Malaria is a deadly disease caused by a group of intracellular protozoan parasites (four species of intracellular parasites cause malaria). Plasmodium falciparum, P. vivax make up most of the infections. In Africa, P. falciparum is responsible for almost all cases of malaria. Outside of Africa, P vivax accounts for a significant portion of malaria cases. The female anopheles is the malaria mosquito, a nighttime biter that may bite in the daytime as well. There are around 220 million malaria cases per year worldwide, with over 430 thousand deaths. Malaria is a leading cause of death among children in many countries. Sub-Saharan Africa has a high incidence of malaria. Tropical and sub-tropical climates typically have the highest incidence of malaria. There is more prevalence of malaria in rural areas. However, urban environments can have explosive outbreaks. Higher elevation and less rainfall significantly reduce the prevalence of malaria. The incubation period of malaria is up to one month. Malaria infects red blood cells and causes a cyclic fever that is caused by large numbers of intraerythrocytic schizonts rupturing. Periodic fevers may be daily, every 48 hours, every 72 hours, or irregularly depending on the type of malaria protozoan. Additionally, patients may experience joint pain, splenomegaly, headaches, anemia or other hematologic irregularities, vomiting and diarrhea, among other signs and symptoms. Malaria can be life-threatening, causing a splenic rupture in some cases, pulmonary edema, altered mental status, seizures, renal and liver failure, and even death secondary to shock and severe parasitemia as well as other causes of death. Repeated exposure to the malaria parasite leads to partial temporary immunity. Following clinical suspicion, the diagnosis of malaria can be made by microscopic visualization of the plasmodium inside red blood cells, antigen assays, and detection of the plasmodium with nucleic acid identification by P.C.R. (polymerase chain reaction). Babesiosis, caused by Babesia parasites, can look like malaria on light microscopy blood smears. Babesiosis is an intracellular pathogen. Babesiosis (a tick-borne disease that is occasionally seen in the United States (mainly the Midwest and Northeast)). There are a variety of drugs used to treat malaria. Some of the commonly used medications are quinine and quinidine. Many other drugs are used to treat malaria, which varies based on the type of plasmodium, if there is drug resistance, and severity of illness. For pregnant people, chloroquine, hydroxychloroquine, or mefloquine should be used for chemoprophylaxis. Chemoprophylaxis for malaria is recommended for travelers to malaria-endemic regions. Prophylactic medication should start before travel and continue up to one month following travel. Currently, there is no vaccine available for malaria. Control of the vector/ anopheles mosquito is important for controlling malaria. Insecticides, including D.D.T., may be used in some countries, as well as insecticide sprayed bed netting.

Reference:

Kachur S. Malaria. In: Boulton ML, Wallace RB. eds. Maxcy-Rosenau-Last Public Health & Preventive Medicine, 16e. McGraw Hill; 2022. Accessed January 05, 2022.