Malaria
Description Diagnostic criteria ICD-10 code: B54 * Notifiable disease. DESCRIPTION Malaria is transmitted by the bite of an infected female Anopheles mosquito. The incubation period varies with the species of the parasite, Plasmodium falciparum being shortest, usually 7–21 days, and P. malariae the longest. The incubation period may be prolonged by use of malaria prophylaxis or certain anti
ICD-10 code: B54
* Notifiable disease.
DESCRIPTION
Malaria is transmitted by the bite of an infected female Anopheles mosquito. The incubation period varies with the species of the parasite, Plasmodium falciparum being shortest, usually 7–21 days, and P. malariae the longest. The incubation period may be prolonged by use of malaria prophylaxis or certain antibiotics.
The confirmation of the diagnosis and treatment of malaria is an emergency as complications develop rapidly. Malaria can be missed outside transmission areas.
DIAGNOSTIC CRITERIA
Clinical
- A child living in, or with recent travel history to a malaria transmission area.
- Fever, which may be intermittent.
- Flu-like symptoms including sweating or rigors, i.e. cold, shaking feeling.
- Body pains and headache.
- Occasionally diarrhoea, loss of appetite, nausea and vomiting, tachypnoea and cough.
- A young child may present with fever, poor feeding, lethargy, vomiting, diarrhoea or cough.
- Clinical features are non-specific and overlap with many other infections.
Investigations:
- Testing is urgent. Obtain the result immediately.
- Rapid diagnostic test.
In areas where malaria transmission occurs, rapid tests should always be available for malaria screening but cannot be used for monitoring response to treatment as they may remain positive for over 4 weeks.
- Rapid diagnostic test.
- Malaria parasites in blood smear – thick and thin smears.
- One negative malaria test does not exclude the diagnosis.
- Repeat smears if initially negative, and malaria suspected.
- If severe malaria suspected, commence therapy and repeat smears after 6–12 hours.
- Repeat smears after 48 hours and if no improvement in degree of parasitaemia, consider alternative therapy.
If severe malaria is suspected and the diagnosis cannot be confirmed immediately, treat while awaiting laboratory results.
Standard Treatment Guidelines and Essential Medicines List for South Africa Paediatric Hospital _2023, 5th edition_Updated July 2024
Chapter 8: Infective/Infectious Diseases, 8.9 Malaria
Click here for 8.9.1 P.Falciparum Malaria, Non-Severe, Uncomplicated
Click here for 8.9.2 P.Falciparum Malaria, Severe, Complicated (Or If Repeated Vomiting)
Click here for 8.9.3 P. Ovale/P. Vivax & P.Malariae
Click here for 8.9.4 Malaria Prophylaxis