarrhea, coughing, and yellowing (jaundice) of the skin and whites of the eyes due to destruction of red blood cells and liver cells.
People with severe P. falciparum malaria can develop bleeding problems, shock, liver or kidney failure, central nervous system problems, coma, and can die from the infection or its complications. Cerebral malaria (coma, or altered mental status or seizures) can occur with severe P. falciparum infection. It is lethal if not treated quickly; even with treatment, about 15%-20% die.
How is malaria transmitted?
The life cycle of the malaria parasite (Plasmodium) is complicated and involves two hosts, humans and Anopheles mosquitoes. The disease is transmitted to humans when an infected Anopheles mosquito bites a person and injects the malaria parasites (sporozoites) into the blood. This is shown in Figure 1, where the illustration shows a mosquito taking a blood meal (circle label 1 in Figure 1).
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| Figure 1: CDC illustration of the life cycles of malaria parasites, Plasmodium spp. SOURCE: CDC |
Sporozoites travel through the bloodstream to the liver, mature, and eventually infect the human red blood cells. While in red blood cells, the parasites again develop until a mosquito takes a blood meal from an infected human and ingests human red blood cells containing the parasites. Then the parasites reach the Anopheles mosquito's stomach and eventually invade the mosquito salivary glands. When an Anopheles mosquito bites a human, these sporozoites complete and repeat the complex Plasmodium life cycle. P. ovale and P. vivax can further complicate the cycle by producing dormant stages (hypnozoites) that may not develop for weeks to years.
What is the incubation period for malaria?
The period between the mosquito bite and the onset of the malarial illness is usually one to three weeks (seven to 21 days). This initial time period is highly variable as reports suggest that the range of incubation periods may range from four days to one year. The usual incubation period may be increased when a person has taken an inadequate course of malaria prevention medications. Certain types of malaria (P. vivax and P. ovale) parasites can also take much longer, as long as eight to 10 months, to cause symptoms. These parasites remain dormant (inactive or hibernating) in the liver cells during this time. Unfortunately, some of these dormant parasites can remain even after a patient recovers from malaria, so the patient can get sick again. This situation is termed relapsing malaria.
How is malaria diagnosed?
Clinical symptoms associated with travel to countries that have identified malarial risk (listed above) suggest malaria as a diagnosis. Malaria tests are not routinely ordered by most physicians so recognition of travel history is essential. Unfortunately, many diseases can mimic symptoms of malaria (for example, yellow fever, dengue fever, typhoid fever, cholera, filariasis, and even measles and tuberculosis). Consequently, physicians need to order the correct special tests to diagnose malaria, especially in industrialized countries where malaria is seldom seen. Without the travel history, it is likely that other tests will be ordered initially. In addition, the long incubation periods may tend to allow people to forget the initial exposure to infected mosquitoes.
The classic and most used diagnostic test for malaria is the blood smear on a microscope slide that is stained (Giemsa stain) to show the parasites inside red blood cells (see Figure 2
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| Figure 2: CDC slide of a Giemsa stained smear of red blood cells showing Plasmodium malariae and Plasmodium falciparum parasites. SOURCE: CDC/Steven Glenn, Laboratory & Consultation Division |
Although this test is easily done, correct results are dependent on the technical skill of the lab technician who prepares and examines the slides with a microscope. Other tests based on immunologic principles exist; including RDTs (rapid diagnostic tests) approved for use in the U.S. in 2007 and polymerase chain reaction (PCR) tests. These are not yet widely available and are more expensive than the traditional Giemsa blood smear. Some investigators suggest such immunologic based tests be confirmed with a Giemsa blood smear.
What is the treatment for malaria?
Three main factors determine treatments: the infecting species of Plasmodium parasite, the clinical situation of the patient (for example, adult, child, or pregnant female with either mild or severe malaria), and the drug susceptibility of the infecting parasites. Drug susceptibility is determined by the geographic area where the infection was acquired. Different areas of the world have malaria types that are resistant to certain medications. The correct drugs for each type of malaria must be prescribed by a doctor who is familiar with malaria treatment protocols. Since people infected with P. falciparum malaria can die (often because of delayed treatment), immediate treatment for P. falciparum malaria is necessary.
Mild malaria can be treated with oral medication; severe malaria (one or more symptoms of either impaired consciousness/coma, severe anemia, renal failure, pulmonary edema, acute respiratory distress syndrome, shock, disseminated intravascular coagulation, spontaneous bleeding, acidosis, hemoglobinuria [hemoglobin in the urine], jaundice, repeated generalized convulsions, and/or parasitemia [parasites in the blood] of > 5%) requires intravenous (IV) drug treatment and fluids in the hospital.
Drug treatment of malaria is not always easy. Chloroquine phosphate (Aralen) is the drug of choice for all malarial parasites except for chloroquine-resistant Plasmodium strains. Although almost all strains of P. malariae are susceptible to chloroquine, P. falciparum, P. vivax, and even some P. ovale strains have been reported as resistant to chloroquine. Unfortunately, resistance is usually noted by drug-treatment failure in the individual patient. There are, however, multiple drug-treatment protocols for treatment of drug-resistant Plasmodium strains (for example, quinine sulfate plus doxycycline [Vibramycin, Oracea, Adoxa, Atridox] or tetracycline [Achromycin], or clindamycin [Cleocin], or atovaquone-proguanil [Malarone]). There are specialized labs that can test the patient's parasites for resistance, but this is not done frequently. Consequently, treatment is usually based on the majority of Plasmodium species diagnosed and its general drug-resistance pattern for the country or world region where the patient became infested. For example, P. falciparum acquired in the Middle East countries is usually susceptible to chloroquine, but if it's acquired in sub-Sahara African countries, it's usually resistant to chloroquine. The WHO's treatment policy, recently established in 2006, is to treat all cases of uncomplicated P. falciparum malaria with artemisinin-derived combination therapy (ACTs). ACTs are drug combinations (for example, artesunate-amodiaquine, artesunate-mefloquine, artesunate-pyronaridine, dihydroartemisinin-piperaquine, and chlorproguanil-dapsoneartesunate) used to treat drug-resistant P. falciparum. Unfortunately, as of 2009, a number of P. falciparum-infected individuals have parasites resistant to ACT drugs.
New drug treatments of malaria are currently under study because Plasmodium species continue to produce resistant strains that frequently spread to other areas. One promising drug class under investigation is the spiroindolones, which have been effective in stopping P. falciparum experimental infections.
- Malaria Related Supplements
- vitamin-A
What other names is Vitamin A known by?
3-Dehydroretinol, 3-Déhydrorétinol, Acétate de Rétinol, Antixerophthalmic Vitamin, Axerophtholum, Dehydroretinol, Déhydrorétinol, Fat-Soluble Vitamin, Oleovitamin A, Palmitate de Rétinol, Retinoids, Rétinoïdes, Retinol, Rétinol, Retinol Acetate, Retinol Palmitate, Retinyl Acetate, Rétinyl Acétate, Retinyl Palmitate, Rétinyl Palmitate, Vitamin A Palmitate, Vitamin A1, Vitamin A2, Vitamina A, Vitamine A, Vitamine A1, Vitamine A2, Vitamine Liposoluble, Vitaminum A.What is Vitamin A?
Vitamin A is a vitamin. It can be found in many fruits, vegetables, eggs, whole milk, butter, fortified margarine, meat, and oily saltwater fish. It can also be made in a laboratory.Effective for...
- Treatment and prevention of vitamin A deficiency.
Possibly Effective for...
- Reducing complications of diseases such as malaria, HIV, measles, and diarrhea in children with vitamin A deficiency.
- Reducing problems during pregnancy and after giving birth in underfed (malnourished) women.
- Breast cancer.
- Prevention of cataracts.
- Improving recovery from laser eye surgery when used in combination with vitamin E.
Possibly Ineffective for...
- Reducing fetal and early infant death in children born to women with nutrition problems.
- Anemia.
- Decreasing the risk of HIV transmission during pregnancy, delivery, and breast-feeding.
- Reducing side effects of chemotherapy in children.
Likely Ineffective for...
- Reducing the risk of tumors in the head and neck.
- Treating pneumonia in children living in poor countries.
Insufficient Evidence to Rate Effectiveness for...
- Lung cancer, ovarian cancer, cervical cancer, esophageal cancer, pancreatic cancer, colorectal cancer, gastric cancer, promoting good vision, age-related macular degeneration (AMD), glaucoma, preventing and speeding recovery from infections, improving immune function, skin conditions other than acne, relieving hayfever symptoms, and other conditions.
Is malaria a particular problem during pregnancy?
Yes. Malaria may pose a serious threat to a pregnant woman and her fetus. Malaria infection in pregnant women may be more severe than in women who are not pregnant. Malaria may also increase the risk of problems with the pregnancy, including prematurity, abortion, and stillbirth. Statistics indicate that in sub-Saharan Africa, between 75,000-200,000 infants die from malaria per year; worldwide estimates indicate about 2 million children die from malaria each year. Therefore, all pregnant women who are living in or traveling to a malaria risk area should consult a doctor and take prescription drugs (for example, sulfadoxine-pyrimethamine) to avoid contracting malaria. Treatment of malaria in the pregnant female is similar to the usual treatment described above; however, drugs such as primaquine (Primaquine), tetracycline (Achromycin, Sumycin), doxycycline, and halofantrine (Halfan) are not recommended as they may harm the fetus. In addition to monitoring the patient for anemia, an OB/GYN specialist often is consulted for further management.
Is malaria a particular problem for children?
Yes. All children, including young infants, living in or traveling to malaria risk areas should take antimalarial drugs (for example, chloroquine and mefloquine [Lariam]). Although the recommendations for most antimalarial drugs are the same as for adults, it is crucial to use the correct dosage for the child. The dosage of drug depends on the age and weight of the child. A specialist in pediatric infectious diseases is recommended for consultation in prophylaxis (prevention) and treatment of children. Since an overdose of an antimalarial drug can be fatal, all antimalarial (and all other) drugs should be stored in childproof containers well out of the child's reach.
How do people avoid getting malaria?
If people must travel to an area known to have malaria, they need to find out which medications to take, and take them as prescribed. Current CDC recommendations suggest individuals begin taking antimalarial drugs about one to two weeks before traveling to a malaria infested area and for four weeks after leaving the area (prophylactic or preventative therapy). Doctors, travel clinics, or the health department can advise individuals as to what medicines to take to keep from getting malaria. Currently, there is no vaccine available for malaria, but researchers are trying to develop one.
Avoid travel to or through countries where malaria occurs if possible. If people must go to areas where malaria occurs, they should take all of the prescribed preventive medicine. In addition, the 2010 CDC international travel recommendations suggest the following precautions be taken in malaria and other disease-infested areas of the world; the following CDC recommendations are not unique for malaria but are posted by the CDC in their malarial prevention publication.
- Avoid outbreaks: To the extent possible, travelers should avoid traveling in areas of known malaria outbreaks. The CDC Travelers' Health web page provides alerts and information on regional disease transmission patterns and outbreak alerts (http://www.cdc.gov/travel).
- Be aware of peak exposure times and places: Exposure to arthropod bites may be reduced if travelers modify their patterns of activity or behavior. Although mosquitoes may bite at any time of day, peak biting activity for vectors of some diseases (for example, dengue, chikungunya) is during daylight hours. Vectors of other diseases (for example, malaria) are most active in twilight periods (for example, dawn and dusk) or in the evening after dark. Avoiding the outdoors or focusing preventive actions during peak hours may reduce risk.
- Wear appropriate clothing: Travelers can minimize areas of exposed skin by wearing long-sleeved shirts, long pants, boots, and hats. Tucking in shirts and wearing socks and closed shoes instead of sandals may reduce risk. Repellents or insecticides such as permethrin can be applied to clothing and gear for added protection; this measure is discussed in detail below.
- Check for ticks: Travelers should be advised to inspect themselves and their clothing for ticks during outdoor activity and at the end of the day. Prompt removal of attached ticks can prevent some infections.
- Bed nets: When accommodations are not adequately screened or air conditioned, bed nets are essential to provide protection and to reduce discomfort caused by biting insects. If bed nets do not reach the floor, they should be tucked under mattresses. Bed nets are most effective when they are treated with an insecticide or repellent such as permethrin. Pretreated, long-lasting bed nets can be purchased prior to traveling, or nets can be treated after purchase. The permethrin will be effective for several months if the bed net is not washed. (Long-lasting pretreated nets may be effective for much longer.)
- Insecticides: Aerosol insecticides, vaporizing mats, and mosquito coils can help to clear rooms or areas of mosquitoes; however, some products available internationally may contain pesticides that are not registered in the United States. Insecticides should always be used with caution, avoiding direct inhalation of spray or smoke.
- Optimum protection can be provided by applying repellents. The CDC recommended insect repellent should contain up to 50% DEET (N,N-diethyl-m-toluamide), which is the most effective mosquito repellent for adults and children over 2 months of age.
How does Vitamin A work?
Vitamin A is required for the proper development and functioning of our eyes, skin, immune system, and many other parts of our bodies.Are there safety concerns?
Vitamin A is safe for most people when used in doses less than 10,000 units per day. Some scientific research suggests that lower doses might increase the risk of osteoporosis and hip fracture, particularly in older people. Adults who eat low-fat dairy products, which are fortified with vitamin A, and a lot of fruits and vegetables usually don't need vitamin A supplements or multivitamins that contain vitamin A.Long-term use of large amounts of vitamin A might cause serious side effects including fatigue, irritability, mental changes, anorexia, stomach discomfort, nausea, vomiting, mild fever, excessive sweating, and many other side effects. In women who have passed menopause, taking too much vitamin A can increase the risk of osteoporosis and hip fracture.
There is growing concern that taking high doses of antioxidant supplements such as vitamin A might do more harm than good. Some research shows that taking high doses of vitamin A supplements might increase the chance of death from all causes and possibly other serious side effects.
Vitamin A is safe for pregnant or breast-feeding women when taken in recommended amounts of less than 10,000 units per day.
Vitamin A is safe for children when taken in the recommended amounts. When amounts greater than those recommended are taken, side effects can include irritability, sleepiness, vomiting, diarrhea, loss of consciousness, headache, vision problems, peeling skin, increased risk of pneumonia and diarrhea, and other problems. The maximum amounts of vitamin A that are safe for children are based on age:
- Less than 2000 units/day in children up to 3 years old.
- Less than 3000 units/day in children ages 4 to 8 years old.
- Less than 5700 units/day in children ages 9 to 13 years old.
- Less than 9300 units/day in children ages 14 to 18 years old.
- You drink a lot of alcohol.
- You have an uncommon form of high cholesterol called "Type V hyperlipoproteinemia."
- You have liver disease.
Are there any interactions with medications?
Medications for skin conditions (Retinoids)
Interaction Rating: Major Do not take this combination. Some medications for skin conditions have vitamin A effects. Taking vitamin A pills and these medications for skin conditions could cause too much vitamin A effects and side effects.
Antibiotics (Tetracycline antibiotics)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider. Vitamin A can interact with some antibiotics. Taking very large amounts of vitamin A along with some antibiotics can increase the chance of a serious side effect called intracranial hypertension. But taking normal doses of vitamin A along with tetracyclines doesn't seem to cause this problem. Do not take large amounts of vitamin A if you are taking antibiotics.
Some of these antibiotics include demeclocycline (Declomycin), minocycline (Minocin), and tetracycline (Achromycin).
Medications that can harm the liver (Hepatotoxic drugs)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider. Taking large amounts of vitamin A might harm the liver. Taking large amounts of vitamin A along with medications that might also harm the liver can increase the risk of liver damage. Do not take large amounts of vitamin A if you are taking a medication that can harm the liver.
Some medications that can harm the liver include acetaminophen (Tylenol and others), amiodarone (Cordarone), carbamazepine (Tegretol), isoniazid (INH), methotrexate (Rheumatrex), methyldopa (Aldomet), fluconazole (Diflucan), itraconazole (Sporanox), erythromycin (Erythrocin, Ilosone, others), phenytoin (Dilantin), lovastatin (Mevacor), pravastatin (Pravachol), simvastatin (Zocor), and many others.
Warfarin (Coumadin)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider. Warfarin (Coumadin) is used to slow blood clotting. Large amounts of vitamin A can also slow blood clotting. Taking vitamin A along with warfarin (Coumadin) can increase the chances of bruising and bleeding. Be sure to have your blood checked regularly. The dose of your warfarin (Coumadin) might need to be changed.
Dosing considerations for Vitamin A.
Adequate Intake (AI) levels of vitamin A for infants have been established: birth to 6 months, 400 mcg/day (1300 units); 7 to 12 months, 500 mcg/day (1700 units).
Recommended Dietary Allowance (RDA) levels for children and adults have been established: children 1 to 3 years, 300 mcg/day (1000 units); 4 to 8 years, 400 mcg/day (1300 units); 9 to 13 years, 600 mcg/day (2000 units); men 14 years and older, 900 mcg/day (3000 units); women 14 years and older, 700 mcg/day (2300 units); pregnancy 14 to 18 years, 750 mcg/day (2500 units); 19 years and older, 770 mcg/day (2600 units); lactation 14 to 18 years, 1200 mcg/day (4000 units); 19 years and older, 1300 mcg/day (4300 units). Tolerable Upper Intake Levels (UL) for vitamin A have also been established. The UL is the highest level of intake that is likely to pose no risk of harmful effects. The ULs for vitamin A are for preformed vitamin A (retinol) and do not include provitamin A carotenoids: infants and children from birth to 3 years, 600 mcg/day (2000 units); children 4 to 8 years, 900 mcg/day (3000 units); 9 to 13 years, 1700 mcg/day (6000 units); 14 to 18 years (including pregnancy and lactation), 2800 mcg/day (9000 units); adults age 19 and older (including pregnancy and lactation), 3000 mcg/day (10,000 units).
Vitamin A dosage is most commonly expressed in units, but dosage in micrograms is sometimes used.
Eating 5 servings of fruits and vegetables per day provides about 50% to 65% of the adult RDA for vitamin A.- source:medicinenet.com
Malaria- Causes, Symptoms and Herbal Remedies
Ayurvedic Name : Vishama JwaraWhat is malaria ?
Malaria is an infectious disease caused by parasitic protozoa of the genus Plasmodium within the red blood cells characterized by attacks of chills, fever and sweating. It is transmitted by the female Anopheles Mosquito which is mainly confined to tropical and subtropical areas. There are approximately 400 Anopheles species known and out of which 30-40 are responsible for transmitting four different species of parasites of the genus Plasmodium - the main cause malaria affecting many human beings. Anopheles gambiae is one of the best known out of these parasites. Quick multiplication of parasites results in destruction of red blood cells and as the number increases the chances of affecting red blood cells also increases.What are the causes of Malaria?
Malaria is mainly caused by parasitic protozoa, which spends most of its life in the red blood cells of humans. Malaria is spread by the female Anopheles mosquito, which transmit the parasites by first ingesting them from an infected person's blood and then injecting the parasite in to an healthy person.Malaria is caused by one of four protozoan species of the genus Plasmodium they are:
- Plasmodium falciparum.
- Plasmodium vivax.
- Plasmodium ovale.
- Plasmodium malariae.
What are the symptoms of Malaria?
Signs and symptoms of Malaria may vary from person to person. Only your doctor can tell you properly about the disease with adequate diagnosis.The main symptoms of malaria include:
- Fever.
- Shaking chills.
- Headache.
- Muscle aches.
- Tiredness.
- Nausea.
- Vomiting.
Malaria symptoms occur at least seven to nine days after being bitten by an infected mosquito. Fever in the first week of travel in a malarial risk area is unlikely to cause malaria, however ill travelers should still seek immediate medical care. Although malaria is unlikely to be the cause and you must evaluate some other fever.
The most common type of malaria infection is that of Plasmodium falciparum and this strain does NOT have a relapsing phase. The other strains like Plasmodium vivax, ovale and malariae can infect the liver and persist in a dormant state for months or even years after exposure to the infection.
Types of Malaria
There are three types of malarial fever that may be classified depending on symptoms or caused by the parasite. The leading symptoms are mainly same but their occurrence and duration do vary. They are1) Tertian Fever.
2) Quartan Fever.
3) Malignant Fever.
Tertian Fever: The attacks surface on alternate days.
Quartan Fever: In this fever the attack of fever occurs after an interval of two days, i.e. if first attack of fever occurs on the first, another attack will occur on the 4th day, then 7th, 9th and so on.
Malignant Tertian: It is a variety of severe type of malarial fever when malignancy sets in and is, thus, the most severe and most alarming type of malarial fever.
Treatment for Curing Malaria
Usually there is no risk of catching malaria in the UK, but if are living in a country with tropical and subtropical areas, then malaria is very common in those areas and any body could catch it.The treatment for malaria depends on where a person is infected with the disease. Different areas of the world have malaria types that are resistant to certain medicines. The correct treatment for each type of malaria must be prescribed by a doctor.
According to the New malaria treatment guidelines - Uncomplicated falciparum malaria must be treated with ACTs and not by artemisinin alone or any other monotherapy because the use of single-drug artemisinin treatment or monotherapy, hastens development of resistance by weakening but not killing the parasite.
Doctors recommend that treatment should be started within 24 hours after you see the first symptom of malaria. Treatment of patients with a simple type of malaria can be conducted at their own homes, but patients with severe type of malaria should be hospitalized as soon as possible.
Infection with Plasmodium falciparum is a medical emergency. About 2% of persons infected with falciparum malaria die, usually because of delayed treatment. Patients who have severe P. falciparum malaria should be given the treatment by continuous intravenous infusion.
Some Herbal and Home Remedies for Treatment of Malaria
- Lime and lemon play a vital role in the treatment of quartan type of malarial fever. About three grams of lime and a juice of 1 lemon should be dissolved in about 60 ml of water. This mixture can be taken before you suspect the attack to take place.
- The herb chirayata, botanically known as Swertia chirata, is also beneficial in the treatment of intermittent type of malarial fevers. It helps in lowering the temperature. An infusion of the herb, prepared by immersing 15 gm of chirayata in 250 ml of hot water with aromatics like cloves and cinnamon, should be given in doses of 15 to 30 ml.
- Alum is also useful in malaria - First take a small amount of alum and then roast it over a hot plate. Now powder it. Half a teaspoon of this powder 0should be taken about four hours before the expected attack and half a teaspoon every two hours after it. This may help you in giving relief.
- The leaves of holy basil are also considered beneficial in the prevention of malaria. The juice of about eleven grams of leaves of holy basil mixed with three grams of powder of black pepper can be taken beneficially in the cold stage of the malarial fever. This will check the severity of the disease.
- source:ayurvedic-medicines.org
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