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Treatment for Malaria

Malaria
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By Dr. Abhay Jain in Internal Medicine

Apr 19, 2022

Malaria  is one of the oldest infections that  causes suffering amongst mankind.For several years cholorquin was the mainstay of treatment. However now for sometime the plasmodium bug which causes malaria has become resistant to this except in areas  where malaria prevalence is low. The main drug now is artemisinin and its derivatives. The treatment of malaria depends on the severity , the kind of plamodium species – mainly vivax, the severity of falciparum in India and the existing resistance pattern to the drugs.

For fever caused by malaria without any real complications affecting the organs in the body any of the artesunate combinations with  one more drug can be given for around  3 days . The rational for using two drugs is to prevent resistance emergence. Fever starts to subside in 48 hours after starting the treatment. For Malaria caused by vivax species  primaquin is given for 14 days to prevent relapses . However  one should get a test called G6PD before taking primaquin.  Besides artesunates  there are several other drugs namely lumifantrine, amiodaquine, mefloquin,atovaquone, proguanil for malaria treatment.

The signs and symptoms of malaria:

If you start to experience uncontrolled chills, fever, nausea, profuse sweating and diarrhea, you might be suffering from Malaria. It is best not to self medicate and consult a specialist. If the symptoms are neglected and the symptoms compound then there are chances of developing complications. Severe Malaria is when your systems have been affected. These include the lungs, kidneys, liver , haemoglobin , brain . Such situations highlight your need to be hospitalized at the earliest, for this kind of malaria needs to treated before  it leads to mortality.Treatment of this requires intravenous injections of artesunate coupled with doxycycline given together for 1 week . Quinine which was given earlier is rarely used now as it is toxic and less effective than artesunate.Supportive treatment of the organs that have been affected is simultaneously instituted . For example  you may require dialysis if the kidneys have stopped working or may need support with a ventilator  if your lungs have got infected and you cannot breathe. The most serious form of malaria is cerebral malaria in which the patient goes into coma. However with early and correct treatment recovery occurs in most patients.Treatment in pregnancy is more or less same though certain drugs cannot be given and we have to use safe drugs for the  foetus.

Malaria prevention:

For preventing malaria , when one is travelling from an area where there is no malaria to an endemic area , it is suggested that they take prophylactic drugs like mefloquin. They can be started once a week for 2 weeks before travel and continued for 4 weeks after leaving. Moreover the following can be followed as simple practices for prevention:

  • Don’t let water stagnate near your surroundings
  • Spray oil, if you see water stagnate
  • Keep your doors and windows closed
  • Use mosquito repellant creams
  • Wear clothes that cover your body
  • Consult a specialist if you develop unexplained fever
Abhay Jain
Content Medically Written & Approved by
Dr. Abhay Jain
Senior Consultant - INTERNAL MEDICINE
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