By Dr Manigandan Chandrasekaran
Malaria is a parasitic infection which presents with high fever in children in hot, tropical countries like India. Malaria can be a life-threatening illness in children. Malaria is caused by a parasite called plasmodium, carried by mosquitoes, which pick it up by biting someone who already has the disease. Malaria is then passed to other people when the mosquitoes bite them. There are other ways to contract malaria, which includes from a pregnant mother to her unborn baby or through blood transfusion and organ donation, but they are rare.
What are the signs and symptoms?
In children, malaria presents with spikes of high grade fever, usually more than 101°F. Fever is commonly associated with chills. Other symptoms of malaria can include irritability and drowsiness, with poor appetite and trouble sleeping. Sometimes, there may be a pattern of symptoms — chills, fever, sweating, which may repeat every two or three days, depending on which malaria parasite is causing the infection.
Less common symptoms include headache, nausea, aches and pains all over the body. If malaria affects the brain, someone might have fits (seizures) or loss of consciousness. The kidneys can also be affected in some cases.
How do you diagnose malaria?
Malaria is suspected if high grade fever with typical symptoms are present in children. Sometimes doctors suspect it based on high grade fever with no obvious cause even if typical symptoms are not there. A blood sample will be taken to be checked under a microscope for malaria parasites, which are seen inside infected red blood cells.
How is malaria treated?
It is treated with anti-malarial drugs given orally or by injection. Depending on the parasite causing the malaria or the seriousness of the presentation, children are treated as an outpatient over a few days or in the hospital with injected medicine.
Doctors also watch for signs of dehydration, convulsions, anemia, and other complications that can affect the brain, kidneys, or spleen. A child may need fluids, blood transfusions, and help with breathing. If diagnosed early and treated, malaria can usually be cured without any complications. The disease can be fatal without treatment, especially in children who are malnourished.
How can we prevent malaria in children?
Health authorities try to prevent it by using mosquito-control programmes aimed at killing mosquitoes that carry the disease.
At home, you can install window screens, use insect repellents and place mosquito netting over beds. Advise children to wear long pants, long sleeves and thick and high socks to dissuade mosquitoes. Try light coloured clothes for your children as mosquitoes find them less attractive. Use air-conditioning or a fan in the room to deter mosquitoes. Stagnant water is a big source for mosquitoes, so ensure there is none around your home.
Mosquitoes capable of transmitting malaria infection usually feed at night, so diminish exposure between dusk and dawn. They tend to hide in vacant spaces like below the bed, behind cupboards, in dark corners, etc, hence use mosquito killing bats in those spaces to ensure there are none in the room when your children go to bed.
Malaria in pregnancy can be deleterious to the unborn baby. It can cause severe anemia in a mother, or low birth weight, even death in unborn babies. The preventive strategies are mosquito avoidance and preventive drug therapy, as necessary.
Bed-netting, enhanced with insecticides, are now available and have successfully lowered the number of malaria deaths. Recently, after several years of research, the malaria vaccine (called RTS,S) was launched in Africa. Hopefully, this will be available widely across the world soon.
Finally, when malaria affects malnourished children, they tend to suffer more with severe complications compared to healthy children. It is important to take care of adequate nutrition in your children.
(The writer is a consultant paediatrician and neonatologist at Cloudnine Group of Hospitals, Chennai.)