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World Immunization Week: 9 Malaria Complications You Need To Be Aware Of

| Reviewed By Arya Krishnan

According to a 2017 WHO report, India ranks fourth in infections and deaths caused by malaria. Malaria is a mosquito-borne disease and children, pregnant women and travellers are more prone to the disease.

The female Anopheles mosquito transfers Plasmodium parasites from its saliva into the person's blood, which enters the bloodstream and move up to the liver and start reproducing [1]. As malaria is transmitted by blood, it can also be transmitted through a transfusion, an organ transplant, and the use of shared syringes.

Some of the signs and symptoms of malaria are kidney failure, headache, diarrhoea, fatigue, body aches, fever, nausea and vomiting, sweating, seizures, shaking chills, anaemia and bloody stools [2].

It only takes a single mosquito bite for a person to be infected. The biggest risk factor for developing malaria is to live in or visit an infected zone. Poverty, lack of knowledge and no access to health care is primarily responsible for malaria deaths across the world [3][4].

In this article, we have listed some of the severe malaria complications as part of World Immunization Week. Observed from 24 April to 30 April, World Immunization Week aims to promote the use of vaccines to protect people of all ages against disease [5].

The theme of World Immunization Week 2020 is #VaccinesWork for All and the campaign will focus on how vaccines and the people who develop, deliver and receive them are heroes by working to protect the health of everyone, everywhere.

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1. Cerebral Malaria

Cerebral malaria is a diffuse encephalopathy, that is, a disease of the brain that alters brain function or structure [6]. It can cause seizures and status epilepticus in people with severe malaria. In some cases, cerebral malaria can lead to paralysis. Cerebral malaria is the most common cause of death in patients suffering from malaria.

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2. Acute Respiratory Distress Syndrome (ARDS)

ARDS occurs when fluid builds up in the tiny air sacs called alveoli in your lungs. That is, ARDS causes the leakage of fluid into your lungs and affect your breathing. Malaria-associated acute respiratory distress syndrome or MA-ARDS is one of the most common complications caused by malaria and has a reported lethality rate of up to 80 per cent, despite anti-malarial treatment [7][8]. This complication causes respiratory distress/breathing problems.

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3. Convulsions

Convulsions can be associated with cerebral malaria [9]. Convulsions are described as a medical condition where body muscles contract and relax rapidly and repeatedly, resulting in uncontrolled actions of the body. In people with malaria, convulsions are more often a result of cerebral dysfunction [10].

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4. Hemolysis

The malarial parasite can destroy the red blood cells completely [11]. This can lead to hemolysis which is the rupture or destruction of the red blood cells (RBC). Sometimes the haemoglobin released by the damaged RBCs can enter the kidneys and can cause kidney failure [12].

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5. Electrolyte/Fluid Imbalance

Individuals affected by malaria can become salt deprived due to excessive loss of fluid through sweating or vomiting or due to its decreased intake [13]. Electrolyte disturbance is known to be the common complication in severe malaria, which also acts as an indicator for the severity of disease [14].

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6. Blackwater Fever

Blackwater fever is a complication of malaria infection in which the red blood cells burst in the bloodstream, that is hemolysis, and causes the release of haemoglobin directly into the blood vessels and into the urine, leading to kidney failure [15].

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7. Splenic Rupture

The spleen produces antibodies against the malarial parasite, making it an important factor in the management of the infection [16]. Enlargement of the spleen in people who have recurrent cases of malaria is quite common. Splenic rupture can occur in patients with vivax malaria, especially when they develop abdominal pain or shock [17].

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8. Low Sugar Levels

One of the other major complications caused by malaria infection is low sugar levels. This happens as the malaria parasites dependent on glucose as a nutrient source [18].

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9. Acute Renal Failure (ARF)

Acute renal failure (ARF) is commonly reported in people with severe malaria infection [19]. Malarial ARF is commonly found in non-immune adults and older children with falciparum malaria.

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Tips To Prevent Malaria

There is no vaccine available to prevent malaria. However, you can consider the following steps to prevent the breeding of mosquitos [20]:

  • While sleeping or travelling to malaria-prone areas, use mosquito repellents.
  • Do not allow the water to stagnate near your house as they serve as the breeding ground for Anopheles mosquitoes.
  • Wear full-sleeve clothes to keep the mosquitoes away from biting you.
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On A Final Note…

People with malaria who receive treatment have a good long-term outlook. However, in the case of the development of the aforementioned complications, the outlook may not be as good. Talk to your doctor about long-term prevention and adopt preventive measures such as covering your skin in mosquito repellents and wearing full-sleeved clothes.

Arya KrishnanEmergency Medicine
MBBS
Arya Krishnan
Read more about: malaria parasite disease