Malaria 101 – 'D' is for DIAGNOSIS and rapid treatment: The faster, the better

Posted on December 01, 2023

Malaria, a potentially fatal disease, demands swift action when its symptoms surface. The disease can progress rapidly and lead to severe complications, so early diagnosis and treatment are essential.

Knowing the A, B, C, Ds of malaria is crucial for prevention, early detection, and effective treatment. “D” is for DIAGNOSIS and treatment. This article underscores the significance of immediate healthcare intervention when a positive diagnosis is made following the onset of malaria symptoms.

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. 

This is more than the flu. Now what?

If you have symptoms suggestive of malaria, especially if you have recently travelled to or reside in a malaria-endemic area, it is crucial to seek medical attention promptly. When seeking medical attention, inform the healthcare provider of symptoms, travel history, and any potential exposure to malaria. The specific type of malaria parasite, as well as its resistance to certain drugs, varies by region. A proper diagnosis by a healthcare professional is therefore necessary to determine the most effective treatment.

Malaria is diagnosed through a combination of clinical evaluation and laboratory tests. The common methods for diagnosis include blood smear microscopy, rapid diagnostic tests (RDTs), or polymerase chain reaction (PCR) tests, to confirm the presence of the parasite and identify the species. The choice of diagnostic method depends on factors such as availability of resources, expertise of healthcare personnel, and specific circumstances of the patient.

Microscopic examination of blood smears is a standard and widely used method for diagnosing malaria. With a blood smear, a drop of an individual’s blood is examined under a light microscope for the presence of parasites between and in the red blood cells. Thick smears are primarily used for detecting parasites and estimating parasite density, while thin smears allow for species identification.

RDTs detect specific malaria antigens in the blood. They are easy to use and provide results within 15 to 20 minutes. RDTs are particularly useful in areas where microscopy is not readily available. Different types of RDTs are available, including those that detect specific Plasmodium species or general malaria antigens.

PCR tests are molecular diagnostic tools that can detect the genetic material of the malaria parasite. PCR is highly sensitive and can identify low levels of parasites in the blood. While more sophisticated and not as readily available in some settings, PCR is useful for confirming malaria diagnosis, especially in cases where microscopy or RDT results are inconclusive.

Yes, it is malaria. Now what?

If malaria is confirmed, the healthcare provider will prescribe appropriate antimalarial medication. The type of treatment depends on the parasite species, degree of drug resistance, area where infection occurred, severity of infection at the start of treatment, age of the person, pregnancy status, and personal allergies and contraindications. Early medical intervention ensures that the appropriate diagnostic tests are conducted and treatment is initiated promptly. This can significantly improve the chances of a full recovery. Take the prescribed medications exactly as directed by the healthcare provider. Completing the full course of treatment is crucial to ensuring that all parasites are eliminated from the body.

Malaria can cause significant fatigue, so it's important to get plenty of rest. Stay well-hydrated to help manage fever and prevent dehydration. Keep an eye on your symptoms and report any changes or worsening conditions to your doctor. Continue taking measures to prevent mosquito bites. Delayed or inadequate treatment can lead to severe complications and, in some cases, death. Prompt treatment also reduces the risk of spreading the disease to others through mosquito bites. Timely intervention can help break the transmission cycle.

Access to healthcare services in some remote or resource-constrained areas may be problematic, and immediate medical care may not be accessible. Home-based treatment can thus become a lifeline. Ensure to speak with a healthcare professional about home-based treatment if you know you will be living or working in such treatment-limited areas.

There is a bit of a rising concern in the malaria treatment space. Artemisinin Combination Therapy (ACT) is a widely-used antimalarial, involving the combination of artemisinin or its derivatives with other antimalarial drugs. Artemisinin was discovered in 1971, when Chinese scientist Tu Youyou and her team isolated the compound from the sweet wormwood plant (Artemisia annua). Artemisinin has revolutionised malaria treatment. The combination improves treatment effectiveness, reduces the risk of drug resistance, and ensures a more comprehensive attack on the malaria parasite at different stages of its lifecycle. ACT has become the frontline treatment for uncomplicated malaria globally, contributing significantly to the success of malaria control programmes and saving countless lives. However, resistance against artemisinin has been found in some regions, prompting an even more urgent need for research to develop new drug therapies.

In conclusion, early malaria diagnosis and treatment can prevent severe complications and save lives. By emphasising the importance of swift action and improving access to healthcare services, significant strides can be made against malaria.

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
- Author Dr Taneshka Kruger

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