National Malaria Day | How much do you know about infectious diseases that claim the lives of millions of people every year?

April 26, 2024 is the 17th "National Malaria Day" in my country. In 2020, my country achieved the goal of eliminating malaria and passed the certification of the World Health Organization in 2021, achieving milestone results in disease prevention and control.

01 What are the dangers of malaria?

Malaria is an infectious disease that seriously endangers human health. More than 1 million people die from malaria every year. If malignant malaria is not treated in time or is not treated properly, it will develop into severe malaria. The patient may experience clinical manifestations such as coma and renal failure, and in severe cases, it may cause death. The mortality rate of malignant malaria is high.

02 What is malaria?

Malaria is a parasitic disease caused by human Plasmodium infection. It is commonly known as "shaking the body" or "fever and cold disease". It is the most common parasitic disease that endangers human health in summer and autumn and is a statutory Class B infectious disease. There are four types of malaria: Plasmodium vivax, Plasmodium falciparum, Plasmodium malariae and Plasmodium ovale[1]. In my country, the main malaria parasites that infect humans are Plasmodium vivax and Plasmodium falciparum, while the other two are relatively rare.

03 How do malaria parasites reproduce and spread?

The development of malarial parasites is asexual, and can be divided into the extra-erythrocytic (i.e., intra-hepatocyte) schizont stage and the intra-erythrocytic schizont stage. The intra-erythrocytic schizonts develop into sporozoites and male and female gametes, and at the same time cause the red blood cells to disintegrate and cause disease [2]. The main way of transmission of malaria is mosquito bites. Among the many mosquito species, only the "Anopheles sinensis" in our province can transmit malaria, and it can only transmit Plasmodium vivax malaria, not other types of malaria. In addition, transfusion of blood or blood products containing malarial parasites and organ transplantation can also cause malaria infection. Malaria is not transmitted through daily contact, such as sitting with a malaria patient or eating together.

04 What are the symptoms of malaria?

Typical symptoms of malaria include fever, chills, and sweating. Multiple attacks may be accompanied by splenomegaly and anemia. In severe cases, coma, convulsions, and multiple organ failure may occur. In particular, patients with malignant malaria are often in danger of death if they are not diagnosed and treated in time[3].

After being infected with Plasmodium, what is the first thing that patients or their families can do to reduce the damage caused by the parasite?

After infection with malarial parasites, they mainly reproduce in large numbers in red blood cells, causing them to rupture and release hemoglobin, which can clog the renal tubules, causing kidney damage and even renal failure. In addition to seeking medical attention in a timely manner, patients should drink plenty of water to promote the excretion of hemoglobin in the urine. If baking soda is available at home, it can be taken orally (3g each time, 3 to 4 times a day) [4] to reduce kidney damage.

05 What should you pay attention to after traveling or working in a malaria-endemic area?

1. Before traveling to a malaria-endemic area: You should understand the malaria epidemic situation at the destination and make personal protection preparations.

2. During malaria-endemic areas: Anti-mosquito measures include the use of mosquito nets, screen doors, screen windows, mosquito repellents, wearing long-sleeved clothing and other personal anti-mosquito measures. For long-term residents, it is recommended to use mosquito nets treated with long-lasting insecticides and indoor residual spraying of insecticides, and to strengthen environmental management in residential areas to reduce mosquito breeding[5].

3. After returning to China: After returning to China, if you experience symptoms such as chills, fever, sweating, etc., you should seek medical attention in time. You should actively inform your travel history when entering the country and seeking medical treatment, and take antimalarial drugs throughout the entire process and in sufficient amounts as prescribed by the doctor.

06 What are the drugs for treating malaria?

Chinese scientist Tu Youyou won the 2015 Nobel Prize in Physiology or Medicine for discovering and extracting artemisinin for the treatment of malaria. Currently, there are two main categories of artemisinin-based oral drugs, including artesunate and artemether injections and artemisinin-based compound oral drugs[6].

(1) Artesunate injection: It is a water-soluble derivative of artemisinin. After intravenous injection, it is rapidly metabolized into dihydroartemisinin in the liver and exerts an insecticidal effect. This drug has been recommended by the WHO as the first choice for the treatment of severe malaria.

(2) Artemether injection: It is a fat-soluble derivative of artemisinin. After intramuscular injection, it is also metabolized by the liver to dihydroartemisinin and exerts an insecticidal effect. This drug has been recommended by the WHO as one of the alternative treatments for severe malaria in areas where artemether injection is not available.

(3) Artemisinin-based combination or combination therapy: my country’s “Guidelines for the Use of Antimalarial Drugs” recommends dihydroartemisinin/piperaquine phosphate tablets, artesunate/amodiaquine tablets, and artemisinin/piperaquine tablets[7].

07 What should you pay attention to when treating malaria?

When treating malaria patients, you must take the full course of medication and the full amount according to the doctor's instructions or instructions. You cannot stop taking the medication if you think the treatment is effective. Relapses may occur if the treatment is not thorough. Severe malaria should be treated in hospital.

In short, if you have typical symptoms of malaria or suspect you have malaria, you should go to the hospital for diagnosis immediately. When you see the doctor, you should remind the doctor that you have been to a malaria-endemic area and may have malaria.

References:

1. Yang Yuejie. Study on severe cases of imported falciparum malaria[J]. Chinese Journal of Tropical Medicine, 2018, 18(7): 662-665.

2. He Zhanying, Wu Wenting, Wang Xiaomei, et al. Analysis of characteristics and risk factors of imported malaria deaths in Beijing[J]. Acta Parasitologica Sinica, 2021, 28(2): 67-70, 75.

3. Zhang Qian, Geng Qibin, Sun Junling, et al. Analysis of epidemiological characteristics of malaria deaths in China from 2005 to 2014[J]. Chinese Journal of Preventive Medicine, 2016, 50(4): 302-305.

4. Li Xuxiang. Several proven prescriptions for treating malaria[J]. Chinese Journal of Folk Remedies, 2009, 17(06): 63. 2009.06.066.

5. Li Renqing, Wang Xiaomei, Sun Yulan, et al. Application of metagenomics next-generation sequencing technology in the diagnosis of imported malaria[J]. Chinese Journal of Parasitology and Parasitic Diseases, 2019, 37(6): 727-729.

6. Zhou Shuisen. Problems in the use of antimalarial drugs in my country and their impact on malaria elimination[J]. Chinese Journal of Tropical Medicine, 2018,18(7): 640-642.

7. Li Lanjuan. Guidelines for diagnosis and treatment of malaria[J]. Chinese Journal of Tropical Medicine, 2022, 22 (08): 695-702. 2022.08.01.

8. Drug instructions for Cotaifu (Dihydroartemisinin Piperaquine Tablets), Baker Norton (Zhejiang) Pharmaceutical Co., Ltd., National Medicine Standard No. H20153107, Approval Date: June 6, 2007, Modification Date: December 1, 2015.