What is malaria?

The word malaria comes from 18th century Italian mala meaning "bad" and aria meaning
"air". Most likely, the term was first used by Dr. Francisco Torti, Italy, when people
thought the disease was caused by foul air in marshy areas.
It was not until 1880 that scientists discovered that malaria was a parasitic disease which
is transmitted by the anopheles mosquito. The mosquito infects the host with a one-cell
parasite called plasmodium. By the end of the 18th century, scientists found out that
Malaria is transmitted from person-to-person through the bite of the female mosquito,
which needs blood for her eggs.

According to the World Health Organization1 (WHO):

Approximately 660,000 people died from malaria in 2010 globally, most of them were
African children.
There were an estimated 219 million cases of malaria infection in 2010 worldwide.
Malaria is a preventable and curable disease.
Malaria mortality rates have fallen by over 25% since 2000. In the WHO African region
rates have dropped by 33%.
The malaria burden in many parts of the world is being dramatically reduced thanks to
increased malaria prevention and control measures.
Malaria is caused by a parasite called Plasmodium, which is transmitted via the bites of
infected mosquitoes. In the human body, the parasites multiply in the liver, and then
infect red blood cells.

There are five types of malaria:

Plasmodium vivax (P. vivax) - milder form of the disease, generally not fatal. However,
infected people still need treatment because their untreated progress can also cause a host
of health problems.
Plasmodium malariae (P. malariae) - milder form of the disease, generally not fatal.
However, the infected human still needs treatment because no treatment can also lead to a
host of health problems. This type of parasite has been known to stay in the blood of
some people for several decades.

Plasmodium ovale (P. ovale) - milder form of the disease, generally not fatal. However,
the infected human still needs to be treated because it may progress and cause a host of
health problems.

Plasmodium falciparum (P. faliparum) - the most serious form of the disease.

Plasmodium knowlesi (P. knowlesi) - causes malaria in macaques but can also infect
humans.
Thetimefromtheinitialmalariainfectionuntilsymptomsappear(incubationperiod)typically
rangesfrom:2
9to14daysforPlasmodium(P.)falciparum.
12to18daysforP.vivaxandP.ovale.
18to40daysforP.malariae.
11to12daysforP.knowlesi.

Commonsymptomsofmalaria
Intheearlystages,malariasymptomsaresometimessimilartothoseofmanyother
infectionscausedbybacteria,viruses,orparasites.Symptomsmayinclude:
Fever.
Chills.
Headache.
Sweats.
Fatigue.
Nauseaandvomiting.
Laboratory Findings:

Low RBC
Low Hemoglobin

Nursing Diagnosis and Nursing Interventions for Malaria

Changes in nutrition less than body requirements related to inadequate food intake,
anorexia, nausea / vomiting
Nursing Intervention :
1 Assess history of nutrition, including foods that are preferred. Observation
and record the client's food input.
2 Rational: watching caloric intake or lack of quality of food consumption.
3 Give extra food to eat little and small.
4 Rational: gastric dilatation may occur when feeding too fast after a period
of anorexia.
5 Maintain a schedule of regular body weight.
6 Rational: Monitors the effectiveness of weight loss or nutrition
intervention.
7 Discuss the preferred client and input in a pure DIET .
8 Rational: It can increase input, increase the sense of participation / control.
9 Observation and record the events of nausea / vomiting, and other related
symptoms.

10 Rational: to show the effect of GI symptoms of anemia (hypoxia) on

organ.
11 Collaboration with a dietitian.
12 Rational: Need help in planning a diet that meets nutritional needs.
High risk of infection related to a decrease in body systems (main defense is inadequate),
invasive procedures.

Nursing Intervention:
1 Monitor body temperature increases.
2 Rational: Fever caused by the effects of endotoxin on the hypothalamus
and hypothermia are important signs that reflect the development status of
shock / decrease in tissue perfusion.
3 Observe the chills and diaforosis.
4 Rational: Shivering often precedes the height of the temperature on a
common infection.
5 Monitor the sign deviation condition / failure to improve during therapy.
6 Rational: It can show Inaccurate antibiotic therapy or growth of
organisms.
7 Provide anti-infective medication as directed.
8 Rational: It can kill / give temporary immunity to common infections.
9 Get spisemen blood.
10 Rational: The identification of the causes of malaria infections.

Hyperthermia is related to increased metabolism of circulating germ dehydration direct

effect on the hypothalamus.

Nursing Intervention:
1 Monitor patient's temperature (degree and pattern), note the chills.
2 Rational: Hipertermi showed an acute infectious disease process. The
pattern of fever indicates a diagnosis.
3 Monitor the temperature of the environment.
4 Rational: The temperature of the room / the number of sheets should be
changed to maintain the temperature close to normal.
5 Give a warm compress bath, avoid using alcohol.
6 Rational: It can help reduce a fever, use of ice / alcohol may cause cold. In
addition, alcohol can dry the skin.
7 Give antipyretics.
8 Rational: Used to reduce fever with its central action on the hypothalamus.
9 Give a cooling blanket.
Rational: Used to reduce fever with hyperthermia.

MANAGEMENT:
Monitorpatientsgeneralconditionthoroughly
Checkandmonitorvitalsigns
Keepacarefulrecordoffluidintakeandoutput
Noteanyappearanceofblackurine(haemoglobinuria)
Performtepidspongingifpatienthavingfever
Administerparacetamolasanantipyreticifnecessary
Monitorthetherapeuticresponse
MALARIACONTROL

Useofinsecticidaltreatedbednetsbypeopleinfectedwithmalariaandpeopleat
risk.
Indoorresidualsprayingwithinsecticidetocontrolthevectormosquitoes

PRECAUTIONMEASURESTOPREVENTMALARIA

Avoidexposuretomosquitoesduringtheearlymorningandearlyevening.
Wearlongsleevedshirtsandlongpantsespeciallywhendoingoutdooractivity
Havescreensovercoverwindowsanddoors
Sprayinsecticideinthebedroombeforegoingtobed

PROGNOSIS:

Ifmalariapatientisnottreated,malariacanquicklybecomelifethreateningby
disruptingthebloodsupplytovitalorgans.

TREATMENT:
MEDICATIONS
Control/reducefeverparacetamol
Antimalariadrugschloroquine,quinine,mefloquine,doxcycline,proguanil