What is the typical incubation period for different malaria species. How can Plasmodium vivax malaria have unexpectedly long incubation periods. What are the implications of prolonged incubation periods for malaria diagnosis and control.

Understanding Malaria Incubation Periods

Malaria, a potentially life-threatening parasitic disease, is characterized by its incubation period – the time between infection and the onset of symptoms. This period varies depending on the Plasmodium species responsible for the infection:

• Plasmodium falciparum: 9-14 days
• Plasmodium vivax: 12-17 days
• Plasmodium malariae: 18-40 days

However, recent observations have challenged these conventional timeframes, particularly for P. vivax infections. Some cases have demonstrated incubation periods extending far beyond the expected range, raising important questions about the parasite’s biology and the implications for malaria control efforts.

The Phenomenon of Prolonged Incubation in P. vivax Malaria

A study conducted in Rio de Janeiro, Brazil, has shed light on unexpectedly long incubation periods in P. vivax malaria cases. The research analyzed 80 confirmed malaria patients over five years, with 49 (63%) infected by P. vivax. Remarkably, seven of these patients exhibited incubation periods ranging from three to 12 months – a significant deviation from the typical 12-17 day period.

These extended incubation cases were primarily observed in returned travelers from Brazilian Amazonian states (6 cases) and Indonesia (1 case). Importantly, none of the affected individuals had taken malaria chemoprophylaxis, ruling out this factor as a potential cause for the delayed onset of symptoms.

Historical Context of Prolonged Incubation

The phenomenon of extended incubation periods in malaria is not entirely new. Early observations date back to the early 20th century:

• 1901-1902: Korteweg in Holland described variations in relapse patterns and incubation periods, including delays of four months or longer.
• 1935: Nikolaev proposed the existence of two P. vivax strains with different incubation periods, suggesting an adaptation to northern latitudes where vectors are seasonally absent.
• 1946: Shute hypothesized an inverse relationship between sporozoite inoculum and incubation period.

However, subsequent research by Tiburskaya in Moscow demonstrated that incubation period length could be determined by inherent properties of the parasite strains, independent of the number of inoculated sporozoites.

Potential Explanations for Extended Incubation Periods

Several theories have been proposed to explain the occurrence of prolonged incubation periods in P. vivax malaria:

1. Strain Diversity

The diversity in essential biological characteristics of P. vivax strains is considered a possible explanation for variations in incubation periods. Some strains may have evolved mechanisms to delay their development in the human host, potentially as an adaptation to environmental conditions or vector availability.

2. Parasite Evolution

The authors of the Brazilian study speculate that new strains of P. vivax may be circulating in endemic regions, or existing strains might be undergoing changes in their biological cycle. This evolution could result in extended dormancy periods within the human host.

3. Host Factors

While not explicitly mentioned in the study, individual variations in immune responses or genetic factors could potentially influence the parasite’s ability to establish infection and progress to symptomatic disease.

Implications for Malaria Diagnosis and Control

The recognition of prolonged incubation periods in P. vivax malaria has significant implications for both clinical practice and public health efforts:

1. Diagnostic Challenges

Extended incubation periods can complicate the diagnosis of malaria, especially in non-endemic areas. Healthcare providers may not consider malaria as a potential cause of fever in patients with a history of travel to endemic regions several months prior.

2. Post-Travel Vigilance

The study emphasizes the importance of considering malaria as a possible cause of febrile illness in returned travelers, regardless of the time elapsed since exposure in transmission areas. This vigilance should extend well beyond the conventionally expected incubation period.

3. Malaria Control Strategies

Prolonged incubation periods may confer advantages to the parasite’s survival and transmission. This could potentially lead to difficulties in malaria control efforts, as individuals with delayed onset of symptoms may serve as reservoirs for infection over extended periods.

The Role of Chemoprophylaxis in Incubation Period Variation

While the use of chemoprophylaxis can influence the duration of the malaria incubation period, it’s important to note that in the Brazilian study, none of the patients with extended incubation had taken preventive medications. This observation suggests that other factors are primarily responsible for the prolonged dormancy of the parasite.

However, the potential impact of chemoprophylaxis on incubation periods should not be overlooked in other contexts. Incomplete or inadequate prophylaxis regimens could potentially contribute to atypical presentation patterns, further complicating diagnosis and management.

Geographical Considerations in P. vivax Incubation Periods

The study’s findings highlight the importance of considering geographical factors in understanding P. vivax malaria incubation periods:

1. Brazilian Amazon

Six of the seven cases with prolonged incubation were associated with travel to Brazilian Amazonian states. This region, known for its high malaria endemicity, may harbor P. vivax strains with unique biological characteristics contributing to extended dormancy.

2. Global Implications

The inclusion of a case from Indonesia suggests that the phenomenon of prolonged incubation is not limited to South American P. vivax strains. This observation underscores the need for global vigilance and further research into potential regional variations in parasite biology.

Future Research Directions

The unexpected findings of prolonged P. vivax incubation periods open up several avenues for future research:

1. Strain Characterization

Detailed genetic and phenotypic analysis of P. vivax isolates from cases with extended incubation periods could provide insights into the mechanisms underlying this phenomenon.

2. Epidemiological Studies

Larger-scale investigations across different geographical regions could help determine the prevalence and distribution of P. vivax strains capable of prolonged dormancy.

3. Host-Parasite Interactions

Exploring the role of host factors, including immune responses and genetic variations, in modulating parasite dormancy and activation could yield valuable insights.

4. Diagnostic Tool Development

Research into biomarkers or diagnostic techniques capable of detecting dormant P. vivax infections could revolutionize malaria surveillance and control efforts.

As our understanding of P. vivax biology continues to evolve, it becomes increasingly clear that the complexity of this parasite extends far beyond initial expectations. The phenomenon of prolonged incubation periods not only challenges conventional knowledge but also highlights the adaptability of the malaria parasite. This adaptability, while fascinating from a biological perspective, presents significant challenges for global malaria control and elimination efforts.

The implications of these findings extend beyond the realm of scientific curiosity. They underscore the need for heightened vigilance in malaria diagnosis, particularly in non-endemic areas where healthcare providers may not routinely consider malaria as a potential cause of illness in patients with distant travel history. Moreover, these observations call for a reevaluation of current strategies for malaria prevention, surveillance, and control.

As research in this area progresses, it is likely that our understanding of P. vivax biology will continue to deepen, potentially leading to novel approaches in combating this persistent global health threat. The unexpected can often be a catalyst for innovation, and in the case of prolonged P. vivax incubation periods, we may find ourselves on the cusp of significant advancements in malaria research and management.

Unexpectedly long incubation period of Plasmodium vivax malaria, in the absence of chemoprophylaxis, in patients diagnosed outside the transmission area in Brazil | Malaria Journal

• Research
• Open Access
• Published: 14 May 2011

• Patrícia Brasil^1,2,
• Anielle de Pina Costa^1,2,
• Renata Saraiva Pedro^1,2,
• Clarisse da Silveira Bressan¹,
• Sidnei da Silva^1,2,
• Pedro Luiz Tauil³ &
• …
• Cláudio Tadeu Daniel-Ribeiro^2,4 

Malaria Journal
volume 10, Article number: 122 (2011)
Cite this article

• 25k Accesses

• 25 Citations

• 3 Altmetric

• Metrics details

Abstract

Background

In 2010, Brazil recorded 3343,599 cases of malaria, with 99. 6% of them concentrated in the Amazon region. Plasmodium vivax accounts for 86% of the cases circulating in the country. The extra-Amazonian region, where transmission does not occur, recorded about 566 cases imported from the Amazonian area in Brazil and South America, from Central America, Asia and African countries. Prolonged incubation periods have been described for P. vivax malaria in temperate climates. The diversity in essential biological characteristics is traditionally considered as one possible explanation to the emergence of relapse in malaria and to the differences in the duration of the incubation period, which can also be explained by the use of chemoprophylaxis. Studying the reported cases of P. vivax malaria in Rio de Janeiro, where there is no vector transmission, has made it possible to evaluate the extension of the incubation period and to notice that it may be extended in some cases.

Methods

Descriptive study of every malaria patients who visited the clinic in the last five years. The mean, standard deviation, median, minimum and maximum of all incubation periods were analysed.

Results

From the total of 80 patients seen in the clinic during the study time, with confirmed diagnosis of malaria, 49 (63%) were infected with P. vivax. Between those, seven had an estimated incubation period varying from three to 12 months and were returned travellers from Brazilian Amazonian states (6) and Indonesia (1). None of them had taken malarial chemoprophylaxis.

Conclusions

The authors emphasize that considering malaria as a possible cause of febrile syndrome should be a post-travel routine, independent of the time elapsed after exposure in the transmission area, even in the absence of malaria chemoprophylaxis. They speculate that, since there is no current and detailed information about the biological cycle of human malaria plasmodia’s in Brazil, it is possible that new strains are circulating in endemic regions or a change in cycle of preexisting strains is occurring. Considering that a prolonged incubation period may confer advantages on the survival of the parasite, difficulties in malaria control might arise.

Background

The malaria incubation period is defined as the time elapsed between exposure to the infectious agent (through the bite of the Anopheles mosquito) and the manifestation of the first clinical sign or symptom. Usually, these periods vary depending on the species of Plasmodium causing malaria. The average incubation period is 9-14 days for Plasmodium falciparum, 12-17 days for infections by Plasmodium vivax and 18-40 days for infections caused by Plasmodium malariae[1].

The relapse patterns and variations in the length of the incubation period, including a delay of four months or longer, was first described by Korteweg in Holland between 1901 and 1902 (cited by Swellengrebel and De Buck [2]). Later, in 1935, Nikolaev proposed that there were two strains of P. vivax (cited by Tiburskaya [3]) with different incubation periods and gave the sub-specific taxonomic name of P. vivax hibernans to the variety with the longest incubation period. It was suggested that this sub-species had adapted to more northern latitudes where the anopheles vector was absent for much of the year. Shute (1946) [4] proposed that the sporozoite infective inoculum would be inversely related to the prepatent and incubation period. However, in Moscow, Tiburskaya [3] demonstrated situations in which the length of the incubation period did not depend on the number of inoculated sporozoites, but instead was determined by the inherent properties of the strains. It was also believed that strains with prolonged latency could be attributed either to the “senility” of the sporozoite towards the end of the season or to the low number of sporozoites in the infective bite [5].

According to Shute [5], the differences between the P. vivax strains could be explained by the assumption that, in varying proportions, all strains of P. vivax produce two types of sporozoites: one eliciting short prepatent periods (Type I) and the other lying dormant or developing slowly to give rise to long prepatent periods (Type II). In this model, the latter type would greatly predominate in “temperate strains”, but not in tropical ones. It was thought that relapses of P. vivax could in reality correspond to a delayed parasitaemia arising from Type II sporozoites. In the same year, Garnham stated that the length of the incubation period was considered the major biological difference between Dutch, Madagascar, and USSR strains, and although there was no evidence of specifically dormant forms, it was believed that if certain sporozoites failed to develop in the normal time, they could be reactivated by an unknown factor one year or more after inoculation [6].

In 1980, Warwick [7] proposed that the ambient winter temperatures could extend the incubation period of P. vivax in humans, based on the concept that temperatures persistently above a minimum of 23.9°C were required for sporozoite maturation [8], thereby limiting vector transmission in cold areas. Finally, in 2007, Nishiura et al in Korea [9] suggested that the incubation periods would likely reflect adaptation to the behaviour of the principal vector of the region, which hibernates during the winter season. Currently, several reports associate the extension of the incubation period to malaria prophylaxis among travellers [10, 11].

The opportunity to study some cases of P. vivax malaria in Rio de Janeiro, where there is no vector transmission, has made it possible to detect and to evaluate certain peculiar aspects of the natural evolution of the disease in human beings. One main aspect was the extension of time required for the parasites to progress through liver schizogony and produce symptoms by their propagation in the bloodstream.

Plasmodium vivax infections with prolonged periods of incubation and no association with malaria prophylaxis in patients from the Amazon region in Brazil and in one patient from Indonesia are presented.

In addition to demonstrating an interesting clinical situation and the need for clinicians to consider the diagnosis of malaria in a patient presenting symptoms a long time after exposure, even in the absence of chemoprophylaxis, our cases raise questions regarding the understanding of the biology of the host/P. vivax interactions.

Methods

Design and study location

This is a descriptive study conducted at the Acute Febrile Disease Outpatient Clinics of IPEC, Fiocruz, a specialized post-travel care clinic located in Rio de Janeiro, from January, 2005, to February, 2010.

Selection of patients

All malaria patients presenting clinical signs or symptoms of malaria and positive thick blood smears were enrolled in the study. The following variables of interest were recorded: estimated incubation period, place and year of infection, date of diagnosis, previous malaria history and year of the first malarial infection. No patients had malaria prophylaxis, had not received blood transfusions nor had close contact with a person with malaria after departure from the endemic area. No patients had haemoglobinopathies. Because it was not possible to determine the date of exposure to the infective mosquito bites, the minimum incubation period was estimated based on literature (9 days for P. falciparum and 12 days for P. vivax) [1]. The maximum was estimated by the interval between the day of the return from the malaria transmission area until the first day of symptoms. The mean, standard deviation, median, minimum and maximum of all incubation periods are shown in Table 1. Each patient gave fully informed consent. Children were not included.

Table 1 Time between the day of the return from the malaria transmission area and the first day of onset of symptoms of malaria cases diagnosed in the Acute Febrile Diseases Clinic, Rio de Janeiro (2005 until January 2010)

Full size table

The project was submitted and approved by the Ethical Committee in Research of the Instituto de Pesquisa Clínica Evandro Chagas (IPEC), Fiocruz (number 0020.0.009.000-07), maintaining strict secrecy and confidentiality of the information obtained.

Detection and quantification of malaria parasites

Thin and thick blood smears were stained with Giemsa and analysed by light microscopy using an immersion oil lens (X100 objective magnification) to identify the parasite species and determine the density of Plasmodium asexual and sexual stages, according to standard procedures [12]. Each smear was evaluated separately by two expert microscopists who had been blinded to the clinical status of the patients.

Data analysis

All information was recorded on a standardised form for study and subsequently entered into a database using Statistical Package for Social Sciences (SPSS). SPSS-WIN 16.0 was also used for data analysis.

Results

During the study period, 80 malarious patients were diagnosed and treated. Of them, 50 (62.5%) presented with P. vivax malaria, 20 (25%) with P. falciparum malaria, eight (10%) with mixed (P. vivax/P. falciparum) infection and two (2.5%) with P. malariae. All patients were travellers, most of them (51) from the Amazon region, in Brazil; 17 travelled from Africa, 11 were from South and Central America, and one was from Indonesia.

Time between the day of return from the malaria transmission area and the first day of onset of symptoms recorded for all patients diagnosed in the Acute Febrile Diseases Clinic Rio de Janeiro (2005 until January 2010) was four times longer for P. vivax than for Plasmodium falciparum and is illustrated in Table 1. The estimated mean incubation period for all cases was 31 days (SD 51 days), with a median of 12 days and extreme values of 9 and 360 days.

An estimated incubation period longer than 90 days was observed in seven (14%) of the patients with P. vivax malaria (Figure 1). The average incubation period (147 days) among this group was about twelve times longer than the classical period described in the literature (12 days). Malaria was contracted during visits to the Amazonian region (in six cases) and Indonesia (in one). Their details are described in Table 2. There were no differences in clinical presentation between individuals with P. vivax infection with different incubation periods. No patient had undergone malaria chemoprophylaxis or had taken any pharmacological drug that could inhibit the parasite’s development.

Figure 1

Estimated incubation period in days for each P. vivax infected patient.

Full size image

Table 2 Patients with P. vivax infection and estimated incubation period ≥ 90 days

Full size table

Discussion

This is the second report of prolonged incubation period of malaria in patients without chemoprophylaxis coming from an endemic area in Brazil. A recent paper by one of the authors of this report (Tauil PL) described three cases of vivax malaria originating from the Amazon region and diagnosed in Brasilia, Federal District, six months after departure from the endemic region in 2008 [13]. Two of those patients were infected in the same town (São Gabriel da Cachoeira, Amazonas State, Brazil), as one of the patients in the present study. Some of the cases in this study were detected in 2005 and 2006, prior to the cases detected in Brasilia and reported by Tauil et al[13]. All possible current explanations for these prolonged periods (use of malaria prophylaxis or other pharmacological drugs that would inhibit the Plasmodium development; blood transfusions; close contact with a person with malaria after departure from the endemic area or haemoglobinopathies) were eliminated. The observation of a longer incubation period (≥90 days) in 14% of the P. vivax malaria patients seen at IPEC, in Rio de Janeiro, may indicate the importance of monitoring these characteristics worldwide, as it may represent an evolutionary change in P. vivax behaviour. The average incubation period of P. vivax malaria presented here was approximately twelve times longer than the classical period described in the literature. In this study, the extended incubation time occurred in both prime-infected (130 days) and non-prime-infected (131 days) patients, so the possibility of relapse among non-prime-infected patients cannot be ruled out. However, in two patients previously infected with malaria, the period between the last infection and the current clinical manifestation was five and six years, by far exceeding the maximum period of relapse reported for P. vivax (three years) [14]. Cities such as Rio de Janeiro, as well as areas in the northern hemisphere without disease transmission may be considered strategic places for monitoring incubation period, clinical cures and treatment failure in cases of malaria, facilitating the identification of the above features without misinterpreting variations as the result of new infections.

During the five years of surveillance (2005-2010) no seasonal differences in the prevalence of clinical P. vivax malaria diagnosed outside the endemic area were observed between these cases with prolonged incubation periods. Regardless, the postulate that extended incubation periods may represent an adaptation of the species to overcome cold temperatures, thereby conferring advantages for the survival of the parasite, does not seem to fit the reality of tropical areas, where the temperature is rarely below 10°C. Although the role of strain-specific variation in prolonged incubation periods has been questioned by some authors [9], it is possible that new strains of Plasmodium are circulating in tropical areas, especially in the Amazon, which is a region frequently visited by foreigners and which has seen the movements of troops.

Fever is one of the most common clinical signs in returning travellers [15–20]. The incubation periods of potential pathogens should be considered when formulating differential diagnoses. The geographic location(s) visited, the traveller’s activities and the frequency of specific diseases in the region are usually taken into account. According to the observations reported here, malaria should be considered among the diseases with longer incubation periods (weeks to months after return), even in patients without malaria chemoprophylaxis.

Conclusions

It is classically considered that the co-existence of short and long-term incubation periods may imply that prolongation of this phase is either a genetically regulated feature of parasites or is controlled within Anopheles spp. by mechanisms yet to be defined. Therefore, new molecular tools need to be used for investigation of biological characteristics and origin of the Plasmodium strains that presents a prolonged incubation time in Brazilian patients that have never visited the temperate zone.

Plasmodium vivax, responsible for 86% of malaria cases in Brazil [21], has long been neglected and mistakenly [22]. The change in incubation period reported here is particularly important in theory, because it raises the possibility of changes in the biology and evolution of this organism, entering into strategic debates taking place on malaria epidemiology and control; and in practice because malaria is one of the most important infectious diseases among travellers and a long incubation period is one of the causes of missing early malaria diagnosis.

Financial support

This work was supported by CGLAB from the Secretaria de Vigilância em Saúde to the Centro de Pesquisa Diagnóstico e Treinamento em Malária (CPD-Mal), Fiocruz, Ministério da Saúde, Brazil.

References

1. Warrell DA: Clinical features of malaria. Essential Malariology. Edited by: Warrell DA, Gilles HM. 2002, New York: Oxford University Press, 192-4

   Google Scholar 

2. Swellengrebel N, De Buck A: Malaria in the Netherlands. 1938, Scheltema and Holkema, Amsterdam, 1-267.

   Google Scholar 

3. Tiburskaya NA: Features specific to the Moscow strain of P. vivax. Trop Dis Bull. 1962, 59: 228-

   Google Scholar 

4. Shute PG: Latency and long-term relapses in benign tertian malaria. Trans R Soc Trop Med Hyg. 1946, 40: 189-200. 10.1016/0035-9203(46)90056-9.

   Article 
   CAS 
   PubMed 

   Google Scholar 

5. Shute PG, Lupascu G, Branzei P, Maryon M, Constantinescu P, Bruce-Chwatt LJ, Draper CC, Killick-Kendrick R, Garnham PC: A strain of Plasmodium vivax characterized by prolonged incubation: the effect of numbers of sporozoites on the length of the prepatent period. Trans R Soc Trop Med Hyg. 1976, 70: 474-481. 10.1016/0035-9203(76)90132-2.

   Article 
   CAS 
   PubMed 

   Google Scholar 

6. “>

   Garnham PCC, Bray RS, Bruce-Chwatt LJ, Draper CC, Killick-Kendrick R, Sergiev PG, Tiburskaya NA, Shute PG, Maryon M: A strain of Plasmodium vivax characterized by prolonged incubation: morphological and biological characteristic. Bull World Health Organ. 1975, 52: 21-32.

   PubMed Central 
   CAS 
   PubMed 

   Google Scholar 

7. Warwick R, Swimer GJ, Britt RP: Prolonged incubation period of imported P. vivax malaria in London. J R Soc Med. 1980, 73: 333-336.

   PubMed Central 
   CAS 
   PubMed 

   Google Scholar 

8. Shute PG, Maryon M: Imported malaria in the United Kingdom. BMJ. 1969, 2: 781-785. 10.1136/bmj.2.5660.781.

   Article 
   PubMed Central 
   CAS 
   PubMed 

   Google Scholar 

9. Nishiura H, Lee HW, Cho SH, Lee WG, In TS, Moon SU, Chung TG, Kim TS: Estimates of short- and long-term incubation periods of Plasmodium vivax malaria in the Republic of Korea. Trans R Soc Trop Med Hyg. 2007, 101: 338-343. 10.1016/j.trstmh.2006.11.002.

   Article 
   PubMed 

   Google Scholar 

10. Schwartz E, Parise M, Kozarsky P, Cetron M: Delayed onset of malaria: implications for chemoprophylaxis in travellers. N Engl J Med. 2003, 349: 1510-1516. 10.1056/NEJMoa021592.

    Article 
    CAS 
    PubMed 

    Google Scholar 

11. Greenwood T, Vikerfors T, Sjöberg M, Skeppner G, Färnert A: Febrile Plasmodium falciparum malaria 4 years after exposure in a man with sickle cell disease. Clin Infect Dis. 2008, 47: 39-41. 10.1086/590250.

    Article 

    Google Scholar 

12. Brasil Ministério da Saúde: Manual de diagnóstico laboratorial da malária. 2005, Brasília: Ministério da Saúde, 112-

    Google Scholar 

13. “>

    Tauil PL, Luz FCO, Oliveira APL, Deckers FAL, Santos JB: Vivax malaria with long incubation period, detected in the Federal District: three case reports. Rev Soc Bras Med Trop. 2010, 43: 213-214. 10.1590/S0037-86822010000200023.

    Article 
    PubMed 

    Google Scholar 

14. Fairhurst RM, Wellems TE: Plasmodium species (Malaria). Mandell, Douglas and Bennett’s Principles and Practice of Infectious Diseases. Edited by: Mandell GL, Bennett JE, Dolin R. 2009, New York: Churchill Livingstone, 3437-3462. 7

    Google Scholar 

15. O’Brien D, Sean T, Brown GV, Torresi J: Fever in returned travelers: review of hospital admissions for a 3-year period. Clin Infect Dis. 2001, 33: 603-609. 10.1086/322602.

    Article 
    PubMed 

    Google Scholar 

16. Magill AJ: Fever in the returned traveler. Infect Dis Clin North Am. 1998, 12: 445-69. 10.1016/S0891-5520(05)70013-1.

    Article 
    CAS 
    PubMed 

    Google Scholar 

17. Felton JM, Bryceson AD: Fever in the returning traveller. Br J Hosp Med. 1996, 55: 705-711.

    CAS 
    PubMed 

    Google Scholar 

18. Humar A, Keystone J: Evaluating fever in travellers returning from tropical countries. BMJ. 1996, 312: 953-956.

    Article 
    PubMed Central 
    CAS 
    PubMed 

    Google Scholar 

19. Doherty JF, Grant AD, Bryceson AD: Fever as the presenting complaint of travellers returning from the tropics. QJM. 1995, 88: 277-281.

    CAS 
    PubMed 

    Google Scholar 

20. Saxe SE, Cardner P: The returning traveler with fever. Infect Dis Clin North Am. 1992, 6: 427-439.

    CAS 
    PubMed 

    Google Scholar 

21. Oliveira-Ferreira J, Lacerda MV, Brasil P, Ladislau JL, Tauil PL, Daniel-Ribeiro CT: Malaria in Brazil: an overview. Malar J. 2010, 9: 115-10.1186/1475-2875-9-115.

    Article 
    PubMed Central 
    PubMed 

    Google Scholar 

22. Galinski MR, Barnwell JW: Plasmodium vivax: who cares?. Malar J. 2008, 7 (Suppl 1): S9-10.1186/1475-2875-7-S1-S9.

    Article 
    PubMed Central 
    PubMed 

    Google Scholar 

Download references

Author information

Authors and Affiliations

1. Instituto de Pesquisa Clínica Evandro Chagas (IPEC), Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro. Av. Brasil 4365. Manguinhos, Rio de Janeiro, RJ, CEP 21.045-900, RJ, Brazil

   Patrícia Brasil, Anielle de Pina Costa, Renata Saraiva Pedro, Clarisse da Silveira Bressan & Sidnei da Silva

2. Centro de Pesquisa Diagnóstico e Treinamento em Malária (CPD-Mal), Fiocruz and Secretaria de Vigilância em Saúde (SVS), Ministério da Saúde (MS), Brazil

   Patrícia Brasil, Anielle de Pina Costa, Renata Saraiva Pedro, Sidnei da Silva & Cláudio Tadeu Daniel-Ribeiro

3. Núcleo de Medicina Tropical. Área de Medicina Social, Faculdade de Medicina, Universidade de Brasília, Brasília, CEP 70.910-900, Brazil

   Pedro Luiz Tauil

4. Laboratório de Pesquisas em Malária. Instituto Oswaldo Cruz, Fiocruz., Pavilhão Leônidas Deane – 5° andar. Av. Brasil 4365. Manguinhos, Rio de Janeiro, RJ, CEP 21.045-900, RJ, Brazil

   Cláudio Tadeu Daniel-Ribeiro

Authors

1. Patrícia Brasil

   View author publications

   You can also search for this author in
   PubMed Google Scholar

2. Anielle de Pina Costa

   View author publications

   You can also search for this author in
   PubMed Google Scholar

3. Renata Saraiva Pedro

   View author publications

   You can also search for this author in
   PubMed Google Scholar

4. Clarisse da Silveira Bressan

   View author publications

   You can also search for this author in
   PubMed Google Scholar

5. Sidnei da Silva

   View author publications

   You can also search for this author in
   PubMed Google Scholar

6. Pedro Luiz Tauil

   View author publications

   You can also search for this author in
   PubMed Google Scholar

7. Cláudio Tadeu Daniel-Ribeiro

   View author publications

   You can also search for this author in
   PubMed Google Scholar

Corresponding author

Correspondence to
Patrícia Brasil.

Additional information

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

PB – responsible for conception and design of the work, interpretation of data and drafting the manuscript.

APC – analyzed data, made the literature review and helped drafting the manuscript.

RSP – helped analyzing the data and reviewed the text.

CSB – responsible for the production of data and helped reviewing the text.

SS – carried out the parasitological examinations and helped in the literature review.

PLT – helped in interpretation of data, literature review and reviewing the manuscript.

CTDR – helped in the design of the work and reviewed the text up to the final version to be published.

All authors read and approved the final manuscript.

Authors’ original submitted files for images

Below are the links to the authors’ original submitted files for images.

Authors’ original file for figure 1

Rights and permissions

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Reprints and Permissions

About this article

Malaria: Practice Essentials, Background, Etiology

1. World malaria report 2022. Geneva: World Health Organization. 2022. Available at https://www.who.int/teams/global-malaria-programme/reports/world-malaria-report-2022.

2. Institute of Medicine (US) Committee on the Economics of Antimalarial Drugs. Arrow KJ, Panosian C, Gelband H. Saving Lives, Buying Time: Economics of Malaria Drugs in an Age of Resistance. US: National Academies Press; 2004. [Full Text].

3. Winegard, Timothy C. The Mosquito: A Human History of Our Deadliest Predator. Dutton; 2020.

4. Boualam MA, Pradines B, Drancourt M, Barbieri R. Malaria in Europe: A Historical Perspective. Front Med (Lausanne). 2021. 8:691095. [QxMD MEDLINE Link].

5. Ockenhouse CF, Magill A, Smith D, Milhous W. History of U.S. military contributions to the study of malaria. Mil Med. 2005 Apr. 170 (4 Suppl):12-6. [QxMD MEDLINE Link].

6. ANDREWS JM, QUINBY GE, LANGMUIR AD. Malaria eradication in the United States. Am J Public Health Nations Health. 1950 Nov. 40 (11):1405-11. [QxMD MEDLINE Link].

7. Beadle C, Hoffman SL. History of malaria in the United States Naval Forces at war: World War I through the Vietnam conflict. Clin Infect Dis. 1993 Feb. 16 (2):320-9. [QxMD MEDLINE Link].

8. webmd.com”>Bennett WN, Markelz AE, Kile MT, Pamplin JC, Barsoumian AE. Infectious Disease Teleconsultation to the Deployed U.S. Military From 2017-2022. Mil Med. 2022 Oct 17. [QxMD MEDLINE Link].

9. Cox FE. History of the discovery of the malaria parasites and their vectors. Parasit Vectors. 2010 Feb 1. 3 (1):5. [QxMD MEDLINE Link].

10. Mace KE, Lucchi NW, Tan KR. Malaria Surveillance – United States, 2017. MMWR Surveill Summ. 2021 Mar 19. 70 (2):1-35. [QxMD MEDLINE Link].

11. Garcia LS. Malaria. Clin Lab Med. 2010 Mar. 30 (1):93-129. [QxMD MEDLINE Link].

12. Milner DA Jr. Malaria Pathogenesis. Cold Spring Harb Perspect Med. 2018 Jan 2. 8 (1):[QxMD MEDLINE Link].

13. White NJ. Determinants of relapse periodicity in Plasmodium vivax malaria. Malar J. 2011 Oct 11. 10:297. [QxMD MEDLINE Link].

14. [Guideline] Treatment of Malaria: Guidelines for Clinicians (United States). cdc.gov. Available at https://www.cdc.gov/malaria/diagnosis_treatment/clinicians1.html. February 14, 2023; Accessed: April 13, 2023.

15. Malaria. Ryan, Edward T., et al. Hunter’s Tropical Medicine and Emerging Infectious Diseases. Elsevier; 2020.

16. Rowe JA, Opi DH, Williams TN. Blood groups and malaria: fresh insights into pathogenesis and identification of targets for intervention. Curr Opin Hematol. 2009 Nov. 16 (6):480-7. [QxMD MEDLINE Link].

17. Daily JP, Minuti A, Khan N. Diagnosis, Treatment, and Prevention of Malaria in the US: A Review. JAMA. 2022 Aug 2. 328 (5):460-471. [QxMD MEDLINE Link].

18. [Guideline] Geneva: World Health Organization. WHO Guidelines for malaria. who.int. Available at https://www.who.int/publications/i/item/guidelines-for-malaria. 14 March, 2023; Accessed: 13 April, 2023.

19. Piperaki ET, Daikos GL. Malaria in Europe: emerging threat or minor nuisance?. Clin Microbiol Infect. 2016 Jun. 22 (6):487-93. [QxMD MEDLINE Link].

20. Carneiro I, Roca-Feltrer A, Griffin JT, Smith L, Tanner M, Schellenberg JA, et al. Age-patterns of malaria vary with severity, transmission intensity and seasonality in sub-Saharan Africa: a systematic review and pooled analysis. PLoS One. 2010 Feb 1. 5 (2):e8988. [QxMD MEDLINE Link].

21. Okiring J, Epstein A, Namuganga JF, Kamya EV, Nabende I, Nassali M, et al. Gender difference in the incidence of malaria diagnosed at public health facilities in Uganda. Malar J. 2022 Jan 21. 21 (1):22. [QxMD MEDLINE Link].

22. Briggs J, Teyssier N, Nankabirwa JI, Rek J, Jagannathan P, Arinaitwe E, et al. Sex-based differences in clearance of chronic Plasmodium falciparum infection. Elife. 2020 Oct 27. 9:[QxMD MEDLINE Link].

23. ALLISON AC. Protection afforded by sickle-cell trait against subtertian malareal infection. Br Med J. 1954 Feb 6. 1 (4857):290-4. [QxMD MEDLINE Link].

24. Thiam F, Diop G, Coulonges C, Derbois C, Mbengue B, Thiam A, et al. G6PD and HBB polymorphisms in the Senegalese population: prevalence, correlation with clinical malaria. PeerJ. 2022. 10:e13487. [QxMD MEDLINE Link].

25. Roberts DJ, Williams TN. Haemoglobinopathies and resistance to malaria. Redox Rep. 2003. 8 (5):304-10. [QxMD MEDLINE Link].

26. Cappadoro M, Giribaldi G, O’Brien E, Turrini F, Mannu F, Ulliers D, et al. Early phagocytosis of glucose-6-phosphate dehydrogenase (G6PD)-deficient erythrocytes parasitized by Plasmodium falciparum may explain malaria protection in G6PD deficiency. Blood. 1998 Oct 1. 92 (7):2527-34. [QxMD MEDLINE Link].

27. Rowe JA, Handel IG, Thera MA, Deans AM, Lyke KE, Koné A, et al. Blood group O protects against severe Plasmodium falciparum malaria through the mechanism of reduced rosetting. Proc Natl Acad Sci U S A. 2007 Oct 30. 104 (44):17471-6. [QxMD MEDLINE Link].

28. Plucinski MM, Rogier E, Dimbu PR, Fortes F, Halsey ES, Aidoo M, et al. Performance of Antigen Concentration Thresholds for Attributing Fever to Malaria among Outpatients in Angola. J Clin Microbiol. 2019 Mar. 57 (3):[QxMD MEDLINE Link].

29. Oakley MS, Gerald N, McCutchan TF, Aravind L, Kumar S. Clinical and molecular aspects of malaria fever. Trends Parasitol. 2011 Oct. 27 (10):442-9. [QxMD MEDLINE Link].

30. White NJ. Anaemia and malaria. Malar J. 2018 Oct 19. 17 (1):371. [QxMD MEDLINE Link].

31. Ghosh D, Stumhofer JS. The spleen: “epicenter” in malaria infection and immunity. J Leukoc Biol. 2021 Oct. 110 (4):753-769. [QxMD MEDLINE Link].

32. Kho S, Qotrunnada L, et al.,. Evaluation of splenic accumulation and colocalization of immature reticulocytes and Plasmodium vivax in asymptomatic malaria: A prospective human splenectomy study. PLoS Med. 2021 May. 18 (5):e1003632. [QxMD MEDLINE Link].

33. webmd.com”>Zakama AK, Ozarslan N, Gaw SL. Placental Malaria. Curr Trop Med Rep. 2020. 7 (4):162-171. [QxMD MEDLINE Link].

34. Trape JF, Tall A, Diagne N, et al. Malaria morbidity and pyrethroid resistance after the introduction of insecticide-treated bednets and artemisinin-based combination therapies: a longitudinal study. Lancet Infect Dis. 2011 Dec. 11(12):925-32. [QxMD MEDLINE Link].

35. Wilson, Mary. Fever. Gary W. Brunette, and Jeffrey B. Nemhauser. CDC Yellow Book 2020: Health Information for International Travel. New York: Oxford Academic; 1 June 2019.

36. Rogers CL, Bain BJ, Garg M, Fernandes S, Mooney C, Chiodini PL, et al. British Society for Haematology guidelines for the laboratory diagnosis of malaria. Br J Haematol. 2022 May. 197 (3):271-282. [QxMD MEDLINE Link].

37. webmd.com”>Rapid diagnostic tests for malaria —Haiti, 2010. MMWR Morb Mortal Wkly Rep. 2010 Oct 29. 59(42):1372-3. [QxMD MEDLINE Link].

38. Wongsrichanalai C, Barcus MJ, Muth S, Sutamihardja A, Wernsdorfer WH. A review of malaria diagnostic tools: microscopy and rapid diagnostic test (RDT). Am J Trop Med Hyg. 2007 Dec. 77(6 Suppl):119-27. [QxMD MEDLINE Link].

39. Centers for Disease Control and Prevention. Notice to Readers: Malaria Rapid Diagnostic Test. Centers for Disease Control and Prevention. Available at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5627a4.htm. Accessed: September 30, 2011.

40. Poespoprodjo JR, Fobia W, Kenangalem E, et al. Adverse pregnancy outcomes in an area where multidrug-resistant plasmodium vivax and Plasmodium falciparum infections are endemic. Clin Infect Dis. 2008 May 1. 46(9):1374-81. [QxMD MEDLINE Link]. [Full Text].

41. de Oliveira AM, Skarbinski J, Ouma PO, et al. Performance of malaria rapid diagnostic tests as part of routine malaria case management in Kenya. Am J Trop Med Hyg. 2009 Mar. 80(3):470-4. [QxMD MEDLINE Link].

42. Polley SD, Gonzalez IJ, Mohamed D, et al. Clinical evaluation of a loop-mediated amplification kit for diagnosis of imported malaria. J Infect Dis. 2013 Aug. 208(4):637-44. [QxMD MEDLINE Link]. [Full Text].

43. d’Acremont V, Malila A, Swai N, et al. Withholding antimalarials in febrile children who have a negative result for a rapid diagnostic test. Clin Infect Dis. 2010 Sep 1. 51(5):506-11. [QxMD MEDLINE Link].

44. Mens P, Spieker N, Omar S, Heijnen M, Schallig H, Kager PA. Is molecular biology the best alternative for diagnosis of malaria to microscopy? A comparison between microscopy, antigen detection and molecular tests in rural Kenya and urban Tanzania. Trop Med Int Health. 2007 Feb. 12(2):238-44. [QxMD MEDLINE Link].

45. [Guideline] Centers for Disease Control and Prevention. Updated CDC Recommendations for Using Artemether-Lumefantrine for the Treatment of Uncomplicated Malaria in Pregnant Women in the United States. Available at https://www.cdc.gov/mmwr/volumes/67/wr/mm6714a4.htm?s_cid=mm6714a4_e#contribAff. April 2018; Accessed: April 13, 2018.

46. Krintafel (tafenoquine) [package insert]. Research Triangle Park, NC: GlaxoSmithKline. July, 2018. Available at [Full Text].

47. Arakoda (tafenoquine) [package insert]. Washington DC: 60 Degrees Pharms, LLC. August, 2018. Available at [Full Text].

48. Watson JA, Nekkab N, White M. Tafenoquine for the prevention of Plasmodium vivax malaria relapse. Lancet Microbe. 2021 May. 2 (5):e175-e176. [QxMD MEDLINE Link].

49. Dondorp AM, Fanello CI, Hendriksen IC, et al. Artesunate versus quinine in the treatment of severe falciparum malaria in African children (AQUAMAT): an open-label, randomised trial. Lancet. 2010 Nov 13. 376(9753):1647-57. [QxMD MEDLINE Link]. [Full Text].

50. Sinclair D, Donegan S, Isba R, Lalloo DG. Artesunate versus quinine for treating severe malaria. Cochrane Database Syst Rev. 2012 Jun 13. 6:CD005967. [QxMD MEDLINE Link].

51. US Food and Drug Administration FDA Approves Coartem Tablets to Treat Malaria. FDA. Available at http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm149559.htm. Accessed: April 8, 2009.

52. Teuscher F, Gatton ML, Chen N, Peters J, Kyle DE, Cheng Q. Artemisinin-induced dormancy in plasmodium falciparum: duration, recovery rates, and implications in treatment failure. J Infect Dis. 2010 Nov 1. 202(9):1362-8. [QxMD MEDLINE Link]. [Full Text].

53. Tozan Y, Klein EY, Darley S, Panicker R, Laxminarayan R, Breman JG. Prereferral rectal artesunate for treatment of severe childhood malaria: a cost-effectiveness analysis. Lancet. 2010 Dec 4. 376(9756):1910-5. [QxMD MEDLINE Link].

54. Amaratunga C, Sreng S, Suon S, et al. Artemisinin-resistant Plasmodium falciparum in Pursat province, western Cambodia: a parasite clearance rate study. Lancet Infect Dis. 2012 Nov. 12(11):851-8. [QxMD MEDLINE Link].

55. Dondorp A, Nosten F, Stepniewska K, Day N, White N, South East Asian Quinine Artesunate Malaria Trial (SEAQUAMAT) group. Artesunate versus quinine for treatment of severe falciparum malaria: a randomised trial. Lancet. 2005 Aug 27-Sep 2. 366 (9487):717-25. [QxMD MEDLINE Link]. [Full Text].

56. Marchand RP, Culleton R, Maeno Y, Quang NT, Nakazawa S. Co-infections of Plasmodium knowlesi, P. falciparum, and P. vivax among Humans and Anopheles dirus Mosquitoes, Southern Vietnam. Emerg Infect Dis. 2011 Jul. 17(7):1232-9. [QxMD MEDLINE Link].

57. William T, Menon J, Rajahram G, et al. Severe Plasmodium knowlesi malaria in a tertiary care hospital, Sabah, Malaysia. Emerg Infect Dis. 2011 Jul. 17(7):1248-55. [QxMD MEDLINE Link].

58. Lowes R. FDA Strengthens Warning on Mefloquine Risks. Medscape Medical News. Jul 29 2013. [Full Text].

59. US Food and Drug Administration. FDA Drug Safety Communication: FDA approves label changes for antimalarial drug mefloquine hydrochloride due to risk of serious psychiatric and nerve side effects. FDA. Available at http://www.fda.gov/downloads/Drugs/DrugSafety/UCM362232.pdf. Accessed: Aug 6 2013.

60. Briand V, Bottero J, Noel H, et al. Intermittent treatment for the prevention of malaria during pregnancy in Benin: a randomized, open-label equivalence trial comparing sulfadoxine-pyrimethamine with mefloquine. J Infect Dis. 2009 Sep 15. 200(6):991-1001. [QxMD MEDLINE Link].

61. Briand V, Cottrell G, Massougbodji A, Cot M. Intermittent preventive treatment for the prevention of malaria during pregnancy in high transmission areas. Malar J. 2007 Dec 4. 6:160. [QxMD MEDLINE Link]. [Full Text].

62. Piola P, Nabasumba C, Turyakira E, et al. Efficacy and safety of artemether-lumefantrine compared with quinine in pregnant women with uncomplicated Plasmodium falciparum malaria: an open-label, randomised, non-inferiority trial. Lancet Infect Dis. 2010 Nov. 10(11):762-9. [QxMD MEDLINE Link].

63. McGready R, Lee SJ, Wiladphaingern J, et al. Adverse effects of falciparum and vivax malaria and the safety of antimalarial treatment in early pregnancy: a population-based study. Lancet Infect Dis. 2012 May. 12 (5):388-96. [QxMD MEDLINE Link].

64. Centers for Disease Control and Prevention. Atlanta, GA: DHHS; 2009. Malaria and Travelers. Available at http://www.cdc.gov/malaria/travelers/index.html. Accessed: Sep 15, 2011.

65. Alonso PL, O’Brien KL. A Malaria Vaccine for Africa – An Important Step in a Century-Long Quest. N Engl J Med. 2022 Mar 17. 386 (11):1005-1007. [QxMD MEDLINE Link].

66. [Guideline] Centers for Disease Control and Prevention. Malaria Diagnosis and Treatment in the United States. Available at http://www.cdc.gov/malaria/diagnosis_treatment/index.html. Accessed: Sep 15, 2011.

67. Ménard R, Tavares J, Cockburn I, Markus M, Zavala F, Amino R. Looking under the skin: the first steps in malarial infection and immunity. Nat Rev Microbiol. 2013 Oct. 11 (10):701-12. [QxMD MEDLINE Link].

68. Ejigiri I, Sinnis P. Plasmodium sporozoite-host interactions from the dermis to the hepatocyte. Curr Opin Microbiol. 2009 Aug. 12 (4):401-7. [QxMD MEDLINE Link].

69. Kori LD, Valecha N, Anvikar AR. Insights into the early liver stage biology of Plasmodium. J Vector Borne Dis. 2018 Jan-Mar. 55 (1):9-13. [QxMD MEDLINE Link].

70. Crutcher JM, Hoffman SL. Malaria. Baron S. Medical Microbiology. 4th ed. Galveston (TX): University of Texas Medical Branch at Galveston; 1996. [Full Text].

71. World Health Organization. Malaria rapid diagnostic test performance. Results of WHO product testing of malaria RDTs: Round 8 (2016-2018). who.int. Available at https://www.who.int/publications/i/item/9789241514965. 2018; Accessed: 13 April, 2023.

72. Chaudhry A, Cunningham J, Cheng Q, Gatton ML. Modelling the epidemiology of malaria and spread of HRP2-negative Plasmodium falciparum following the replacement of HRP2-detecting rapid diagnostic tests. PLOS Glob Public Health. 2022. 2 (1):e0000106. [QxMD MEDLINE Link].

73. Iriart X, Menard S, Chauvin P, Mohamed HS, Charpentier E, Mohamed MA, et al. Misdiagnosis of imported falciparum malaria from African areas due to an increased prevalence of pfhrp2/pfhrp3 gene deletion: the Djibouti case. Emerg Microbes Infect. 2020 Dec. 9 (1):1984-1987. [QxMD MEDLINE Link].

Malaria. You need to know! – SSS Administration

Sysert City District Administration

Official website

When visiting foreign countries, you always need to know how to protect yourself and loved ones from various diseases.

In 2018, no cases of malaria were registered among the population of the Sysert GO, but an imported case of the disease was registered from a resident of the Sverdlovsk region while staying in India (Goa).
Malaria is one of the most widespread diseases. Intensive endemic foci covers South and Southeast Asia, Oceania, Central and South America, tropical and subtropical parts of Africa.

About the infection:
Malaria is a group of human protozoan transmissible diseases transmitted by mosquitoes of the genus Anopheles. It is characterized by febrile paroxysms, anemia, enlargement of the liver and spleen. May relapse.
The causative agents of malaria are unicellular microorganisms belonging to the phylum Protozoa, class Sporozoa, order Haemosporidea, family Plasmodi, genus Plasinodium. More than 60 species of Plasmodium are known.
Human malaria is caused by 4 types of pathogen: 1) Pl. falciparum – the causative agent of tropical malaria, 2) Pl. Vivax is the causative agent of three-day vivax malaria, 3) Pl. ovale – the causative agent of oval malaria, 4) Pl. malariae is the causative agent of four-day malaria.
The vectors are mosquitoes.
Mechanism of transmission – transmissible – by the bite of a mosquito that has been infected with Plasmodium
Possible: parenteral route of infection (through blood transfusions or through medical instruments) and infection from an infected mother to fetus during pregnancy.
The source of infection is a sick person or parasite carrier, and mosquitoes of the genus Anopheles.
Incubation period: with tropical malaria – 8-30 days, with three days with a short incubation – 7-20 days, with long-term incubation – 6-14 months, with oval malaria – 11-16 days, with four days – 15-40 days .
Malaria has an acute onset and presents with fever, chills, malaise, weakness and headache.
After 3-4 days, an attack occurs, accompanied by chills, fever up to 40-41C, facial flushing, shortness of breath, agitation, delirium, headache, arterial hypotension, diarrhea. The attack ends with a critical drop in temperature, profuse sweating. The duration of the attack is 6-10 hours. Attacks can be daily or occur after 1-2 days. The liver and spleen are enlarged, the skin is pale, the sclera are subicteric, anemia is growing. Early (in a few weeks) and late (in 8-10 months or more) relapses are possible. In some cases, jaundice, renal failure, coma, and infectious toxic shock develop. The total duration of three-day malaria is from 1.5 to 4 years (rarely up to 8 years), oval malaria – from 1 to 4 years (rarely up to 8 years), four-day malaria 2-5 years (sometimes several decades), tropical malaria – up to 1.5 years. Tropical malaria is characterized by the most severe course, determining up to 98% of all deaths from this invasion. The average mortality rate is 1%, NO:
If not treated within the first 24 hours, malaria can develop into a severe illness, often fatal!

Methods of prevention:
Non-specific prophylaxis of malaria is:
– In the evening wear long sleeves, trousers, a long dress in a light color that attracts mosquitoes to a lesser extent , on exposed parts of the body, especially when staying outdoors should be applied repellents .
– After dusk, it is recommended to stay in rooms inaccessible to mosquitoes . To prevent mosquitoes from entering the premises and protecting them from their bites, windows and doors should be screened or curtained. If this cannot be done, windows and doors should be tightly closed at night, and they can also be treated with insecticides.
– Sleep under the mesh cover , the edges of which are carefully tucked under the mattress. Before going to bed, it is necessary to check the integrity of the canopy and the absence of mosquitoes under it.
– Treat living quarters and net curtains daily in the evening with sprays containing insecticides or burn insecticidal candles (sticks) in the bedroom at night .
Specific prevention of malaria is the use of antimalarial drugs.
– Persons traveling to endemic areas must undergo a course of chemoprophylaxis with Chingamine, Amodiakhin, Chloridine. For maximum effectiveness, these drugs are recommended to alternate every month.

• Publication date:
  4.07.2019
• Last Modified Date:
  4.07.2019

Fluorography in Barnaul – Patients

Malaria

Synonyms: intermittent fever, marsh fever, paludism.

This is an acute protozoal transmissible (bloody) disease, manifested by attacks of fever, hemolytic anemia, enlargement of the liver and spleen, prone to recurrent course. The disease is common in countries with warm and hot climates.

Malaria was practically eradicated in the USSR in 1960. In recent years, cases of importation of malaria from countries with a tropical and subtropical climate, most often from Africa, India, Afghanistan, Thailand, as well as the Republics of Tajikistan and Azerbaijan, have been noted in the Russian Federation.

Malarial Plasmodium 4 species transmitted by female mosquitoes of the genus Anopheles.

The source of infection is an infested person, sick, parasite carriers. Under natural conditions, human infection from some animals (lizards, birds, rodents, monkeys) is possible. The mechanism of infection is transmissible, through the bite of an infected female mosquito. Infection is also possible parenterally – with blood transfusions from a donor-parasite carrier, during parenteral manipulations, and in rare cases – transplacental or during childbirth.

Susceptibility to malaria is high, especially in children. Along with this, natural resistance to malaria remains.

Types of malaria: 1. three-day

2. four-day

3. tropical

4. ovale – malaria Disease periods:

90 002 1. incubation

2. primary (acute) manifestations

3. latent

4. relapse period

5. convalescence period.

Diagnosis

Recognition of malaria is based on epidemiological history and leading clinical signs – paroxysmal fever, hepatosplenomegaly, hemolytic anemia. Which is confirmed by the result of a blood test.

Clinic

The clinical picture of the disease is characterized by paroxysms: fever attacks that develop in stages with chills, fever and sweating. The onset of the disease is acute. There may be prodromal signs in the form of general malaise, weakness.

Malaria has an incubation period of 10 days to 14 months, depending on the pathogen. Against the background of chemoprophylaxis, the duration of the incubation period increases.

The malarial paroxysm is divided into phases: “chill” (1-3 hours), “fever” (6-8 hours), and “sweat”. The total duration of the attack is from 1 to 14 hours, with tropical malaria up to 36 hours. General toxic phenomena develop: body temperature rises to 40-41 ° C, headache, myalgia, dizziness, often vomiting, lumbar pain.

The end of the attack is accompanied by sweating, a decrease in the effects of intoxication.

In the absence of adequate therapy after 1-3 months. relapses develop.

Tropical malaria is a severe form of malaria infection.