Malaria Flashcards
What is the most prevalent parasite in Africa?
Plasmodium falciparum
What is the most prevalent parasite outside sub-Saharan Africa?
Plasmodium vivax
What are the 5 plasmodium species that cause human disease?
Falciparum, vivax, malariae, ovale, knowlesi
What are risk factors?
Travel, infants, pregnancy, old age
What is the first step in the malaria life cycle?
Sporozoites are transferred to a human
Where do sporozoites travel to?
The liver via the blood
What do sporozoites mature into in the liver?
Schizonts containing merozoite offspring
What happens when schizonts rupture?
Merozoites are released and they enter RBCs
What happens to merozoites in RBCs?
They form larger trophozoites and erythrocytic schizonts
What happens when erythrocytic schizonts rupture?
The clinical presentations of malaria are produced
When should you consider malaria?
In anyone with a fever who has previously visited a malarial area, regardless of prophylaxis
What are the symptoms of malaria?
Fever, chills, headache, cough, splenomegaly
What might a patient present with if diagnosis is delayed?
Jaundice, confusion, seizures
What travel history should you take?
Country, area, date of return, stopovers
What investigations should you do?
Thick and thin smear, travel history, rapid diagnostic tests, PCR, blood tests, CXR, LP
What test detects the parasite antigen?
Rapid diagnostic test
What should you do if malaria is suspected but blood film is negative?
Repeat at 12-24h and then again after another 24h
What are some differential diagnoses?
Dengue, typhoid, hepatitis, meningitis/encephalitis, HIV, viral haemorrhagic fever
When is there a risk of haemolysis with primaquine?
In G6PD deficiency
When should you get expert help?
In pregnancy or G6PD deficiency
What shouldn’t you forget about malaria?
It is a notifiable disease
What should you give patients going to a malarial area?
Chemoprophylaxis and bite prevention advice
What are symptoms of severe disease in P. falciparum?
SOB, fits, hypovolaemia, AKI, nephrotic syndrome
What blood tests should be done?
FBC, LFT, U&E, blood gases, blood culture
