Most malaria is treated and the person gets better. A few signs mean it has turned severe. Severe malaria kills within hours, and it is treated with an injection that a home cannot give, so the only correct action is to reach a health facility now.
Go to a hospital now, at any hour, if you see any one of these
One sign is enough. Do not wait to see whether a second one appears.
- A fit or convulsion, or more than one.
- Very deep sleep, confusion, or not waking properly. If you cannot rouse the person to sit up and answer you, treat it as an emergency.
- Cannot drink, or vomits everything. In a baby, cannot breastfeed.
- Fast or difficult breathing, or the chest pulling in with each breath.
- Very pale palms, inner eyelids or tongue. This is severe anaemia and it can kill quietly, without the person looking dramatic.
- Dark urine, the colour of Coca-Cola, or passing very little urine, or none.
- Yellow eyes.
- Bleeding from the nose or gums, or blood in vomit or stool.
- Cold, clammy hands with a weak fast pulse.
Pregnancy changes the rule
A pregnant woman with malaria goes to a facility the same day, danger signs or not. Malaria in pregnancy becomes severe faster, drops the blood level faster, and endangers the baby as well as the mother. Do not treat her at home and do not wait.
A child under five changes the rule too
Young children move from ordinary malaria to severe malaria in hours rather than days. In a child, the four signs to act on immediately are: not able to drink or breastfeed, vomiting everything, a fit, or being unusually sleepy and floppy. Any one of them means the hospital now.
A negative test does not cancel a danger sign
Rapid tests miss some cases, and a test taken too early can read negative while the person is already becoming ill. If someone has the signs above, go, whatever the test said. Say at the facility that a test was already done and when.
On the way
- Keep the person cool. Wipe with a damp cloth. Do not wrap them up.
- If they are not fully awake, lay them on their side so that vomit drains out.
- Give nothing by mouth to someone who is not fully awake, not water, not medicine. It goes into the lungs.
- Carry any medicine already taken, and the test result if there is one, so the facility knows.
- Go to a facility that can give an injection or a drip. A shop or a small clinic that only sells tablets is a delay, not a step.
What you should not do
- Do not treat severe malaria at home with tablets.
- Do not wait for the morning, and do not wait for transport to become cheaper.
- Do not stop a treatment already started because the person looks better.