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Malaria: Types, Symptoms, Causes and Treatment

By Dr. Vishesh Bharucha +2 more

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Introduction

Malaria is one of the most dreaded diseases. It is widespread across more than 90 countries, particularly in sub-Saharan Africa, South Asia, and regions of South America. It occurs when the malaria parasite, Plasmodium, infects the female mosquito, Anopheles1. When the malaria mosquito bites humans, within a period of 10 to 15 days, the malaria symptoms start to occur2.  

types of malaria and their symptoms

Malaria symptoms vary depending on the subspecies of the Plasmodium that has infected the Anopheles mosquito. Based on the malarial parasite involved, there are four different types of malaria. Each of these types have a different severity of symptoms and needs to be treated differently.  

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In this blog, we will discuss in detail about malaria; its type, symptoms and treatment. These will help you better understand this infection and know when to act promptly. 

Malaria in India

India carries a significant share of the malaria burden in the South-East Asia region, though cases have declined considerably over the past decade due to sustained control efforts. The disease is not evenly spread across the country; transmission tends to cluster in certain states and districts.

The highest-burden regions include the eastern and central states of Odisha, Chhattisgarh, Jharkhand, and Madhya Pradesh, along with parts of Maharashtra. The Northeastern states, including Assam, Meghalaya, Mizoram, Tripura, and Arunachal Pradesh, also report substantial malaria activity10.

Within these states, transmission is concentrated in forested, hilly, tribal, rural, and high-rainfall areas. Such regions often combine dense vegetation, water collection sites that allow mosquitoes to breed, and limited access to healthcare, which together create favourable conditions for the disease to spread. Both Plasmodium vivax and Plasmodium falciparum circulate in India, with their relative proportions varying by region. Plasmodium vivax accounts for a large proportion of reported malaria cases, while Plasmodium falciparum is associated with a higher risk of severe disease and complications. Understanding where malaria is common can help travellers and residents take timely precautions.

Types of Malarial Diseases

1. Plasmodium Vivax (P.v)

This is the most common kind of malaria. It is the most widely distributed kind, found all across the globe. More than half of malaria infections found across India are of this type. It may be present in dormant stages and its presence can lead to recurrent episodes of the disease. 

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More often than not, it does not prove fatal but can be severely debilitating. Common symptoms of this kind of malarial disease include fever and chills, diarrhoea, severe fatigue and flu-like symptoms3.  

2. Plasmodium Ovale (P.o)

This is one of the least common types of malaria. It is found mostly in western countries of Africa. Rarely, it is also observed in areas of Philippines, Indonesia, and Papua New Guinea. The symptoms include high fevers and shaking chills, headache, cough, diarrhoea, abdominal/joint pain, and body aches. This malaria disease can be recurring as the parasite rests in the patient’s liver and can stay dormant for years. Relapse may occur at any time during this period, with red blood cells being attacked, and the symptoms appearing again. Among all the types of malaria, this one is dangerous, if not deadly4

3. Plasmodium Falciparum (P.f)

This is the deadliest subtype of malaria in the world. This subspecies of the parasite is found in Africa, Southeast Asia, and South America. Unlike the above species, this species does not cause liver-stage relapses. 

The patient feels the malaria symptoms like nausea, fatigue, body aches, enlarged spleen, pain in the abdomen, muscles, and joints, fever, headaches, anaemia and specific neurological symptoms like confusion and seizures. The severity of this malaria disease are such that it needs to be checked for, diagnosed and treated in time to prevent fatalities. It can cause significant harm to the brain and the nervous system. Paralysis and convulsions can also occur in this malaria.  

If you are travelling to any of the above areas, take your antimalaria medications to prevent this disease5. Additionally, malaria vaccines such as RTS,S/AS01 and R21/Matrix-M are now available to protect children against P. falciparum infection2

4. Plasmodium malariae (P.m)

This is the least common kind of malaria. Fever and chills are the usual malaria symptoms. Sub-Saharan Africa and the southwest Pacific are where the malaria parasite causing this kind of malaria is common. It may persist in the bloodstream at low levels for extended periods, causing chronic infection, but it does not remain in dormant form in the liver1,6

FeatureP. falciparumP. vivaxP. ovaleP. malariae
Geographic distribution1Africa, Southeast Asia, South AmericaWorldwide, the most common type in IndiaMainly West Africa; rarely Asia-PacificSub-Saharan Africa, the southwest Pacific
SeverityMost severeUsually mild to moderate, but severeUsually mildUsually mild
Can it come back after recovery?Does not relapse, but reinfection can occur YesYesNo (but can persist at low levels in blood for years)
Key symptoms/complicationsFever, anaemia, organ involvement, cerebral malaria, seizures, and confusionFever, chills, fatigue, flu-like illness, recurrent episodesfatigue, flu-like illness, recurrent episodes, fever, chills, headache, body achesFever, chills; chronic low-grade infection
Fatality risk2High if untreatedLow, rarely fatalLowLow

Warning Signs of Malaria

warning sign of malaria

Most malaria infections can be treated effectively when diagnosed early. However, malaria, particularly P. falciparum, can sometimes progress rapidly and become life-threatening. Recognising the warning signs of severe malaria can help you or a loved one get help in time.

Children, pregnant women, older adults, and people with weakened immune systems may be at higher risk of severe malaria and should seek medical evaluation promptly if malaria is suspected. 

Seek immediate medical care if a person with suspected or confirmed malaria develops any of the following11:

  • Confusion, drowsiness, or altered consciousness
  • Seizures (fits)
  • Difficulty breathing or rapid breathing
  • Persistent vomiting and inability to keep fluids down
  • Severe weakness or being unable to sit or stand
  • Yellowing of the eyes or skin (jaundice)
  • Dark or reduced urine output.
  • Unusual or significant bleeding
  • Severe pallor (unusual paleness) or signs of severe anaemia 
  • Loss of consciousness

These signs may indicate that the infection is affecting vital organs such as the brain, lungs, or kidneys. Do not wait for symptoms to improve on their own.

Severe malaria is a medical emergency and requires urgent hospital treatment. If you notice any of these signs, seek emergency care without delay.

Treatment of Malaria

Various regimens are followed in the treatment of malaria, depending on the type and drug resistance in humans. Some common ones include7

  • Chloroquine for uncomplicated chloroquine-sensitive malaria 
  • Mefloquine alternative for uncomplicated chloroquine-resistant cases 
  • Quinine for chloroquine-resistant and severe malaria 
  • Doxycycline used in combination with quinine 
  • Pyrimethamine-Sulfadoxine combined with quinine in resistant cases 
  • Primaquine for P. vivax and P. ovale (targets liver hypnozoites) 
  • Halofantrine used in some resistant P. vivax cases  
  • Artemisinin based combination therapy in severe and chloroquine resistance P. falciparum cases 
  • Clindamycin adjunct therapy in resistant or severe infections 

Note: Primaquine should be used with caution in G6PD-deficient patients. 

Drug Resistance in Malaria

  • Malaria treatment has become more complex because some malaria parasites have developed resistance to certain medicines. Chloroquine-resistant strains of Plasmodium falciparum are now widespread, which is why chloroquine is no longer relied upon for treating falciparum malaria in many regions. This is also a reason treatment recommendations differ from one area to another, as the medicines that work best depend on local resistance patterns12.
  • For P. falciparum, Artemisinin-based Combination Therapies (ACTs) are the recommended first-line treatment in most parts of the world, including India, because they remain highly effective and combine two medicines to reduce the chance of further resistance developing. Because resistance evolves over time, it is important that diagnosis and treatment follow current local and national guidelines rather than older or general advice. A doctor will choose the appropriate regimen based on the malaria type and the region involved. It is important to complete the full course of prescribed antimalarial treatment, even if symptoms improve, to help ensure complete parasite clearance and reduce the risk of treatment failure12.

How to Prevent Malaria?

While you may think it’s impossible to avoid getting bitten by a mosquito, malaria prevention methods are widely known and accepted. Here are a few8,9

1. Avoidance

If you can avoid travelling to an area where malaria is common, then do that. This may mean changing your travel plans, but if you can’t avoid it follow the below-mentioned precautions. 

2. Medication

There are standard medications you can take if you are planning to travel to a country where malaria is a risk.  

3. Personal Protection

A good way of protecting yourself is to wear clothing that covers the skin of your arms and legs. Additionally, you can also use mosquito-specific repellent sprays as well as topical creams and lotions. Look for the following ingredients in repellents for protection from mosquitoes: 

  • DEET (20 to 50% concentrated) 
  • KBR 3023 and icaridin  
  • IR3535 
  • Oil of lemon eucalyptus (OLE) 
  • Para-menthane-diol (PMD) 
  • 2-undecanon 

4. Added Protection

Use mosquito nets to cover your sleeping area and install screens on doors and windows to keep mosquitoes out. For extra protection, use permethrin-treated nets and clothing, or apply 0.5% permethrin spray to gear such as boots, pants, socks, and tents.  

5. Medication for Travellers (Prophylaxis)

If you are travelling to an area where malaria is common, your doctor may recommend preventive medication, known as chemoprophylaxis, taken before, during, and for a period after your trip. Because no preventive measure is fully protective on its own, these medicines are used alongside mosquito-bite prevention. Commonly used options include8

  • Atovaquone-proguanil: Often chosen for shorter trips and generally well tolerated.
  • Doxycycline: An antibiotic that also offers protection against malaria; it may not suit everyone.
  • Mefloquine: Sometimes used for longer stays, though it is not appropriate for people with certain medical histories.

The right choice depends on several factors, including your destination, how long you will be travelling, your medical history and any existing conditions, and the local drug-resistance patterns in the area. For this reason, you should consult a doctor or a travel-health clinic well before departure, ideally a few weeks ahead, so the medication can be started at the correct time. This blog does not provide dosages; medication and timing should always be decided by a healthcare professional.

6. Malaria Vaccines

Vaccines are now an important addition to malaria prevention. Two vaccines have been recommended by the World Health Organization for use in children living in regions where Plasmodium falciparum malaria is common13:

  • RTS, S/AS01 (Mosquirix): The first malaria vaccine recommended by the WHO.
  • R21/Matrix-M: A more recently recommended vaccine.

These vaccines are intended primarily to reduce severe P. falciparum malaria and deaths in young children, the group at most risk. Both have been shown to meaningfully lower the risk of malaria when delivered as part of routine childhood immunisation in endemic areas.

It is important to understand that these vaccines reduce risk but do not provide complete protection, and they are not a replacement for other measures. Children and families should continue to use mosquito nets, repellents, and other bite-prevention methods, and seek prompt treatment if malaria is suspected. Vaccine availability and rollout vary by country, so local health authorities can advise on what is offered in a given area.

Also Read: What Is Hantavirus? Symptoms, Causes, & Effective Prevention

Conclusion

While malaria is usually a non-fatal disease, some types may be dangerous and require prompt recognition and treatment. Knowing the types of malaria and their severity allows you to act immediately if you notice any symptoms.   

Depending upon the type, several antimalarial medicines are available for treatment, used in various permutations and combinations with other drugs. Yet, the cornerstone of management remains taking adequate precautions to prevent the occurrence of these infections in the first place.

Also Read: Tuberculosis: Types, Causes, Treatment and Prevention

References

  1. Buck E, Finnigan NA. Malaria [Internet]. Treasure Island (FL): StatPearls Publishing. 2025 Jan; [updated 2023 Jul 31; cited 2025 Jul 2]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK551711/ 
  2. World Health Organization. Malaria [Internet]. Geneva: World Health Organization; 2024 [cited 2025 Jul 2]. Available from: https://www.who.int/news-room/fact-sheets/detail/malaria 
  3. Menkin‑Smith L, Winders WT. Plasmodium vivax Malaria [Internet]. Treasure Island (FL): StatPearls Publishing. 2025 Jan; [updated 2023 Jul 17; cited 2025 Jul 2]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538333/ 
  4. Okafor CN, Finnigan NA. Plasmodium ovale Malaria [Internet]. Treasure Island (FL): StatPearls Publishing. 2025 Jan; [updated 2023 Aug 14; cited 2025 Jul 2]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519021/ 
  5. Zekar L, Sharman T. Plasmodium falciparum Malaria [Internet]. Treasure Island (FL): StatPearls Publishing. 2025 Jan; [updated 2023 Aug 8; cited 2025 Jul 2]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK555962/ 
  6. Mueller I, Zimmerman PA, Reeder JC. Plasmodium malariae and Plasmodium ovale–the “bashful” malaria parasites. Trends Parasitol. 2007 Jun;23(6):278-83. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC3728836/ 
  7. Crutcher JM, Hoffman SL. Malaria. In: Baron S, editor. Medical Microbiology [Internet]. 4th ed. Galveston (TX): University of Texas Medical Branch at Galveston; 1996. Chapter 83 [cited 2025 Jul 2]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK8584/ 
  8. Centers for Disease Control and Prevention. Preventing malaria while traveling [Internet]. CDC; [cited 2025 Jul 2]. Available from: https://www.cdc.gov/malaria/prevention/index.html 
  9. Mississippi State Department of Health. Vector Control and Permethrin Use for Personal Protection [Internet]. MS; [cited 2025 Jul 7]. Available from: https://msdh.ms.gov/page/resources/458.pdf 
  10. World Health Organization. World malaria report 2025: addressing the threat of antimalarial drug resistance. Geneva: World Health Organization; 2025. Available from: https://www.who.int/teams/global-malaria-programme/reports/world-malaria-report-2025
  11. World Health Organization. WHO guidelines for malaria. Geneva: World Health Organization; 2025. Available from: https://www.who.int/publications/i/item/guidelines-for-malaria
  12. Drug resistance: malaria. New Delhi: National Centre for Vector Borne Diseases Control, Ministry of Health and Family Welfare, Government of India. Available from: https://ncvbdc.mohfw.gov.in/index1.php?lang=1&level=1&sublinkid=5811&lid=3799 
  13. Malaria vaccines (RTS,S and R21): Q&A on RTS,S malaria vaccine. Geneva: World Health Organization; 2026. Available from: https://www.who.int/news-room/questions-and-answers/item/q-a-on-rts-s-malaria-vaccine

 Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof. 

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