INTRODUCTION

 

• Malaria is a potentially life threatening parasitic disease. caused by parasites known as Plasmodium viviax (P.vivax), Plasmodium falciparum (P.falciparum), Plasmodium malariae (P.malariae) and Plasmodium ovale (P.ovale)
• It is transmitted by the infective bite of Anopheles mosquito
• Man develops disease after 10 to 14 days of being bitten by an infective mosquito
• There are two types of parasites of human malaria, Plasmodium vivax, P. falciparum, which are commonly reported from India.
• Inside the human host, the parasite undergoes a series of changes as part of its complex life cycle. (Plasmodium is a protozoan parasite)
• The parasite completes life cycle in liver cells (pre-erythrocytic schizogony) and red blood cells (erythrocytic schizogony)
• Infection with P.falciparum is the most deadly form of malaria.

 SYMPTOMS OF SEVERE AND COMPLICATED MALARIA

 

The priority requirement is the early recognition of signs and symptoms of severe malaria that should lead to prompt emergency care of patient.  The signs and symptoms that can be used are non-specific and may be due to any severe febrile disease, which may be severe malaria, other severe febrile disease or concomitant malaria and severe bacterial infection.

The symptoms are a history of high fever, plus at least one of the following:-

·         Prostration (inability to sit), altered consciousness lethargy or coma

·         Breathing difficulties

·         Severe anaemia

·         Generalized convulsions/fits

·         Inability to drink/vomiting

·         Dark and/or limited production of urine

Patients with prostration and/or breathing difficulties should, if at all possible, be treated with parenteral antimalarials and antibiotics.   Oral treatment should be substituted as soon as reliably possible.  Frequent monitoring of laboratory parameters is essential – blood sugar, blood urine, fluid balance, associated infection, etc.  Drugs that increase gastro intestinal bleeding should be avoided.