Treating and Preventing Malaria

by National Institute of Health

(Page 4 of 5)

Chloroquine, long considered the medicine of choice for treating malaria, is no longer considered the first-line antimalarial drug in many countries, and national malaria control programs are recommending alternatives. chloroquine-resistant parasites are becoming more widespread, doctors must carefully monitor patients who are treated with it.

If the number of parasites in the blood does not drop significantly during treatment, it may mean the parasites are resistant to the medicine. In addition, if a person develops any fever within a period of weeks to months after apparently successful treatment, the medicine may not have gotten rid of all the parasites. Additional treatment may then be required.

Health care workers should watch patients with P. falciparum malaria closely for potentially severe complications, including anemia, kidney failure, fluid imbalance, or respiratory distress. Brain damage can occur following cerebral malaria, which happens when large numbers of red blood cells containing parasites clog tiny blood vessels in the brain.

Preventing Malaria

Before leaving home, anyone traveling to a malarious area should consult CDC, WHO, a knowledgeable health care provider, an international travel clinic, or a local health department to get advice on what medicines to take before, during, and after the trip. Health risks for malaria vary with the destination and types of activities the traveler will undertake.

A traveler who spends even a single night in a malarious area risks getting infected. The first line of defense is to limit contact with mosquitoes by taking these measures. Use mosquito repellent, keep arms and legs covered, stay indoors beginning at dusk and throughout the night (when Anopheles mosquitoes like to feed), sleep under mosquito netting.

People traveling to malarious areas should also protect themselves by taking antimalarial medicines to prevent infection. CDC has current guidelines on antimalarial drugs.

Anyone who develops fever or other symptoms suggesting malaria, either while taking preventive medicines or after stopping them, should seek medical attention immediately.

Malaria and Pregnancy

Malaria poses a serious threat to both the pregnant woman and her unborn child. Women who live in malarious areas are much more likely to develop acute P. falciparum malaria when they become pregnant. ants born to mothers with malaria often will have low birth weights.

If possible, pregnant women from non-malarious areas should postpone travel to those regions until after their babies are born. gnant women who cannot postpone travel until after delivery should protect themselves from mosquito bites and take antimalarial medicines, if recommended by their doctors.

Prospects of Conquering Malaria

Researchers in the fight against malaria have three major goals: new medicines, better methods of mosquito control, and a vaccine to prevent people from becoming infected.

Medicines

Medicines to treat malaria have been around for thousands of years. erhaps the best known of the traditional remedies is quinine, which is derived from the bark of the cinchona tree. The Spanish learned about quinine from Peruvian Indians in the 1600s, and export of quinine to Europe, and later the United States, was a lucrative business until World War II cut off access to the world supply of cinchona bark. In the 1940s, an intensive research program to find alternatives to quinine gave rise to the manufacture of chloroquine and numerous other chemical compounds that became the forerunners of "modern" antimalarial drugs.

Unfortunately, malaria parasites in many geographic regions have become resistant to alternative drugs, many of which were discovered only in the last 30 years. Even quinine, the long-lived mainstay of malaria treatment, is losing its effectiveness in certain areas.

To address the problem of drug-resistant malaria, scientists are conducting research on the genetic devices that enable Plasmodium parasites to avoid the toxic effects of malaria drugs. Understanding how those devices work should enable scientists to develop new medicines or alter existing ones to make it more difficult for drug resistance to emerge. By knowing how the parasite survives and interacts with people during each distinct phase of its development, researchers also hope to develop drugs that attack the parasite at different stages.

About the Author

NIH is the nation's medical research agency - making important medical discoveries that improve health and save lives. The National Institutes of Health (NIH), a part of the U.S. Department of Health and Human Services, is the primary Federal agency for conducting and supporting medical research.