Malaria

Question 1

Define malaria.

Answer 1

Malaria is a parasitic infection caused by protozoa of the genus Plasmodium. Five species are known to infect humans; Plasmodium falciparum is the most life-threatening.

Question 2

Explain the aetiology/risk factors of malaria.

Answer 2

Travel to endemic area
Inadequate or absent chemoprophylaxis
Insecticide-treated bed net not used in endemic area
Settled migrants returning from travel to endemic area of origin
Low host immunity
Pregnancy
Age <5 years
Immunocompromised
Older age

Question 3

Summarise the epidemiology of malaria.

Answer 3

There were an estimated 219 million malaria cases worldwide (in 87 countries) in 2017, resulting in an estimated 435,000 deaths. Approximately 92% of all malaria cases and 93% of all malaria deaths occurred in the African region, and the majority of deaths were due to Plasmodium falciparum infection.

Question 4

Recognise the presenting symptoms of malaria. Recognise the signs of malaria on physical examination.

Answer 4

Fever
Headache
Myalgia
Arthralgia
Diarrhoea
Nausea and vomiting
Abdominal pain
Pallor
Hepatosplenomegaly, jaundice
Altered level of consciousness
Hypotension
Anuria/oliguria

Question 5

Identify appropriate investigations for malaria and interpret the results.

Answer 5

Giemsa-stained thick and thin blood smears
Rapid diagnostic tests (RDTs)
FBC
Serum electrolytes, urea and creatinine
Serum LFTs
Serum blood glucose
Urinalysis
Arterial blood gas