Infectious disease caused by members of the Plasmodium family of protozoan parasites

Aetiology

• Plasmodium parasite from female anopheles mosquito
• P. falciparum most severe - can cross the blood-brain barrier
• Sub-Saharan Africa accounted for approximately 93% of all malaria cases and 94% of deaths in 2018

Clinical features

• Presentation very variable; the incubation period is usually 1-4 weeks after exposure, although it can lie dormant for years

Symptoms

• Fever (up to 41℃) with sweats and rigors
  • The most characteristic symptom of malaria is the fever, which spikes very high every 48 hours
  • In someone with an unexplained fever, consider whether they have travelled somewhere with malaria present
• Pallor
• Non-specific malaise
• Myalgia
• Headache
• Nausea and vomiting
• P. falciparum can rapidly progress to severe cerebral malaria, seizures and coma

Signs

• Pallor due to the anaemia
• Hepatosplenomegaly
• Jaundice (bilirubin is released during the rupture of red blood cells)

Investigations