Overview
Malaria is a mosquito-borne infectious disease caused by Plasmodium parasites and transmitted through the bite of infected female Anopheles mosquitoes.
Disease Summary
- Category
- Infectious Disease
- Cause
- Plasmodium species
- Transmission
- Female Anopheles mosquito bite
- Body System
- Blood
- Preventable
- Yes
- Curable
- Yes
Symptoms
Common Symptoms
Most people with uncomplicated malaria experience one or more of the following symptoms.
Fever
Often the first symptom and may occur in cycles.
Chills
Frequently accompanies fever and may be followed by sweating.
Headache
Can range from mild to severe and is commonly reported.
Body Aches
General muscle and joint pain may occur during infection.
Danger Signs
Seek urgent medical attention immediately if any of the following symptoms develop.
Confusion
May indicate cerebral malaria and requires immediate medical care.
Difficulty Breathing
Can indicate severe malaria and should be assessed urgently.
Repeated Vomiting
Persistent vomiting increases the risk of dehydration and complications.
Seizures
A medical emergency requiring immediate hospital treatment.
Diagnosis
Clinical Assessment
Diagnosis begins with evaluating the patient’s symptoms, travel history and physical examination.
Laboratory Tests
Rapid Diagnostic Tests (RDTs) and blood microscopy are used to confirm malaria infection.
Microscopy
Microscopy remains the reference method for detecting malaria parasites and identifying the infecting species.
Laboratory Tests
Rapid Diagnostic Test (RDT)
Detects malaria antigens quickly and is widely used for rapid diagnosis, particularly where microscopy is unavailable.
Blood Film Microscopy
The gold standard for confirming malaria infection, identifying parasite species and estimating parasite density.
Complete Blood Count (CBC)
Often demonstrates anaemia and thrombocytopenia, which are common laboratory findings in malaria.
Polymerase Chain Reaction (PCR)
Highly sensitive molecular test mainly used for research, confirmation of difficult cases and species identification.
Treatment
Artemisinin-based Combination Therapy (ACT)
ACT is the recommended first-line treatment for uncomplicated Plasmodium falciparum malaria. Treatment should begin promptly after laboratory confirmation.
Intravenous Artesunate
Intravenous artesunate is recommended for severe malaria. Patients should be transitioned to oral ACT once clinically stable.
Prevention
Sleep under insecticide-treated mosquito nets
Sleeping under long-lasting insecticide-treated nets (LLINs) every night is one of the most effective ways to prevent malaria.
Use mosquito repellents
Apply insect repellents to exposed skin, especially during the evening and night when mosquitoes are most active.
Eliminate mosquito breeding sites
Remove stagnant water around homes and communities to reduce mosquito breeding.
Seek early testing and treatment
Anyone with fever in a malaria-endemic area should seek prompt testing and treatment.
Risk Factors
High Risk
These individuals are more likely to develop severe malaria.
- Children under five years
- Pregnant women
- Immunocompromised individuals
Increased Risk
These groups have a higher chance of acquiring malaria.
- Travellers to endemic regions
- Older adults
- Individuals without prior immunity
Exposure Factors
Environmental and behavioural factors that increase mosquito exposure.
- Living near stagnant water
- Sleeping without mosquito nets
- Outdoor exposure during evening hours
Complications
Cerebral Malaria
A severe form of malaria that affects the brain and can cause confusion, seizures, coma, or death if not treated promptly.
Severe Anaemia
Destruction of red blood cells may lead to severe anaemia, resulting in weakness, fatigue, and reduced oxygen delivery to tissues.
Acute Respiratory Distress
Severe malaria may lead to fluid accumulation in the lungs, causing difficulty breathing and requiring urgent medical care.
When to Seek Medical Care
Difficulty Breathing
Difficulty breathing may indicate severe malaria and requires immediate hospital care.
Confusion or Seizures
Confusion, seizures or reduced consciousness are medical emergencies.
Persistent Vomiting
Persistent vomiting increases the risk of dehydration and prevents effective oral treatment.
Loss of Consciousness
Seek emergency medical care immediately if a person becomes unconscious.
Prognosis
Excellent with Early Treatment
Most patients recover completely when malaria is diagnosed early and treated appropriately.
Poor if Treatment is Delayed
Delayed diagnosis or treatment increases the risk of severe malaria, organ failure and death.
Follow-up Care
Patients recovering from severe malaria may require follow-up to monitor recovery and detect complications.
Differential Diagnosis
Typhoid Fever
Typhoid fever commonly presents with prolonged fever and malaise, making it an important alternative diagnosis.
Dengue Fever
Dengue fever may resemble malaria with fever, headache and muscle pain but typically lacks malaria parasites on blood films.
Bacterial Sepsis
Sepsis may present with fever and altered mental status and should always be considered in severely ill patients.
Viral Infections
Influenza, COVID-19 and other viral illnesses can present with similar constitutional symptoms.
References
World Health Organization (WHO)
World Health Organization guidance on malaria epidemiology, diagnosis, treatment and prevention.
Centers for Disease Control and Prevention (CDC)
Clinical guidance, travel recommendations and educational resources on malaria.
MSD Manual Professional Edition
Evidence-based medical reference covering malaria and other infectious diseases.
National Malaria Control Programme
National malaria policies, treatment guidelines and public health recommendations.
Frequently Asked Questions
Can malaria be cured?
Yes. Most uncomplicated malaria cases can be cured with appropriate antimalarial medication when treatment begins early.
Can malaria spread from person to person?
No. Malaria is transmitted primarily through the bite of infected female Anopheles mosquitoes rather than direct person-to-person contact.
Can malaria come back after treatment?
Some malaria species, particularly Plasmodium vivax and Plasmodium ovale, can relapse because dormant parasites remain in the liver.
Can malaria be prevented?
Yes. Sleeping under insecticide-treated nets, controlling mosquitoes, and taking preventive medicines when indicated are effective preventive measures.