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Malaria is a disease that is caused by the bite of an infected mosquito. The bite injects tiny parasites into your bloodstream, that multiply and cause you an infection. 

In Nigeria, malaria is responsible for 60% of all hospital visits. It is life-threatening and accounts for 30% of deaths in children, 11% of deaths in pregnant women, and 25% of death in babies less than one year. In 2021, the World Health Organization (WHO), reported that Nigeria contributed to 27% of the global malaria burden and 32% of malaria deaths globally. 

Infants, children under 5 years, pregnant women, and people with low immunity (such as HIV/AIDS patients and migrants) have a high risk of contracting malaria. To reduce infections, the WHO recommends using treated bed nets and insecticides.

Symptoms of Malaria in Nigeria

The first symptoms of malaria are fever, headache, and chills. They usually appear 10 – 15 days after the infected mosquito bite. Other symptoms include:

• Weakness
• Headache
• Nausea and vomiting
• Diarrhea
• Abdominal pain
• Muscle or joint pain
• Rapid breathing
• Rapid heart rate
• Cold and cough
• Bitter taste in the mouth
• Sweating
• Disturbing dreams
• A general feeling of being unwell

Some people who have malaria may experience “fever cycles” or “malaria attacks”. The attack usually starts with shivering and chills, followed by a high fever and sweating (this stage can cause seizures in children) and then a return to normal body temperature. 

Causes of Malaria

Malaria is caused by the bite of a mosquito infected with the Plasmodium parasite. Five species of malaria parasites are known to infect humans, but two of these species – P. falciparum and P. vivax cause the most deadly infections.  P. falciparum is the deadliest and is common in Nigeria and other African countries. 

In some cases, pregnant women infected with malaria can pass the disease to their children before or during birth. This is known as congenital malaria.

Since the parasites that cause malaria affect the blood, malaria can also be transmitted through:

• Organ transplant
• Blood transfusion
• Use of shared needles or syringes

Possible Complications of Malaria

If malaria is left untreated for a long period, the following complications could develop:

• Cerebral malaria involves seizures and, in rare cases, coma
• Anemia
• Unusual low blood sugar (hypoglycemia)
• Liver failure, which can lead to jaundice
• Kidney failure
• Swelling and rupturing of the spleen
• Breathing problems caused by a build-up of fluid in the lungs
• Dehydration, leading to shock and death

Malaria relapses

Malaria may disappear but recur weeks or months later with some species of Plasmodium (p.vivax). This occurs because the parasites have dormant stages, during which there is no active infection. If symptoms reactivate, they are certain medications that help prevent further relapse.

Also read: 10 Best Nigerian Foods to Eat For Peptic Ulcer

Diagnosis

To diagnose malaria, your healthcare provider will review your symptoms and medical history, conduct a physical exam, and order blood tests. Some blood tests can produce results in less than 15 minutes, while others can take several days to complete. Blood tests will indicate:

• Whether you have malaria and the type of malaria you have
• If your infection is caused by a parasite resistant to certain types of drugs
• If the disease has caused anemia
• If the disease has affected your vital organs or caused any complications

Treatment of Malaria in Nigeria

Medications are the first-line treatment of malaria.  It is important to start treating malaria as soon as you notice any symptoms. Your healthcare provider will prescribe medications to destroy the malaria parasite. However, some parasites can be resistant to malaria drugs.

The most common antimalarial drugs used in Nigeria include:

• Artemisinin-based combination therapies (ACTs). ACTs are recommended by the WHO as the first drug of choice in the treatment of uncomplicated falciparum malaria. The combination of two or more drugs works synergistically to eradicate the malaria parasite. Common examples include Artemether + lumefantrine (Coartem), artesunate + amodiaquine (Camosunate), artesunate + mefloquine, artesunate + sulfadoxine-pyrimethamine, and dihydroartemisinin + piperaquine.
• Chloroquine phosphate. Chloroquine was formerly the preferred first-line treatment for malaria. But in many parts of the world, falciparum parasites have become resistant to chloroquine, and the drug is no longer used as a first-line treatment.

Other common antimalarial drugs include:

• Atovaquone-proguanil (Malarone)
• Quinine sulfate (Qualaquin) with doxycycline (Oracea)
• Mefloquine
• Sulfadoxine and pyrimethamine (Fansidar)
• Primaquine phosphate (helps prevent relapse with p.vivax)

Common side effects of Malaria drugs

Antimalarial drugs can cause side effects and interfere with any other drug you’re taking. Make sure to tell your healthcare provider about any other medicines you’re taking. Common side effects experienced include:

• Nausea and vomiting
• Headache
• Anemia
• Loss of appetite
• Involuntary movements
• Confusion and vision problems
• Diarrhea or constipation
• Change in urine color
• Trouble sleeping
• Seizures

Make sure to discuss with your healthcare provider about any prolonged side effects.

Prevention

Mosquitoes mostly bite between dusk and dawn. To prevent mosquito bites – especially when resting outdoors –  the following preventive measures are recommended: 

• Indoor spraying: Spray inside your home with NAFDAC-approved insecticides. These include repellents containing DEET, picaridin, lemon eucalyptus oil, and para-menthane-3,8-diol (PMD). Make sure to follow spraying instructions and open your windows afterward.
• Insecticide-treated nets: Bed nets treated with insecticides, such as permethrin, help prevent mosquito bites while you are sleeping.
• Cover your skin: Try to cover your body as much as possible when you are outdoors. Wear long pants and long-sleeve shirts when you go out in the evenings.
• Apply skin repellent: Apply approved insect repellents to your skin when you go out in the evenings or sleep in mosquito-prone areas. Examples include those containing N-diethyl-benzamide. Do not apply on the face and use sparingly on children.
• Apply repellent to clothing. You can spray permethrin-containing insecticides on your clothing when you go out in the evenings.
• Keep your surroundings dry: Empty, drain, cover, and eliminate standing water in your environment. As mosquitoes tend to reproduce and replicate in stagnant waters.

Preventive medicines

If you’re pregnant or planning to travel out to a malaria-endemic region, they’re drugs that can help protect you against malaria. Talk to your provider to provide you with drugs to take before, during, and after your pregnancy or trip. Example of a drug used to prevent malaria in pregnancy is sulfadoxine and pyrimethamine (Fansidar). Take the dosage as instructed by your healthcare provider.  

Malaria Vaccine for Children 

In October 2021, the World Health Organization recommended a broad use of the RTS, S/AS01 malaria vaccine for children living in regions with high numbers of P. falciparum malaria cases. The vaccine has been shown to significantly reduce deadly severe malaria, among young children. However, research is still ongoing to develop a second vaccine that will meet the demand in all populations.

Outlook

Although malaria is a serious disease, most people make a full recovery after treatment.

However, a relapse may occur if you’re infected with P. vivax or P. ovale. Make sure to speak with your provider if you notice a recurrence. 

Takeaway

Malaria is a life-threatening disease that is caused by the bite of an infected female anopheles mosquito. 

Its common symptoms include fever, chills, headache, and joint pain, which may disappear for a few days but reappear weeks later. If left untreated, you can develop fatal complications, such as anemia and organ failure.

Ensure to speak to a healthcare provider when you notice any lingering symptoms, and prevent infection by protecting yourself from mosquito bites and taking preventive medications. If you’re traveling where malaria is common, talk to your provider months before you leave – especially if you’re pregnant.