Are There Effective Treatments For Malaria?
Key takeaways:
Malaria is a disease spread by parasites found in female Anopheles mosquitoes in certain areas with warm climates, like sub-Saharan Africa.
Different medications — such as chloroquine, artemether-lumefantrine (Coartem), and artesunate — may be used to treat malaria.
In October 2021, the World Health Organization (WHO) recommended a malaria vaccine for young children in areas where malaria is common. This is the world’s first malaria vaccine.
When traveling to areas where malaria is present, talk to your healthcare provider about effective prevention strategies like avoiding mosquito bites and taking preventive medications.
Many people who are planning trips to certain destinations like sub-Saharan Africa, South Asia, or parts of Oceania may come across travel recommendations for malaria. But what exactly is malaria? And does the disease only exist in tropical climates outside of the U.S.? Although malaria was declared to be eliminated in the U.S. in 1951, can people living in the U.S. still become infected?
Read on to learn more about malaria, how the disease is treated, and different ways to protect yourself from becoming infected while traveling abroad.
What is malaria?
Malaria is a serious disease spread by parasites in certain female mosquitoes known as Anopheles mosquitoes. There are five kinds of parasites that cause malaria.
These malaria-causing parasites spread when a mosquito bites an infected person and then bites a non-infected person. Malaria parasites survive in the blood cells of people who are infected and can also spread through:
Blood transfusions
Sharing contaminated needles or syringes
Organ transplants
An infected mother to child during delivery
People infected with malaria don’t usually develop symptoms until about 10 days to 4 weeks after being infected. But for some people, symptoms may not occur until much later on — even as late as 1 year after being infected.
The most common symptoms of malaria include:
Fever
Shaking chills
Tiredness
Headache
Muscle aches
Nausea and vomiting
Diarrhea
Yellowing of the skin and eyes (jaundice)
In very severe cases, untreated malaria can cause kidney failure, seizures, coma, and even death. Fortunately, malaria cannot be spread through close contact — unlike the common cold or flu.
How is it diagnosed?
It’s hard to tell if someone has malaria by only looking at symptoms. Fever and other symptoms may resemble other conditions, so tests are needed to make a diagnosis.
The best way of diagnosing malaria is through a laboratory test in which blood is spread out — called a blood smear — and examined under a microscope to detect malaria parasites. But, this type of test is not available in some parts of the world.
Rapid diagnostic tests that provide results in 15 to 20 minutes can also be used to diagnose malaria, and they are widely used in many countries. These tests are used to identify malaria antigens, which are specific molecules known to exist in malaria parasites. Although blood smears are the preferred way to detect malaria, antigen detection tests may be helpful in areas where microscopic diagnosis is not readily available.
Other tests are also available that can determine if someone previously had malaria.
How many people does it still affect?
In recent years, according to the World Health Organization (WHO), over 200 million people are affected by malaria every year. Of those infected, over 400,000 people die every year — the greatest number of deaths occur in children under 5 years old living in sub-Saharan Africa.
Compared to different parts of the world with warmer, tropical climates, there are approximately 2,000 cases of malaria that are diagnosed in the U.S. every year. Although malaria has been eradicated in the U.S., people can become infected when traveling internationally.
According to the Centers for Disease Control and Prevention (CDC), almost all of these cases occurred in people returning from other parts of the world where malaria is present.
How can I prevent malaria?
The majority of malaria cases diagnosed in the U.S. occur in people traveling to areas where malaria is more common — such as sub-Saharan Africa. Because of this, the CDC recommends taking the following precautions when traveling:
Find out if your destination has high malaria transmission.
Determine your malaria risk based on different things, such as activities that you’ll be doing while traveling and other health conditions you might have (e.g., pregnancy).
Know the symptoms of malaria and seek medical help right away if you have a fever or experience flu-like symptoms.
Prevent yourself from mosquito bites by using mosquito repellents and bed nets.
Discuss with your provider the different medications used to prevent malaria.
Malaria precautions should always be taken when possible, but medications can also be used to prevent malaria. Medications used to treat malaria are discussed below, but medications used to prevent malaria include:
Atovaquone-proguanil (Malarone)
Chloroquine phosphate (Aralen)
Hydroxychloroquine (Plaquenil)
Depending on the medication, your healthcare provider may recommend that you start taking the medication days to weeks before traveling. Although the frequency and duration can change depending on the preventative medication, you will also need to take the medication during and after your travels.
Is there a malaria vaccine?
As of October 2021, yes. This is the world’s first malaria vaccine.
The World Health Organization (WHO) recently recommended a malaria vaccine for children at high risk of getting the illness. In a statement, they said that the vaccine should be used in areas where malaria is common, like sub-Saharan Africa.
The vaccine is called Mosquirix (RTS,S/AS01). It’s injected into the muscle, and four doses are needed. It can be given to children between 5 months and 5 years old. GlaxoSmithKline, a British pharmaceutical company, has been working on this vaccine for more than 30 years.
The WHO made this recommendation after looking at Mosquirix’s safety and effectiveness data. So far, over 2 million doses of the vaccine have been given in three African countries: Ghana, Kenya, and Malawi.
After giving these doses, the WHO considers Mosquirix to be “generally safe.” The most common side effects are injection site pain and fever. It’s about 30% effective against severe illness caused by malaria. Even though this rate may seem low, some experts believe it could save the lives of more than 20,000 children every year.
Mosquirix only works against one type of malaria caused by a parasite called Plasmodium falciparum. This germ causes the most deadly type of malaria. The vaccine also isn’t a replacement for bed nets that are meant to protect children from mosquitoes while sleeping.
What treatment options are currently available for malaria?
After a person is diagnosed with malaria — either through a microscopic test or rapid diagnostic test — treatment should be started right away to prevent future complications.
The recommended treatment will depend on where the person got infected — different malaria parasites may respond better to some medications than others.
Aside from where you became infected with malaria, your healthcare provider will also consider other things to determine the best treatment, including:
Your age
Whether you are pregnant
How severe your symptoms are
Previous medications used for malaria prevention or treatment
Other health conditions
Malaria symptoms can range from mild or uncomplicated to severe. Malaria is considered severe if people experience any of the following symptoms:
Loss of consciousness
Overall weakness
Seizures
Low blood sugar
Not enough healthy red blood cells (anemia)
Significant bleeding
Kidney damage
Difficulty breathing
What’s the best treatment for uncomplicated malaria?
The best treatment for malaria depends on the specific malaria parasite and how severe the symptoms are.
The CDC recommends using chloroquine phosphate (Aralen) or hydroxychloroquine (Plaquenil) to treat most people with uncomplicated malaria — meaning they do not have the severe symptoms listed above — who are infected with parasites that will respond to these medications. Chloroquine and hydroxychloroquine work by killing the parasites that cause malaria. The most common side effects that people experience when taking these medications include:
Stomach upset
Dizziness
Headache
Itching
For more resistant strains of malaria parasites, the CDC and WHO recommend using artemisinin-based combination therapies (ACTs). These combinations of medications work in different ways to kill the malaria-causing parasite.
Artemether-lumefantrine (Coartem) is a recommended ACT in the U.S. and can cause side effects such as:
Headache
Dizziness
Nausea and vomiting
Loss of appetite
Tiredness
Muscle aches
Sleep disturbances
Other ACTs may also be used if someone is being treated for malaria in another country.
If ACTs aren’t an option or shouldn’t be used, other medications are available. Many of the same medications used to prevent malaria can also be used to treat malaria, and they’re occasionally used in combination with one another.
What’s the best treatment for severe malaria?
People with severe malaria should be treated with an intravenous (IV) medication that’s administered directly into their bloodstream. Both the CDC and WHO recommend IV artesunate as a first-choice medication for severe malaria.
If this isn’t available, artemether-lumefantrine or atovaquone-proguanil would be considered next.
The bottom line
Malaria is a serious disease spread by Anopheles mosquitoes. Although malaria has been largely eliminated in the U.S., people traveling to areas where malaria is present can become infected, especially if they don’t take appropriate precautions.
Before traveling to areas where malaria is more common, make sure to discuss with your healthcare provider about strategies to avoid mosquito bites as well as different medications that can be used to prevent malaria. The discovery of certain medications — such as chloroquine and artesunate — as well as public health efforts from the CDC and WHO have been essential in tackling malaria both within the U.S. and worldwide.
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