Malaria

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Malaria
Malaria
Video: Malaria
Video: Malaria - causes, symptoms, diagnosis, treatment, pathology 2023, February
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malaria

Malaria is an infectious disease that is transmitted by mosquitoes. It is caused by unicellular parasites - so-called plasmodia - in the blood and is one of the most dangerous tropical diseases.

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Pathogen: unicellular parasites of the genus Plasmodium (Plasmodium falciparum, vivax, ovale and malariae); After an infection, the pathogens multiply in the liver cells, then attack the red blood cells and trigger the typical symptoms.

Transmission: crepuscular and nocturnal mosquitoes of the genus Anopheles (mosquitoes).

Distribution: 90 percent of malaria cases occur in tropical Africa. Other main risk areas are the Solomon Islands, Amazonia, India, Afghanistan, Indochina and Papua New Guinea.

  • Malaria spread Eastern Hemisphere
  • Malaria Spread Western Hemisphere

Malaria is one of the most important and dangerous parasitic diseases in humans. According to the WHO, an estimated 216 million cases of malaria occurred worldwide in 2016, with 445,000 deaths. Overall, however, due to intensive efforts (mainly distribution of insecticide-impregnated mosquito nets to the population in the distribution areas, treatment of infected people with effective drugs), both numbers are declining.

Austria is one of those countries in which there is no malaria transmission; locals only come into contact with malaria when traveling. According to Statistics Austria, 82 cases of malaria were reported in Austria in 2016. Nowadays these are mainly people with a migration background who return infected after visiting their original homeland.

Incubation period: eight days to several months.

Symptoms: In the foreground of all forms of malaria are high fever over 38 degrees Celsius and flu-like symptoms such as headache and body aches, sweats, chills. In addition, there is anemia (anemia). The other course of the disease depends on the type of pathogen.

  • Malaria tropica:The most dangerous form of malaria, triggered by Plasmodium falciparum, can be characterized by high fever, diarrhea and functional disorders of the liver, kidneys, heart and lungs. It can very quickly lead to kidney failure, coma and shock and thus become life-threatening. The most feared and dangerous complication of tropical malaria is cerebral malaria, i.e. involvement of the brain. The malaria tropica is an acutely life-threatening clinical picture, the rapid application of the right therapy (within 24 hours) is vital. If the malaria is already recognized and treated correctly at this point, the patient has a hundred percent chance of survival. With every day you wait, the chance of survival decreases.If left untreated, tropica malaria is fatal for 50 to 60 percent of Central Europeans!
  • Malaria tertiana (P. vivax, more rarely P. ovale) and quartana (P. malariae): These forms of malaria are also associated with high fever. Depending on the pathogen, a certain fever rhythm occurs: With tertian malaria there is a fever every three days, with quartana malaria every fourth day. However, the clinical picture almost always shows a benign course.

Diagnosis: pathogen detection in the blood.

Prevention & Therapy: There are various drugs that can be used for regular prevention, as "emergency self-therapy" or as therapy. The choice of antimalarial agent depends on the travel destination and the resistance situation of the malaria pathogen. Travelers should find out about the current prophylaxis recommendations at a travel medicine or tropical institute no later than two weeks prior to departure and, if necessary, consult a travel doctor or an infectiologist.

Malaria prophylaxis: To prevent malaria, appropriate measures to protect against insect bites are important. There are also options for chemoprophylaxis:

  • Chemoprophylaxis: This is understood to mean drugs that do not prevent the infection, but prevent the malaria pathogens from multiplying in the blood and thus prevent the outbreak of malaria. They are recommended for travel to high risk areas with poor medical care and must be taken repeatedly at regular intervals.

    Important: In the event of an infection, it can take a few weeks for symptoms to appear. After the mosquito bite, the pathogen first reaches the liver cells and multiplies there. Only then does it get into the blood and trigger the typical symptoms. Most chemoprophylaxis preparations can only effectively combat the pathogen at this point. They must therefore be taken for up to four weeks after leaving the malaria area. Some modern preparations are already effective when the pathogen is still in the liver cells; The exact intake schedule will be informed individually.

    The drugs available are not free from side effects. In addition, resistances are increasing, ie the pathogen causing tropical malaria becomes less sensitive. Long-term prevention therefore only makes sense if there is a high risk of malaria and poor local medical care, as well as if the resistance situation is critical.

  • Emergency self-therapy: No chemoprophylaxis is required in areas with low malaria prevalence. However, travelers are advised to bring medication with them to be taken if symptoms suspect malaria (e.g. high fever) occur locally. This is known as "Emergency Self-Therapy" (NST). The following are decisive for the effectiveness of an NST:

    • Immediate use with any fever over 38 degrees, regardless of whether there are additional symptoms (such as diarrhea), but only if you have been in the malaria area for at least a week (before that, malaria cannot break out due to its incubation period)
    • Use of the right drug in the right dosage.

Note Even after taking emergency self-therapy, medical help must be sought as soon as possible!

Malaria therapy: The security of a correctly performed malaria prophylaxis is quite high. Nevertheless, if you develop a fever within four months of the trip, you must always consider the possibility of tropical malaria and, up to five years later, tertian malaria and inform your doctor of the trip. Only an examination of the blood during the attack of fever can provide clarity. If the suspicion is confirmed, immediate malaria therapy by a tropical medicine specialist or an infectiologist can bring about complete healing.

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