Prophylaxis

There are five species of Plasmodium, of which:

• Plasmodium falciparum has the greatest mortality
• Plasmodium vivax has the greatest morbidity

Vector: female anopheles mosquito

Falciparum Malaria

Falciparum malaria is the commonest, and most severe, type of malaria.

Clinical features

Falciparum malaria typically presents with symptoms suggestive of a flu-like illness. The classical triad of symptoms includes paroxysms of fever, chills, and sweating. These symptoms may occur every 48 hours corresponding to the erythrocytic cycle of the Plasmodium falciparum parasite. Fever is often high, intermittent, and may be accompanied by rigors. Initial manifestations can be non-specific and include malaise, headache, and myalgia, which might be mistaken for a viral syndrome.

General features of Falciparum malaria

• fever: The hallmark of malaria, typically cyclical, often accompanied by sweating and sometimes rigors.
• gastrointestinal:
  • anorexia, nausea, vomiting, and abdominal pain are frequent
  • diarrhoea can occasionally be a feature, more commonly in children
  • patients may exhibit mild jaundice and occasional pruritus
• respiratory: Cough and, in some cases, mild tachypnoea may occur, though primary respiratory complications are rare in non-severe cases.
• musculoskeletal: Generalised body aches and joint pains are common.
• neurological:
  • headache is prominent and often severe.
  • dizziness and sleep disturbances may also be observed.
• cardiovascular: Tachycardia may be evident, and although hypotension is more typical of severe malaria, it can occasionally be seen in non-severe cases as well.
• haematological:
  • thrombocytopaenia is the most significant haematological finding and can occur in the absence of severe disease.
  • mild anaemia may also be present.
• renal: While acute kidney injury is associated with severe malaria, non-severe cases might show mild to moderate increases in creatinine or blood urea nitrogen levels.