Prevention of Malaria: Important Symptoms and Prevention

How Malaria Spreads

When an infected Anopheles mosquito bites a person, parasites enter the bloodstream, travel to the liver and multiply. After about one to two weeks, they re-enter the blood and infect red blood cells, which burst in cycles, causing the characteristic fever. When a mosquito bites an infected person, it picks up the parasite and can pass it on to the next person it bites.

Malaria is not spread by touch, coughing or sharing food. It can rarely spread through blood transfusion, shared needles or from mother to baby during pregnancy.

The Mosquito

• Anopheles mosquitoes bite mainly between dusk and dawn.
• They breed in clean or slightly polluted stagnant water, such as puddles, ponds, ditches, rice fields, construction pits, discarded containers and water tanks.
• They rest indoors on walls and curtains, or outdoors in vegetation.
• Peak activity follows the rains, when breeding sites multiply.

Types of Malaria

Five Plasmodium species infect humans.

• Plasmodium vivax: the most common in India, causing relapsing malaria because dormant forms can stay in the liver and reactivate weeks or months later.
• Plasmodium falciparum: the most dangerous, responsible for severe malaria, cerebral malaria and most deaths. It can progress rapidly.
• Plasmodium malariae, ovale and knowlesi: less common.

Symptoms of Malaria

Symptoms usually appear 7 to 30 days after the bite, sometimes later. Early malaria resembles flu or other fevers.

• Fever, often high, with chills and rigors (shaking).
• Classic pattern: cold stage with shivering, hot stage with high fever, and sweating stage with profuse sweating and exhaustion. Fever may recur every 48 to 72 hours, although in many patients it is irregular.
• Headache, body aches and fatigue.
• Nausea, vomiting and loss of appetite.
• Diarrhoea or abdominal pain.
• Pale skin and weakness from anaemia.
• Yellowing of the eyes (jaundice) in some patients.
• Enlarged spleen with left-sided abdominal discomfort.

Severe Malaria: Emergency Signs

Severe malaria, usually due to falciparum, can cause organ failure. Seek emergency care for:

• Drowsiness, confusion, seizures or unconsciousness (cerebral malaria).
• Difficulty breathing or very fast breathing.
• Severe anaemia and pallor.
• Jaundice with dark urine, or very little urine, suggesting kidney failure.
• Persistent vomiting and inability to drink or take tablets.
• Bleeding, very low blood pressure or shock.
• Low blood sugar, especially in children and pregnant women.
• Dark, cola-coloured urine.

Who Is at Higher Risk?

• Children, particularly under five, who have less immunity.
• Pregnant women, in whom malaria can cause miscarriage, premature delivery, low birth weight and severe maternal anaemia.
• People living near stagnant water, construction sites and slums.
• Travellers to malaria-endemic areas.
• Migrant workers and people sleeping outdoors.
• People with weakened immunity or no previous exposure.

How Malaria Is Diagnosed

Any fever in a malaria season, or after travel to an endemic area, should prompt testing.

• Rapid diagnostic test (RDT): a finger-prick test giving results in 15 to 20 minutes, detecting parasite proteins.
• Peripheral blood smear: a stained blood film examined under a microscope to identify parasites, their species and density. A single negative smear does not exclude malaria, so repeat testing may be needed if fever persists.
• PCR: a highly sensitive test for difficult cases.
• Supporting tests: complete blood count (low platelets and anaemia are common), liver and kidney function, blood sugar and others for severe disease.

Because malaria can be confused with dengue, typhoid and other infections, and may coexist with them, doctors often test for several illnesses.

Treatment

Treatment depends on the type of malaria, the severity, the patient's age and pregnancy status, and local drug resistance. It must be prescribed by a doctor and completed.

• Uncomplicated falciparum malaria: artemisinin-based combination therapy (ACT), taken for three days.
• Vivax malaria: chloroquine in most areas, followed by primaquine for 14 days to clear dormant liver forms and prevent relapse, after testing for G6PD deficiency, which can cause haemolysis with primaquine. Newer single-dose options exist in some settings.
• Severe malaria: intravenous artesunate, given in hospital, followed by a full course of oral treatment, along with supportive care such as fluids, transfusion, management of low blood sugar, seizures, kidney failure or breathing problems, often in an ICU.
• Pregnancy and children: specific, safe regimens chosen by the doctor.
• Supportive care: paracetamol for fever, fluids, rest and nutrition.

Complete the full course even if you feel better, and return if fever recurs. Never rely on leftover or self-bought antimalarials. Delays of even one or two days in treating falciparum malaria can be dangerous.

Preventing Malaria: What Every Household Can Do

Prevention has two parts: reduce mosquito breeding and prevent bites.

1. Eliminate Breeding Sites

• Do not allow water to stagnate around your home, building or workplace. Fill or drain puddles, ditches and low spots, and fix leaking pipes and taps.
• Empty and dry coolers, buckets, tyres, pots, trays and containers at least once a week.
• Cover water tanks, drums and storage containers tightly.
• Clean roof gutters and terraces that collect rainwater.
• Remove construction debris and discarded containers.
• Ask your society or municipality to treat standing water with larvicide, and to fog or spray in outbreak situations.
• Use larvivorous fish (such as Gambusia) in ornamental ponds and water bodies, as advised by local authorities.
• Keep vegetation trimmed around homes.

2. Prevent Mosquito Bites

• Use insecticide-treated bed nets (long-lasting insecticidal nets) while sleeping, especially children, pregnant women and anyone sleeping outdoors or with open windows.
• Install window and door screens and keep them in good repair.
• Use mosquito repellents with DEET, picaridin or oil of lemon eucalyptus on exposed skin, following label instructions, and mosquito coils or vaporisers in well-ventilated spaces with caution, especially around young children and people with asthma.
• Wear full-sleeved shirts and long trousers at dusk and dawn, in light colours.
• Stay indoors during peak biting hours where possible, or use fans and air-conditioning.
• Use indoor residual spraying where public health programmes provide it.

3. Early Detection and Treatment

• Get tested for any fever lasting more than 24 to 48 hours in the season, especially with chills.
• Treat promptly and completely. Early treatment prevents severe disease and reduces spread by breaking the cycle of transmission.
• Sleep under a net during treatment so that mosquitoes do not pick up parasites from you.
• Inform the doctor about travel to endemic areas, even weeks or months before.

4. Protection for Travellers

• Check the risk at your destination, and consult a doctor or travel clinic four to six weeks before departure.
• Take preventive medicines (chemoprophylaxis) if recommended, such as doxycycline, atovaquone-proguanil or mefloquine, starting before travel and continuing afterwards as directed. Do not take them without medical advice.
• Use bed nets, repellents and protective clothing.
• Seek medical care promptly if fever occurs during or up to a year after returning from an endemic area.

5. Special Care in Pregnancy and Childhood

• Pregnant women in endemic areas should use bed nets, avoid travel to high-risk areas and seek care early for any fever. Preventive treatment may be offered in some regions.
• Children should sleep under nets, wear protective clothing and be tested promptly for fever.
• Newborn and infant fevers always need urgent medical review.

Malaria and Other Fevers: Do Not Self-Diagnose

Many illnesses present with fever, headache and body aches during the monsoon, including dengue, chikungunya, typhoid, influenza and leptospirosis. They need different treatments, and the wrong guess can be dangerous. Do not treat fever with random antibiotics or antimalarials. Take paracetamol for comfort and see a doctor if fever persists beyond a day or two, if there are chills, if the fever recurs, or if any warning sign appears.

Community Action

Malaria control succeeds when communities work together.

• Residents' associations can organise weekly checks of water collections, cleanliness drives and larvicide treatment.
• Employers and construction companies should drain water and provide nets and screened accommodation for workers.
• Schools can teach children how to stop mosquito breeding.
• Report outbreaks and unusual clusters of fever to local health authorities.
• Support public health workers who carry out fogging, spraying and testing.

After Treatment

• Finish all medicines and attend follow-up tests if advised.
• Expect weakness for a few weeks. Eat nutritious food, rich in protein and iron, and drink fluids.
• Watch for relapse of vivax malaria months later, and return for testing if fever reappears.
• Continue preventive measures at home.
• Previous infection does not provide lasting full protection.

Myths About Malaria

• "Malaria is only a problem in villages and forests." Cities also see malaria, particularly where water collects.
• "Malaria always has regular fever every other day." Patterns are often irregular.
• "A negative test on the first day rules it out." Repeat tests are sometimes needed.
• "Herbal remedies can cure malaria." Only proven medicines cure it, and delay is dangerous.
• "Once I had malaria, I am immune." Immunity is partial and short-lived.
• "Mosquito coils are enough to prevent malaria." They reduce bites but should be combined with nets, screens and elimination of breeding sites.

Care at Trustmed Hospital

At Trustmed Hospital in Badshahpur, Gurugram, our general medicine and paediatrics teams evaluate fevers with in-house diagnostics including malaria tests and blood counts, and treat patients in comfortable private rooms. Severe cases are managed with emergency care and ICU support, and our insurance desk helps with cashless admission. For fever with chills, call +91-8700232311 or book an appointment.

Frequently Asked Questions