Overview of Quaternary Malaria

Quaternary malaria, also known as quartan malaria, is a less common form of malaria caused by the parasite Plasmodium malariae. Unlike the more aggressive forms like P. falciparum or P. vivax, this type tends to cause recurring fevers every 72 hours, referred to as quartan fever. Though considered milder, it can persist for years and lead to serious kidney complications if left untreated. The infection spreads through the bite of an infected female Anopheles mosquito and has a global presence, particularly in parts of Africa, Asia and South America.

Types of Quaternary Malaria

1. Plasmodium malariae Infection: Causes quartan malaria and presents with a 72-hour fever cycle.

2. Mixed Infections: May occur alongside other Plasmodium species like P. falciparum or P. vivax, complicating the disease pattern.

3. Chronic Quaternary Malaria: Persisting in the blood for years, often asymptomatic, but can lead to long-term complications.

Symptoms of Quaternary Malaria

Cyclical fever spikes every 72 hours (quartan fever pattern)

Chills and shaking during fever episodes

Profuse sweating as fever breaks

Headache and body aches

Fatigue and weakness

Enlarged spleen

Mild jaundice in prolonged cases

Persistent low-grade parasitemia

Causes of Quaternary Malaria

Caused by the Plasmodium malariae parasite

Transmitted by the bite of an infected Anopheles mosquito

In rare cases, transmission via blood transfusion or contaminated needles

May remain dormant in the blood and reactivate years later

Complications in Quaternary Malaria

Chronic kidney disease (notably nephrotic syndrome)

Splenomegaly (enlarged spleen)

Anemia due to prolonged red blood cell destruction

Relapsing febrile illness over months or years

Rarely, immune complex-related damage to organs

Risk Factors of Quaternary Malaria

Living in or traveling to malaria-endemic regions

Lack of use of insect repellent or mosquito nets

Weakened immune system

Poor access to preventive healthcare

Blood transfusions in endemic areas

Preventions of Quaternary Malaria

Use insecticide-treated bed nets

Apply mosquito repellents containing DEET or picaridin

Wear long-sleeved clothing in mosquito-prone areas

Stay in screened or air-conditioned rooms

Take antimalarial prophylaxis if traveling to endemic areas

Ensure blood transfusions are screened in endemic countries