TABLE OF CONTENTS

• Causes of Malaria
• Types of Malaria
• Risk Factors
• Symptoms of Malaria
• Malaria Diagnosis
• Malaria Treatment
• Complications of Malaria
• Malaria Prevention

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Malaria is a serious and potentially fatal disease caused by protozoan parasites. It is primarily transmitted through the bite of infected mosquitoes in many tropical and subtropical regions. When bitten, the mosquito transfers parasites that attack red blood cells.

Several species of Plasmodium parasites infect humans, including Plasmodium falciparum, P. vivax, P. ovale, and P. malariae. P. knowlesi, a species naturally infecting monkeys in Southeast Asia, can also infect humans, making it a zoonotic disease.

P. falciparum is the most dangerous type and can be fatal if not treated promptly. Infected individuals often experience high fever, chills, and severe illness.

If left untreated, malaria can lead to serious health issues such as seizures, brain damage, respiratory difficulties, organ failure, and death. However, with proper precautions, the disease is preventable.

Causes of Malaria

Malaria is caused specifically by the bite of an infected female Anopheles mosquito. Among the parasite species that infect humans, P. falciparum and P. vivax pose the greatest threat.

Once inside the human body, the parasite travels to the liver to multiply, then attacks red blood cells, which transport oxygen. The parasites continue to multiply inside the blood cells until they rupture, causing worsening symptoms.

Malaria is not contagious from person to person but can be transmitted through:

• Mother to unborn child
• Shared needles
• Blood transfusion
• Organ transplant

Types of Malaria

There are five main types of malaria, based on the infecting parasite:

1. Plasmodium vivax (Pv)

This is the most common and widely distributed type. Though typically non-fatal, it can severely weaken the immune system. Symptoms include:

• Fever and chills
• Diarrhea
• Extreme fatigue

2. Plasmodium ovale (Po)

One of the rarest types, mostly found in Western countries such as Ghana, Nigeria, and Liberia. Symptoms include:

• High fever and chills
• Joint pain
• Diarrhea
• Full-body aches

This type can relapse because the parasite may remain dormant in the liver for up to four years.

3. Plasmodium falciparum (Pf)

Known as “tropical malaria,” this subtype is found in Africa, Southeast Asia, and South America. Symptoms include:

• Nausea
• Fatigue
• Enlarged spleen
• Abdominal, muscle, and joint pain
• Fever
• Headache
• Anemia
• Seizures

If untreated, it can cause brain and nervous system complications, paralysis, or severe seizures.

4. Plasmodium malariae (Pm)

A rare type, accounting for less than 1% of cases. It is prevalent in South America, Southeast Asia, and Africa. Main symptoms include persistent fever and chills.

5. Plasmodium knowlesi (Pk)

A type originating from primates but can infect humans. Common in long-tailed and pig-tailed macaques, its symptoms resemble those of P. malariae but can progress rapidly to severe illness.

Risk Factors

Malaria-carrying mosquitoes thrive in tropical and subtropical climates. People living or traveling in these regions are at higher risk:

• Africa
• Central and South America
• The Dominican Republic, Haiti, and other Caribbean islands
• Eastern Europe
• South and Southeast Asia
• Islands in the Central and South Pacific (Oceania)

Children, the elderly, and pregnant women are more susceptible to severe illness and complications.

Symptoms of Malaria

Common signs and symptoms include:

• Fever
• Chills
• General discomfort
• Headache
• Nausea and vomiting
• Diarrhea
• Abdominal pain
• Muscle or joint pain
• Fatigue
• Rapid breathing
• Fast heart rate
• Cough

Some individuals experience cyclical “malaria attacks,” beginning with chills, followed by high fever, then excessive sweating and return to normal temperature.

Symptoms usually appear within a few weeks after the bite of an infected mosquito, though certain parasite types can remain dormant in the body for up to a year.

Malaria Diagnosis

Doctors may perform the following to diagnose malaria:

1. Medical interview to assess the patient’s history, current symptoms, and recent travel to malaria-endemic areas.
2. Physical examination, checking for common physical signs; further testing may follow if symptoms are unclear.
3. Additional tests, such as:

• Blood test – Examines a sample under a microscope to detect parasites.
• Rapid diagnostic test (RDT) – Identifies malaria antigens in the blood.
• Polymerase chain reaction (PCR) – Detects parasite DNA and assesses infection severity.
• Other lab tests – Includes red blood cell counts, parasite load, and parasitemia levels.

Malaria Treatment

Malaria is treatable with medication. Treatment type and duration depend on the parasite species, geographic origin, patient age, pregnancy status, and symptom severity.

Common treatments include:

1. Chloroquine phosphate

Used where parasites are still sensitive. However, many regions have developed resistance to chloroquine.

2. Artemisinin-based Combination Therapies (ACTs)

The preferred treatment for resistant malaria. Examples: artemether-lumefantrine (Coartem), artesunate-mefloquine.

3. Other antimalarials

Atovaquone-proguanil (Malarone), quinine sulfate (Qualaquin) with doxycycline, and primaquine phosphate.

Complications of Malaria

Complications may arise within hours or days of initial symptoms. Seek immediate medical help if any of the following occur:

1. Anemia – Caused by destruction of red blood cells.
2. Cerebral malaria – Can cause brain swelling, permanent damage, seizures, or coma.
3. Respiratory issues – Fluid buildup in the lungs (pulmonary edema) may impair breathing.
4. Organ failure – Potential damage to kidneys, liver, or spleen rupture.
5. Hypoglycemia – Especially in severe cases or with quinine treatment, can lead to coma or death.
6. Neurological issues – Triggered by P. falciparum, causing seizures, confusion, or paralysis.

Other serious complications include liver failure, sudden blood pressure drops, ARDS, kidney failure, dehydration, and recurrent malaria due to dormant parasites.

Malaria Prevention

Prevent infection by being vigilant against mosquito bites and maintaining a clean environment.

If you live in or plan to travel to an endemic area, take the following precautions, especially at dusk and dawn when mosquitoes are most active:

• Wear long sleeves and pants, and tuck them into socks.
• Apply insect repellent on skin and clothing (permethrin-based products are effective).
• Sleep under insecticide-treated mosquito nets.

Before traveling to an endemic area, consult a doctor months in advance about possible preventive medication. 

These drugs are often the same as those used for treatment but depend on your destination, length of stay, and health condition.

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References

Very Well Health. Accessed 2025. Causes and Risk Factors of Malaria

Mayo Clinic. Accessed 2025. Malaria

National Health Service. Accessed 2025. Malaria

Clinical Microbiology Reviews. Accessed 2025. Human Infections and Detection of Plasmodium knowlesi

PharmEasy. Accessed 2025. Malaria: Types, Symptoms, Causes And Treatment

National Center for Vector Borne Diseases Control. Accessed 2025. How to detect, treat and prevent malaria

FAQs

1. Can malaria be completely cured?

Yes, with prompt and appropriate treatment. However, some malaria types may recur if parasites remain dormant in the body.

2. Who is most at risk for malaria?

Those living in or traveling to malaria-endemic areas, pregnant women, children, and individuals with weakened immune systems.

3. Is there a vaccine for malaria?

Yes. Vaccines such as RTS,S/AS01 (Mosquirix) have been introduced in some malaria-endemic countries, especially for children.