Symptoms of malaria include fever, shivering, arthralgia or joint pain, vomiting, anemia which is caused by haemolysis, hemoglobinuria, retinal damage (Beare et al., 2006) and convulsions. Others include headache, loss of appetite and general body weakness.
The classic symptoms of malaria occur in cycles of sudden coldness followed by rigor, then fever and sweating lasting four to six hours and occurring every two days in P. vivax and P. ovale infection and every three days for P. malariae. However, P. falciparum can have recurrent fever every 36-48 hours or the fever may be almost continues. For reasons that are poorly understood, but that may be related to high intracranial pressure, children with malaria frequently exhibit abnormal posturing, a sign indicating severe brain damage (Idro et al., 2005).
The classic symptoms of malaria occur in cycles of sudden coldness followed by rigor, then fever and sweating lasting four to six hours and occurring every two days in P. vivax and P. ovale infection and every three days for P. malariae. However, P. falciparum can have recurrent fever every 36-48 hours or the fever may be almost continues. For reasons that are poorly understood, but that may be related to high intracranial pressure, children with malaria frequently exhibit abnormal posturing, a sign indicating severe brain damage (Idro et al., 2005).
Malaria has been found to cause cognitive impairments especially in children. It causes widespread anemia during a period of rapid brain development and also direct brain damage. This neurologic damage results from cerebral malaria to which children are more vulnerable (Biovin, 2002). Severe malaria is almost exclusively caused by P. falciparum infection and usually arises 6-14 days after infection (Trampuz et al., 2003). Consequences of severe malaria include coma and death if untreated. Young children and pregnant women are especially vulnerable. Splenomegaly, severe headache, cerebral ischemia, hepatomegaly/ hypoglycemia and hemoglobiuria with renal failure may occur. Renal failure may cause black water fever where haemoglobin from lysed red blood cells leaks into the urine. Severe malaria may progress extremely rapidly and cause death within hours or days. In most severe cases of the disease, fatality rates can exceed 20%, even with intensive care and treatment (Kain et al., 1998). In endemic areas, treatment is often less satisfactory and the overall fatality rate for all cases of malaria can be as high as one in ten (Mockenhaupt et al., 2004)
Another report stated that cerebral malaria can lead to hemiplegia, delirium, convulsions, hyperpyrexia, coma and death. Benign tertian malaria which is caused by P. vivax or P.ovale is usually not fatal but responds poorly to antimalarial treatment. It is characterized by alternate day paraoxysms and initial symptoms of fever, headache and myalgia. The typical malaria paroxysm is divided into three parts. There is a “cold stage” initially which starts with a rigor and lasts for 20-30 minutes. This is followed by a “hot stage” with temperatures of over 40o C, lasting for 3-8 hours. Finally, there is a “wet stage” characterized by profuse diaphoresis and general debility. Vasoconstriction occurs during the cold stage followed by vasodilatation in the hot stage. Vasodilatation is accompanied by decreased central venous pressure and hypotension in severe attacks (Adepoju-Bello and Ogbeche, 2003)
Quartan malaria which is caused by an infection with P. malariae has an exoerythrocytic stage lasting as long as 30-40 days. After this period, the symptoms which are manifested are malarial paroxysms with intermittent fever, hematuria, edema and albuminuria. Quartan malaria responds well to antimalarials (Aguwa, 1996).
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