Malaria Flashcards
What is the cause of malaria?
plasmodium protozoa spread by female anopheles mosquito
What are the different types of parasite?
- falciparum
- vivax
- ovale
- malariae
What parasite causes the most deaths worldwide? Where is it most prevalent?
falciparum
most prevalent parasite in Africa
What parasite is the most prevalent outside of sub-saharan africa
vivax
what is the incubation period of p. falciparum
10-14 days
What are the sx of malaria?
non-specific: fever, headache, malaise, myalgia, diarrhoea, cough
What are the features of severe falciparum malaria?
parasitaemia
hypoglycaemia BM <2.2
lactate >2
platelets <30
What are the complications of malaria?
- cerebral malaria - seizures + coma
- AKI - black water fever
- ARDS, DIC, hypoglycaemia
What are the features of non-falciparum malaria?
- General - cyclical fever, headache
- Abrupt onset fever (>40), tachycardia, riggers, profuse sweating
- Anaemia and hepatosplenomegaly
What are the investigations for malaria?
- thick and thin blood smears - Giemsa stained x3 over 48hrs before diagnosis of malaria is ruled out
- Rapid diagnostic test
- RBC, U+E, LFTs, BM in falciparum for complications
What is the treatment of complicated/severe falciparum malaria?
i. parenteral artesunate (IV)
ii. Quinine
iii. Flids + ITU support
What SE of artesunate do you need to be aware of
haemoysis 7-21days post treatment so check Hb 14 days
What is the treatment of uncomplicated non falciparum malaria
chloroquine
What additional treatment do vivax and ovale require and why?
eradication of liver hypnozoites with primaquine as dormant parasites can stay dormant in the liver
What do you need to be aware of in patients taking primaquine with G6PD deficiency?
risk of haemolysis
