More than half the paediatric fevers treated in public health clinics in Africa are caused by diseases other than malaria, according to a study by Oxford University and other research groups, whose authors caution against the “continued indiscriminate use of anti-malarials for all fevers across Africa.”  

Of the 183 million children with malaria symptoms treated by public health clinics in 2007, only 43 percent were diagnosed with malaria, but many more most likely received anti-malarial medication. ”Malaria is still routinely made as the diagnosis of convenience in response to paediatric fever,” the study’s lead researcher, Peter Gething, told IRIN. “This in part stems fromofficial guidelines that have only recently been updated, and in part because often the only treatments available in front-line clinics are anti-malarials.” In 2006 the World Health Organization (WHO) recommended that health workers in countries with a high number of suspected cases of malaria treat children with fevers – the main clinical symptom of malaria – for the disease, even without a diagnosis. There was little else to do at the time, said WHO expert Peter Olumese. “the probability was high that the fevers were from malaria, the disease could turn fatal quickly and there was no time to lose, and there were no proven diagnostic tools,” he told IRIN. Since then, rapid diagnostic testing for malaria has become available, making it possible to confirm diagnoses without health workers, a microscope or a laboratory. In 2008, 11.5 million of these tests were distributed in Africa; in 2009, the Global Fund to Fight AIDS, Tuberculosis and Malaria financed 74 million tests, and another 105 million in 2010, according to the Roll back Malaria Partnership. People in communities have been trained to test one another for malaria. In Senegal, people of all ages are treated for malaria in government-funded health centres only once there is a positive result from a laboratory or rapid test. In sub-Saharan Africa 31 countries have a policy of “universal diagnostic testing”, while another 15 countries in the region have set a goal of testing before treatment in children aged five and older, judging it too risky to delay treatment in younger patients.

More on malaria from IRIN

 BURKINA FASO: when is malaria not malaria?

 GLOBAL: Spoonfuls of sugar could save malaria patients

 MALI: Combating malaria misdiagnosis

 TIMOR-LESTE: Rebuilding infrastructure poses challenge to tackling malaria

Yet it can be equally risky to treat someone for malaria based only on the assumption that they have the disease, the director of WHO’s global malaria programme, Robert Newman, told IRIN. ”you might be wasting ACT [anti-malarial artemisinin-based Combination Therapy], while increasing the risk for drug resistance; also, you are not treating the underlying febrile disease and the drug delay can be fatal. If you treat bacterial pneumonia with anti-malarials, you still have a problem.” On Kinaserom, one of the islands in Lake Chad, health workers recently started using rapid tests to check patients suspected of having malaria. Mahamat Boukar Moussa, the head nurse at a clinic on the island, told IRIN he gave patients malaria medication even when test results were negative. “the tests are not accurate and we cannot risk inaction.” Raoul Ngarhounoum, the regional health director overseeing the rollout of malaria rapid testing, told IRIN he agreed with the health workers’ scepticism. “these are malaria-endemic areas, and just because a test says it is not malaria does not mean it is not.” Gething said that besides quality control, “Simply supplying RDT [rapid diagnostic testing] universally is likely to be less effective if it is not accompanied by sufficient training for front-line health workers.” The Foundation for Innovative new Diagnostics, which works with WHO to create quality control standards for rapid tests, recommends spot checking in each batch of tests ordered to ensure the tests were not poorly manufactured, or had been damaged in transit or storage. Malaria treatment would not change overnight, said Gething. “In an ideal world, all fevers reaching clinics in Africa would be tested for malaria, using a reliable diagnostic test … as always, the reality on the ground is more complex. for years the advice has been to treat all fevers as malaria, and changing that dogma is likely to take time.” 

Malaria is a mosquito-born infectious disease. It is caused by a eukaryotic protist of the genus plasmodium. its occurrence can be seen more in tropical and sub-tropical regions. parts of the Americas (22 countries) and major areas of Asia and Africa are regions where malaria has spread already.

More than 250 million cases of malaria, killing more than 2 million people, killing millions of children in Sub-Saharan Africa – malaria has been a prominent source of death and destruction in the world. Malaria is generally associated with poverty and is a major obstacle to economic growth.

Causes

Humans can be infected by five species of plasmodium parasite. Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, Plasmodium malariae, and Plasmodium knowlesi – these are the five species which are responsible for the infection of malaria. some are fatal and some others are mild. Plasmodium falciparum causes the cerebral malaria symptoms which is said to be a life-threatening and serious form of malaria.

A mosquito bite causes malaria. The parasite microbe is getting into the blood through a sharp, hypoderme needle-like sting. When one travels intyo mosquito infected areas and when one is bitten by a mosquito, he becomes a victim to malaria. When infected blood is transfused into the body of a normal person, it gets transmitted.

Symptoms

Symptoms visit alternately and stay for a longer duration. This will be the case in the initial stages. Malaria-causing parasite is responsible for the cyclic infection of the disease. If the symptoms of malaria surface following a cyclic pattern, it is a sure case of malaria. these symptoms can be realized in bacterial, viral and parasitic infections also.

• Chills, fever and profuse sweating will be experienced regularly
• Jaundice symptoms getting displaced are a possibility
• Bloody stools tend to develop
• Muscle pain will be experienced to a great extent
• Anemia
• Headache, nausea and vomiting will add to the list of growing grievances by occurring frequently

Treatment

real high fever , body feels hot but patient feels ice cold n shivers , weakness ,body pain , lack of interest in eating( but one shld eat) genrally empr incr in afternoon . feel like puking etc
one shld consult doc immediately n keep body tempr in ctrl

The classical (but rarely observed) malaria attack lasts 6-10 hours. it consists of:

a cold stage (sensation of cold, shivering)
a hot stage (fever, headaches, vomiting; seizures in young children)
and finally a sweating stage (sweats, return to normal temperature, tiredness)
Classically (but infrequently observed) the attacks occur every second day with the "tertian" parasites (P. falciparum, P. vivax, and P. ovale) and every third day with the "quartan" parasite (P. malariae).

More commonly, the patient presents with a combination of the following symptoms:

Fever
Chills
Sweats
Headaches
Nausea and vomiting
Body aches
General malaise.
In countries where cases of malaria are infrequent, these symptoms may be attributed to influenza, a cold, or other common infections, especially if malaria is not suspected. Conversely, in countries where malaria is frequent, residents often recognize the symptoms as malaria and treat themselves without seeking diagnostic confirmation ("presumptive treatment").

Physical findings may include:

Elevated temperature
Perspiration
Weakness
Enlarged spleen.
In P. falciparum malaria, additional findings may include:

Mild jaundice
Enlargement of the liver
Increased respiratory rate.
Diagnosis of malaria depends on the demonstration of parasites on a blood smear examined under a microscope. In P. falciparum malaria, additional laboratory findings may include mild anemia, mild decrease in blood platelets (thrombocytopenia), elevation of bilirubin, elevation of aminotransferases, albuminuria, and the presence of abnormal bodies in the urine (urinary "casts").

Severe Malaria
Severe malaria occurs when P. falciparum infections are complicated by serious organ failures or abnormalities in the patient's blood or metabolism. the manifestations of severe malaria include:

Cerebral malaria, with abnormal behavior, impairment of consciousness, seizures, coma, or other neurologic abnormalities
Severe anemia due to hemolysis (destruction of the red blood cells)
Hemoglobinuria (hemoglobin in the urine) due to hemolysis
Pulmonary edema (fluid buildup in the lungs) or acute respiratory distress syndrome (ARDS), which may occur even after the parasite counts have decreased in response to treatment
Abnormalities in blood coagulation and thrombocytopenia (decrease in blood platelets)
Cardiovascular collapse and shock
Other manifestations that should raise concern are:

Acute kidney failure
Hyperparasitemia, where more than 5% of the red blood cells are infected by malaria parasites
Metabolic acidosis (excessive acidity in the blood and tissue fluids), often in association with hypoglycemia
Hypoglycemia (low blood glucose). Hypoglycaemia may also occur in pregnant women with uncomplicated malaria, or after treatment with quinine.
Severe malaria occurs most often in persons who have no immunity to malaria or whose immunity has decreased. These include all residents of areas with low or no malaria transmission, and young children and pregnant women in areas with high transmission.

In all areas, severe malaria is a medical emergency and should be treated urgently and aggressively.

Malaria Relapses
In P. vivax and P. ovale infections, patients having recovered from the first episode of illness may suffer several additional attacks ("relapses") after months or even years without symptoms. Relapses occur because P. vivax and P. ovale have dormant liver stage parasites ("hypnozoites") that may reactivate. Treatment to reduce the chance of such relapses is available and should follow treatment of the first attack.

Other Manifestations of Malaria
Neurologic defects may occasionally persist following cerebral malaria, especially in children. such defects include troubles with movements (ataxia), palsies, speech difficulties, deafness, and blindness.
Recurrent infections with P. falciparum may result in severe anemia. this occurs especially in young children in tropical Africa with frequent infections that are inadequately treated.
Malaria during pregnancy (especially P. falciparum) may cause severe disease in the mother, and may lead to premature delivery or delivery of a low-birth-weight baby.
On rare occasions, P. vivax malaria can cause rupture of the spleen or acute respiratory distress syndrome (ARDS).
Nephrotic syndrome (a chronic, severe kidney disease) can result from chronic or repeated infections with P. malariae.
Hyperreactive malarial splenomegaly (also called "tropical splenomegaly syndrome") occurs infrequently and is attributed to an abnormal immune response to repeated malarial infections. the disease is marked by a very enlarged spleen and liver, abnormal immunologic findings, anemia, and a susceptibility to other infections (such as skin or respiratory infections).

Vomiting/diarrhoea. Basically shitting and puking

(i am a doc)feeling extremely cold with riggers and shivering, that with a warm body but cold feet, aching all over body especially in the back, this continues for half hour to 2-3hours, then a sudden feeling of nausea,vomiting, afterwards with a better light feeling + the temperature goes down by this time and there is intense sweating

hi, just go to miraclemineral.org/

Malaria is a common infection in hot, tropical areas but can also occur (rarely) in temperate climates. it is caused by any of four single-celled parasites of the Plasmodium species, which are carried by mosquitoes infected from biting someone who already has the disease. Malaria is then transmitted to other people when they are bitten by the infected mosquitoes. it is rarely passed from person to person (from mother to child in "congenital malaria," or through blood transfusion, organ donation, or shared needles).

Worldwide, 300-500 million people are infected with malaria each year. Most cases occur in sub-Saharan Africa, with approximately 2 million people dying there each year. Malaria is rare in the United States, with only about 1,300 cases reported each year over the last 10 years. Most of these cases occurred in travelers, military personnel, and immigrants who had become infected by malaria parasites outside the United States.

Signs and Symptoms
A child with early symptoms of malaria may be irritable and drowsy, with poor appetite and trouble sleeping. These symptoms are usually followed by chills, then a fever with rapid breathing. the fever may either gradually increase over 1 to 2 days or may rise very suddenly to 105 degrees Fahrenheit (40.6 degrees Celsius) or above. Then, as fever ends and body temperature quickly returns to normal, the child has an intense episode of sweating. the same pattern of symptoms – chills, fever, sweating – may repeat at intervals of 2 or 3 days, depending on which particular species of malaria parasite is causing the infection. because the initial symptoms are not specific and can be mistaken for other diseases, it can be difficult to diagnose. In countries where the disease is seen a lot, it's not uncommon for doctors to treat people for malaria who have fever of no obvious cause without getting laboratory confirmation.

Other symptoms of malaria include headache, nausea, aches and pains all over the body (especially the back and abdomen), and an abnormally large spleen. When malaria affects the brain, a child may have convulsions or lose consciousness. If malaria affects the kidneys, the amount of urine produced by the child may be abnormally low. In falciparum malaria, caused by the Plasmodium falciparum parasite, the episode of fever and chills is especially intense, and this variety may be fatal in about 20% of cases.

Once malaria parasites enter the bloodstream, they travel to the liver and multiply. Every few days, thousands of parasites are released from the liver into the blood, where they destroy red blood cells. some parasites also remain in the liver and continue to multiply, releasing more parasites into the blood every few days.

The incubation period for malaria is the time between the mosquito bite and the release of parasites from the liver. this varies, depending on which malaria parasite is causing the disease. In general, it can range from 10 days to a month.

With treatment, malaria can usually be cured in about 2 weeks. Without treatment, it can be fatal, especially in children who are poorly nourished.

Prevention
Health authorities try to prevent malaria by using mosquito-control programs aimed at killing mosquitoes that carry the disease. If you travel to an area of the world with a high risk for malaria, you can install window screens, use insect repellents, and place mosquito netting over beds. Insecticide-impregnated bed netting has successfully reduced the number of malarial deaths among African children.

Check with your doctor before visiting any tropical or subtropical area at high risk for malaria. your doctor can give your family anti-malarial drugs to prevent the disease. several malaria vaccines are currently being developed and tested across the world, but because the malaria parasite has a complicated life cycle, it is a difficult vaccine to develop.

Diagnosis and Treatment
Doctors diagnose malaria by using special blood tests. A blood sample is sent to the laboratory and checked under a microscope for malaria parasites, which may be seen inside infected red blood cells.

Doctors treat malaria with anti-malarial drugs, such as chloroquine or quinine, given by mouth, by injection, or intravenously (into the veins). Depending on the type of parasite causing the malaria, a person can be treated as an outpatient over a few days or may require hospitalization with IV medication. Doctors also watch for signs of dehydration, convulsions, anemia, and other complications that can affect the brain, kidneys, or spleen. the patient may require fluids, blood transfusions, and breathing assistance.

Malaria is a leading cause of death worldwide. If diagnosed early and treated, it can be cured. however, many people who live in areas where malaria is common get repeated infections and never really recover between episodes of illness.