Tropical malaria (pathogen, symptoms, treatment). Malaria

The fear of contracting an infectious disease is familiar to many travelers to tropical countries. It is in the warm regions that most of the 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 a terrible disease - read in our publication.

Description of the infection

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

The disease got 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 because, along with hepatolienal syndrome (enlargement of the liver and spleen) and anemia (anemia), paroxysm of fever is considered the main symptom of malaria.

"Malarial fever causes 3 million deaths each year, of which one million are young children."

The main source of infection in malaria is the bite of a female malarial mosquito, since anopheles males feed on the nectar of flowers. Infection occurs when the causative agent strain of malaria enters the blood of a person:

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

People have been suffering from malaria since ancient times. The intermittent fever inherent in the disease is described in a Chinese chronicle dated to 2700 BC. e. The search for the root cause of malaria lasted for thousands of years, but the first success came to physicians in 1880, when the French physician Charles Laveran was able to detect plasmodia in the blood of an infected patient.

Malaria has been known since ancient times

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

However, only those members of the Anopheles genus that live in southern latitudes cause malaria, 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.

Mosquitoes are the main carrier of the disease.

"According to the WHO, 90% of infections have been reported in Africa."

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

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

The degree of infection is determined by the number of bites of infectious mosquitoes per year. In the countries of Southeast Asia, 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 most often occur in endemic areas or in remote areas where people do not have access to essential medicines.

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

Varieties of pathology

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

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

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

As a rule, with tropical malaria, cerebral, septic, algidic 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. Downstream, the three-day form of the pathology is similar to oval malaria caused by a strain of Plasmodium ovale, which is much less common. If malaria attacks are similar in symptoms, then the methods of its treatment are usually the same.

The incubation of strains that cause a three-day form of infection is short and long, depending on the variety of Plasmodium. The first signs of malaria of the three-day type can appear both after 14 days and after 14 months.

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

The disease is characterized by the development of complications.

"Negroids have antimalarial immunity and are resistant to the Plasmodium vivax strain."

Four-day malaria (quartana) 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 are quickly eliminated with medication, but it is difficult to completely get rid of malaria.

"Bouts of four-day malaria can recur even 10 to 20 years after its symptoms have been eliminated."

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

Another pathogen, a strain of Plasmodium knowlesi, has recently been discovered. It is known that this strain of Plasmodium causes the spread of malaria in Southeast Asia. So far, epidemiology does not have complete information about the features of this form of the disease.

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

The specifics of the development of infectious pathology

"Several thousand daughter cells can develop from a single sporozoite, enhancing the progress of the disease."

The subsequent stages in the 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 blood flow, Plasmodium penetrate into the hepatocytes of the liver and are divided into forms of rapid and slow development. Subsequently, chronic malaria arises from a slowly developing form, causing numerous relapses. After the liver cells are destroyed, the plasmodia enter the blood vessels and attack the red blood cells. At this stage, the clinical symptoms of malaria do not appear.

Erythrocyte schizogony.

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

Gametocytogonia.

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 stomach of the mosquito, where the gametocytes enter with the blood after the bite.

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

The duration of the life cycle of plasmodia influences the incubation period of malaria.

Manifestations of symptoms

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

Four-day malaria can appear within 25-42 days.

The pathogenesis of tropical malaria occurs relatively quickly - in 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 the intensity and nature of the manifestations.

prodromal period.

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

period of primary symptoms.

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

Intercritical period.

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

Symptoms of the disease depend on the stage.

In addition, there are such consequences of malaria as yellowness of the skin, confusion, drowsiness or insomnia, anemia.

Features of pathological changes

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

The four-day form is characterized by a recurrence 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 the predominance of heat for 40 hours. Often the body of patients can not withstand such a load, which leads to death.

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

It is possible to detect complications of malaria in the form of an increase in organs in children a few days after the onset of the disease with the help of palpation. Children, unlike adults, are not protected by immunity capable of resisting 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 a patient has been in a malarial coma for more than a day, petechial hemorrhage and necrobiosis in certain parts 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 complete blood count, urinalysis, biochemical analysis, as well as clinical, epidemic, anamnestic criteria and laboratory results are used.

Differential diagnostic testing of patients' blood smears for malaria and possible complications is indicated for all patients with febrile symptoms. The procedure is prescribed before the start of treatment.

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

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

The aims and objectives of treatment measures are summarized in the form of a short guide:

Treatment has a number of main directions.

The vital activity of the causative agent of the disease in the patient's body must be interrupted.
The development of complications should be prevented.
Do everything to save the life of the patient.
To ensure the prevention of the development of a chronic form of pathology and the appearance of relapses.
Prevent the spread of the infectious agent.
Prevent Plasmodium from developing resistance to antimalarial drugs.

The basis of medical care for the patient is preparations of hematoschizotropic (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. In addition, a diet is recommended, aimed at increasing immunity and general strengthening of the patient's body, and folk remedies for malaria.

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 severe complications as malarial coma, the development of hemorrhagic and convulsive syndrome, malarial algid, cerebral edema, renal failure, urinary retention, the appearance of a hemorrhagic rash, DIC, etc.

The fight against malaria involves measures to prevent the disease - protection from mosquito bites, vaccination and 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, you need long-term adequate treatment.

The content of the article

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

Historical malaria data

As an independent disease, malaria was isolated from the mass of febrile diseases by Hippocrates in the 5th century BC. BC e., however, the systematic study of malaria began only in the 17th century. So, in 1640, the doctor Juan del Vego proposed an infusion of cinchona bark for the treatment of malaria.
For the first time, a detailed description of the clinical picture of malaria was made in 1696 by the Genevan physician Morton. The Italian researcher G. Lancisi in 1717 connected cases of malaria with the negative impact of fumes 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 by p. R. Ross. Discovery in malariology, which were made in the XX century. (Synthesis of effective antimalarial drugs, insecticides, etc.), studies of the epidemiological characteristics of the disease made it possible to develop a global program for the eradication of malaria, adopted at the VIII session of the WHO in 1955. 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 growth in the importation of malaria to non-endemic regions.

Etiology of malaria

The causative agents of malaria belong to the Protozoa phylum, class Sporosoa, family Plasmodiidae, genus Plasmodium. Known four types of malarial plasmodium 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.

Human infection with zoonotic Plasmodium species (about 70 species) is rare. In the process of life, plasmodia go through a development cycle, which consists of two phases: sporogony- the sexual phase in the body of the 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 malaria patient or carrier of Plasmodium. At the same time, male and female sexual forms of plasmodium (micro- and macrogametocytes) enter the stomach of the mosquito, which turn into mature micro- and macrogametes. After the fusion of mature gametes (fertilization), a zygote is formed, which later turns into an ookinet.
The latter penetrates the outer shell of the mosquito's stomach and turns into an oocyst. In the future, the oocyst grows, its content divides many times, resulting in the formation of a large number of invasive forms - sporozoites. The sporozoites are concentrated in the salivary glands of the mosquito, where they can be stored for up to 2 months. The speed of sporogony depends on the type of plasmodia and the ambient temperature. So, in P. vivax at the optimum temperature (25 ° C), sporogony lasts 10 days. If the ambient temperature does not exceed 15 ° C, sporogony stops.

schizogony

Shizogony occurs in the human body and has two phases: tissue (pre-, or extra-erythrocyte) and erythrocyte.
tissue schizogony occurs in hepatocytes, where tissue trophozoites, schizonts and an abundance of tissue merozoites are successively formed from sporozoites (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 four-day and tropical malaria, after the end of tissue schizogony, merozoites completely exit the liver into the blood, and in three-day and oval malaria, due to 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 prolonged incubation and distant (real) relapses of the disease.

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

Today, malaria is rarely observed in temperate zones, but is widespread in Africa, South America, and Southeast Asia, where stable foci of the disease have formed. In endemic regions, about 1 million children die every year from malaria, which is the main cause of their death, especially at an early age. The degree of spread of malaria in certain 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 (%)

Pathologically, significant dystrophic changes in the internal organs are detected. The liver and, especially the spleen, are significantly enlarged, slate-gray in color due to the deposition of pigment, foci of necrosis are found. 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, enlarge the spleen and liver (splenohepatomegaly), which acquire a dense texture. A blood test reveals a decrease in the number of erythrocytes, hemoglobin, leukopenia with relative lymphocytosis, thrombocytopenia, an increase in ESR.

In primary malaria, the number of paroxysms can reach 10-14. If the course is favorable, from the 6-8th attack, the body temperature during paroxysms gradually decreases, the liver and spleen contract, the blood picture returns to normal 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, repeated vomiting appear.

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

doubt - adynamia, drowsiness, sleep inversion, the patient is reluctant to make contact,
stupor - consciousness is sharply inhibited, the patient reacts only to strong stimuli, reflexes are reduced, convulsions, meningeal symptoms are possible,
coma - fainting, reflexes are sharply reduced or not caused.

Hemoglobinuric fever develops as a result of intravascular hemolysis, more often during the 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, hyperazotemia appear.

Lethality is high. The patient dies with 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.

The rupture of the spleen occurs suddenly and is characterized by dagger pain in the upper abdomen with spread to the left shoulder and shoulder blade. There is a sharp pallor, cold sweat, tachycardia, thready pulse, blood pressure decreases. Free fluid appears in the abdominal cavity. If emergency surgery is not performed, patients die from acute blood loss against the background of hypovolemic shock.

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

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

If in tropical and four-day malaria with the help of hemoschizotropic drugs it is possible to completely free the body from schizonts, then for the radical treatment of three-day and oval malaria, a simultaneous prescription of drugs with a histoschizotropic effect (against extra-erythrocyte schizonts) is required. Apply primaquine at 0.027 g per day (15 mg of base) in 1 - C intake for 14 days or quinocide at 30 mg per day for 10 days. Such treatment is effective in 97-99% of cases.

Chloridin, primaquine have a gamototropic effect. With 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 undergo individual chemoprophylaxis. For this purpose, hemoschizotropic drugs are used, more often hingamin 0.5 g once a week, and in hyperendemic areas - 2 times a week. The drug is prescribed 5 days before entering the endemic zone, during the stay in the zone and within 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 1 time per week), chloridine (0.025-0.05 g 1 time per week), etc. The effectiveness of chemoprophylaxis increases in the case of alternating two or three drugs every one to two months. In endemic foci caused by chingamino-resistant strains of malarial plasmodium, for the purpose of individual prevention, fanzidar, metakelfin (chloridin-Lsulfalen) are used. Persons arriving from three-day malaria cells are given seasonal prophylaxis of relapses with primaquine (0.027 g per day for 14 days) for two years. To protect against mosquito bites, repellents, curtains and the like are used.

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

Part 1

Recognizing the symptoms of malaria

Strong chill. Another main symptom of malaria is severe shaking chills, which alternate with periods of sweating. Terrific chills are also characteristic of many other infectious diseases, but with malaria it is usually more pronounced and intense. The chill is so intense that it causes teeth to chatter and even interferes with sleep. With a particularly severe chill, it can be confused with a seizure. Typically, the chills of malaria do not get better by wrapping yourself in a blanket or warm clothes.

Vomiting and diarrhea. Another common secondary symptom of malaria is vomiting and diarrhea, which occur many times throughout the day. They often coexist, reminiscent of the initial symptoms of food poisoning, as well as some bacterial infections. The main difference is that with food poisoning, vomiting and diarrhea resolve after a few days, while with malaria they can last for several weeks (depending on treatment).

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

Clouding of consciousness, multiple convulsions, coma and neurological disorders indicate swelling and brain damage.
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.
Renal failure.
Liver failure.
Shock (very low blood pressure).
Enlarged spleen.

Part 2

Risk factors

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 do not have the money for mosquito control and other preventive measures against malaria.

When traveling to high-risk regions, take preventive measures. To protect yourself from mosquito bites Anopheles, do not stay too long outdoors; wear long-sleeved shirts, trousers and cover as much of the skin as possible; apply insect repellant 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 antimalarial drug.

Malaria should be regarded as 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 very important to let your doctor know that you have recently returned from an area where there is a risk of malaria, otherwise he may not think of it as a possible cause of your symptoms at first and may not make a timely diagnosis.

Malaria is a disease of the African continent, South America and Southeast Asia. Most of the cases of infection are recorded 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 death of the population.

Etiology

Malaria mosquitoes are ubiquitous. They breed in stagnant, well-heated water bodies, where favorable conditions are preserved - high humidity and high air temperature. That is why malaria used to be called "swamp fever". Malaria mosquitoes are outwardly different from other mosquitoes: they are slightly larger, have darker colors and transverse white stripes on their legs. Their bites also differ from ordinary mosquitoes: malarial mosquitoes bite more painfully, the bitten place swells and itches.

Pathogenesis

In the development of plasmodium, 2 phases are distinguished: sporogony in the mosquito body and schizogony in the human body.

In more rare cases, there is:

Transplacental route - from a sick mother to a child,
Hemotransfusion route - during blood transfusion,
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 for young children living in endemic regions.

malaria distribution regions

The incidence is usually recorded in the autumn-summer period, and in hot countries - during the year. This is anthroponosis: only humans get malaria.

Immunity after an infection is unstable, type-specific.

Clinic

Malaria has an acute onset and presents with fever, chills, malaise, weakness, and headache. rises suddenly, the patient shakes. In the future, dyspeptic and pain syndromes are added, which are manifested by muscle and joint pain, nausea, vomiting, diarrhea, hepatosplenomegaly, and convulsions.

Types of malaria

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

In the interictal period, body temperature returns to normal, patients experience fatigue, fatigue, weakness. The spleen and liver thicken, the skin and sclera become subicteric. In the general blood test, erythropenia, anemia, leukopenia, and thrombocytopenia are detected. Against the background of attacks of malaria, all body systems suffer: sexual, excretory, hematopoietic.

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

In children, malaria is very severe. The clinic of pathology in children under the age of 5 years is distinguished by its originality. There are atypical attacks of fever 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 persistent low-grade fever persists. Intoxication is often accompanied by severe dyspepsia: diarrhea, abdominal pain. Affected children develop anemia and hepatosplenomegaly, and a hemorrhagic or patchy rash appears on the skin.

Tropical malaria is much more severe. The disease is characterized by less pronounced chills and sweating, but more prolonged bouts of fever with an irregular febrile curve. During the fall in body temperature, chilling reappears, 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. Perhaps the development of toxic hepatitis, respiratory and renal pathology with the corresponding symptoms. In children, malaria has all the characteristic features: febrile paroxysms, a special nature of fever, hepatosplenomegaly.

Diagnostics

Diagnosis of malaria is based on a 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 you to determine the number of microbes, as well as their genus and type. For this, two types of smear are prepared - thin and thick. The study of a thick drop of blood is carried out if malaria is suspected, to identify Plasmodium and determine its sensitivity to antimalarial drugs. To determine the type of pathogen and the stage of its development allows the study of a thin drop of blood.

In the general analysis of blood in patients with malaria, hypochromic anemia, leukocytosis, and thrombocytopenia are detected; in the general analysis of urine - hemoglobinuria, hematuria.

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

Serodiagnosis is of secondary importance. Enzyme immunoassay is carried out, during which the presence of specific antibodies in the patient's blood is determined.

Treatment

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

Etiotropic treatment of malaria: "Hingamine", "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 saline solutions are administered intravenously,"Reopoliglyukin", isotonic saline solution, "Hemodez". Patients are prescribed "Furosemide", "Mannitol", "Eufillin", carry out oxygen therapy, hemosorption, hemodialysis.

For the treatment of complications of malaria, glucocorticosteroids are used - intravenously "Prednisolone", "Dexamethasone". According to the indications, plasma or erythrocyte mass is transfused.

Patients with malaria should strengthen the immune system. It is recommended to add nuts, dried fruits, oranges, lemons to the daily diet. It is necessary during the illness to exclude the use of "heavy" food, and it is better to give preference to soups, vegetable salads, 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 registered with an infectious disease doctor 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 the timely detection and treatment of patients with malaria and carriers of malarial plasmodium, epidemiological surveillance of endemic regions, the destruction of mosquitoes and the use of remedies for their bites.

There is currently no vaccine for malaria. Specific prevention of malaria is the use of antimalarial drugs. Persons traveling to endemic areas should undergo a course of chemoprophylaxis with Khingamine, Amodiakhin, Chloridine. For maximum effectiveness, these drugs are recommended to alternate every month.

Using natural or synthetic repellents, you can protect yourself from mosquito bites. They are collective and individual and are available in the form of a 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.