Malaria

Question 1

What are the species of malaria w/ key characteristics?

Answer 1

Plasmodium falciparum = responsible for majority of deaths
Plasmodium vivax + ovale = dormant liver stages causing relapses
Plasmodium malariae = chronic lifelong infection
Plasmodium knowlesi = parasite of monkeys in SE asia

Question 2

S+S malaria

Answer 2

Fever, sweats and/or chills — absence of fever does not exclude the possibility of malaria.
Headache.
Confusion.
General malaise, lethargy and fatigue — somnolence is more common in children than adults.
Myalgia and arthralgia.
Gastrointestinal disturbance (such as nausea, abdominal pain, vomiting, and diarrhoea).
Anorexia, poor feeding in children.
Jaundice.
Sore throat, cough, lower respiratory tract symptoms and respiratory distress.

Question 3

Investigations

Answer 3

Thick + thin blood smears stained with Giemsa stain

Question 4

Management

Answer 4

Chloroquine for non-falciparum malaria

Quinine sulfate + doxycycline for falciparum

Question 5

Complications of malaria

Answer 5

Cerebral malaria 
Renal impairment 
Acidosis 
Hypoglycaemia 
ARDS
Anaemia 
Splenic rupture 
DIC

Question 6

How can malaria be prevented?

Answer 6

Start 1 week before entering zone + continue for 4 weeks on return
Chloroquine, proguanil, mefloquine, Malarone, doxycycline