15 Things You Need to Know About Malaria

As a doctor at KLM Health Services, I regularly get questions about diseases transmitted by mosquitos. The Zika virus is a hot topic right now, and there’s Chikungunya and Dengue, but let’s not forget malaria, which affects 219 million people annually, resulting in 660,000 deaths. This is tragic considering that there a simple measures ensuring that travellers can prevent malaria when visiting high-risk destinations.

 While working in Africa and in everyday practice, I am regularly confronted with fables and misconceptions about malaria. I also know that prevention advice can vary from country to country, and even from doctor to doctor. Travellers are sometimes confused by the differences between advice given before departure and advice given on site by locals and in travel guides. In this blog, I’d like to clear things up by addressing a number of facts and fables about malaria.

Malaria in brief

Malaria is caused by the parasite Plasmodium. There are various types of Plasmodium, at least five of which can cause malaria in humans. After being bitten by an infected Anopheles mosquito, the parasites first develop in the liver of the infected person before being transferred to the blood.

Symptoms

The symptoms of malaria include fever, headache and muscle pain. This is the body’s response to the parasite, which destroys red blood cells. The parasite multiplies in the red blood cells, thereby destroying them, which can lead to severe anaemia and may damage various internal organs. If left untreated, the most severe form of malaria (Malaria tropica, which is caused by Plasmodium falciparum) can lead to all sorts of other serious afflictions (sequellae) and death.

8 fables about malaria

1) “I always use mosquito repellent, so I won’t get malaria,” or “I’m taking malaria pills, so I won’t get infected.”

Malaria pills alone are not enough. You should also take other measures. And only applying mosquito repellent certainly isn’t enough. It takes just one malaria mosquito to infect you, and you will find those in the jungle as well as a four-star hotel. It is therefore a good idea to take malaria pills as well as applying repellent.

2) “I don’t take malaria pills, because of all the side-effects.”

The side-effects of malaria pills can be reduced by obtaining good instructions and adhering to them. Fables about side-effects are often based on experiences involving medication that were frequently prescribed in the past, but not anymore. There are various types of preventative medication for malaria, so if there are side-effects, you can always try an alternative.

3) ‘I take the malaria pills along with me and only start taking them if I start feeling ill.”

This is very unwise. Without proper blood analysis, you can never be sure that you have malaria. And if you do have malaria, you require a different dosage with a different type of pills. What’s also risky is that the initial symptoms are very similar to flu and may only present themselves one or two weeks after infection. The disease may develop very quickly after that and, if you don’t recognise the symptoms, it may be too late to get proper treatment and you may end up in coma.

Never underestimate malaria. It should always be treated under a doctor’s supervision.

4) “It’s annoying to keep taking pills so long after you have left the malaria zone.”
This is an exaggeration. The most commonly prescribed malaria pill, atovaquon/ proguanil, has to be taken for a week after leaving the malaria zone. Most other pills have to be taken for four weeks. This is because the pills work in different ways.

5) “Malaria tablets don’t prevent malaria, but ensure that the symptoms are less severe, which may cause the disease to go undiagnosed.”

This is not true. If you take the pills as instructed, they do not prevent malaria parasites from entering your body if you are bitten by an infected mosquito, but they do ensure that the parasites are killed very quickly, before they can cause the disease.

It also bears mentioning that, even if the disease is less severe, malaria parasites can be detected in a blood sample.

6) “I fly to malaria zones so often, it can’t be a good thing to keep taking those pills.”
I hear a lot of cabin and cockpit crew saying this. Over the years, experience has been gained with the use of atovaquon/proguanil over longer periods of time. Although the instructions sometimes say otherwise, medical experts agree that this medication can be used for longer periods of time without additional side-effects, health risks or reduction in the effectiveness of the medication.

7) “I’ll be staying in the hotel, so there’s no risk of me getting malaria.”

Although hotels make every effort to ward off mosquitos, there is a very real risk of catching malaria if you stay at a hotel. Every year, numerous airlines report cases of flight crew who have contracted malaria after spending just one night in a crew hotel.

8) “I’m pregnant and cannot therefore use DEET”

This is incorrect. According to guidelines from the Netherlands national coordination centre for travel advice (LCR), a mosquito repellent milk containing up to 30% DEET can be used safely throughout the entire pregnancy. Pregnant women are advised to avoid travelling to high-risk malaria areas entirely, due to the serious consequences for mother and child of a malaria infection. If the journey is unavoidable, malaria pills can be obtained which are safe to use during pregnancy alongside mosquito repellent.

Mosquito-GrootBLOG

Malaria vaccine

In recent years, there has been a lot of research into the development of a malaria vaccine, partly financed by the Bill & Melinda Gates Foundation. Because malaria is a parasite and not a virus, the development is a bigger challenge than it is when developing vaccines for viruses. Unfortunately, the results have been rather disappointing, which means a malaria vaccine for travellers is probably still a long way off.

7 facts about malaria

  • Malaria is caused by a parasite and can only be transferred from human to human via an Anopheles
  • On average, approximately 219 million people catch malaria every year.
  • Approximately half of the global population runs the risk of catching malaria.
  • Malaria is a leading cause of death among young children in poorer tropical countries.
  • Malaria kills around 660,000 people each year.
  • Malaria can be prevented and cured!
  • You can prevent malaria by taking malaria pills as instructed, in combination with a mosquito repellent containing DEET, wearing clothing that effectively covers your skin, and sleeping under mosquito nets (impregnated with insecticide).

Read these other blogs if you want to know more about Zika or desease spreading mosquitos.

In short: prepare yourself properly and prevent malaria! KLM Health Services has various travel clinics that offer advice, vaccinations, malaria pills and mosquito repellents.

Posted by:   Noud Schel  | 
Join the conversation Show comments

Keith peers

A great read.

Noud Schel

Thank you Keith, glad you enjoyed it!

John Tomlinson

Thank you.. This informstion has been very instructive in preparation for travel and life in the tropics.

Noud Schel

Nice to hear, John!

David McGuire

Thanks for this useful blog. As someone who works on malaria prevention for a living I would add a couple of other thoughts.

Since the vast majority of bites from the female anopheles mosquitoes that transmit malaria occur indoors and between 10pm and 5am, it is very helpful to sleep under and insecticide-treated bednet whenever possible. It is also a good idea to spray your room with insecticide a least 1 hour before going to sleep, focusing on typical hiding spots behind curtains, under beds, in closets, etc.

If you experience flu-like symptoms after returning from a malarious area, make sure to see a doctor ASAP and tell them about your potential exposure. Malaria is easy to diagnose if technicians are looking for it but if you don’t tell them where you were the Dr. is likely to assume the flu and not look, which could lead to trouble

Noud Schel

Hi David, thank you for your additional comments, I totally agree.

Walter Fokkens

Excellent stukkie Noud!
Ik reis veel naar malaria gebieden en zou alles moeten weten, maar ik lees het graag nog een keer.
Walter

Noud Schel

Bedankt Walter, goed om te horen!

Marjan

I like to travel in june to south africa. Is it necassary to take malaria pills.?

Noud Schel

Hi Marjan, that depends on your travel plans. In some areas in South Africa it is advised to take pills in specific months. In other areas it is recommended to use anti-mosquito measures only or no measures at all. I recommend going to a travel clinic for personal advice tailored to your travel schedule.

kjell borje moe

“Use malaria tablets” – there are no pills against P. falciparum. And know we are told that vivax is getting more and more resistant against all kind of profylakse and terap. med.

Myriam

Agree…. Lariam was not enough for me to kill it off….

Myriam

Hi ! Thks for the article! Just would like to add that Pills taken as instructed do not always ensure the bug is killed quickly, sometimes it stays… You can also get malaria even if you protect yourself. I’ve caught plasmodium falciparum with (well taken) lariam, mozzies were biting me through 100%Deet in Tanzania.
I’ve had sore throat symptoms, headaches, extreme fatigue, and …. Low grade fever.

When in doubt when in Africa, just get a prik blood test…
Happy travels :)))

Noud Schel

Hi Myriam, there are always exceptions to the rules but also there are lots of stories going around about malaria that are based on wrong information, that’s why I wanted to clear things up a bit with this blog. I agree with your advice: when in doubt, have yourself checked for malaria.

Pat McCardle

I have had my spleen removed after trauma, what is your advice about travelling to West Africa…..Should I or shouldn’t I travel?

Ruben J

You’re certainly at a greater risk of experiencing a much more severe malaria and to make things worse, P. Falciparum is very prevalent in west Africa. Although good medication and protection will help, you are at a greater risk. Keep that in mind.

Noud Schel

Hi Pat, Ruben is right. If you want to travel to West Africa, make sure you visit a Travel Clinic for advice on how to protect yourself.

Ruben J

Hoi Noud
Leuk om te lezen. Heb volgende week tentamen infectieziekten, extra info voor een toets is nooit verkeerd.

Gr RJ

Jos

Good blog. Ik ga deze zomer op vakantie naar Maleisië en Borneo. Zal dochter dit verhaal goed laten lezen en hopelijk valt het kwartje dat beschermen niet iets is dat ouders doen om te plagen. Dank hiervoor. ;-))

Mary jane

Malaria cannot be transmitted sexually as well

RaviHospital

Thanks for posting such a useful and informative post.

John Smith

Your article is very good and very valuable knowledge in it.
Malaria is a preventable and treatable disease. The primary objective of treatment is to ensure complete cure, that is the rapid and full elimination of the Plasmodium parasite from the patient’s blood, in order to prevent progression of uncomplicated malaria to severe disease or death, and to prevent chronic infection that leads to malaria-related anaemia.
From a public health perspective, the goal of treatment is to reduce transmission of the infection to others, by reducing the infectious reservoir, and to prevent the emergence and spread of resistance to antimalarial medicines.

There are many meds available at online pharmacy stores for Anti Malarial treatment mygenericpharmacy.com is the one that i know.

John Smith

Malaria is a disease caused by a parasite. The parasite is transmitted to humans through the bites of infected mosquitoes. People who have malaria usually feel very sick, with a high fever and shaking chills.

There are many meds available at online pharmacy stores for Anti Malarial treatment mygenericpharmacy.com is the one that i know.

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