Malaria Infection Specialist Doctor In Mumbai The World Health Organization ( WHO ) reported 241 million cases and 627 thousand deaths from malaria in 2020. The malaria parasite is transmitted via the bite of a female Anopheles spp mosquito. The two most common species responsible for malaria are Plasmodium falciparum and P. vivax. In areas where malaria is consistently present, groups at highest risk include young children ( 6 months - 5 years ), who can develop severe illness, and pregnant women, who are at risk for anemia and delivering low birthweight newborns. Travelers, with no previous exposure to malaria parasite, are at very high risk for severe disease if infected with Plasmodium falciparum. The initial symptoms in a patient, suffering from malaria, are nonspecific and may include fever, chills, malaise, fatigue, sweating, headache, cough, anorexia, nausea, vomiting, abdominal pain, diarrhea, body pain and joints pain. Early in the course of infection, fever episodes occur at irregular intervals each day. Later in the course of infection, febrile episodes may occur every other day for P. vivax and P. falciparum. While most severe malaria is usually due to P. falciparum, patients with severe malaria due to P. vivax have also been described. Those at greatest risk for severe disease include those with poor immunity, children between 6 months to 5 years of age, and pregnant women. The symptoms of severe malaria may include one of more of the: altered consciousness, seizures, breathlessness, low blood pressure, kidney and renal failure, bleeding, low hemoglobin and very low blood sugar level. The very high level of parasites in blood, also lead to increasing disease severity. The involvement of a specialist for early diagnosis is paramount to prevent development of manifestations of severe malaria. The severe involvement of brain is termed as cerebral malaria, the patients have altered consciousness or unconsciousness, abnormal behavior and even seizures. The role of a specialist is of supreme importance for prompt and accurate diagnosis of malaria, as this can reduce associated suffering and deaths. The tools for diagnosis of malaria include microscopy which is basically visualization of parasites in stained blood smears and rapid diagnostic tests ( RDTs ), which detect antigen or antibody. The use of microscopy for smear examination is the standard tool for diagnosis of malaria. RDTs should be used if microscopy is not readily available. The microscopy allows identification of the Plasmodium species as well as quantity of parasites in the blood. If malaria is suspected and the initial smear is negative, additional smears should be prepared and examined over the subsequent 48 to 72 hours. RDTs have become important diagnostic tools and give results within 15 to 20 minutes. The antimalarial drugs are used for the treatment and prevention of malaria infection. Chloroquine was the first drug produced on a large scale for treatment and prevention of malaria infection. The emergence of widespread resistance has led to decline in its use. The treatment commonly includes chloroquine or artemisinin combination therapy ( ACT ). However in view of widespread chloroquine resistance in our country, ACT is preferred. The first line of therapy for the treatment of severe malaria is intravenous artesunate, a kind of artemisinin formulation. P. vivax infections can relapse. Hence presumptive anti – relapse therapy with primaquine should be administered. In cases of P. falciparum infection, to reduce transmissibility, a single dose of primaquine is generally administered on the first day of malaria treatment. The repellents applied to exposed skin may be used to protect against mosquito bites. However their efficacy for protection against malaria is variable. WHO recommends pyrethroid – treated long – lasting insecticidal nets ( LLINs ) for deployment in areas with ongoing malaria transmission. Thus far use of these nets, does not appear to have toxicity for humans. The mass administration of systemic insecticides to reduce malaria transmission is an area of growing interest. A successful malaria vaccine has the potential to reduce the global disease burden. The WHO approved the RTS, S vaccine in October 2021 for children in Sub – Sahara Africa. At present no malaria vaccine is available in India. The residential interventions include house screening and indoor residual spraying. The indoor residual spraying involves spraying insecticides on indoor residential walls and ceilings. There is a continuing research to achieve control, elimination, and eradication of malaria.