Malaria, a widespread and potentially deadly disease, is both preventable and treatable. Knowing the A, B, C, Ds of malaria is crucial for prevention, early detection, and effective treatment. "A" is for AWARENESS. Understanding the symptoms and risk factors helps individuals recognise the signs of malaria early, enabling prompt action and potentially saving lives.

This article delves into the essential aspects of learning to recognise common malaria symptoms and understanding the difference between mild and severe manifestations of the disease.

The University of Pretoria Institute for Sustainable Malaria Control creates a platform for diverse experts to bring their unique skills and knowledge to the table and join forces to address malaria holistically. 

What causes symptoms?

To understand what causes the symptoms, one needs to look at the parasite's life cycle, or at least part of it. Very simply put, when a human gets bitten by a female Anopheles mosquito carrying the malaria-causing Plasmodium, these tiny parasites are injected into the bloodstream. The parasites then travel to the liver, where they mature and reproduce asexually.

After multiplying, they re-enter the bloodstream and infect red blood cells, where they multiply more. This process damages the blood cells and triggers the body's immune response, leading to the characteristic flu-like symptoms as the immune system tries to fight off the infection. The cycle of parasite reproduction and immune response contributes to the recurring symptoms associated with malaria. The time from infection to onset is usually 10 to 14 days.

Common Malaria Symptoms

Malaria symptoms can vary in presentation, but some are more frequently observed than others. It's essential to be aware of these common symptoms, which include:

• Fever: Perhaps the most well-known symptom, fever is often the first indicator of a malaria infection. The fever can be sudden and severe, accompanied by a rise in body temperature.
• Chills: Chills often accompany fever and may alternate with periods of intense heat, giving rise to intense sweating.
• Sweating: Profuse sweating is another hallmark symptom of malaria. Sweating episodes can be severe and lead to significant discomfort.
• Fatigue: Extreme tiredness and a general sense of weakness are frequently reported by individuals with malaria. This fatigue can be debilitating.
• Muscle aches: Muscle aches and pains are typical, contributing to the overall discomfort experienced by malaria sufferers.

It's important to note that these symptoms often mimic those of other diseases, such as the flu. Therefore, if an individual experiences any of these signs and lives in or has recently been in a malaria-endemic area , it is essential to seek immediate medical attention.

Mild versus severe symptoms

Different species of the Plasmodium parasite can cause varying degrees of disease severity. Plasmodium falciparum malaria, the most common in Africa, can be diagnosed as either a mild (uncomplicated), flu-like illness or a severe (complicated) and life-threatening condition. Distinguishing between mild and severe symptoms is crucial for determining the appropriate course of action.

Mild malaria symptoms, often called uncomplicated malaria, consist of bouts of mild fever typically accompanied by the common flu-like symptoms alternating with periods of absence of feeling sick. These mild symptoms can sometimes be mistaken for other common illnesses, leading to delayed diagnosis and treatment. Prompt and appropriate treatment with antimalarial medication is highly effective in treating mild malaria and preventing it from progressing to a severe form.

Severe malaria, on the other hand, can be life-threatening. Cerebral malaria is a well-known severe case of malaria that can develop if left untreated. Symptoms of cerebral malaria include delirium, generalised convulsions, and impaired consciousness. Cerebral malaria is the most severe neurological complication of infection with Plasmodium falciparum. Other severe symptoms include severe anaemia (resulting in paleness and weakness), respiratory distress (rapid breathing), and organ dysfunction (e.g., jaundice, kidney failure). Eventually, persistent coma can set in, ultimately leading to death. Early recognition of severe symptoms is vital, requiring hospitalisation and intravenous antimalarial medications.

The overall health of the infected person can play a role. Individuals with weakened immune systems, such as young children, pregnant women, and those with other health conditions, are more likely to experience severe symptoms. Individuals with some level of immunity, acquired through previous exposure to the parasite, may experience milder symptoms. In contrast, those with no prior exposure or immunity are more susceptible to severe forms of the disease. 

Understanding malaria symptoms and their severity is vital for timely diagnosis and appropriate treatment. Familiarising oneself with typical symptoms is the first step in recognising a potential malaria infection. Differentiating between mild and severe malaria symptoms can be a matter of life and death. Raising awareness and understanding of malaria symptoms can aid in early diagnosis and effective disease management.

For more information, visit the webpage of the University of Pretoria Institute for Sustainable Malaria Control, a multi-disciplinary research institute making a substantial contribution towards the creation of a malaria-free Africa.

Read more from the Malaria 101 series