186 Where There Is No Doctor 2011
MALARIA
Malaria is an infection of the blood that causes chills and high fever. Malaria is
spread by mosquitos. The mosquito sucks up the malaria parasites in the blood of an
infected person and injects them into the next person it bites. People with HIV are twice
as likely to catch malaria.
Signs of malaria:
• The typical attack has 3 stages:
1. It begins with
chills—and often
headache. The person
shivers or shakes for
15 minutes to an hour.
2. Chills are followed by fever,
often 40° or more. The person is
weak, flushed (red skin), and at
times delirious (not in his right
mind). The fever lasts several
hours or days.
3. Finally the person
begins to sweat, and
his temperature goes
down. After an attack,
the person feels weak,
but may feel more or
less OK.
• Usually malaria causes fevers every 2 or 3 days (depending on the kind of malaria),
but in the beginning it may cause fever daily. Also, the fever pattern may not be
regular or typical. For this reason anyone who suffers from unexplained fevers
should have his blood tested for malaria.
• Chronic malaria often causes a large spleen and anemia (see p. 124). For people
with HIV (p. 399) it can cause them to get sick faster.
• In young children, anemia and paleness can begin within a day or two. In children
with malaria affecting the brain (cerebral malaria), seizures (fits) may be followed
by periods of unconsciousness. Also, the palms may show a blue gray color, and
breathing may be rapid and deep. (Note: Children who have not been breastfed are
more likely to get malaria.)
Analysis and treatment:
♦ If you suspect malaria or have repeated fevers, if possible go to a health center for a
blood test. In areas where an especially dangerous type of malaria called falciparum
occurs, seek treatment immediately.
♦ In areas where malaria is common and blood tests are not available, treat any
unexplained high fever as malaria. Take the malaria medicine known to work
best in your area. (See pages 363 to 367 for dosages and information on malaria
medicines.)
♦ If you get better with the medicine, but after several days the fevers start again, you
may need another medicine. Get advice from the nearest health center.
♦ If a person who possibly has malaria begins to have seizures or other signs of
meningitis (p. 185) he may have cerebral malaria. If possible, inject quinine or
artesunate at once (see p. 366).