malaria fevers are cyclical;
synchronized with the
bursting of merozoites into
bloodstream
chills +
sweating
head +
body aches
nausea +
vomiting +
diarrhead
severe malaria
impaired
consciousness/cerebral
malaria
fits,
prostration,
coma
severe
anaemia
respiratory
distress
multi organ
failure
renal
failure
pulmonary
oedema
death:
10-50% of
cases
fever
PATHOLOGY
EPIDEMIOLOGY
Hypoendemic
little
transmission;
sporatic,
self-limiting
outbreaks
little public
health
importance
poor
development
of immunity!
disease
affects all
ages equally
EX: China, Mexico
Mesoendemic
present in
most areas;
variable
transmission
intensity
generally of
ph
importance
development
of immunity
disease
doesn't
effect older
generations
EX: India,
most of
SE Asia
Hyperendemic
intense,
widespread
(but still
seasonal
transmission)
often a
ph
problem
development
of good
immunity
disease
mainly
of
children
EX: African
Saehl
Holoendemic
intense,
widespread,
seasonal
variation is
slight
can be
#1 ph
problem
good
immunity
disease
mainly
<5s
EX: Humid,
lowland
tropical
African
CONTROL
Prevention
VC!
IRS
LLINS/ITNs
ITNs provided 17% protective
efficacy against mortality
about 5.5 lives saved per
1,000 under nets
treated nets
can cut
incidence in
half
Treatment
Drugs!
parenteral
Quinine,
artesunate
(better)
orals
artesunate,
quinine,
chloroquine...
ACT: not affordable
in African without
subsidy
Diagnostics
microscopy
most
accurate
requires lab
and trained
staff
rapid
diagnostic
tests
point of care
diagnostic!
doesn't require
lab or electricity;
minimum training
based on
antigen
capture
no intensity result: just +/-
2 types: HRP-2 (persists after cure),
LDH- negative 2 days after cure
PCR-based
assays
serological tests
DDx fever
Fever of unknown origin (FUO) in adults is defined as a temperature higher than 38.3 C (100.9 F) that
lasts for more than three weeks with no obvious source despite appropriate investigation. The four
categories of potential etiology of FUO are classic, nosocomial, immune deficient, and human
immunodeficiency virus–related. The four subgroups of the differential diagnosis of FUO are infections,
malignancies, autoimmune conditions, and miscellaneous. A thorough history, physical examination,
and standard laboratory testing remain the basis of the initial evaluation of the patient with FUO. Newer
diagnostic modalities, including updated serology, viral cultures, computed tomography, and magnetic
resonance imaging, have important roles in the assessment of these patients.
Night Sweats
Parasitic infectious disease transmitted by a mosquito and caused by Plasmodium, Species. The word
Malaria, meaning ‘bad air’ in Italian, was so named because of the historical belief that the disease was
caused by swamp vapors