Are They the Same? Dengue vs Malaria

Dengue and malaria are two prevalent mosquito-borne diseases that can be fatal if not effectively addressed. Aedes mosquitoes, which carry dengue, and Anopheles mosquitoes, which carry malaria, live in different habitats and exhibit distinct behaviours.¹

By implementing effective management and maintaining a vigilant approach, we can confidently address these diseases and minimise their impact on human health.

What is Dengue?

Dengue fever, a virus transmitted by the Aedes mosquito, is prevalent in South Asia during the monsoon seasons, occurring from April to September and from October to March. The virus tends to thrive in stagnant water, making containment a significant concern.²

In November 2023, the World Health Organization (WHO) reported a total of 78 deaths, compared to 35 deaths during the same period in 2022. The number of dengue caseshas increased to 100,936, contrasting with the 39,188 cases recorded in the same timeframe last year.³⁴

This increase represents a notable rise of 43,297 cases, indicating a significant 110.5% surge compared to the previous year in 2022. It is essential that prompt action is taken to address this escalating situation.³

What is Malaria?

Malaria, a disease transmitted mainly by infected female Anopheles mosquitoes, is a complex phenomenon. To contract malaria parasites, these mosquitoes must feed on an individual carrying the parasites.⁵ 

Malaysia successfully eliminated human malaria infections from 2018 to 2021. However, this year has seen a worrying increase, surpassing 2022's total cases. Climate change is a contributing factor. Notably, Kelantan reported 215 cases, Sabah had 840 cases by June, and Terengganu had 26 cases in the first five months. This contrasts with Malaysia's previous zero malaria cases between 2018 and 2021, posing new challenges for control efforts.⁶⁴ 

Malaria vs Dengue: What Are the Symptoms?

In 2021, WHO reported 619,000 malaria deaths globally.7 Additionally, 100 to 400 million people worldwide face the risk of getting malaria each year.8 In 2022, there were 249 million malaria cases, 5 million more than in 2021. Malaria deaths increased in 2020 to 631,000 but decreased to 608,000 in 2022. Notably, the percentage of malaria deaths in children under 5 decreased from 87% in 2000 to 76% in 2015, with no further change since then. 

Despite these global trends, it's crucial to recognise and distinguish between symptoms of malaria and dengue fever.⁹

Malaria

During a blood meal, an infected female Anopheles mosquito introduces sporozoites into the human host.¹⁰ Symptoms usually start within 10–15 days of getting bitten by an infected mosquito, while others might experience symptoms much later, possibly up to a year or more.¹¹⁷

The range of malaria symptoms includes:¹¹

• Fever and flu-like illness
• Chills
• Headaches, muscle aches and a constant feeling of fatigue
• Digestive problems (diarrhoea, nausea and vomiting)

In addition to these symptoms, malaria can also lead to:¹¹

• Anaemia
• Jaundice

It's crucial to understand that if left untreated, malaria infections can progress to a severe stage, resulting in grave consequences. The unchecked advancement of malaria can lead to conditions such as:¹¹

• Kidney failure
• Seizures
• Mental confusion
• Coma
• In the most dire cases, death

Dengue

Dengue fever, a commonly encountered viral illness, usually takes a mild course, with many individuals experiencing either mild symptoms or none at all.¹² The majority of those affected find relief within 1 to 2 weeks but 1 in 20 may develop severe dengue.¹²¹³

Typically, dengue symptoms may appear 4 to 10 days post-infection and persist for 2 to 7 days. These include:⁸

• High fever (as high as 40°C)
• ​Headache​
• Eye pain (behind the eyes)
• Muscle and joint pains
• Digestive distress (nausea, vomiting, and swollen glands)
• Rash

Individuals who have previously had dengue are at risk of being infected again and developing severe dengue, which is also known as dengue haemorrhagic fever.^8,14 This phenomenon is often referred to as "secondary dengue infection".¹⁴

This escalation often occurs after the initial fever subsides and can bring about:⁸

• Abdominal pain
• Persistent vomiting
• Breathing difficulties
• Bleeding incidents
• Fatigue and restlessness
• Blood in vomit or stool
• Extreme thirst

How Can We Effectively Combat These Diseases?

When it comes to dengue, it's crucial to highlight that there's no specific cure, and the focus is on easing pain symptoms. Healthcare providers commonly use medications like paracetamol to effectively manage discomfort.⁸ On the other hand, malaria is now being tackled with a broader approach since October 2021. The World Health Organization (WHO) recommends the extensive use of the RTS,S/AS01 malaria vaccine among children living in areas with moderate to high P. falciparum malaria transmission.7 This vaccine has proven to significantly reduce both malaria and severe cases among young children. 

Additionally, traditional malaria treatment involves prescription drugs targeting and eliminating the parasite causing the disease. The choice of drugs and the treatment duration depend on factors such as:¹⁵

• Malaria parasite type
• Symptom severity
• Age
• Pregnancy

Malaria and dengue infections, both transmitted through mosquito bites, pose significant threats to human health. Adopting effective prevention methods is paramount in curbing their spread. Maintaining cleanliness in our surroundings and eradicating stagnant water sources are crucial steps in reducing mosquito breeding grounds, especially for dengue prevention. However, it's important to note that malaria prevention also involves additional measures.

In addition to cleanliness, utilising mosquito nets, repellents, and protective clothing can greatly diminish the likelihood of mosquito bites and infection.¹⁶ These preventive measures provide a comprehensive approach to mosquito-borne diseases, addressing common factors shared by both malaria and dengue.

By staying informed and taking initiatives to safeguard not just ourselves but our loved ones too, we can actively participate in the elimination of both malaria and dengue fever. Let us take responsibility and guarantee a healthier future for all.

Reference

1. Arsalan, Q., Qadar, L. T., Ochani, R. K., Tahir, F., & Majid, Z. (2019). Collateral Presentation of Malaria and Dengue Viral Hemorrhagic Fever: A Rare Case. Cureus, 11(2), e4050. https://doi.org/10.7759/cureus.4050
2. Al Jazeera. (2023). Global warming, longer monsoon rains making dengue deadlier in South Asia. Retrieved September 29, 2023, from Al Jazeera: https://www.aljazeera.com/news/2023/9/8/global-warming-longer-monsoon-rains-making-dengue-deadlier-in-south-asia
3. Malay Mail. (2023). Health D-G: Dengue cases up 18.7pc from Sept 3 to 9, two deaths reported. Retrieved September 29, 2023, from Malay Mail: https://www.malaymail.com/news/malaysia/2023/09/15/health-d-g-dengue-cases-up-187pc-from-sept-3-to-9-two-deaths-reported/91062
4. “Malaria makes a scary comeback.”, 2 October 2023. Retrieved December 4, 2023, from The Star: https://www.thestar.com.my/news/nation/2023/10/02/malaria-makes-a-scary-comeback. 
5. Centers for Disease Control and Prevention. (2023). Malaria - How Malaria Spreads. Retrieved September 29, 2023, from CDC: https://www.cdc.gov/malaria/about/malaria_spreads.html
6. Abdul Rahim, F. A., Md Yatim, M. F., Abdul Mutalip, M. H., & Mahmud, M. A. F. (2023). Assessing the population’s correct knowledge of malaria in Malaysia: a vital component for malaria elimination certification. Malaria Journal, 22(1). https://doi.org/10.1186/s12936-023-04704-1
7. World Health Organization. (2023). Malaria. Retrieved September 29, 2023, from WHO: https://www.who.int/news-room/fact-sheets/detail/malaria
8. World Health Organization. (2023). Dengue and severe dengue. Retrieved September 29, 2023, from WHO: https://www.who.int/news-room/fact-sheets/detail/dengue-and-severe-dengue
9. WHO. “World malaria report 2023.” Retrieved December 4, 2023, from World Health Organization (WHO): https://www.who.int/teams/global-malaria-programme/reports/world-malaria-report-2023. 
10. Centers for Disease Control and Prevention. (2023). Malaria - About Malaria - Biology. Retrieved September 29, 2023, from CDC: https://www.cdc.gov/malaria/about/biology/index.html
11. Centers for Disease Control and Prevention. (2023). Malaria - Symptoms of Malaria. Retrieved September 29, 2023, from CDC: https://www.cdc.gov/malaria/about/symptoms_malaria.html
12. Heilman, J. M., De Wolff, J., Beards, G. M., & Basden, B. J. (2014). Dengue fever: a Wikipedia clinical review. Open Med, 8(4), 105–115.
13. CDC. “Symptoms and Treatment | Dengue.” Retrieved December 4, 2023, from CDC: https://www.cdc.gov/dengue/symptoms/index.html. 
14. Bhatt, P., Sabeena, S. P., Varma, M., & Arunkumar, G. (2021). Current Understanding of the Pathogenesis of Dengue Virus Infection. Current microbiology, 78(1), 17–32. https://doi.org/10.1007/s00284-020-02284-w
15. Mayo Clinic (2023). Malaria - Diagnosis & treatment. Retrieved September 27, 2023, from Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/malaria/diagnosis-treatment/drc-20351190
16. Centers for Disease Control and Prevention. (2023). Avoid Dengue by Preventing Mosquito Bites. Retrieved September 27, 2023, from CDC: https://www.cdc.gov/ncezid/dvbd/media/avoid-dengue.html

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Disclaimer: This information is available to the public for information purposes only; it should not be used for diagnosing or treating a health problem or disease. It is not intended to substitute consultation with a healthcare provider. Please consult your healthcare provider for advice.

C-ANPROM/MY/DENV/0239 DEC 2023