How to Treat Malaria

Last Updated: February 16, 2022 References Approved

Malaria is a disease that's most often caused by mosquito bites from mosquitos that carry malaria parasites. If left untreated, those with malaria may develop severe complications and even die. Although there's currently no vaccination against malaria, treatment is usually very successful at curing it. Successful treatment depends on your ability to recognize your risk factors and symptoms and get treatment as early as possible.

Part 1

Part 1 of 2:

Diagnosing Malaria

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Determine if you’re at risk of malaria. Though certain populations are at higher risk, anyone can get malaria. You should be aware of the risk factors to know if there’s a possibility you’ve contracted the disease. In very rare cases, it can be spread through blood transfusions or organ transplants if the medical staff has made a mistake in screening the donor. Sharing needles for injection can also spread the disease. However, because the disease is most often spread by mosquito bites, most people with malaria are found in tropical and subtropical climates.
- The CDC offers a thorough listing of malaria risk by country.^{[1]
  X
  Trustworthy Source
  Centers for Disease Control and Prevention
  Main public health institute for the US, run by the Dept. of Health and Human Services
  Go to source} Countries where you're highly likely to contract malaria include Angola, Cameroon, Chad, Côte d'Ivoire, and Liberia, among others. The deadliest strains of malaria are found in Africa, south of the Sahara.^{[2]
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  Research source}
- Note that the risk is posed not just to people who live in these countries, but also those traveling through them.
2
Watch for symptoms after you've been in a high-risk country. Malaria normally has an incubation period of about seven to 30 days before symptoms begin appearing. But if you're a traveller from a low-risk country, you may have taken preventative anti-malarial medication before entering the country. If you contract malaria despite that medication, the medication can still slow down the disease's progression. It might take months for your symptoms to appear.^{[3]
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Trustworthy Source
Centers for Disease Control and Prevention
Main public health institute for the US, run by the Dept. of Health and Human Services
Go to source} To be safe, you should be vigilant for a full year after traveling to a high-risk area. Remind your doctor of your travels during every check-up during that year.

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3
Learn about the different types of malaria.^{[4]
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Trustworthy Source
Centers for Disease Control and Prevention
Main public health institute for the US, run by the Dept. of Health and Human Services
Go to source} Malaria is commonly seen in one of three manners: as uncomplicated malaria, as severe malaria, or as a malaria relapse. Uncomplicated malaria is the most common type, but it is rarely seen in hospital settings because people mistake it for cold, flu, or a simple infection. Residents of high-risk areas often recognize the symptoms as uncomplicated malaria and treat it on their own. Severe malaria, on the other hand, can cause organ failure and is potentially lethal. It requires immediate medical attention. Relapses after an initial bout of malaria often go unnoticed because they may not always present with noticeable symptoms.
4
Recognize the symptoms of uncomplicated malaria.^{[5]
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Trustworthy Source
Centers for Disease Control and Prevention
Main public health institute for the US, run by the Dept. of Health and Human Services
Go to source} Uncomplicated malaria can appear in recurring "attacks" that typically last six to 10 hours. During these bouts, patients progress from the cold stage, through the hot stage, then the sweating stage.
- In the cold stage, they feel cold and shiver.
- During the hot stage, they experience fever, headaches, and vomiting. Children may experience seizures.
- In the sweating stage, the patient experiences fatigue and excessive sweating while the body returns to a normal temperature.
- Other symptoms include yellowed skin from mild jaundice and rapid breathing.
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Watch carefully for symptoms of severe malaria. Many people have nonspecific symptoms such as fatigue, headaches, nausea, vomiting, or body aches.^{[6]
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Trustworthy Source
Centers for Disease Control and Prevention
Main public health institute for the US, run by the Dept. of Health and Human Services
Go to source} If the infection progresses to a stage where it interferes with organ, blood, or metabolism function, symptoms become more dramatic. Severe malaria is potentially lethal, and requires immediate medical attention. Contact your doctor or emergency services if you experience any of the following:
- Strange behavior changes
- Loss of consciousness
- Seizures
- Anemia (you may look pale, feel very tired or weak, have dizziness, or have a rapid heart rate)
- Dark or reddish urine (from hemoglobin)
- Trouble breathing
- Abnormal blood coagulation
- Low blood pressure
- Kidney failure (decreased urine, swollen legs or feet from fluid retention, chest pain or pressure)^{[7]
  X
  Trustworthy Source
  Mayo Clinic
  Educational website from one of the world's leading hospitals
  Go to source}
- Low blood sugar (especially in pregnant women)
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Contact your medical professional. Regardless of whether you're showing symptoms, you should always let your doctor know immediately when you've travelled to a high risk area. While those in high-risk areas sometimes "wait and see" if uncomplicated malaria will progress, people in low-risk areas should not. If you have any suspicion that you have malaria, you should contact your doctor immediately to get tested and treated.
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Submit to a blood smear.^{[8]
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Trustworthy Source
Centers for Disease Control and Prevention
Main public health institute for the US, run by the Dept. of Health and Human Services
Go to source} To check your blood for the parasites that cause malaria, your doctor will take a blood sample to be analyzed in the lab. Even if your first blood smear comes back negative for malaria parasites, the doctor will repeat the test every eight to 12 hours for 36 hours.
- The doctor may also order a rapid blood test to indicate whether there's significant risk of malaria. If the initial rapid blood test is positive, he or she will order blood smears to confirm the diagnosis.
- Your doctor will also test your blood for a CBC and test the function of your liver and possibly other organs.

Part 2

Part 2 of 2:

Treating Malaria

1
Get early diagnosis and treatment. Although malaria can be dangerous and deadly, it's also a highly treatable disease. While there's not yet a vaccine to prevent contracting the disease, early treatment has proven to be very effective at containing and curing it.^{[9]
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Research source} The success of your treatment depends on contacting your healthcare provider as soon as possible.
2
Take your prescribed medications.^{[10]
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Trustworthy Source
Mayo Clinic
Educational website from one of the world's leading hospitals
Go to source} Your doctor has many options to choose from when deciding how to treat your malaria. He or she will choose a regimen for you based on what type of malaria parasite was found in your blood smear, your age, whether you're pregnant, and the severity of your symptoms. Most malaria treatments are taken orally, but patients with complications might need IV medication. Like any living organism, the parasites that cause malaria can adapt to fight off medications, but the following drugs have a high success rate:
- Chloroquine (Aralen)
- Quinine sulfate (Qualaquin)
- Hydroxychloroquine (Plaquenil)
- Mefloquine
- Combination of atovaquone and proguanil (Malarone)
3
Stay comfortable during treatment. The best thing you can do is get plenty of rest during the recovery process. Because there are so many options for treating malaria, not everyone will have the same experience. However, common side effects include blurred vision, nausea, diarrhea, vomiting, and stomach pain or upset. Some of the drugs also cause heartburn, insomnia, anxiety or mental clouding, and dizziness or coordination problems.
- Pay attention to your body to pick up on these side effects, and report them to your doctor when you experience them. They may be able to give you additional medications to help combat them.
- Drink lots of fluids to prevent heartburn.
- Fluids are especially important if you are experiencing vomiting or diarrhea. You lose a lot of water through these side effects, and have to rehydrate yourself to keep your body as healthy as possible.
- Stick to a bland diet to treat stomach upset.
- Stay off your feet, and don't over-exert yourself if you're having coordination problems.
- Your doctor will monitor you for signs of dehydration, anemia, and seizures. She will watch for complications affecting your organs.
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Wait for the fever to subside.^{[11]
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Research source} Treatment for malaria is aggressive and fast-acting. If everything goes according to plan and you don’t suffer any complications, your fever should be gone within 36-48 hours. In most cases, the parasite that cause malaria will be completely out of your system within two to three days, and you will be recovered within two weeks.^{[12]
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- The doctor will continue to test your blood smears while you’re being treated for malaria. If the treatment is successful, they will see a decrease in the number of malaria parasites in your blood with every smear.
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Take primaquine to prevent relapses.^{[13]
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Trustworthy Source
PubMed Central
Journal archive from the U.S. National Institutes of Health
Go to source}^{[14]
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Research source
hhttp://cid.oxfordjournals.org/content/39/9/1336.full} Although your initial bout of malaria may be gone, the disease can recur sporadically for years afterward. Though this often happens without noticeable symptoms, you may feel flu-like symptoms during relapses. Either way, you want to prevent the infection from returning as best you can. Primaquine is an anti-malarial taken after other drugs have killed off the malaria parasites in your blood.
- You will begin taking primaquine two weeks after the malaria has passed.
- Your dosage and length of treatment will be based on your specific case: what kind of infection you had and how you responded to treatment. Most often, a two-week course is recommended.
- Follow your doctor's instruction exactly. Do not adjust dosages up or down in any way, and take the medication on the exact schedule prescribed.
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Avoid further mosquito bites.^{[15]
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Trustworthy Source
Centers for Disease Control and Prevention
Main public health institute for the US, run by the Dept. of Health and Human Services
Go to source} If you live in a low-risk area, do not travel to high-risk areas while you are recovering from malaria. Additional mosquito bites may prove disastrous. If you live in an area where malaria is common, protect yourself as best as possible.
- Cover your skin with long pants and sleeves, even in hot weather.
- Wear mosquito repellent at all times.
- Look specifically for products containing DEET, Picaridin, Oil of lemon eucalyptus (OLE) or PMD, or IR3535. Check the packaging to make sure your products have these effective chemicals in them.
- Light mosquito-repellent candles to keep mosquitos out of your area.
- Stay in screened-in, air-conditioned areas where mosquitos are less likely to be.
- Use bed nets when sleeping in areas infested with mosquitoes.

Warnings

Infection with Plasmodium falciparum (one type of malaria) if not promptly treated, may cause seizures, mental confusion, kidney failure, coma, and death.

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Purchase your antimalarial drugs before you travel overseas. People in countries that are at high risk for malaria have been known to sell "fake" or substandard drugs to travelers.

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