What is Severe Malaria?

Matt Brady

Severe malaria is a life-threatening form of malaria that's most often caused by Plasmodium falciparum, one of the deadliest species of malaria parasite. Symptoms of severe malaria include coma, seizures, anemia, and kidney damage. Without treatment, this form of malaria can progress quickly and result in death. This form of malaria is most common in African children as well as in travelers who haven't been exposed to P. falciparum malaria before. Treating the disease generally requires intravenously administered antimalarial agents.

A mosquito spreading malaria.
A mosquito spreading malaria.

Most cases of severe malaria are contracted in Africa, particularly sub-Saharan Africa, where the P. falciparum parasite is most prevalent. P. falciparum can, however, be contracted in other parts of the world, such as parts of South America. There have been a few cases in which other species of malaria parasitesP. vivax and P. ovale—have also caused severe malaria.

IV fluids may be required to aid in the treatment of malaria.
IV fluids may be required to aid in the treatment of malaria.

Severe malaria also can quickly develop from a malarial infection that would otherwise have done little damage if treated quickly. It might also develop from a strain of P. falciparum that proves particularly drug-resistant. Once it develops, severe malaria can be very deadly. Adults and children with the disease can develop severe respiratory complications, suffer acute renal failure, develop anemia or hypoglycemia, and even slip into coma.

In most cases, travelers going to a malarial zone need to take prophylactic anti-malaria medication that is available only by prescription.
In most cases, travelers going to a malarial zone need to take prophylactic anti-malaria medication that is available only by prescription.

Certain demographics are at greater risk than others for developing severe malaria. Western tourists visiting Africa or other parts of the world where malaria is common are at a high risk. African children are also at great risk for contracting the disease. Most adults in Africa develop something of an immunity to malaria, but the immune systems of young children aren't yet strong enough to cope with the disease. As a result, many African children contract the disease, and a significant percentage die from it.

Even people from parts of the world where malaria is common can contract severe malaria when traveling through areas where the P. falciparum parasite is prevalent. This is the case in people who are traveling from Southeast Asia and South America, regions where malaria, but not the P. falciparum strain, is common. To prevent being affected by the P. falciparum parasite, travelers can get a malaria vaccine, or opt to take malaria pills while traveling.

Individuals who contract severe malaria may be physically unable to take oral medications. As a result, intravenous (IV) fluids containing antimalarial agents such as quinine may be administered. Due to adverse reactions to quinine in some individuals, a number of medical facilities have begun to instead administer artesunate, a water-soluble drug developed from artemisinin, an herb that has long been used in ancient Chinese medicine. Artesunate is not only highly effective against malaria, without the negative side-effects of quinine, but it can be given either by IV or injection.

Severe malaria can cause respiratory complications, acute renal failure, and even coma.
Severe malaria can cause respiratory complications, acute renal failure, and even coma.

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