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Malaria + protective factors
disease caused by Plasmodium protozoa → spread via female mosquitos (4 different species)
Plasmodium falciparum → severe
Plasmodium vivax → most common, benign
protective factors: sickle-cell trait, G6PD deficiency, HLA-B53, absent Duffy antigens
Malaria presentations
flu-like px: headache, myalgia, anorexia
fever +/- chills (RBC rupture = pyrogenic cytokines released)
splenomegaly
jaundice
pallor
severe: altered consciousness/seizures, respiratory distress, hypotension, haemoglobunuria
Malaria fever patterns
Falciparum: irregular fever
Vivax / ovale: cyclical tertian pattern (every 48 hours)
Malariae: cyclical quartan pattern (every 72 hours)
Malaria investigations + treatment
Blood film (gold standard)
thick → sensitive
thin → determine species
FBC → thrombocytopenia, normocytic anaemia, normal WBC, reticulocytosis
Rapid diagnostic test (detect PfHRP2)
Tx: ACT (avoid in 1st trimester) or chloroquine