What You Need to Know about Malaria in Thailand
Malaria is prevalent in tropical and subtropical regions around the world and in Thailand, yet a lot of travelers and expats still chose the “Land of Smiles” as one of their top destinations for relocation and vacation.
What are the causes, symptoms, diagnosis, treatment, and preventive measures for malaria in Thailand? Find out everything expats and travelers need to know about malaria and how you can ensure access to trusted healthcare providers whenever necessary with international health insurance.
Further reading: Top 13 Diseases and Medical Conditions in Thailand that Expats Should Be Aware Of
Malaria: Overview
Malaria is a mosquito-borne infectious disease caused by Plasmodium parasites. Until today, 5 types of Plasmodium species are known to harm humans: P. falciparum, P. vivax, P. ovale, P. malariae, and P. Knowlesi.
Among them, P. falciparum is the deadliest (75% of total deaths), which can cause severe anemia and end-organ damage within 24 hours, usually found in Africa; P. vivax accounts for 20% of total deaths by malaria and is the dominant parasite in most countries outside sub-Saharan Africa.
The existence of Malaria mainly depends on climatic factors such as temperature, humidity, and rainfall. Since mosquitoes lay eggs on the surface of water containing heavy vegetation, it is one of the diseases most commonly spread during wet seasons (June to October) in Thailand.
Malaria has been affecting the globe for centuries. Unfortunately, Thailand is classified as one of the malaria countries.
Malaria: Epidemiology
Malaria remains a significant health challenge in Thailand even though the government has made substantial progress in malaria control and elimination. The disease still poses a threat, particularly in regions with dense forests such as the borders with Myanmar and Cambodia.
The disease thrives in humid environments with temperatures between 20-30°C, which are optimal for both parasite development and mosquito survival. Most malaria cases in Thailand are reported at altitudes below 1,500 meters and in proximity to water bodies, where mosquitoes breed.
Although the overall incidence of malaria has decreased significantly over the past two decades, certain populations remain at higher risk. Vulnerable groups include children under 5 years old, pregnant women, and migrant workers who may have limited access to healthcare.
There is a clear rural-urban divide in malaria transmission in Thailand. Rural areas have seen higher rates of transmission, likely due to poverty contributing to limited access to healthcare and preventive measures. Poor housing conditions and a lack of resources further exacerbate the situation.
Malaria: Risk Groups
Anyone can get malaria. Most cases occur in people who live in countries with malaria transmission. People from countries with no malaria can become infected when they travel to countries with malaria. Hence, regular check-ups are required when residing in places with reported malaria cases.
Malaria is a burden in some nations without a fully developed medical system and suburban/rural Thailand is no exception. It disproportionately affects children under 5 and those residing in rural areas where access to medical treatments is limited, including:
- Children under 5 years
- Pregnant women
- Non-immune travelers
- People with HIV/AIDS
- Refugees/migrants
Malaria: Transmission
Malaria is transmitted by infected Anopheles mosquitoes. When mosquitoes bite any malaria patient, they become infected and will pass on the disease when biting another person. Malaria is not contagious, meaning causal contact with malaria-infected people is safe.
However, Plasmodium parasites are found in the red blood cells of an infected person. This signifies that malaria can also be transmitted through blood transfusion, organ transplant, or the shared use of needles or syringes contaminated with blood.
Malaria: Symptoms
Depending on the malaria strain infected, the latent period varies from 9 days to over 1 year. Typical medical manifestations include:
- Fever and sweating
- Fatigue
- Diarrhea, nausea and vomiting
- Headaches and muscle aches
- Chills all over your body
- Chest pain, breathing difficulties, and cough
In more severe cases, it can cause:
- Jaundice (yellowing of eyes and skin)
- Seizures
- Dark or bloody urine
- Abnormal bleeding
- Unconsciousness
- Coma (cerebral Malaria)
- Death
A classic symptom of malaria is paroxysm, a cyclical occurrence of sudden coldness followed by shivering and then fever and sweating. Hence, the disease can also be observed through patterned fluctuations in body temperature. The periodicity varies between 36 hours to 3 days depending on the malaria strain.
Without proper treatment, the debilitating cycle can continue for years. Therefore, approaching trusted medical professionals is key to curing malaria in Thailand.
Malaria: Diagnosis
1. Clinical Assessment
Symptoms: Healthcare providers begin by evaluating symptoms, which typically include fever, chills, headache, fatigue, nausea, and muscle aches. A history of travel to malaria-endemic areas is crucial for diagnosis.
Physical Examination: Doctors may look for signs such as anemia, jaundice, or splenomegaly (enlarged spleen).
2. Laboratory Tests
Laboratory tests provide 3 valuable pieces of information: the presence of malaria, malaria species, and the percentage of red blood cells infected. All of these are key information in planning an appropriate treatment.
Blood Smear: The most common diagnostic method is a blood smear. A drop of blood is placed on a slide and stained to identify malaria parasites under a microscope. This method can confirm the presence of the parasite and the specific species.
Rapid Diagnostic Tests (RDTs): These tests detect specific antigens produced by the malaria parasite. RDTs are quick and can provide results within 15-20 minutes, making them useful in areas with limited access to laboratory facilities.
Polymerase Chain Reaction (PCR): PCR testing can identify malaria DNA in the blood. It is more sensitive and specific than blood smears but is typically used in research or complex cases due to higher costs and longer processing times.
3. Follow-Up
If malaria is diagnosed, further tests may be conducted to determine the severity of the infection and guide treatment decisions. Monitoring for complications is essential, especially in severe cases.
Note: There are also various test kits available to detect antigens derived from malaria parasites. These Rapid Diagnostic Tests offer a reliable source of testing where microscopy is not possible. If tested positive, reach out for medical treatment as soon as possible.
Malaria: Treatment
Early diagnosis and prompt treatment are crucial for malaria treatment. Doctors usually prescribe a course of anti-malarial drugs. It should be completed to ensure clearance of the malaria parasite and mitigate the possibility of relapses.
Doctors will choose your medication based on:
- The type of malaria
- Whether a malaria parasite is resistant to a medicine
- The weight or age of the person infected with malaria
- Whether the person is pregnant.
Anti-malarial drugs can cause side effects, depending on the medication, they can be:
- Gastrointestinal issues such as nausea and diarrhea
- Increased sensitivity to sunlight
- Insomnia and disturbing dreams
- Psychological disorders and vision problems
- Ringing in the ears (tinnitus)
- Headaches
- Anemia
- Seizures
The disease can continue if treated with the wrong drug. Species in some areas might already have developed drug resistance, thus the type of drugs and length of treatment can vary.
Malaria: Safety & Prevention
There are three general directions for prevention—the prevention of mosquito bites, the prevention of mosquito proliferation, and getting prevention medication.
Prevention of Mosquito Bites
Prevention of mosquito bites minimizes your chances of contacting mosquitoes. You can do so by practicing the below protective measures.
Protective Clothing
- Wear loose, light-colored, long-sleeved tops and trouser
- Use loose-fitting garment
- Tuck pants into sock when going outdoors
Use Repellents
- Use EPA-registered insect repellents containing DEET (30%), Picaridin, or IR3535 on exposed body parts
- Re-apply insect repellents whenever necessary (once every 2-3 hours)
- Avoid using fragrances outdoors
Home Protection
- Use bed nets or screens with insecticide sprayed on while sleeping
- Turn on the air conditioning if possible
Outdoor Timing
- Avoid outdoor activities during dawn and dusk
- Stay away from known mosquito areas at peak times
- Limit outdoor time during peak mosquito season
Prevention of Mosquito Proliferation
Environmental hygiene is essential when it comes to creating a mosquito-free area. Make sure your surroundings are not desirable for mosquito breeding. There are some relatively easy measures to minimize your contact with mosquitoes, especially if you live in rural Thailand.
- Regularly empty and clean flower pot plates, pet water bowls, unused containers, old tires, and even fallen leaves that collect water.
- Practice water management effectively. You can change the water in vases weekly, cover water storage containers, clean roof gutters, and check and empty air conditioner drain pans.
- Keep your living spaces maintained by fixing leaky outdoor faucets if necessary, keeping trash bins covered, sealing holes in window/door screens, and removing puddles after rain as much as you can.
- If you have a garden, keep it clean and fresh with simple garden care. Keep grass short, remove fallen leaves, clear obvious debris, and ensure good drainage around the house to minimize the chance of mosquitoes laying eggs in hidden areas.
Prevention Medication (Chemoprophylaxis)
Travelers to malaria endemic areas should consult their doctor weeks before departure. Your medical professional will decide which preventive drug is the most appropriate for your country of destination.
Depending on the type of drug you get, chemoprophylaxis drugs could require you to start 2-3 weeks prior to departure. All prophylactic drugs should be taken on schedule for the duration of the stay and continued for up to 4 weeks after the last possible exposure to infection.
Common chemoprophylaxis drugs include:
Atovaquone/proguanil (Malarone)
- Take daily, starting 1-2 days before travel
- Continue through trip and 7 days after
- Generally well-tolerated
Doxycycline
- Take daily, starting 1-2 days before travel
- Continue through trip and 4 weeks after
- Avoid sun exposure while taking
Mefloquine (Lariam)
- Take weekly, starting 2-3 weeks before travel
- Continue through trip and 4 weeks after
- Not recommended for some mental health conditions
- Requires early planning
Conclusion
Early detection and intervention are key when it comes to treating malaria in Thailand. Many expats and travelers therefore opt for private healthcare to guarantee access to medical assistance whenever necessary.
Private healthcare has English-speaking staff and significantly lower waiting times compared with public healthcare. Opting for private healthcare is not cheap, but is made affordable with expat health insurance or travel insurance.
Insurers offer various levels of health insurance plans, and we understand that it can be daunting to navigate all the plans and insurance jargon. This is why you may consider working with a reputed insurance broker like Pacific Prime.
We have over 20 years of experience helping individuals from all over the world find comprehensive and affordable health insurance that fits their needs and budget, and provide claims support services throughout their insurance journey with us.
Contact our team of expert advisors today, or get an instant quote!
If you find this piece of information useful, don’t forget to check out dengue fever in Thailand and chikungunya in Thailand to understand the diseases that exist in the country!
Frequently Asked Questions
What are the symptoms of malaria, and how can I recognize them?
Common symptoms include fever, chills, headache, sweating, fatigue, nausea, and vomiting. If you experience these symptoms after traveling to a malaria-endemic area, seek medical attention immediately for peace of mind. Please note that having these symptoms doesn’t mean you are infected.
Can I get malaria in Thailand?
Yes. Malaria is a risk in rural Thailand according to the World Health Organization (WHO). Only hilly areas are endemic, and there is no malaria transmission in urban areas such as Bangkok, Chiangmai, Pattaya, Phuket, and Samui. Most cases are from the borders of Thai-Myanmar and Thai-Cambodia.
Is malaria treatment available in Thailand, and what should I do if I suspect I have it?
Yes, malaria treatment is available in Thailand. If you suspect you have malaria, visit a healthcare facility for diagnosis and treatment as soon as possible. Expats usually opt for private facilities to ensure timely treatment through securing international health insurance.
Since joining Pacific Prime, Eric was exposed to a new world of insurance. Having learned about insurance products extensively, he has taken joy and satisfaction in helping individuals and businesses manage risks and protect themselves against financial loss through the power of words.
Although born and raised in Hong Kong, he spent a quarter of his life living and studying in the UK. He believes his multicultural experience is a great asset in understanding the needs and wants of expats and globe-trotters.
Eric’s strengths lie in his strong research, analytical, and communication skills, obtained through his BA in Linguistics from the University of York and MSc in Teaching English to Speakers of Other Languages (TESOL) from the University of Bristol.
Outside of work, he enjoys some me-time gaming and reading on his own, occasionally going absolutely mental on a night out with friends.
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