Overview
Malaria is a mosquito-borne infectious disease caused by Plasmodium parasites and transmitted through the bite of infected female Anopheles mosquitoes.
Key Fact
Warning
AT A GLANCE
Disease Summary
Symptoms
Common Symptoms
Most people with uncomplicated malaria experience one or more of the following symptoms.
Fever
Chills
Headache
Body Aches
Danger Signs
Seek urgent medical attention immediately if any of the following symptoms develop.
Confusion
Difficulty Breathing
Repeated Vomiting
Seizures
Diagnosis
Clinical Assessment
Laboratory Tests
Microscopy
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.
Laboratory Note
Microscopy remains the reference standard for malaria diagnosis whenever quality laboratory services are available.
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.
Treatment Note
Treatment should begin as soon as possible after diagnosis. Delayed treatment increases the risk of severe disease and complications.
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.
Prevention Note
Pregnant women, young children, older adults and immunocompromised individuals are at greater risk of severe malaria and should consistently follow preventive measures.
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
Risk Note
Individuals at higher risk should seek medical attention promptly if malaria symptoms develop.
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.
Complication Note
Severe malaria is a medical emergency. Early diagnosis and prompt treatment greatly reduce the risk of serious complications and death.
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.
Emergency Advice
Do not attempt to manage severe malaria at home. Early treatment in a health facility greatly improves outcomes.
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.
Prognosis Note
Prompt diagnosis and adherence to recommended treatment are the most important factors influencing recovery.
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.
Clinical Note
Laboratory testing is essential because several infectious diseases share similar symptoms with malaria. Clinical features alone are often insufficient to establish the diagnosis.
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.