Malaria is an infectious disease that is caused by the plasmodium parasite, of which there are four species. The parasite is carried by mosquitoes and can be transferred to humans who are bitten by the infected mosquitoes. Typical symptoms of malaria include fevers, headaches, and vomiting, and the disease may also lead to jaundice and seizures. The first symptoms usually appear within 10 to 15 days after infection. In rare cases, malaria can be fatal. Around the world, 216 million cases were diagnosed in 2016 and the disease resulted in approximately 445,000 to 730,000 deaths. In the United States, an estimated 20,000 cases are diagnosed each year, most of them in travelers who have recently returned from regions with a high prevalence of the illness. Malaria can be prevented by taking oral antimalarial medications and using nets, insect repellents, and other methods of mosquito control. Blood tests are needed to diagnose malaria. If prompt treatment is received, the disease is generally short in duration.
Certain risk factors can place people at an increased risk of contracting malaria. Let's examine some of them in detail.
1 - Living In or Visiting Malaria-Prone Areas
Malaria has been identified in more than 100 countries. Regions with active malaria are generally concentrated around the equator in tropical and subtropical countries. More than 90 percent of malaria diagnoses and deaths occur in Africa, and the disease is also found in Haiti, the Dominican Republic, India, the Philippines, Mexico, Brazil, China, and Indonesia. Living in or visiting a country where malaria is endemic increases the probability that a person may be bitten by an infected mosquito. At-risk individuals should take as many precautions as possible. Wearing long sleeved shirts, long pants, hats, and other protective clothing can reduce the risk of mosquito bites. Insect repellent should be sprayed on skin and over the clothes, and pants should be tucked into socks. Avoid leaving windows and doors open, remove standing water, and use mosquito nets over beds while sleeping. If possible, try to remain indoors between dusk and dawn when mosquitoes can be particularly active. Travelers to malaria-prone regions should consult their doctor at least six to eight weeks before departure as they will need to begin a regimen of anti-malarial drugs and continue this during their trip.
2 - Being Pregnant
Pregnancy puts extra strain on the heart, lungs, and immune system, making pregnant women more likely to contract malaria and less able to fight it than those who are not pregnant. The disease can also affect the health of the unborn baby. In particular, pregnant women are strongly advised not to travel to malaria-prone regions. While anti-malarial drugs exist, many of these are not safe to use during pregnancy. Others that are safe may only provide minimal protection and come with side effects that may be undesirable. Some pregnant women may not be suitable candidates for any of the available antimalarial drugs, and no antimalarial can provide 100 percent protection from the disease.
3 - Having a Blood Transfusion
Although rare, there have been reported cases of patients contracting malaria after receiving a blood transfusion. Centers for Disease Control records indicate that 97 cases of malaria were contracted through blood transfusions in the United States from 1963 to 2012. To minimize the risks of transfusion-related infection, American guidelines for potential blood donors state that those who have traveled to an area where malaria is present cannot donate blood until at least one year after they return to the United States. Persons who have resided in countries where malaria exists cannot donate blood until they have lived in the United States for three years. Anyone who has received a malaria diagnosis must be free of symptoms for a minimum of three years before they can become eligible to donate blood. If you receive a blood transfusion and feel at all unwell afterwards, speak to your doctor.
4 - Being Diabetic or Obese
A Swedish study conducted in 2017 found that individuals with diabetes or obesity face a higher risk of severe malaria than those who do not have either condition. In particular, obesity alone was linked to increased severity of the disease, and this increase was magnified by the presence of high blood pressure, high cholesterol, and diabetes. Travelers with these and other chronic conditions or weakened immune systems need to be disciplined about taking proper mosquito control measures and adhering to anti-malarial medication schedules. Dosages of anti-malarial medications may need to be adjusted for these patient populations.