Malaria is a parasite that lives in red blood cells.
Malaria spreads through the bite of an infected Anopheles mosquito, which bites between dusk and dawn. The parasite goes first to the liver, then into the red blood cells, where it multiplies and bursts them in waves. Each wave brings fever with shivering. The right medicines clear it, but one kind can turn serious within a day or two, so a fever that could be malaria needs a test the same day.
In plain words.
Two kinds are common in India. Vivax is rarely deadly, but some of its parasites sleep in the liver and can cause fresh attacks weeks or months later. Falciparum can become severe quickly, affecting the brain, kidneys and lungs, especially in children, in pregnancy, and in people who have not had malaria before.
The classic pattern is shaking chills, then high fever, then sweating, often with headache, body ache and vomiting. The fever may come every day or every other day, but often it has no clear pattern. So any fever in or after the rainy season, or after a trip to a malaria area, deserves a malaria test.
A blood test, either a rapid test or a smear looked at under a microscope, confirms it the same day. Treatment depends on the kind: usually tablets for three days, and for vivax, a 14-day course of primaquine to clear the sleeping liver forms. With falciparum, a single dose of primaquine is usually added to stop the infection spreading to others. Primaquine can harm people with a common inherited condition called G6PD deficiency, so a G6PD test is done first where possible, and it is not given in pregnancy or to babies under one year old. Severe malaria needs injections in hospital.
The parasite’s journey
An infected mosquito bites between dusk and dawn. The parasites travel in the blood to the liver and multiply there quietly, usually for one to four weeks, with no fever yet.
They burst out of the liver into the blood and enter red cells. Inside, each one multiplies and bursts the cell, setting more free to attack new cells. Each wave of bursting brings fever with chills.
The right tablets clear the parasites from the blood, and the fever settles. With vivax, a second medicine, primaquine, clears the ones sleeping in the liver, so the attacks do not come back.
Go to hospital now if
- Confusion, drowsiness, a fit, or unable to sit or stand: call 112. Malaria may be affecting the brain.
- Fast or difficult breathing, very little urine, dark cola-coloured urine, or any bleeding: go to hospital now.
- Vomiting again and again, so that tablets or fluids do not stay down: go to hospital now.
- Yellow eyes with fever and feeling very weak: go to hospital now.
- Cold, clammy skin, feeling faint on standing, or very pale lips and palms: go to hospital now.
Call 112 or go to the nearest emergency department. Ambulance: 108 (102 in some states).
Get a malaria test the same day if
- You have any fever in or after the rainy season, or after a trip to a malaria area in the last few months
- The fever comes with chills or sweating
- You are pregnant, or it is a young child with fever
- Fever returns after malaria was treated
Tests that help.
Not everyone needs every test. He decides which ones are worth doing for you.
| Test | What it tells |
|---|---|
| Rapid malaria test | A finger-prick test that shows vivax or falciparum within about 20 minutes. It can stay positive for some weeks after treatment, so a smear is better when fever comes back. |
| Blood smear for malaria parasites | Confirms it, names the kind, and shows how many parasites there are. One negative test does not rule it out: repeat it if the fever continues. |
| Complete blood count | Haemoglobin and platelets are often low in malaria. |
| Kidney and liver function, and blood sugar | In anyone who is quite unwell, to look for signs of severe malaria. |
| G6PD test | Before primaquine, the medicine that clears the liver forms. |
Have it ready.
Tick them off as you gather them. The ticks stay on this phone only.
Online, or in person?
Finish the whole course, even if the fever settles in a day or two. Stopping early lets the parasites come back, and with vivax, skipping the 14-day liver course means more attacks later. Do not take malaria tablets “just in case” without a test.
A video call can
Needs a visit in person
- Blood tests, at a laboratory or by home collection
- Injected treatment in hospital for severe malaria
- Close watching for pregnant women and young children with malaria
- Any sign in the red box: that is an emergency
Talk it through with Dr. Arya.
Bring your reports and medicines to a video consultation. He goes through them with you, in plain words, and says clearly if you need to be seen in person.
Book a video consultationDr. Prabhat Arya · MBBS, MD (Internal Medicine) · Delhi Medical Council Reg. No. DMC-83759