, explains, “Yes, malaria can stay dormant in the body and reappear months or even years after the initial infection. It is a phenomenon known as relapse or recrudescence, depending on the cause. This mainly depends on the species of Plasmodium involved.”

She says that two types of malaria parasites, Plasmodium vivax and Plasmodium ovale, are known for their sneaky ability to hide out in your liver as dormant forms called hypnozoites. “These can remain hidden for weeks, months, or even years after the first infection. They can reactivate and cause a relapse without a new mosquito bite. This is why patients often fall sick again long after recovering from the initial episode,” Dr. Inamdar adds.

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It’s important to know that not every kind of malaria acts this way. Plasmodium falciparum, the most dangerous type, doesn’t form dormant liver stages. But Dr. Inamdar warns that it can still cause trouble. “Plasmodium does not cause relapse but can cause recrudescence if not completely cleared from the bloodstream, often due to incomplete treatment or drug resistance. This reappearance of symptoms may occur within weeks or months.” So, whether it’s a relapse from the liver or a resurgence in the blood, malaria can definitely come back if it’s not fully treated.

Chronic or recurring malaria isn’t just an inconvenience. Dr. Inamdar points out, “Chronic malaria can lead to repeated bouts of fever, fatigue, and anaemia, which significantly impair quality of life. Moreover, untreated relapses can still transmit the parasite to mosquitoes, perpetuating the infection cycle in the community.”

To prevent this, doctors often prescribe a second course of medication like primaquine to wipe out those hidden liver parasites, especially in P. vivax infections. “Completing the full course of prescribed antimalarial drugs is critical, even if you start feeling better,” Dr Inamdar stresses. Regular follow-ups and staying alert to recurring symptoms are key, especially for people living in or returning from malaria-prone areas.

A study published in The Lancet Infectious Diseases backs up these concerns. Researchers found that relapses of P. vivax malaria can occur up to three years after the initial infection, and incomplete treatment is a major risk factor for recurrence. The study highlights the importance of using the right drugs and making sure the full course is finished to prevent future episodes. 

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Malaria isn’t always gone just because you feel better. Some types can hide and come back months or even years later. The best way to protect yourself? Take all your medicine, keep up with doctor visits, and watch for any returning symptoms. Staying alert can keep you and your community safer in the long run.