Malaria in Malawi

Last night I went to a dinner party, looking forward to good food and time with friends, and while there began to feel ill – headache, extreme fatigue, fever and unsteadiness on my feet. Lucky me though – among my friends there were three doctors and two medical students so I was in good hands.

My symptoms led the doctors to suspect I might have malaria. This, despite the fact that I have been taking Malarone, an anti-malarial medication also known generically as atovaquone and proguanil hydrochloride, since I arrived in Africa on June 11. One of the doctors said that the malarial parasite species common in Malawi (Plasmodium falciparum) has developed resistance to Malarone, although I could not find evidence for this when looking around online this morning. At that doctor’s recommendation I began a course of mefloquine hydrochloride (which many may know as Lariam): three doses of 500mg every 12 hours for 36 hours. Mefloquine is often taken as a prophylaxis to prevent malaria – in higher doses it can treat it too. A rare but feared side effect of mefloquine is psychosis!

The doctor suggested that if I felt worse in the morning that I go to the hospital to get a blood screening test for malaria. I am feeling much better now but still not 100% so will wait another 24 hours to see how it goes. As one of the doctors said (while laughing!): “Now you’ve been introduced to malaria”. I guess I could consider this as an essential rite of passage for a travelling public health specialist. But if I were feeling any worse, I might not be looking at it in such a positive light…

Malaria is common worldwide but is particularly deadly among children under five years old and especially in African countries. In Malawi it is the second-leading cause of death among this age group and the fourth leading cause of death for all age groups nationwide, behind HIV/AIDS (1), lower respiratory infections (2) and diarrhoeal diseases (3).

Here are some key facts about malaria from the World Health Organization:

  • Malaria is a life-threatening disease caused by parasites that are transmitted to people through the bites of infected mosquitoes.
  • In 2010, malaria caused an estimated 655 000 deaths (with an uncertainty range of 537 000 to 907 000), mostly among African children.
  • Malaria is preventable and curable.
  • Increased malaria prevention and control measures are dramatically reducing the malaria burden in many places.
  • Non-immune travellers from malaria-free areas are very vulnerable to the disease when they get infected.

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