Malaria: Symptoms, Treatment and Prevention in Pakistan

Every year, as the monsoon rains arrive and water collects in ditches, drains and flooded fields, doctors in Pakistan see a rise in fever cases. Many of them are malaria. It is spread by mosquitoes, it can be cured when found early, and it can be dangerous when it is not. If you or your child has a fever that comes and goes with shivering, a quick blood test can settle the question.

What causes malaria?

Malaria is caused by a parasite called Plasmodium, which is passed on by the bite of an infected female Anopheles mosquito. These mosquitoes bite mainly from dusk to dawn. Two types are important in Pakistan: Plasmodium vivax, which is the more common, and Plasmodium falciparum, which is the more dangerous. Malaria does not spread directly from person to person.

Malaria symptoms

Symptoms usually start 1 to 4 weeks after the bite, although vivax can stay silent for months. The classic pattern comes in stages: a sudden feeling of cold with shaking chills, then a high fever, then heavy sweating and exhaustion. The cycle may repeat every two to three days. Other symptoms include:

• Headache and body aches
• Nausea, vomiting and loss of appetite
• Weakness and tiredness
• Pale skin from anaemia, and sometimes a yellow tint

Early malaria can look like dengue or typhoid, so please do not guess. A test is the only way to tell them apart.

Severe malaria is an emergency

Go to a hospital immediately if there is confusion, extreme drowsiness, seizures, difficulty breathing, severe weakness, repeated vomiting, dark urine, very little urine, yellow eyes or bleeding. Severe malaria, mainly from falciparum, can become life-threatening within hours. Children, pregnant women and people with weak immunity are at greater risk.

How is malaria diagnosed?

A blood test called a malaria film (smear) or a rapid diagnostic test gives a result within hours. If the first test is negative but the fever continues, your doctor may repeat it. Never start malaria tablets without a positive test unless your doctor decides to treat you.

Treatment

Malaria is curable, and the medicine depends on the type of parasite and where you live. In general:

• Vivax malaria is commonly treated with chloroquine. Because vivax can hide in the liver and return months later, doctors also give a second medicine, primaquine or tafenoquine, to prevent relapse. A blood test for G6PD deficiency is needed first, because these medicines can break down red blood cells in people who lack this enzyme.
• Falciparum malaria is treated with artemisinin-based combinations such as artemether and lumefantrine. Severe cases need injectable artesunate in hospital.
• Paracetamol helps with fever and aches, and plenty of fluids and ORS prevent dehydration.

Finish the full course even when you feel better, and do not share leftover tablets. Doses depend on age and weight, so use only the schedule your doctor gives you.

How to prevent malaria

• Sleep under a mosquito net, preferably an insecticide-treated one, and use window screens.
• Wear long sleeves and trousers in the evening and use a repellent containing DEET or picaridin.
• Drain standing water around the home, such as old tyres, buckets, coolers and puddles, because mosquitoes breed there.
• Use mosquito coils or vaporisers indoors, with good ventilation.
• Protect children and pregnant women especially, and see a doctor at once if they develop fever.
• Travelling to a high-risk area? Ask your doctor about preventive tablets before you go.

When to see a doctor

• Any fever with chills in the rainy season or after travel to a malaria-affected area
• Fever that returns every few days
• Fever in a child, a pregnant woman or an older person
• Any warning sign of severe malaria listed above

Key takeaways

• Malaria is spread by night-biting mosquitoes and causes fever with shaking chills.
• Test before treating, because dengue and typhoid look similar.
• Vivax needs a second medicine to prevent relapse, after a G6PD test.
• Nets, repellents and removing standing water protect you best.

Related medicines on Medimart

These are medicines doctors commonly use for malaria and its symptoms:

• Chloroquine: used for vivax malaria
• Artemether and lumefantrine: used for falciparum malaria
• Artesunate: used in severe malaria under medical care
• Paracetamol: for fever and body aches
• Oral rehydration salts (ORS): to replace lost fluids

Prescription medicines are supplied only against a valid prescription. Please take them only as advised by your doctor.

Browse malaria medicines on Medimart with delivery across Pakistan. Prescription medicines are supplied only against a valid prescription.

This guide is for general information and does not replace advice from a doctor. A fever with shaking chills needs a blood test.