Malaria

Question 1

1) What parasite causes the most severe form of malaria?
2) Name another type of parasite that causes malaria
3) How is malaria spread?

Answer 1

1) Plasmodium falciparum
2) Plasmodium vivax, plasmodium ovale and plasmodium malariae
3) Bites from female Anopheles mosquitoes that carry the disease

Question 2

In which 2 species of plasmodium can a dormant infection occur?

Answer 2

P. Vivax and P. Ovale

Question 3

1) Name 2 non-specific symptoms of malaria
2) Name a sign of malaria

Answer 3

1) Fever, sweats and rigor, malaise, myalgia, headache, vomiting
2) Pallor, hepatosplenomegaly, jaundice

Question 4

How can malaria be diagnosed?

Answer 4

Malaria blood film (headphone shapes in RBC in falciparum malaria). Antigen testing and PCR
also available. LAMP test used in Southampton which has a negative predictive value of 100%

Question 5

How is a diagnosis of malaria excluded?

Answer 5

3 negative samples are sent over 3 consecutive days

Question 6

1) What is the first line medication for uncomplicated P. Falciparum infection, and give an example of one of these?
2) Name 2 other medication options if the first line medication is unavailable are unavailable

Answer 6

1) Artemisinin-based combination therapies (ACTs) i.e. artemether with lumefantrine (3 days)
2) Proguanil and atovaquone (3 days), quinine sulphate with doxycycline or clindamycin (7 days)

Question 7

1) What is the first line medication of severe P. Falciparum infection?
2) What is the medication given if the above medicine is unavailable?

Answer 7

1) IV artesunate
2) IV quinine dihydrochloride (arrhythmia and hypoglycaemia as s/e

Question 8

Name 2 complications of P. Falciparum malaria

Answer 8

• Cerebral malaria
• Seizures
• Reduced consciousness
• Acute kidney injury
• Pulmonary oedema
• Disseminated intravascular coagulopathy (DIC)
• Severe haemolytic anaemia
• Multi-organ failure and death

Question 9

Name 2 medications that can be given for prophylaxis of malaria

Answer 9

• Proguanil and atovaquone (Malarone)
• Chloroquine
• Mefloquine
• Doxycycline

Question 10

Malaria prophylaxis can cause haemolytic anaemia in patients with what condition?

Answer 10

G6PD deficiency

Question 11

Malaria symptoms commonly start how long after infecion?

Answer 11

4 weeks