World Malaria Day 2025 — Understanding The Difference Between Malaria, Dengue, And Chikungunya

{By: Dr Pradeep D’costa}

Diseases spread by mosquitoes are a major health problem in warm and humid regions like India. These illnesses often appear during certain seasons—especially after the rains—and can put a lot of pressure on hospitals and health services. The most common mosquito-borne diseases are Malaria, Dengue, and Chikungunya. Although they are all spread by mosquito bites, they are caused by different pathogens (harmful organisms such as viruses or parasites). These diseases can look similar in the beginning because they all cause high fever, tiredness, and body pain. But they are actually very different in how they develop in the body, how they are tested for (diagnosed), and how they should be treated (treatment regimens). If a disease is wrongly identified or treated late, it can lead to serious health problems. Today, due to changes in weather, growing cities, and mosquitoes adapting to new environments, these diseases are spreading faster and in more places than before. That’s why it’s so important—for doctors, hospitals, and everyday people—to understand the key differences between malaria, dengue, and chikungunya. This helps in quicker diagnosis, better treatment, and stronger prevention efforts.

ALSO READ: World Malaria Day 2025 — Know The Symptoms, Precautions, And All About This Disease

What Causes These Diseases?

  • Malaria: It is caused by Plasmodium parasites, with the most common types being P. falciparum and P. vivax. It is a parasitic infection.
  • Dengue: It is caused by the Dengue virus (DENV), which has four types: DENV-1 to DENV-4. It is a viral infection.
  • Chikungunya: It is caused by the Chikungunya virus (CHIKV), making it another viral infection.

Malaria is caused by a parasite that lives in red blood cells and is spread when a person is bitten by a mosquito carrying the parasite. Dengue and chikungunya are caused by viruses, which cannot be treated with antibiotics and rely mostly on the body’s immune system to recover.

How Are These Diseases Transmitted?

All three diseases are spread by mosquitoes, but the type of mosquito and their behaviour are different.

  • Malaria is spread by Anopheles mosquitoes, which primarily bite at night, especially between dusk and dawn. These mosquitoes breed in stagnant water sources like ponds and puddles.
  • Dengue is transmitted by Aedes aegypti mosquitoes. They are most active during the day, particularly in the morning and late afternoon. They breed in clean, still water commonly found in urban areas such as flowerpots, coolers, and discarded containers.
  • Chikungunya is spread by both Aedes aegypti and Aedes albopictus mosquitoes. These mosquitoes also bite during the day and usually breed in clean water located in and around houses, such as water storage containers and plant trays.

This means that malaria is more likely to be contracted at night, while dengue and chikungunya are more common during the day, especially in cities.

How Long After A Bite Do Symptoms Appear?

  • Malaria has an incubation period ranging from 7 to 30 days, depending on the specific type of Plasmodium parasite involved.
  • Dengue typically shows symptoms after an incubation period of 4 to 10 days following the mosquito bite.
  • Chikungunya usually has an incubation period of 2 to 12 days, with most cases showing symptoms between 3 to 7 days after infection.

This time period between the mosquito bite and the appearance of symptoms is called the incubation period. Malaria can take longer to show symptoms, especially if it involves a species like P. vivax, which can stay inactive in the liver for weeks.

How Do The Symptoms Differ?

Although all three illnesses start with high fever, they differ in other signs and severity.

Fever

  • Malaria: The fever typically comes and goes in cycles and is accompanied by chills.
  • Dengue: The fever is sudden and very high.
  • Chikungunya: The fever also appears suddenly and is high.

Rash

  • Malaria: Rashes are rare.
  • Dengue: It commonly causes rashes, especially on the arms, legs, and chest.
  • Chikungunya: Often leads to rashes that may resemble those seen in measles.

Headache

  • Malaria: Headaches are usually frontal, affecting the forehead area.
  • Dengue: It causes very severe headaches, often felt behind the eyes.
  • Chikungunya: It can cause moderate to severe headaches.

Joint Pain

  • Malaria: It may cause mild to moderate joint pain.
  • Dengue: Joint pain is usually mild and more common in children.
  • Chikungunya: It's known for very severe and long-lasting joint pain.

Bleeding

  • Malaria: Bleeding is rare.
  • Dengue: Bleeding is common, especially from the gums, in the stool, or as skin spots.
  • Chikungunya: Bleeding is rare.

Weakness

  • Malaria: Weakness is common.
  • Dengue: It causes extreme weakness.
  • Chikungunya: Weakness often lasts for weeks.

Organ Involvement

  • Malaria: It may affect the liver, spleen, and brain in severe cases.
  • Dengue: It can affect the liver and blood vessels.
  • Chikungunya: Rarely affects organs but can impact the nerves in some cases.

Dengue is especially known for causing low platelet counts, which can lead to bleeding problems. Chikungunya, on the other hand, is known for severe joint pain, which may continue for months in some people. Malaria, especially the falciparum type, can cause complications in the brain, liver, and kidneys if not treated early.

How Are These Diseases Diagnosed?

Doctors use different tests to confirm the diagnosis:

  • Malaria: Malaria is diagnosed using a blood smear test observed under a microscope. A Rapid Diagnostic Test (RDT) can also be used to detect malaria. In some cases, a more advanced test like PCR (Polymerase Chain Reaction) may be used for accurate detection.
  • Dengue: In the early stage of dengue, the NS1 antigen test is commonly used for diagnosis. In the later stages, IgM and IgG antibody tests help confirm the infection. RT-PCR (Reverse Transcription Polymerase Chain Reaction) can also detect the dengue virus.
  • Chikungunya: Chikungunya is usually diagnosed with an IgM antibody test. RT-PCR testing is another method used to confirm chikungunya infection, especially in the early phase.

The NS1 test for dengue is useful in the first 4–5 days of illness. In malaria, a blood smear remains the most accurate test, where the parasite is seen under a microscope.

What Are The Possible Complications?

  • Malaria: It can lead to serious complications such as cerebral malaria, which involves brain swelling. It may also cause kidney failure, severe anemia, and in some cases, rupture of the spleen.
  • Dengue: It may result in life-threatening complications like dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Other serious issues include fluid leakage from blood vessels and severe internal bleeding.
  • Chikungunya: It's generally less fatal but can cause persistent joint pain and long-term fatigue. In rare cases, it may also trigger neurological disorders such as Guillain-Barré syndrome.

In dengue, if the blood pressure drops or fluid leaks from blood vessels, it can be fatal without hospital care. Chikungunya usually doesn’t kill, but it can debilitate patients with long-term joint problems.

How Are They Treated?

  • Malaria: It's treated with specific anti-malarial medications, such as Artemisinin-based Combination Therapies (ACTs), chloroquine, or primaquine, depending on the type and severity of infection.
  • Dengue: It does not have a specific antiviral treatment. Management involves supportive care, including adequate fluid intake, rest, and paracetamol for fever and pain relief. Aspirin and ibuprofen should be avoided as they can increase the risk of bleeding.
  • Chikungunya: It's managed through supportive care, such as rest, fluids, and medications to relieve pain and fever. Non-steroidal anti-inflammatory drugs (NSAIDs) can be used after ruling out dengue.

For malaria, early diagnosis and treatment can be life-saving. Dengue and chikungunya are viral illnesses, so antibiotics are not effective, and there is no direct cure—only the symptoms are managed.

Can These Diseases Be Prevented And Are Vaccines Available?

  • Malaria: It can be prevented by using mosquito nets, applying insect sprays, and eliminating mosquito breeding sites such as stagnant water. Vaccine trials for malaria are ongoing in India, with the RTS,S vaccine currently being evaluated.
  • Dengue: Prevention involves removing standing water from around the home, wearing full-sleeved clothing, and using mosquito repellents. The Dengvaxia vaccine has been approved in some countries but with certain restrictions, while another vaccine, Qdenga, is currently in the trial phase.
  • Chikungunya: Prevention methods are similar to those for dengue—avoiding mosquito bites by keeping the surroundings clean, using repellents, and wearing protective clothing. A vaccine is in advanced stages of trial but is not yet available in India.

Since the Aedes mosquito breeds in clean water, household prevention—like emptying containers and using repellents—is very effective against dengue and chikungunya. Malaria prevention relies more on nets and controlling water stagnation in rural areas.

India sees over a million malaria cases every year, and dengue and chikungunya outbreaks are increasing in urban areas due to poor waste management and water storage practices. Even though malaria, dengue, and chikungunya are all spread by mosquitoes and can look similar at first, they are very different diseases. They affect the body differently, need different tests to diagnose, and require different kinds of treatment. Some, like dengue, can lead to serious bleeding problems; others, like chikungunya, can cause long-term joint pain. Malaria, if not treated, can damage vital organs. Knowing the differences helps in faster diagnosis, proper treatment, and better prevention.

The author, Dr Pradeep D’costa, is a Senior Consultant - Internal Medicine at Sahyadri Super Speciality Hospital, Nagar Road, Pun

[Disclaimer: The information provided in the article, including treatment suggestions shared by doctors, is intended for general informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition.]

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