MALARIA

Question 0

What is malaria? Which Protozoa causes death in children?

Answer 0

Mosquito borne parasitic protozoan disease

Protozoa falciparum

Question 1

Mode of spread?

Answer 1

Acquired in endemic area
Usually all cases from returned travellers
Secondary to blood transfusion (rare)

Question 2

Sx?

Answer 2

Symptomatic weeks after infection
No prophylaxis guaranteed to prevent malaria

Uncomplicated malaria often improves after 2 days. Fever resolves after 4 days.

Constitutional: fatigue, malaise, arthralgia, myalgia, headache

Cough

Fever, chills, sweats

N+V, diarrhoea, jaundice

Question 3

Investigations?

Answer 3

CBE EUC LFT

• raised WCC only in 25%
• anaemia, thrombocytopenia

Malaria rapid testing (immunochromatography)

Haemolytic bloods picture
- peripheral blood smear showing RBC containing parasites

Question 4

Prophylaxis?

Answer 4

Doxycycline until 4 weeks after leaving area

Question 5

Management?

Answer 5

Artermether and lumefantrine

Admit if

• severe symptoms
• CNS infection
• > 5% RBCs affected

Question 6

Complications?

Answer 6

Usually all from Plasmodium falcidurum

• ARDS
• cerebral malaria
• lactic acidosis
• AKI
• coagulopathy