Malaria Malaria parasite connecting to a red blood cell Pronunciation / m ə ˈ l ɛər i ə / Specialty Infectious disease Symptoms Fever, vomiting, headache, yellow skin [1] Complications Seizures , coma [1] Usual onset 10–15 days post exposure [2] Causes Plasmodium spread by mosquitoes [1] Diagnostic method Examination of the blood, antigen detection tests [1] Prevention Mosquito nets , insect repellent , mosquito control , medications [1] Medication Antimalarial medication [2] Frequency 228 million (2018) [3] Deaths 405,000 in 2018 [3] Malaria is a mosquito-borne infectious disease that affects humans and other animals. [2] Malaria causes symptoms that typically include fever , tiredness , vomiting , and headaches . [1] In severe cases, it can cause yellow skin , seizures , coma , or death . [1] Symptoms usually begin ten to fifteen days after being bitten by an infected mosquito . [2] If not properly treated, people may have recurrences of the disease months later. [2] In those who have recently survived an infection , reinfection usually causes milder symptoms. [1] This partial resistance disappears over months to years if the person has no continuing exposure to malaria. [1] Malaria is caused by single-celled microorganisms of the Plasmodium group. [2] The disease is most commonly spread by an infected female Anopheles mosquito. [2] The mosquito bite introduces the parasites from the mosquito's saliva into a person's blood . [2] The parasites travel to the liver where they mature and reproduce . [1] Five species of Plasmodium can infect and be spread by humans. [1] Most deaths are caused by P. falciparum , whereas P. vivax , P. ovale , and P. malariae generally cause a milder form of malaria. [1] [2] The species P. knowlesi rarely causes disease in humans. [2] Malaria is typically diagnosed by the microscopic examination of blood using blood films , or with antigen-based rapid diagnostic tests . [1] Methods that use the polymerase chain reaction to detect the parasite's DNA have been developed, but are not widely used in areas where malaria is common due to their cost and complexity. [4] The risk of disease can be reduced by preventing mosquito bites through the use of mosquito nets and insect repellents or with mosquito-control measures such as spraying insecticides and draining standing water . [1] Several medications are available to prevent malaria in travellers to areas where the disease is common. [2] Occasional doses of the combination medication sulfadoxine/pyrimethamine are recommended in infants and after the first trimester of pregnancy in areas with high rates of malaria. [2] As of 2020, there is one vaccine which has been shown to reduce the risk of malaria by about 40% in children in Africa. [5] [6] Efforts to develop more effective vaccines are ongoing. [6] The recommended treatment for malaria is a combination of antimalarial medications that includes artemisinin . [1] [2] The second medication may be either mefloquine , lumefantrine , or sulfadoxine/pyrimethamine. [7] Quinine , along with doxycycline , may be used if artemisinin is not available. [7] It is recommended that in areas where the disease is common, malaria is confirmed if possible before treatment is started due to concerns of increasing drug resistance . [2] Resistance among the parasites has developed to several antimalarial medications; for example, chloroquine -resistant P. falciparum has spread to most malarial areas, and resistance to artemisinin has become a problem in some parts of Southeast Asia. [2] The disease is widespread in the tropical and subtropical regions that exist in a broad band around the equator . [1] This includes much of sub-Saharan Africa , Asia , and Latin America . [2] In 2018 there were 228 million cases of malaria worldwide resulting in an estimated 405,000 deaths. [3] Approximately 93% of the cases and 94% of deaths occurred in Africa. [3] Rates of disease have decreased from 2010 to 2014 but increased from 2015 to 2017, during which there were 231 million cases. [3] Malaria is commonly associated with poverty and has a significant negative effect on economic development . [8] [9] In Africa, it is estimated to result in losses of US$12 billion a year due to increased healthcare costs, lost ability to work, and adverse effects on tourism. [10] Play media Video summary ( script ) Contents 1 Signs and symptoms 1.1 Complications 2 Cause 2.1 Life cycle 2.2 Recurrent malaria 2.3 Climate change 3 Pathophysiology 3.1 Genetic resistance 3.2 Liver dysfunction 4 Diagnosis 4.1 Classification 5 Prevention 5.1 Mosquito control 5.1.1 Insecticide treated nets 5.1.2 Indoor residual spraying 5.1.3 Housing modifications 5.1.4 Other mosquito control methods 5.2 Medications 5.3 Others 6 Treatment 6.1 Uncomplicated malaria 6.2 Severe and complicated malaria 6.3 Resistance 7 Prognosis 8 Epidemiology 9 History 10 Society and culture 10.1 Economic impact 10.2 Counterfeit and substandard drugs 10.3 War 10.4 Eradication efforts 11 Research 11.1 Vaccine 11.2 Medications 11.3 New targets 11.4 Other 12 Other animals 13 References 13.1 Citations 13.2 Sources 14 Further reading 15 External links Signs and symptoms [ edit ] Main symptoms of malaria [11] The signs and symptoms of malaria typically begin 8–25 days following infection, [11] but may occur later in those who have taken antimalarial medications as prevention . [4] Initial manifestations of the disease—common to all malaria species—are similar to flu-like symptoms , [12] and can resemble other conditions such as sepsis , gastroenteritis , and viral diseases . [4] The presentation may include headache , fever , shivering , joint pain , vomiting , hemolytic anemia , jaundice , hemoglobin in the urine , retinal damage , and convulsions . [13] The classic symptom of malaria is paroxysm —a cyclical occurrence of sudden coldness followed by shivering and then fever and sweating, occurring every two days ( tertian fever ) in P. vivax and P. ovale infections, and every three days ( quartan fever ) for P. malariae . ... The mosquitoes remain on the wall until they fall down dead on the floor. Insecticide treated nets [ edit ] A mosquito net in use. Mosquito nets help keep mosquitoes away from people and reduce infection rates and transmission of malaria. Nets are not a perfect barrier and are often treated with an insecticide designed to kill the mosquito before it has time to find a way past the net. Insecticide-treated nets are estimated to be twice as effective as untreated nets and offer greater than 70% protection compared with no net. [73] Between 2000 and 2008, the use of ITNs saved the lives of an estimated 250,000 infants in Sub-Saharan Africa. [74] About 13% of households in Sub-Saharan countries owned ITNs in 2007 [75] and 31% of African households were estimated to own at least one ITN in 2008. ... That number increased to 20.3 million (18.5%) African children using ITNs in 2007, leaving 89.6 million children unprotected [76] and to 68% African children using mosquito nets in 2015. [77] Most nets are impregnated with pyrethroids , a class of insecticides with low toxicity .
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