Malaria, dengue hemorrhagic fever (DHF), and Chikungunya are three types of diseases that are transmitted through mosquitoes. All three are serious illnesses and accompanied by severe symptoms. Because the symptoms are quite similar, these three diseases are difficult to distinguish without the help of laboratory testing. Although difficult to do, you must be able to distinguish between the three to be able to provide the right treatment.
Method 1 of 4: Understanding Malaria
Step 1. Know the causes of malaria
Malaria is caused by Plasmodium, which is a single-celled parasite that is usually transmitted through mosquitoes.
- This parasite is injected into the body's circulatory system through mosquito saliva, which then travels to the liver to grow and reproduce.
- When it is an adult, plasmodium will infect red blood cells until they burst. Then, the mature Plasmodium from the ruptured red blood cells will spread and infect other red blood cells.
Step 2. Know the signs and symptoms of malaria
Usually, the manifestation (embodiment) of malaria will begin 8-25 days after the mosquito bite. However, if the patient is already taking prophylaxis (drugs to prevent infection), the incubation period will increase.
- Red blood cells that are infected and spread throughout the body will eventually die.
- This can lead to severe liver infections.
- Sometimes, infected red blood cells become more "sticky" and clump more easily. As a result, blood flow to the brain can be blocked.
- The severity of the symptoms and signs of malaria depends on three factors: the type of malaria you have, the strength of your immune system, and the health of your spleen.
- There are 5 types of malaria: P. vivax, P. malaria, P. ovale, P. falciparum, and 'P. Knowlesi'.
Step 3. Watch for symptoms of splenic failure
The spleen is where the dead red blood cells collect.
- During a malaria infection, red blood cells die quickly and the spleen is unable to meet the body's needs, leading to sepsis and organ failure.
- Watch for an enlarged spleen, which can occur when the spleen is overwhelmed by the large number of dead red blood cells and causes an abnormally large size.
Step 4. Take your temperature to detect a high fever
Malaria patients often have a high fever.
- Your body temperature can reach 40 degrees Celsius.
- Fever is your body's immune system response to suppress the growth of bacteria.
- Fever is often accompanied by chills, which make muscles burn calories and raise body temperature. Usually, cold heat also makes you sweat profusely.
Step 5. Get a diagnosis
Because the symptoms of malaria are not specific, it is difficult to diagnose in countries where the disease is developing, such as Indonesia.
- Your medical and travel history will be assessed to determine if you have traveled to a country where malaria is common.
- Get a physical exam. Although not specific, the results of this examination can be used to make an initial diagnosis.
- Get a blood film. The doctor will take a drop of your blood and place it on a microscopic slide. Blood will be overwritten so that the red blood cells will be easier to see through a microscope. The doctor will analyze the film for the presence of the plasmodium parasite. Two or more tests usually take 36 hours to confirm the presence of malaria.
Method 2 of 4: Understanding Dengue Hemorrhagic Fever (DHF)
Step 1. Know the cause of DHF
There are four types of dengue virus, and all of them are transmitted through mosquitoes. Humans are the primary host of dengue fever, which often occurs in the tropics.
- The bite of a mosquito infected with the virus will spread it through saliva or saliva.
- Dengue fever can also be transmitted from humans. For example, blood infected with the virus is accidentally used for blood transfusions. In fact, transmission of dengue can occur due to organ donation and transmission from mother to child.
Step 2. Recognize the symptoms and signs of DHF
The incubation period for DHF (the period when symptoms are not visible) is usually about 3-14 days. Symptoms can vary, depending on the type of virus and the level of strength of the body's immune system.
- The virus will circulate throughout the body after infection and attack white blood cells and other antibodies. Thus, your body system weakens.
- The virus will continue to multiply in the cell until the cell bursts and dies. The ruptured white blood cells release cytokines that initiate the body's inflammatory response when it tries to ward off viruses.
- The death of white blood cells will trigger another leakage of fluid from the cells, which can progress to hypoproteinemia (lack of protein), hypoalbuminema (lack of albumin), pleural effusion (fluid in the lungs), ascites (fluid in the abdominal area), hypotension (low blood pressure), shock, and ultimately death.
Step 3. Use a thermometer to identify fever
The patient will have a high fever as the body tries to suppress the virus.
Like other systemic infections, your body will increase its temperature to kill the virus
Step 4. Watch for intense headaches
Severe headaches are often experienced by DHF patients.
- The cause of this headache is still unknown, but it may be related to a high fever.
- An increase in body temperature can irritate the nerves and cause a very painful and widespread headache.
Step 5. Watch for pain behind your eye
Pain in the eyes due to dengue fever usually gets worse when the patient is in a brightly lit room.
- This pain is described as a dull, deep pain.
- This eye pain is a side effect of an intense headache. Because the nerve endings in the head have the same pathway, pain is felt not only in the head, but also in the eyes.
Step 6. Look for excessive bleeding
Widespread bleeding can occur because the virus attacks the capillaries, which are the smallest blood vessels in the body.
- When capillaries (fine blood vessels) burst, the blood in them will spread out of the bloodstream.
- Blood pressure drops as blood leaves the body, eventually leading to internal bleeding, shock, and death.
- In severe cases, bleeding usually occurs in the nose and gums, which have many small blood vessels.
- Your pulse also weakens due to reduced blood volume in the body.
Step 7. Watch for rashes
As your fever begins to drop, a skin rash may begin to appear.
- This rash is reddish in color, similar to measles.
- This rash is caused by the rupture of small capillaries.
Step 8. Know how to diagnose DHF
DHF is diagnosed through a thorough physical examination, medical history, and laboratory tests.
- Your doctor will try to identify your body's symptoms and signs. He will also ask if you have lived in or recently visited an area prone to dengue.
- The doctor will suspect dengue if the patient shows warning symptoms, such as abdominal pain, liver enlargement, bleeding in the mouth, low platelet and white blood cell counts, restlessness, and decreased pulse rate.
- Doctors can use the ELISA test to identify immunoglobulins in the bloodstream that signal the presence of dengue infection.
Method 3 of 4: Understanding Chikungunya
Step 1. Understand the cause of Chikungunya disease
The virus is transmitted through mosquitoes and was recently declared a growing global health threat.
- The way this virus affects the body is still not fully understood. However, the symptoms and disease process are almost the same as DHF.
- Chikungunya infects muscle cells in the body. There, the virus reproduces until the cell dies, and then reproduces and looks for new host cells.
Step 2. Recognize the symptoms and signs of Chikungunya
The incubation period for Chikungunya is about 1-12 days. Chikungunya usually attacks muscles, joints, skin, related tissues, and even the central nervous system.
Step 3. Watch for rash and fever
Because Chikungunya is a systemic infection, it is usually accompanied by fever and skin rash.
- This skin rash is usually almost the same as the rash in dengue fever. This rash is also caused by damage to blood vessels.
- Fever occurs when the body increases its temperature as it tries to kill the invading virus.
- You may have a headache, nausea, and vomiting from the fever.
Step 4. Watch for muscle and joint pain
Because the virus destroys cells in your muscles and joints, you will experience muscle weakness and joint pain.
Joint and muscle pain can be severe and acute
Step 5. Notice the reduced ability to taste
Many Chikungunya patients also experience decreased taste buds.
This is due to viral attack on the nerve endings of the tongue and reduced sensitivity of the sense of taste
Step 6. Get a Chikungunya diagnosis
You must get an accurate diagnosis to be able to treat the disease properly.
Virus isolation is the most accurate type of test and is used to diagnose Chikungunya. However, these tests can take 1-2 weeks and must be performed in a laboratory with a biosafety level 3, which may not be available in developing countries, where the disease is prevalent.
This technique is done by taking a blood sample from a patient and injecting the virus into it. The blood sample is then monitored until it shows a certain response
- RT-PCR (Reverse Transcription Polymerase Chain Reaction) makes the Chikungunya gene more visible and the evidence of disease easier to see. The results can be obtained in 1-2 days.
- ELISA assay can be used to measure immunoglobulin levels and identify Chikungunya virus. The results can be obtained in 2-3 days.
Method 4 of 4: Distinguishing Malaria, DHF, and Chikungunya
Step 1. Identify the type of mosquito that transmits the disease
Chikungunya and dengue are usually transmitted by the Aedes aegypti mosquito.
However, malaria is transmitted by the Anopheles mosquito
Step 2. Identify the type of agent causing the disease
Malaria is caused by Anopheles, which is a protozoan.
- Chikungunya and dengue are caused by viruses.
- DHF is caused by dengue virus, while Chikungunya is caused by Alphavirus.
Step 3. Note the difference in the incubation period of each disease
DHF has a shorter incubation period, usually around 3-4 days.
- Chikungunya has an incubation period of 1 week.
- Symptoms of malaria will appear after at least 2 weeks apart.
Step 4. Notice the differences in the symptoms of each disease
The main difference between DHF and Chikungunya lies in the symptoms and signs of each disease.
- The most obvious symptoms of dengue are usually low platelet counts, high risk of bleeding, and pain behind the eyes. These symptoms are absent in Chikungunya disease.
- DHF and Chikungunya have symptoms in the form of joint pain. However, the joint pain and inflammation in Chikungunya disease is more intense and pronounced
- Malaria is known to have symptoms of paroxysm, a cycle of chills/shaking, then fever/sweating. This cycle usually takes place every two days.
Step 5. Get diagnostic tests to differentiate the three diseases
Although the symptoms and signs of the disease can be a rough guide for diagnosing the disease, laboratory and diagnostic tests must be carried out to determine the type of disease suffered.
- Malaria is diagnosed by blood films.
- Chikungunya and DHF were diagnosed by ELISA.
- If you have a severe fever that comes and goes along with muscle and joint pain, don't ignore it. See a doctor if these symptoms do not go away after three days.
- Dengue fever, malaria, and Chikungunya can be deadly if not treated immediately.