Can Malaria Return? Can Malaria Cause Death?

Question: Did malaria come back for sure even after medical treatment?
Can malaria cause death?

Answer: To answer your first question, there are some cases in which malaria can come back. First of all, you can become re-infected – treatment for malaria does not prevent re-infection, so if you have had it once, while your body may now have some natural immunity, you can still definitely be infected again. Secondly, some types of malaria (most commonly Plasmodium vivax) are able to hide in the body and reoccur months or even years later if not treated initially with a special kind of medication, called primaquine. Finally, there are cases where the treatment provided for the malaria infection is not adequate (which can be due to a number of reasons), and is only good enough to reduce the number of malaria parasites in the blood, not kill them entirely. This allows the patient to feel better, maybe for a few days or longer, but then the malaria parasites multiply again in the blood and he or she will start to feel sick again. This is known as “recrudescence”. Reasons why medication may not work include when the drugs may be counterfeit or expired, and thus not strong enough; the wrong type of medication for the type of malaria (for example, in many parts of the world, malaria is resistant to a drug called chloroquine, yet it is still provided in some places); when the dose provided to the patient is incorrect; or the patient does not complete the full dose of the medication.

For your second question, yes, malaria can cause death. The most deadly form of the disease is Plasmodium falciparum, which can cause death very rapidly if not treated. The people at highest risk of severe malaria are children under five years old and pregnant women.