Malaria

Malaria is a life-threatening disease, caused by a parasite, that is spread to humans by some types of mosquitoes. It does not spread directly from person to person, and is mostly found in tropical countries and can be prevented and cured.

Symptoms can range from mild to life-threatening. Mild symptoms are fever, chills and headache. Severe symptoms include fatigue, confusion, seizures, and difficulty breathing. Left untreated, P. falciparum malaria can progress to severe illness and death within 24 hours.

Some people are at a higher risk of severe malaria infection. Infants, children under 5 years, pregnant women, travellers and people with HIV or AIDS are at a higher risk.

Malaria can be prevented by avoiding mosquito bites (bed nets and anti-mosquito sprays and ointments) and with preventive medicines (antimalarials). Treatments are also available to treat malaria and if given early will clear the infection and prevent mild cases from getting worse.

Malaria mostly spreads to people through the bites of some infected female Anopheles mosquitoes. Blood transfusion and needles contaminated with malaria-infected blood may also transmit malaria.

Fever, headache, and chills are typically the common initial signs of malaria. These symptoms generally develop within 10–15 days after being bitten by an infected mosquito.

For some people, especially those who have had malaria before, symptoms may be mild. Early testing for malaria is crucial. This is because certain strains of malaria can lead to severe illness and even death. The initial symptoms of malaria are also very similar to the symptoms of other deadly diseases.  

Those at a higher risk of developing severe disease include infants, children under 5 years, pregnant women, travellers, and individuals with HIV or AIDS. Malaria infection during pregnancy can cause early delivery, or delivery of a baby with low birth weight.

Severe symptoms Include:

• extreme tiredness and fatigue
• impaired consciousness
• multiple convulsions (seizures or fits)
• difficulty breathing
• dark or bloody urine (wee)
• jaundice (yellowing of the eyes and skin)
• abnormal bleeding.

People with severe symptoms should get emergency care right away. Getting treatment early for mild malaria can stop the infection from becoming severe.

Malaria mostly spreads to people through the bites of some infected female Anopheles mosquitoes. Blood transfusion and needles contaminated with malaria-infected blood may also transmit malaria.

Five Plasmodium parasite species cause malaria in humans and 2 of these species, P. falciparum and P. vivax, are the biggest threat. P. falciparum is the deadliest malaria parasite and the most common on the African continent.

P. vivax is the dominant malaria parasite in most countries outside of sub-Saharan Africa. The other malaria species which can infect humans are P. malariae, P. ovale and P. knowlesi.

Malaria prevention involves a two-pronged approach: avoiding mosquito bites and using medicines. Consult with a doctor or travel clinic if you don’t live in an area where malaria is common if you are travelling to malaria-prone areas.

There are various recommendations to minimise the risk of contracting malaria:

1. Use mosquito nets: Especially when sleeping in areas where malaria is prevalent.
2. Apply mosquito repellents: Use products containing DEET, IR3535, or Icaridin, particularly after dusk.
3. Employ coils and vaporizers: Additional measures to repel mosquitoes.
4. Wear protective clothing: Long sleeves and trousers reduce exposure to mosquito bites.
5. Install window screens: Prevent mosquitoes from entering living spaces.

Since October 2023, the World Health Organization (WHO) has recommended the use of malaria vaccines to prevent a specific type of malaria, P. falciparum, for children living in areas where malaria is common. P. falciparum is the deadliest type of malaria and is most common across Africa. This programme has been prioritised to specific areas where the risk of malaria is high.

There are two malaria vaccines currently available for use in these areas: RTS,S/AS01 and R21/Matrix-M. Both vaccines prevent around 75% of malaria cases when given before the start of the malaria season in areas where large amounts of the disease spread every season.

However, even better vaccines are needed that provide higher and more long-lasting protection against P. falciparum malaria. There are no available vaccines that protect against P. vivax malaria, so much work still needs to be done.

Read more information on our Malaria Vaccine page

Getting diagnosed and treated quickly for malaria is really important.

It helps to reduce how severe the disease may be, preventing deaths and stopping it from spreading.

Healthcare workers may prescribe the following medicines to treat malaria:

• Artemisinin-based combination therapy medicines are the most effective treatment for P. falciparum malaria.
• Chloroquine is recommended for the treatment of infection with the P. vivax parasite (only in places where it is still sensitive to this medicine – see more below about antimicrobial resistance).
• Primaquine should be added to the main treatment to prevent relapses of infection with the P. vivax and P. ovale parasites. 

Anti-microbial resistance (AMR)

In the past ten years, there's been a growing problem with certain malaria drugs not working as well as they used to. This is especially concerning in the Greater Mekong area. The World Health Organization (WHO) is also worried because reports show this issue is now happening in parts of Africa like Eritrea, Rwanda, Uganda, and Tanzania.

To tackle this problem, it's important to keep a close eye on how well the drugs are working. Regular checks can help us know if the medicines are still effective and guide how we treat malaria in places where it's common. This way, we can quickly respond if the drugs are not working well.

If you want to learn more about what WHO is doing in the Greater Mekong region against drug resistance, you can visit the Mekong Malaria Elimination Programme webpage.

Malaria: the role of the Mekong Malaria Elimination programme

Malaria elimination

In 2022, 34 countries reported having less than 1000 cases of malaria that originated within their borders. This is good news because it shows an increase from only 13 countries in 2000.

When a country goes three years without any new cases of malaria starting from within its borders, it can apply for a special certification from the World Health Organization (WHO). This certification means that the country has successfully eliminated malaria.

Since 2015, 12 countries have been declared malaria-free. These include: Maldives (2015), Sri Lanka (2016), Kyrgyzstan (2016), Paraguay (2018), Uzbekistan (2018), Argentina (2019), Algeria (2019), China (2021), El Salvador (2021), Azerbaijan (2023), Tajikistan (2023), and Belize (2023).

Malaria eradication: what we need to do.