Last Updated on January 19, 2023 by Shabnam Sengupta
In some of the world’s most populous regions, malaria continues to be a serious health concern. A parasite of the genus Plasmodium is what causes infection. Studies have shown that blood infected with malaria undergoes hematologic and biochemical changes, and this illness is frequently accompanied by complications. Reduced red blood cells, fewer platelets, and bleeding disorders are some blood-related changes associated with malaria infection. Patients with severe malaria are frequently related to liver involvement, which can cause enlarged liver, jaundice, and elevated levels of the liver enzymes. This article discusses malarial association with jaundice, how malaria affects the liver and results in jaundice, and how malarial jaundice should be treated.
How is jaundice associated with malaria?
WHO states that four factors have been identified as the main predictive markers of outcome in paediatric malaria. These include jaundice, hypoglycaemia, respiratory distress, and cerebral malaria, which impairs consciousness. The term “malarial hepatitis” refers to jaundice brought on by malaria. Jaundice is a key indicator of P. falciparum malaria. Malaria and jaundice are common problems in Indonesia and other Southeast Asian nations.
The condition is characterized by elevated bilirubin levels, and these elevated levels, particularly in children, indicate the severity of the disease. It should be stressed that these serum bilirubin levels are unmistakably linked to kernicterus and liver damage. Other factors that are crucial in the development of kernicterus may be present in many cases of jaundice in cases of P. falciparum malaria in very young children under two years of age.
How is the liver impacted by malaria?
The liver, where there is a massive parasitic multiplication, is the site of the second stage of malarial infection, which then spreads to the red blood cells. The liver is therefore the first organ to be exposed in cases of Plasmodium falciparum malaria. Elevated bilirubin levels may be seen in P. falciparum malaria cases that are particularly severe.
- Malaria-related jaundice is primarily caused by haemolysis,
- Reduced activity of liver cells, and
- Changes in small bowel function allow conjugated bilirubin to enter the bloodstream again.
After being bitten by an Anopheles mosquito, malaria takes approximately two weeks to develop. Newborn children are particularly vulnerable to elevated bilirubin levels at this time.
How is malarial jaundice managed?
The principles for treating malaria with jaundice are the same as those for treating severe malaria with complications, namely, getting rid of the infection as quickly as possible with injectable anti-malarial drug administration, symptomatic and supportive therapy, and complications treatment. Intravenous artesunate is the first choice and quinine is the second choice when choosing antimalarial medications for severe malaria.
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