Malaria FAQs

What is malaria?
Malaria is a serious and sometimes fatal disease caused by a parasite. Affected individuals typically display high fevers, shaking chills, and flu-like illness. Four kinds of malaria parasites can infect humans: Plasmodium falciparum, P. vivax, P. ovale, and P. malariae. Infection with any of the malaria species can make a person feel very ill; infection with P. falciparum, if not promptly treated, can be fatal. Although malaria claims many lives, the disease is preventable and does not need to equal a death sentence.

Is malaria a serious disease?
Yes. Malaria is a leading cause of death and disease worldwide, especially in developing countries. Most deaths occur in young children. In Africa, for example, a child dies from malaria every 30 seconds. Because malaria causes so much illness and death, the disease drains many national economies. It is particularly destructive in impoverished nations, which must often contend with vicious cycles of disease and poverty.

Where does malaria occur?
Malaria is typically found in warmer climates — in tropical and subtropical countries. Higher temperatures allow the Anopheles mosquito to thrive. Malaria parasites, which grow and develop inside the mosquito, need warmth to complete their growth before they are mature enough to be transmitted to humans.

Malaria occurs in over 100 countries and territories. More than 40% of the world's population is at risk. Large areas of Central and South America, Hispaniola (the Caribbean island that is divided between Haiti and the Dominican Republic), Africa, the Indian subcontinent, Southeast Asia, the Middle East, and Oceania are considered malaria-risk areas.

How is malaria transmitted?
People usually get malaria after being bitten by an infected female Anopheles mosquito. Only Anopheles mosquitoes can transmit malaria and they must have been infected through a previous blood meal taken from an infected person. Malaria is not transmitted from person to person like a cold or the flu. You cannot get malaria from casual contact with malaria-infected people.

Because the malaria parasite is found in red blood cells, malaria can also be transmitted through blood transfusion, organ transplant, or the shared use of needles or syringes contaminated with blood. Malaria may also be transmitted from a mother to her fetus before or during delivery; the latter is referred to as congenital malaria.

Prevention & Control

Malaria control is carried out through several interventions, which are often combined for greater efficacy:

1. case management (diagnosis and treatment) of patients suffering from malaria;
2. prevention of infection through vector control (reducing contact between mosquitoes and humans); and
3. disease prevention through the administration of anti-malarial drugs to particularly vulnerable population groups such as pregnant women and infants.

Effective case management mandates prompt treatment of sick persons. Treatment eliminates the parasite and thus interrupts the transmission cycle. The World Health Organization (WHO) recommends that anyone suspected of having malaria receive diagnosis and effective drug treatment within 24 hours of symptom onset. If the patient does not have access to a heath care provider, as is often the case in malaria-endemic areas, or those where the disease has a habitual presence, home treatment is acceptable.

Infection is averted when malaria-carrying Anopheles mosquitoes are prevented from biting humans. Vector control aims to reduce contacts between mosquitoes and humans. Some vector control measures (destruction of larval breeding sites, insecticide spraying inside houses) require organized teams (for example, from the Ministry of Health) and resources that are not always available. An alternate approach, insecticide-treated bed nets (ITNs), combines vector control and personal protection. This intervention can often be conducted by the communities and has become a significant malaria control approach.

Anti-malarial drug administration to vulnerable populations does not prevent infection; it can, however, prevent full manifestation of the disease and control its continued spread by eliminating parasites present in the blood. Pregnant women constitute the most frequently targeted vulnerable group. They benefit significantly from "intermittent preventive treatment" (IPT) with anti-malarial drugs, which are most often distributed at antenatal consultations during the second and third trimesters of pregnancy.

Successful malaria control activities require coordinated actions by national authorities (especially the Ministry of Health), international organizations (such as the World Health Organization and UNICEF), governmental and nongovernmental agencies, the private sector, and affected communities.

Effective malaria control mandates health education, which informs communities how to prevent and treat the disease; health worker training and supervision to ensure proper service delivery; and the provision of equipment and supplies (e.g., microscopes, drugs, bed nets) to allow health workers and communities to carry out the interventions.

Diagnosis & Treatment

In addition to immediately recognizing symptoms in affected individuals, effective malaria treatment mandates alerting the entire community that disease-carrying mosquitoes are present. In endemic areas, the World Health Organization recommends that treatment be started within 24 hours after the first symptoms appear. Patients with uncomplicated malaria can be treated on an ambulatory basis (without hospitalization), but patients with severe malaria should be hospitalized. In areas where the disease is not endemic, all malaria patients with malaria should be kept under clinical observation.

Because the first symptoms of malaria — fever, chills, sweats, fatigue, headaches, muscle pains, nausea and vomiting — are also typical of the flu and viral infections, the disease often necessitates laboratory test confirmation. Those afflicted with severe malaria, however, often exhibit more striking and suspicious clinical findings — confusion, coma, focal neurological signs, severe anemia, and respiratory difficulties.

In highly endemic areas (particularly in Africa), the prevalence of asymptomatic infections and resource constraints has led peripheral health facilities to use "presumptive treatment." In other words, patients who suffer from a fever that does not have any obvious cause are presumed to have malaria and are treated for that disease, even without laboratory test. Though this practice is often dictated by necessity, it frequently leads to incorrect diagnoses and unnecessary use of antimalarial drugs. This increases expenses and heightens the risk of selecting for drug-resistant parasites.

Malaria treatment must be tailored to reflect several considerations: the type or species of the infecting parasite; the area where the infection was acquired and its drug-resistance; the patient's clinical status and any pre-existing illness or condition, including pregnancy, drug allergies, or use of other medications.