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World Malaria Day: 9 Malaria Complications You Need To Be Aware Of
Every year, 25 April is observed as World Malaria Day. World Malaria Day was established in May 2007 by the 60th session of the World Health Assembly of WHO. The day is observed with the intention of providing education and understanding of malaria and spreading awareness of malaria prevention and treatment.
World Malaria Day 2022 theme is, "We can conquer this terrible illness and enhance people's livelihood and wellbeing by looking to these nations as an example."
According to a 2017 WHO report, India ranks fourth in infections and deaths caused by malaria. Malaria is a mosquito-borne disease and children, pregnant women and travellers are more prone to the disease.

The female Anopheles mosquito transfers Plasmodium parasites from its saliva into the person's blood, which enters the bloodstream and moves up to the liver and starts reproducing [1]. As malaria is transmitted by blood, it can also be transmitted through a transfusion, an organ transplant, and the use of shared syringes.
Some of the signs and symptoms of malaria are kidney failure, headache, diarrhoea, fatigue, body aches, fever, nausea and vomiting, sweating, seizures, shaking chills, anaemia and bloody stools [2].
It only takes a single mosquito bite for a person to be infected. The biggest risk factor for developing malaria is living in or visiting an infected zone. Poverty, lack of knowledge and no access to health care are primarily responsible for malaria deaths across the world [3][4].

1. Cerebral Malaria
Cerebral malaria is a diffuse encephalopathy, that is, a disease of the brain that alters brain function or structure [6]. It can cause seizures and status epilepticus in people with severe malaria. In some cases, cerebral malaria can lead to paralysis. Cerebral malaria is the most common cause of death in patients suffering from malaria.

2. Acute Respiratory Distress Syndrome (ARDS)
ARDS occurs when fluid builds up in the tiny air sacs called alveoli in your lungs. That is, ARDS causes the leakage of fluid into your lungs and affect your breathing.Malaria-associated acute respiratory distress syndrome or MA-ARDS is one of the most common complications caused by malaria and has a reported lethality rate of up to 80 per cent, despite anti-malarial treatment [7][8]. This complication causes respiratory distress/breathing problems.

3. Convulsions
Convulsions can be associated with cerebral malaria [9]. Convulsions are described as a medical condition where body muscles contract and relax rapidly and repeatedly, resulting in uncontrolled actions of the body. In people with malaria, convulsions are more often a result of cerebral dysfunction [10].

4. Hemolysis
The malarial parasite can destroy the red blood cells completely [11]. This can lead to hemolysis which is the rupture or destruction of the red blood cells (RBC). Sometimes the haemoglobin released by the damaged RBCs can enter the kidneys and can cause kidney failure [12].

5. Electrolyte/Fluid Imbalance
Individuals affected by malaria can become salt deprived due to excessive loss of fluid through sweating or vomiting or due to its decreased intake [13]. Electrolyte disturbance is known to be the common complication in severe malaria, which also acts as an indicator for the severity of disease [14].

6. Blackwater Fever
Blackwater fever is a complication of malaria infection in which the red blood cells burst in the bloodstream, that is hemolysis, and causes the release of haemoglobin directly into the blood vessels and into the urine, leading to kidney failure [15].

7. Splenic Rupture
The spleen produces antibodies against the malarial parasite, making it an important factor in the management of the infection [16]. Enlargement of the spleen in people who have recurrent cases of malaria is quite common. Splenic rupture can occur in patients with vivax malaria, especially when they develop abdominal pain or shock [17].

8. Low Sugar Levels
One of the other major complications caused by malaria infection is low sugar levels. This happens as the malaria parasites dependent on glucose as a nutrient source [18].

9. Acute Renal Failure (ARF)
Acute renal failure (ARF) is commonly reported in people with severe malaria infection [19]. Malarial ARF is commonly found in non-immune adults and older children with falciparum malaria.

Tips To Prevent Malaria
There is no vaccine available to prevent malaria. However, you can consider the following steps to prevent the breeding of mosquitos [20]:
- While sleeping or travelling to malaria-prone areas, use mosquito repellents.
- Do not allow the water to stagnate near your house as they serve as the breeding ground for Anopheles mosquitoes.
- Wear full-sleeve clothes to keep the mosquitoes away from biting you.

On A Final Note…
People with malaria who receive treatment have a good long-term outlook. However, in the case of the development of the aforementioned complications, the outlook may not be as good. Talk to your doctor about long-term prevention and adopt preventive measures such as covering your skin in mosquito repellents and wearing full-sleeved clothes.




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