Malaria is a parasitic infection transmitted to humans by the bite of a specific mosquito. The symptoms resemble those of gastroenteritis with, in addition, a lot of fever. It is a disease that can be fatal.
Malaria is a parasitic disease transmitted by mosquitoes of the genus Anopheles. Malaria surveillance is carried out in France speak Malaria CNR. 90% of malaria cases are located in Africa as well as 96% of deaths, recalls Public Health France. “Malaria is most common infection parasitic in the world, and it is also one of the most serious” informs us Dr Guillaume Béraud, infectious disease specialist in Poitiers. “It is estimated that nearly 2 billion people would be exposed to it in the world, and we can imagine that this figure will increase considerably with the global warming.” A twenty people die each year in France from malaria contracted while travelling.
Definition: what is malaria?
Malaria is a disease caused by a parasite of the genus Plasmodium that can infect humans through an Anopheles mosquito bite. The word “malaria” comes from the Latin “paludis” which means “swamp”. The disease is also called “malaria”. In general, the initial infection is not worrying, but it is the resurgences which are in question in the life-threatening forms. This disease can be deadly without proper treatment.
What are the symptoms of malaria?
Malaria looks like gastroenteritis with high fever. During inoculation (parasite that enters the body), infection is manifested by :
► A high fever (which appears approximately 2 months after the bite mosquito)
► Diffuse pain, abdominal, joint, muscular, headaches.
► Of the digestive disorders (vomiting and diarrhoea).
THE parasite remains in the body, in the liver particular, then it can lead to an attack of malaria with theappearance of chills occurring suddenly and lasting less than two hours then high fever for a few hours followed by heavy sweating. “These symptoms will occur cyclically every two to three days and the periodicity of the crises then depends on the species of parasite in question” explains the infectious disease specialist. As a consequence of the infestation of red blood cells by the parasite, the patient will present in addition to fever, jaundice (yellow discoloration of the skin) and a splenomegaly (increased size of the spleen). Neurological manifestations (we then speak of cerebral malaria) such as seizures or one coma evoke a cerebral malaria that can rapidly lead to death. In the absence of support, if the patient survives, the evolution can be done towards reviviscences with attacks which are repeated more or less regularly.
How long does an attack of malaria last?
“Symptoms will arise cyclically every two to three days and the periodicity of the seizures depends on the species of parasite in question” repeats the infectiologist.
“It is only the females that bite because they need the hemoglobin in the blood for the maturation of the eggs”
What causes malaria?
This pathology transmitted to humans by the bite of a female Anopheles mosquitowhich is generally found under the tropicsin Africain Central and South America or in Asia. “ Only females bite because they need hemoglobin from the blood for egg maturation. There are other transmission possibilities but which are rarer, such as blood transfusion from someone who has malaria to someone else. But in 99.9% of cases, transmission is through the bite of a mosquito. “, comments Professor Patrice Bourée, infectiologist at the Alfred Fournier Institute in Paris. Once in the body, Plasmodium lodges in the liver and red blood cells. It exists several types of Plasmodium :
- Plasmodium falciparum on the one hand (which is responsible for severe, potentially fatal forms of malaria)
- Plasmodium vivaxovale and malariae, which can cause recurrences sometimes for several years.
What are the risk factors?
“ The main risk factor is traveling to countries where there are Anopheles mosquitoes and reservoirs of malaria since mosquitoes do not produce plasmodium, the parasite responsible for malaria. He will suck someone’s blood and if that person has the parasite, on the next bite he will inoculate you. They are mostly found in black Africa and the Amazon“, continues Professor Bourée.
What are the consequences of malaria?
“Malaria is a parasite that will lodge in red blood cells and cause them to burst. As a result, after a while, the patient will become anemic and above all cause very characteristic symptoms with a bout of fever of at least 40° chills, heat and sweat“, reports the infectiologist.
Can you die from malaria?
Yes. The estimated number of death attributable to malaria amounted to 627,000 in 2020, reports theWHO. THE Plasmodium falciparum is the only parasite that can cause severe malaria if the infection is not treated in time.
As Dr. Béraud observes, “Malaria is always suspected in a person who presents with high fever after a trip in a tropical area. Then, to make the diagnosis of malaria, it is necessary observe fever attacks, their intensity and frequency. A blood test finds a decrease in red blood cells, platelets, and a increase in the inflammation-specific protein, CRP. Microscopic examination of a blood smear by a parasitologist makes it possible to confirm malaria, and to characterize the type of parasite in question.
Is there a vaccine against malaria?
The currently available malaria vaccine is experimental. “It seems relatively efficient but not completely, explains Dr. Béraud. He is reserved for children in some African countries within the framework of protocols, but not topical in Western countries.”” It is very complicated to develop a vaccine since this parasite changes shape all the timeit gets into the liver in the red blood cells, in the spleen, etc.“, notes Professor Patrice Bourée. Since October 2021, the WHO has recommended the wide use of malaria vaccine RTS, S/AS01 in children in areas with moderate to high malaria transmission P. falciparum .
What drugs are used for malaria?
” In the past, the standard treatment was quininethen it was nivaquina” recalls Professor Bourée. antimalarial drugs, inhibiting parasite activity, limit the risk of infections and considerably reduce the symptoms. THE three more common drugs today are Lariam© (mefloquine), Malarone© (atovaquone), effective but expensive and not reimbursed, and doxycycline©, less expensive but also less effective.“Antimalarials suffer, wrongly, from a bad reputation, because ofside effects listed very rare and largely overestimated, explains the infectious disease specialist.They are however very effective and we must not forget that a twenty people die each year in France from malaria contracted while travelling.” In addition, to be effective, these treatments must all be extended for several days or even several weeks after return:“It happens that a person presents a malaria attack after his return because he interrupted his treatment early” insists the specialist.
Which mosquito repellents to use against malaria?
The first preventive measure remains to do not get bitten by mosquitoes. There are several ways to protect yourself against it, such as mosquito net impregnated with insecticide for the night, of the mosquito repellents applied to the skin and covering clothes (evening and night).“Malaria-carrying mosquitoes are most active between dusk and the middle of the night”recalls Dr. Béraud. It is also recommended toavoid rural areas, more frequently infested.
If caught in time, the chance of recovery is 99.9%
What are the chances of recovery?
“Malaria is very common. If caught in time, the chance of recovery is 99.9%. In general, the remaining 1% are people who have been slow to seek treatment. You just have to think about it when you come back from one of these countries“, wishes to reassure the infectiologist.
What are the risks for pregnant women?
Pregnancy increases the risk of malaria infection and makes women more vulnerable to its effects. The risk of maternal and fetal mortality is therefore increased. It is estimated that approximately 100,000 infants die every year worldwide following infection during pregnancy. For less serious forms, there remains an increased risk of premature delivery and too low weight of the newborn. Ideally, the pregnant women will avoid travel to infested areas. If necessary, certain combinations of antimalarials can be prescribed to them without risk to the fetus.
Thank you to Dr Guillaume Béraud, infectious disease specialist and Pr Patrice Bourée, infectious disease specialist at the Alfred Fournier Institute in Paris.