That day I got malaria

When we left for Africa, there were a few things that we were highly warned about : DON’T ride boda boda without helmet, DON’T walk in the dark alone, DON’T eat without washing your hands and DON’T get malaria.

Easier said than done, my friend.

Let me explain a bit : 

First, what is malaria ? 

“Malaria is a life-threatening mosquito-borne blood disease caused by a Plasmodium parasite.

It is transmitted to humans through the bite of the Anopheles mosquito.

Once an infected mosquito bites a human, the parasites multiply in the host's liver before infecting and destroying red blood cells.

In uncomplicated malaria, symptoms progress as follows, through cold, hot, and sweating stages:

- A sensation of cold with shivering

- Fever, headaches, and vomiting

- Seizures sometimes occur in younger people with the disease

- Sweats, followed by a return to normal temperature, with tiredness”

Medical News Today

In simpler words, malaria is a disease that you get through mosquito bites, and that induces (among other things) high fever. In 2016, there were an estimated 216 million cases of malaria and deaths reached 445 000 in 91 countries, mostly in Sub-Saharan Africa. 

There is unfortunately no vaccination against malaria; the only form of prevention is either physical (mosquito nets, repellent) or medical (anti-malaria pills). 

The risk prevalence in Kenya is high, and even more so in our Western Province region (30%) because of weather, humidity (and Lake Victoria) and sanitation. 

Back in Europe, malaria is considered extremely dangerous, yet prevention treatment is quite polemic. Depending on your medical institution or your doctor, you can hear anything and its contrary. In our case, we were strongly advised by our NGO and trainers to take the prevention treatment; but my city’s Tropical Diseases Unit doctor advised me against it for the long term. Indeed, the prevention drugs are very strong, with side effects such as hallucinations, dizziness, photo sensibility, liver damage… 

Anyhow,taking the medication or not is really a personal decision (to be made under medical advice of course). 

Fast forward to Kenya; we decided to take Malarone during the rainy season (theoretically September to November).

During the first few weeks we didn’t feel so healthy, but it is hard to put it on the malarone, as our whole environment and hygiene and food habits were changing(an article on this later). We did not have huge side effects other than stomach issues and hallucinations for Linda (quite scary). 

Then one Friday, three weeks after arriving, I woke up feeling pretty sick. The night before I had taken for the first time a sleeping pill, so I just figured it was the side effect: feeling dizzy, weak, a bit nauseous, general fatigue. I spent the whole morning foggy at home, thinking it was going to clear off during the day.

As we were about to leave for the office, I felt that I was getting dizzier, warmer and sweaty, so I decided to take my temperature, just to be sure. To my surprise, I was at 38.5°C (usually I’m at 37°C); but at that point I thought it could be anything, for example diarrhea (which often comes with fever here). Our local partners advised me to get tested immediately, so Linda and Abraham kindly took me to the local clinic, located near our office.

The malaria test is quite simple; a blood sample is analysed under microscope to check if there are parasites in the blood. 

At that precise instant, I was getting quite nervous, but still I refused to believe I could have actually gotten malaria; Linda and I were both arguing that no, of course, it wasn’t even possible… Until the lab technician returned, and told me I indeed had parasites in my blood. I had malaria !

Quite the shock! 

I tried not to panic (or more like, I started panicking and Linda tried to reassure me), while being prescribed the medication.

We then went back to the office to discuss the next steps, and I decided to go back home to rest and monitor the fever, and go to the hospital only if the fever got too high (above 40). Our recommended hospital is a 1,5-hour drive away so I preferred monitoring from home.

To be honest I was pretty lucky, as I “only” had high fever (up to 39.8) and extreme fatigue. I spent two days in bed, feeling better little by little yet still feverish on the second day. It was unsettling to have constant high fever for so many hours and to feel sweaty and chills all the time! Even when I was feeling better in my bed, I tried to get up and I would start sweating again and feeling the fever rise. The third day, I felt mostly tired and very very sore (all my body was aching!). 

Overall the experience was not as traumatizing as I thought it would be, more like a bad flu than anything. Perhaps the harshest was the duo-cotecxin (treatment), which is extremely strong and gave me stomach problems for the next couple of days. 

After that, I decided to stop the prevention treatment as anyways I most likely already had parasites in my blood and malarone is quite strong too. Now I’m just careful with mosquito nets and repellent!

And at least now I can say I had a very “local medical experience”!