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How dangerous is plasmodium falciparum malaria?

Dr Shirish Kumar
Haematologist,
WHO,
Geneva

Q: My 32 years old husband is in the hospital with Plasmodium falciparum malaria. Can you please tell me the risks after he recovers from this parasitic illness? I heard it can cause abnormalities if we try to get pregnant, is this true?

A:Malaria can be caused by several species of a parasite called Plasmodium following a bite by an infected mosquito. P. falciparum is the most virulent, causing severe disease as high levels of the parasite may develop in the blood and due to the tendency of the parasite to clog the capillaries of different organs. Involvement of the brain resulting in coma is seen only with P. falciparum malaria as also kidney and lung involvement. These symptoms are usually seen in young children and un-immunised individuals (people living in malaria free areas). Pregnant women are at increased risk of severe disease and death. In addition, increased risk of low birth weight, fetal loss, and prematurity may occur in non-immune mothers and immune primigravidas. P. falciparum may be resistant to chloroquine and rarely, it may cause the initial infection up to a year later.