MALARIA ATTACK RECURRING: BIG, BIG PROBLEM.

by malaria.com

QUESTION

My Father aged 65 years was diagnosed with malaria 15 days back and was on medication. Fever was recurring frequently and he had developed a lung infection. Three days back fever stopped and did not occur for 2 days and malarial infection was reducing. Now the Fever has started coming but other parameters are normal. Can you please suggest what needs to be done?

ANSWER

If your father also developed a lung infection, was he treated with antibiotics? If not, his later fever could be caused by that infection, and could be unrelated to the malaria.

He should have another blood test, to look for the malaria parasites; if they are still present, then you should talk to his doctor about trying another type of anti-malarial medication—the World Health Organization recommends artemisinin-based combination therapies (ACTs), such as Coartem, Alu and Duo-Cotecxin, as the first-line treatment against uncomplicated malaria.

However, given that your father appears to have concurrent other medical conditions, it may be that other treatment is more appropriate, and as such it is very important that you check with your doctor before taking additional medication.
Comments
    I have similar stubborn malaria and have been disturbing me. I have used several malaria drugs but pt kept on reoccuring. I have visited my doctor again and he has recommended Duo-Cotecxin 3,3,2. God forbid, incase it reoccur what do i do pls? Thanks.
   In cases of apparent recurring malaria, it is really important to ascertain whether it is a true relapse (where the initial blood infection is cured, but dormant forms persist in the liver and cause a new infection of the blood at a later date – this only occurs with Plasmodium vivax and Plasmodium ovale infection), or re-infection (where the infection is cured, but you get infected again) or recrudescence (where the blood infection is not completely cured and so as soon as treatment ends, the infection can come back). Determining this will require your doctor to do blood tests after you have completed treatment, to see if any parasites are persisting in your blood. The type of parasite can also be identified using a blood test. Depending on which of the above is affecting you, you have several future options. If you have true relapse, then you should talk to your doctor about taking primaquine, which can kill the dormant liver stages of P. vivax and P. ovale and prevent future relapses. The drug is not necessarily suitable for people who suffer from G6DP deficiency, so you may need to have a test for this condition first. If you are suffering from frequent re-infection, then you should focus on malaria prevention. This includes reducing the number of mosquitoes in and around your home (such as spraying with insecticides and removing stagnant water sources, which act as breeding grounds for malarial mosquitoes) as well as protecting yourself from the bites (i.e. sleeping under a long-lasting insecticide treated bednet). If your treatment is failing for some reason and you have recrudescence, again knowing the type of parasite might be able to suggest more effective treatment method (some drugs are more effective against certain types of malaria, for example, and there are also strains of malaria which are resistant to certain medicines). Also, you should ensure that the medication you take is not counterfeit and not expired – this can be a problem in many places. Finally, it is worth remembering that the symptoms of malaria are often very general, and in some places, clinicians will incorrectly diagnose malaria based on symptoms – this is why it is important to always have a positive blood test before being treated for malaria.