Tropical malaria (pathogen, symptoms, treatment). Malaria

The fear of contracting an infectious disease is familiar to many travelers to tropical countries. It is in warm regions that most pathogens of severe pathologies in the human body live. One such disease is tropical malaria.

What kind of disease is this, what are the causes and sequence of its occurrence, what are the symptoms and treatment and how to help the body quickly get rid of this terrible disease - read in our publication.

Description of the infection

At the moment, science has identified five types of plasmodia - the causative agents of this pathology.

The disease gets its name from the Italian word malaria. In translation, malaria means bad, spoiled air. Another name for this disease is also known - swamp fever. This is explained by the fact that, along with hepatolienal syndrome (enlarged liver and spleen) and anemia (anemia), paroxysmal fever is considered the main symptom of malaria.

“Every year, malarial fever causes the death of 3 million people, including one million young children.”

The main source of infection for malaria is the bite of a female anopheles mosquito, as male Anopheles mosquitoes feed on the nectar of flowers. Infection occurs when the causative agent of the disease, a strain of malaria, enters the human blood:

  • After being bitten by an Anopheles mosquito.
  • From mother to child during pregnancy and childbirth.
  • Through the use of non-sterile medical instruments with remains of infected blood cells.

People have been suffering from malaria since ancient times. The intermittent fever associated with the disease is described in a Chinese chronicle dating back to 2700 BC. e. The search for the main cause of malaria lasted for millennia, but the first success came to doctors in 1880, when the French doctor Charles Laveran was able to detect plasmodia in the blood of an infected patient.

Malaria has been known since ancient times

In women: pain and inflammation of the ovaries. Fibroma, myoma, fibrocystic mastopathy, inflammation of the adrenal glands, bladder and kidneys develop.

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Features of human infection

Anopheles, the genus of which the malarial mosquito belongs to, lives on almost all continents, with the exception of territories whose climate is too harsh - Antarctica, the Far North and Eastern Siberia.

However, malaria is caused only by those members of the Anopheles genus that live in southern latitudes, since the Plasmodium they carry can only survive in warm climates.

With the help of the image you will learn what a malaria mosquito looks like.

The main carrier of the disease is mosquitoes.

“According to WHO, 90% of cases of infection are registered in Africa.”

Anopheles are blood-sucking insects. Therefore, malaria is considered a disease of vector-borne etiology, that is, an infection transmitted by blood-sucking arthropods.

The life cycle of Anopheles takes place near bodies of water, where the mosquito lays eggs and larvae appear. For this reason, malaria is common in waterlogged and swampy areas. An increase in incidence can be observed during periods of heavy rains that replace drought, as well as as a result of population migration from epidemiologically disadvantaged regions.

The extent of infection is determined by the number of bites from infectious mosquitoes per year. In Southeast Asian countries, this figure rarely reaches one, while residents of tropical Africa can be attacked by insect vectors more than 300 times a year.

The main distribution area of ​​the disease is tropical latitudes.

Like many infectious diseases, epidemics and acute outbreaks of malaria are most often found in endemic areas or in remote areas where people do not have access to necessary medicines.

To reduce the incidence rate, modern epidemiology recommends vaccination of people living in swampy areas where the disease is usually common.

Types of pathology

The development of various forms of malaria is provoked by different types of Plasmodium.

The most common and one of the most dangerous types of disease is tropical malaria. It is characterized by fulminant damage to internal organs, a rapid course of the disease, and a large number of severe complications. Often leads to death. Treatment of the infection is complicated by the strain's resistance to most antimalarials. The causative agent is Plasmodium falciparum.

This type of infection is characterized by remitting fever with significant daily temperature fluctuations, including a critical decrease in its parameters. The attacks are repeated at short intervals. The infection lasts for a year.

As a rule, with tropical malaria, cerebral, septic, algid and renal forms of pathologies develop, as well as malarial coma, increased tendon reflexes and a coma.

Three-day malaria is the result of infection with a strain of Plasmodium vivax. In its course, the three-day form of the pathology is similar to oval malaria, caused by the Plasmodium ovale strain, which is much less common. If attacks of malaria are similar in symptoms, then the methods of treatment are usually the same.

Incubation of strains that cause a three-day form of infection is short and long, depending on the type of plasmodium. The first signs of three-day malaria can appear either after 14 days or after 14 months.

Its course is characterized by multiple relapses and the appearance of complications in the form of hepatitis or nephritis. The pathology responds well to treatment. The total duration of infection is 2 years.

The disease is characterized by the development of complications.

“Representatives of the Negroid race have antimalarial immunity and are resistant to the Plasmodium vivax strain.”

Quartana malaria is a form of infection with a strain of Plasmodium malariae.

Malaria of the four-day type is characterized by a benign course, without enlargement of the spleen and liver and other pathological conditions that usually develop against the background of the disease. The main symptoms of quartana can be quickly eliminated with medication, but it is difficult to completely get rid of malaria.

“Attacks of quaternary malaria can recur even 10-20 years after the symptoms disappear.”

There are known cases of people becoming infected as a result of blood transfusions from donors who had previously had a four-day form of infection.

Another causative agent of the disease, a strain of Plasmodium knowlesi, was recently discovered. This strain of Plasmodium is known to cause the spread of malaria throughout Southeast Asia. So far, epidemiology does not have complete information about the characteristics of this form of the disease.

All types of malaria differ in symptoms, course and prognosis of the disease.

Specifics of the development of infectious pathology

“Several thousand daughter cells can develop from a single sporozoite, enhancing the progression of the disease.”

Subsequent stages of development of the pathogen determine all the pathological processes that characterize the clinical picture of malaria.

  • Tissue schizogony.

The disease has several stages of development.

Moving along with the bloodstream, plasmodia penetrate liver hepatocytes and are divided into forms of fast and slow development. Subsequently, chronic malaria arises from a slowly developing form, causing numerous relapses. After destroying liver cells, plasmodia penetrate blood vessels and attack red blood cells. At this stage, clinical symptoms of malaria do not appear.

  • Erythrocyte schizogony.

Having penetrated into red blood cells, schizonts absorb hemoglobin and increase in size, which causes rupture of the red blood cell and the release of malarial toxins and newly formed cells - merozoites - into the blood. Each merozoite again invades the erythrocyte, starting a repeat cycle of damage. At this stage of malaria, a characteristic clinical picture appears - fever, enlargement of the spleen and liver.

  • Gametocytogony.

The final stage of erythrocyte schizogony, which is characterized by the formation of plasmodium germ cells in the blood vessels of the internal organs of a person. The process is completed in the mosquito’s stomach, where gametocytes enter along with the blood after the bite.

The life cycle of Plasmodium, which causes malaria, is presented in the video below.

The length of the Plasmodium life cycle affects the incubation period of malaria.

Manifestations of symptoms

From the moment an infectious pathogen enters the human body to the stage when the pathological anatomy of malaria appears, a lot of time can pass.

Quadrilateral malaria may appear within 25-42 days.

The pathogenesis of tropical malaria occurs relatively quickly - within 10-20 days.

Three-day malaria has an incubation period of 10 to 21 days. Infection, transmitted by slowly developing forms, becomes acute within 6-12 months.

Oval malaria manifests itself in 11-16 days, when infected with slowly developing forms - from 6 to 18 months.

Depending on the period of development of the disease, the symptoms of malaria differ in intensity and nature of manifestations.

  • Prodromal period.

The first signs of the disease are nonspecific and look more like a viral infection than a serious disease such as malaria. The malaise is accompanied by headaches, deterioration of health, weakness and fatigue, periodically manifested by muscle pain and a feeling of discomfort in the abdomen. The average duration of the period is 3-4 days.

  • Period of primary symptoms.

Occurs when an attack of fever occurs. Paroxysm, characteristic of the acute period, appears in the form of successive stages - chills with a temperature increase from 39 ° C and lasting up to 4 hours, fever with a temperature increase up to 41 ° C and lasting up to 12 hours, increased sweating, lowering the temperature to 35 ° C.

  • Interictal period.

During it, body temperature normalizes and well-being improves.

Symptoms of the disease depend on the stage.

In addition, consequences of malaria such as yellowing of the skin, confusion, drowsiness or insomnia, and anemia are observed.

Features of pathological changes

Depending on the type of disease, malarial paroxysm is determined by specific characteristics. The definition of tertian malaria is a short morning attack occurring every other day. The duration of the attack is up to 8 hours.

The four-day form is characterized by repetition of attacks every two days.

During the tropical form of the disease, short interictal periods (3-4 hours) are observed, and the temperature curve is characterized by a predominance of fever for 40 hours. Often the body of patients cannot withstand such a load, which leads to death.

With a long course of the disease, the plasmoid pigment is absorbed by internal organs.

Complications of malaria in the form of enlarged organs in children can be detected a few days after the onset of the disease by palpation. Children, unlike adults, are not protected by immunity that can resist infection.

In the tropical form of infection, pathological anatomy is observed in the brain, pancreatic and intestinal mucosa, heart and subcutaneous tissue, in the tissues of which stasis is formed. If the patient has had a malarial coma for more than a day, pinpoint hemorrhage and necrobiosis in certain areas of the brain are possible.

The pathomorphology of three-day and four-day malaria is practically the same.

Elimination of the consequences of infection

To diagnose an infectious lesion in medicine, a general blood test, urinalysis, biochemical analysis, as well as clinical, epidemic, anamnestic criteria and laboratory test results are used.

Differential diagnostic tests of patients' blood smears to detect malaria and possible complications are indicated in all patients with symptoms of fever. The procedure is prescribed before the start of treatment.

Often the source of infection becomes donors - carriers of pathogens transmitted through blood.

As soon as the diagnosis is confirmed, the patient is hospitalized in an infectious diseases hospital and treatment is prescribed.

The objectives and goals of treatment measures are summarized in the form of a small manual:

Treatment has a number of main directions.

  • The vital activity of the pathogen in the patient’s body must be interrupted.
  • The development of complications should be prevented.
  • Do everything to save the patient’s life.
  • Ensure prevention of the development of a chronic form of pathology and the occurrence of relapses.
  • Prevent the spread of the infectious agent.
  • Prevent plasmodia from developing resistance to antimalarial drugs.

The basis of medical care for the patient is drugs of hematoschizotropic action (Hingamin, Delagil, Chloridine) and gametocidal action (Delagil). In the acute course of the disease, the patient is provided with complete rest, plenty of fluids, and protection from hypothermia. Additionally, a diet aimed at increasing immunity and general strengthening of the patient’s body, and folk remedies for malaria are recommended.

Even a strong and healthy man finds it difficult to cope with the infection on his own. Without the help of professional doctors, the disease can cause such serious complications as malarial coma, the development of hemorrhagic and convulsive syndrome, malarial algid, cerebral edema, renal failure, urinary retention, hemorrhagic rash, disseminated intravascular coagulation syndrome, etc.

The fight against malaria involves measures to prevent the disease - protection from mosquito bites, vaccination and taking antimalarial drugs.

The disease is very insidious. It must be treated under constant medical supervision. At home, it is impossible to achieve the desired effect; at best, it will be possible to remove the symptoms of the disease. However, this is not enough - to avoid relapse, long-term adequate treatment is needed.

Contents of the article

Malaria(disease synonyms: fever, swamp fever) is an acute infectious protozoal disease, which is caused by several species of Plasmodium, transmitted by mosquitoes of the genus Anopheles and is characterized by primary damage to the system of mononuclear phagocytes and erythrocytes, manifested by attacks of fever, hepatolienal syndrome, hemolytic anemia, and a tendency to relapse.

Historical data of malaria

As an independent disease, malaria was isolated from the mass of febrile diseases by Hippocrates in the 5th century. BC e., however, the systematic study of malaria began only in the 17th century. Thus, in 1640, the doctor Juan del Vego proposed an infusion of cinchona bark to treat malaria.
The first detailed description of the clinical picture of malaria was made in 1696 by the Genevan physician Morton. The Italian researcher G. Lancisi in 1717 linked cases of malaria with the negative effects of evaporation from marshy areas (translated from Italian: Mala aria - spoiled air).

The causative agent of malaria discovered and described in 1880 p. A. Laveran. The role of mosquitoes from the genus Anopheles as carriers of malaria was established in 1887 p. R. Ross. Discoveries in malariology that were made in the 20th century. (Synthesis of effective antimalarial drugs, insecticides, etc.), studies of the epidemiological features of the disease made it possible to develop a global program for the elimination of malaria, adopted at the VIII session of WHO in 1955. The work carried out made it possible to sharply reduce the incidence in the world, however, as a result of the emergence of resistance of certain strains of Plasmodium to With specific treatment and vectors for insecticides, the activity of the main foci of invasion has remained, as evidenced by the increase in the incidence of malaria in recent years, as well as the increase in the import of malaria into non-endemic regions.

Etiology of malaria

The causative agents of malaria belong to the phylum Protozoa, class Sporosoa, family Plasmodiidae, genus Plasmodium. Known four species of Plasmodium falciparum that can cause malaria in humans:
  • P. vivax - three-day malaria,
  • P. ovale - three-day ovalemalaria,
  • P. malariae - four-day malaria,
  • P. falciparum - tropical malaria.
Infection of humans with zoonotic Plasmodium species (about 70 species) is rare. During their life, plasmodia go through a development cycle, which consists of two phases: sporogony- sexual phase in the body of a female Anopheles mosquito and schizogony- asexual phase in the human body.

Sporogony

Mosquitoes of the genus Anopheles become infected by sucking the blood of a patient with malaria or a carrier of Plasmodium. At the same time, male and female sexual forms of plasmodium (micro- and macrogametocytes) enter the mosquito’s stomach, which transform into mature micro- and macrogametes. After the fusion of mature gametes (fertilization), a zygote is formed, which later turns into an ookinete.
The latter penetrates the outer lining of the mosquito's stomach and turns into oocysts. Subsequently, the oocyst grows, its content is divided many times, resulting in the formation of a large number of invasive forms - sporozoites. Sporozoites are concentrated in the salivary glands of the mosquito, where they can be stored for 2 months. The rate of sporogony depends on the type of plasmodium and the ambient temperature. Thus, in P. vivax at the optimal temperature (25 ° C), sporogony lasts 10 days. If the ambient temperature does not exceed 15 ° C, sporogony stops.

Schizogony

Schizogony occurs in the human body and has two phases: tissue (pre- or extra-erythrocyte) and erythrocyte.
Tissue schizogony occurs in hepatocytes, where sporozoites successively form tissue trophozoites, schizonts and an abundance of tissue merozoites (in P. vivax - up to 10 thousand per sporozoite, in P. falciparum - up to 50 thousand). The shortest duration of tissue schizogony is 6 days in P. falciparum, 8 in P. vivax, 9 in P. ovale and 15 days in P. malariae.
It has been proven that in case of four-day and tropical malaria, after the end of tissue schizogony, merozoites completely exit the liver into the blood, and in case of three-day and oval malaria, due to the genetic heterogeneity of sporozoites, tissue schizogony can occur both immediately after inoculation (tachysporozoites) and after 1. 5-2 years after it (brady or hypnozoites), which is the cause of long incubation and distant (real) relapses of the disease.

Susceptibility to infection is high, especially in young children. Carriers of abnormal hemoglobin-S (HbS) are relatively resistant to malaria. Seasonality in regions of temperate and subtropical climates is summer-autumn; in countries with a tropical climate, cases of malaria are recorded throughout the year.

Today, malaria is rarely observed in zones with a temperate climate, but is widespread in the countries of Africa, South America, and Southeast Asia, where stable foci of the disease have formed. In endemic regions, about 1 million children die each year from malaria, which is the leading cause of death, especially at an early age. The degree of spread of malaria in individual endemic regions is characterized by the splenic index (SI) - the ratio of the number of persons with an enlarged spleen to the total number of those examined (%)

Pathomorphologically, significant dystrophic changes in the internal organs are detected. The liver and especially the spleen are significantly enlarged, slate-gray in color due to pigment deposition, and foci of necrosis are detected. Necrobiotic changes and hemorrhages are found in the kidneys, myocardium, adrenal glands and other organs.

After the first attacks, patients develop subicteric sclera and skin, the spleen and liver become enlarged (splenohepatomegaly), which acquire a dense consistency. Blood tests reveal a decrease in the number of red blood cells, hemoglobin, leukopenia with relative lymphocytosis, thrombocytopenia, and an increase in ESR.

In primary malaria, the number of paroxysms can reach 10-14. If the course is favorable, from the 6th-8th attack the body temperature during paroxysms gradually decreases, the liver and spleen contract, the blood picture normalizes and the patient gradually recovers.

Malarial coma develops in malignant forms of the disease, more often in primary tropical malaria. First, against the background of high body temperature, an unbearable headache and repeated vomiting appear.

A disturbance of consciousness develops rapidly and goes through three successive phases:

  1. somnolence - adynamia, drowsiness, sleep inversion, the patient is reluctant to make contact,
  2. stupor - consciousness is sharply inhibited, the patient reacts only to strong stimuli, reflexes are reduced, convulsions, meningeal symptoms are possible,
  3. coma - fainting, reflexes are sharply reduced or not evoked.
Hemoglobinuric fever develops as a result of intravascular hemolysis, more often during treatment of patients with tropical malaria with quinine. This complication begins suddenly: a sharp chill, a rapid increase in body temperature to 40-41 ° C. Soon the urine becomes dark brown, jaundice increases, signs of acute kidney failure, and hyperazotemia appear.

Mortality is high. The patient dies due to manifestations of azotemic coma. More often, hemoglobinuric fever develops in individuals with a genetically determined deficiency of glucose-6-phosphate dehydrogenase, which leads to a decrease in erythrocyte resistance.

Splenic rupture occurs suddenly and is characterized by dagger-like pain in the upper abdomen spreading to the left shoulder and scapula. There is severe pallor, cold sweat, tachycardia, thread-like pulse, and blood pressure decreases. Free fluid appears in the abdominal cavity. If emergency surgery is not performed, patients die from acute blood loss due to hypovolemic shock.

Other possible complications include malarial algid, pulmonary edema, disseminated intravascular coagulation, hemorrhagic syndrome, acute renal failure, etc.

Microscopic examination of blood for malaria should be carried out not only in patients with suspected malaria, but also in all patients with fever of unknown origin.

If in case of tropical and tetrad malaria with the help of hemoschizotropic drugs it is possible to completely free the body from schizonts, then for radical treatment of tetrad malaria and oval malaria a one-time prescription of drugs with a histoschizotropic effect (against extra-erythrocytic schizonts) is required. Primaquine is used at 0.027 g per day (15 mg base) in 1 - C doses for 14 days or quinocide at 30 mg per day for 10 days. This treatment is effective in 97-99% of cases.

Chloridine and primaquine have a gamontotropic effect. For three-day, oval and four-day malaria, gamontotropic treatment is not carried out, since in these forms of malaria the gamonts quickly disappear from the blood after the cessation of erythrocyte schizogony.

Persons traveling to endemic areas are given individual chemoprophylaxis. For this purpose, hemoschizotropic drugs are used, most often khingamine 0.5 g once a week, and in hyperendemic areas - 2 times a week. The drug is prescribed 5 days before entering an endemic zone, during stay in the zone and for 8 weeks after departure. Among the population of endemic areas, chemoprophylaxis begins 1-2 weeks before the appearance of mosquitoes. Chemoprophylaxis of malaria can also be carried out with bigumal (0.1 g per day), amodiaquine (0.3 g once a week), chloridine (0.025-0.05 g once a week), etc. The effectiveness of chemoprophylaxis increases in case of alternating two or three drugs every one to two months. In endemic foci caused by hingamine-resistant strains of malarial plasmodia, for the purpose of individual prevention, fanzidar, metakelfin (chloridine-bsulfalene) are used. Persons arriving from three-day malaria cells are given seasonal relapse prevention with primaquine (0.027 g per day for 14 days) for two years. To protect against mosquito bites, repellents, curtains, etc. are used.

The proposed merozoite, schizont and sporozoite vaccines are at the testing stage.

Part 1

Identifying symptoms of malaria

Severe chills. Another main symptom of malaria is severe, shaking chills, alternating with periods of sweating. Shaky chills are characteristic of many other infectious diseases, but with malaria they are usually more pronounced and intense. The chills are so intense that they cause teeth to chatter and even interfere with sleep. If the chills are particularly severe, it can be confused with a seizure. Typically, chills due to malaria are not relieved by wrapping yourself in a blanket or warm clothing.

Vomiting and diarrhea. Another common secondary symptom of malaria is vomiting and diarrhea, which occurs many times throughout the day. They often accompany each other, which resembles the initial symptoms of food poisoning, as well as some bacterial infections. The main difference is that with food poisoning, vomiting and diarrhea go away after a few days, while with malaria it can last several weeks (depending on treatment).

Recognize late symptoms. If, after the appearance of primary and secondary symptoms, the patient does not seek medical help and does not receive appropriate treatment, which is not always available in developing countries, then the disease progresses and leads to significant damage to the body. In this case, late symptoms of malaria appear and the risk of complications and death increases significantly.

  • Confusion, multiple convulsions, coma and neurological disorders indicate swelling and damage to the brain.
  • Severe anemia, abnormal bleeding, difficulty in deep breathing and respiratory failure indicate severe blood poisoning and infection in the lungs.
  • Jaundice (yellowish skin and eyes) indicates liver damage and dysfunction.
  • Kidney failure.
  • Liver failure.
  • Shock (very low blood pressure).
  • Enlarged spleen.

Part 2

Risk factors
  1. Be very careful when visiting underdeveloped tropical regions. Those who live or visit countries where the disease is common are at greatest risk of contracting malaria. The risk is especially high when visiting poor and underdeveloped tropical countries because they lack the money for mosquito control and other malaria preventive measures.

    Take preventive measures when traveling to high-risk areas. To protect yourself from mosquito bites Anopheles, do not stay outside for too long; wear long sleeve shirts, trousers and cover as much skin as possible with clothing; apply an insect repellent containing diethyltoluamide (N,N-diethylmethylbenzamide) or picaridin; spend time in rooms with windows protected by mosquito nets or with air conditioning; sleep on a bed with a mosquito net treated with an insecticide (such as permethrin). Also, talk to your doctor about taking an anti-malarial drug.

  • Malaria should be considered a deadly disease. If you suspect you have malaria, contact your doctor immediately.
  • The symptoms of malaria are similar to those of many other diseases. It is important to tell your doctor that you have recently returned from an area where there is a risk of malaria, otherwise he may not initially think of it as a possible cause of your symptoms and may not make a diagnosis in time.

Malaria is a disease of the African continent, South America and Southeast Asia. Most cases of infection occur in young children living in West and Central Africa. In these countries, malaria leads among all infectious pathologies and is the main cause of disability and mortality in the population.

Etiology

Malaria mosquitoes are ubiquitous. They breed in stagnant, well-warmed bodies of water, where favorable conditions remain - high humidity and high air temperature. That is why malaria was previously called “swamp fever.” Malaria mosquitoes differ in appearance from other mosquitoes: they are slightly larger, have darker colors and transverse white stripes on their legs. Their bites also differ from ordinary mosquitoes: malaria mosquitoes bite more painfully, the bitten area swells and itches.

Pathogenesis

There are 2 phases in the development of Plasmodium: sporogony in the mosquito body and schizogony in the human body.

In more rare cases, this occurs:

  1. Transplacental route - from sick mother to child,
  2. Blood transfusion route - during blood transfusion,
  3. Infection through contaminated medical instruments.

The infection is characterized by high susceptibility. Residents of the equatorial and subequatorial zones are most susceptible to malaria infection. Malaria is the leading cause of death among young children living in endemic regions.

malaria regions

The incidence is usually recorded in the autumn-summer period, and in hot countries - throughout the year. This is an anthroponosis: only people get sick from malaria.

Immunity after an infection is unstable and type-specific.

Clinic

Malaria has an acute onset and is characterized by fever, chills, malaise, weakness and headache. rises suddenly, the patient shakes. Later, dyspeptic and pain syndromes are added, which are manifested by pain in muscles and joints, nausea, vomiting, diarrhea, hepatosplenomegaly, and convulsions.

Types of malaria

Three-day malaria is characterized by paroxysmal course. The attack lasts 10-12 hours and is conventionally divided into 3 stages: chills, fever and apyrexia.


During the interictal period, body temperature normalizes, patients experience fatigue, weakness, and weakness. The spleen and liver become denser, the skin and sclera become subicteric. A general blood test reveals erythropenia, anemia, leukopenia, and thrombocytopenia. During attacks of malaria, all systems of the body suffer: reproductive, excretory, hematopoietic.

The disease is characterized by a long-term benign course, attacks are repeated every other day.

In children, malaria is very severe. The pathology clinic for children under 5 years of age is unique. Atypical attacks of fever occur without chills and sweating. The child turns pale, his limbs become cold, general cyanosis, convulsions, and vomiting appear. At the beginning of the disease, the body temperature reaches high numbers, and then a persistent low-grade fever persists. Intoxication is often accompanied by severe dyspepsia: diarrhea, abdominal pain. Sick children develop anemia and hepatosplenomegaly, and a hemorrhagic or macular rash appears on the skin.

Tropical malaria is much more severe. The disease is characterized by less severe chills and sweating, but longer bouts of fever with an irregular fever curve. During a fall in body temperature, chilling occurs again, a second rise and a critical decline. Against the background of severe intoxication, patients develop cerebral signs - headache, confusion, convulsions, insomnia, delirium, malarial coma, collapse. The development of toxic hepatitis, respiratory and renal pathology with corresponding symptoms is possible. In children, malaria has all the characteristic features: febrile paroxysms, a special type of fever, hepatosplenomegaly.

Diagnostics

Diagnosis of malaria is based on the characteristic clinical picture and epidemiological data.

Laboratory research methods occupy a leading place in the diagnosis of malaria. Microscopic examination of the patient's blood allows us to determine the number of microbes, as well as their type and type. For this, two types of smears are prepared - thin and thick. A thick drop of blood is examined if malaria is suspected, to identify Plasmodium and determine its sensitivity to antimalarial drugs. The type of pathogen and the stage of its development can be determined by examining a thin drop of blood.

A general blood test in patients with malaria reveals hypochromic anemia, leukocytosis, and thrombocytopenia; in a general urine analysis - hemoglobinuria, hematuria.

PCR is a fast, reliable and reliable method for laboratory diagnosis of malaria. This expensive method is not used for screening, but only as an addition to the main diagnosis.

Serodiagnosis is of auxiliary value. An enzyme immunoassay is performed, during which the presence of specific antibodies in the patient’s blood is determined.

Treatment

All patients with malaria are hospitalized in an infectious diseases hospital.

Etiotropic treatment of malaria: “Hingamin”, “Quinine”, “Chloridine”, “Chloroquine”, “Akrikhin”, sulfonamides, antibiotics - “Tetracycline”, “Doxycycline”.

In addition to etiotropic therapy, symptomatic and pathogenetic treatment is carried out, including detoxification measures, restoration of microcirculation, decongestant therapy, and the fight against hypoxia.

Colloidal, crystalloid, complex salt solutions are administered intravenously,"Reopoliglyukin", isotonic saline solution, "Hemodez". Patients are prescribed Furosemide, Mannitol, Eufillin, and undergo oxygen therapy, hemosorption, and hemodialysis.

To treat complications of malaria, glucocorticosteroids are used - intravenous Prednisolone, Dexamethasone. According to indications, plasma or red blood cells are transfused.

Patients with malaria should strengthen their immunity. It is recommended to add nuts, dried fruits, oranges, and lemons to your daily diet. During illness, it is necessary to avoid eating “heavy” foods, and prefer soups, vegetable salads, and cereals. You should drink as much water as possible. It lowers body temperature and removes toxins from the patient's body.

Persons who have had malaria are monitored by an infectious disease specialist and undergo periodic examinations for plasmodium carriage for 2 years.

Folk remedies will help speed up the healing process:

Timely diagnosis and specific therapy shorten the duration of the disease and prevent the development of severe complications.

Prevention

Preventive measures include timely identification and treatment of patients with malaria and carriers of malarial plasmodium, conducting epidemiological surveillance of endemic regions, extermination of mosquitoes and the use of remedies for their bites.

A vaccine against malaria has not yet been developed. Specific prevention of malaria involves the use of antimalarial drugs. Persons traveling to endemic areas must undergo a course of chemoprophylaxis with Hingamin, Amodiaquine, and Chloridine. For greatest effectiveness, it is recommended to alternate these drugs every month.

You can protect yourself from mosquito bites by using natural or synthetic repellents. They are collective and individual and are available in the form of spray, cream, gel, pencils, candles and spirals.

Mosquitoes are afraid of the smell of tomatoes, valerian, tobacco, basil oil, anise, cedar and eucalyptus. A couple of drops of essential oil are added to vegetable oil and applied to exposed areas of the body.

Video: life cycle of falciparum plasmodium



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