Malaria

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Definition/Description

Malaria is a parasitic infection caused by the bite of a female Anopheles mosquito.¹ The infection can result from any one of five parasites from the Plasmodium group including Plasmodium flaciparum (P. flaciparum), Plasmodium vivax (P. vivax), Plasmodium ovale (P. ovale), Plasmodium malariae (P. malariae), and Plasmodium knowlesi (P. knowlesi). Malaria causes fever, chills, malaise, headaches, and myalgia and can result in death if not treated appropriately.¹ The disease is most prevalent in Sub Suhahran Africa and Southeast Asia.¹ It has been eliminated from the United States, but is still one of the most common causes of fever in travelers that have returned from the aforementioned areas.¹

Prevalence

An estimated 500 million cases of Malaria occur each year, with 1-2 million deaths.²  About 90 % of these deaths occur in Sub-Saharan Africa.⁶ Severe Malaria (caused by P. falciparum) has a mortality rate of about 15-20%.¹ About 1,500 cases are diagnosed within United States every year.⁴ An estimated 50% of the world’s population, about 3.3 billion people, are at risk for Malaria.⁶ The following areas are most commonly affected by malaria : Africa, India, Pakistan, Southeast Asia, Paupa New Guinea, Haiti, and parts of South America.² 109 countries and territories are affected worldwide and the disease is most prevelant in area of tropical climate, as the Anopheles mosquito is able to live in areas with warm temperatures.⁶ Transmission of Malaria has been eliminated from the U.S., Puerto Rico, Jamaica, Chile, Israel, Lebanon, North Korea, and Europe. However, Anopheles mosquitos are found throughout the world, except for Antarctica.  As a result, the disease can be re-introduced into any country.

Characteristics/Clinical Presentation

The person infected with Malaria will not present with symptoms until about 7 days to 4 weeks after he or she has been bitten.⁶ However, symptoms may not occur until up to 6 months to 1 year after the bite.² The bite of a female Anopheles mosquito produces infection and consequent death to erythrocytes, or red blood cells, (see the Plasmodium life cycle in “causes” for more information) which causes hemolysis, anemia, and tissue hypoxia.² Symptoms could include fever, chills, malaise, headaches, and myalgia. Cough, abdominal pain, and diarrhea may also occur, but are less likely.¹ 

Infection by the P. Falciparum parasite produces the most severe form of Malaria and is the most life-threatening.⁴ When diagnosed with Malaria, the patient is classified as either severe (complicated) or uncomplicated. The criteria for diagnosis of severe Malaria is listed in the “diagnosis” section. If infected by P. vivax or P. ovale, the patient may experience relapsing Malaria in which the infection can lie dormant in the body for up to 4 years.⁴

Associated Co-morbidities

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Medications

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Diagnostic Tests/Lab Tests/Lab Values

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Causes

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Systemic Involvement

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Medical Management (current best evidence)

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Physical Therapy Management (current best evidence)

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Alternative/Holistic Management (current best evidence)

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Differential Diagnosis

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Case Reports

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Resources

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Recent Related Research (from Pubmed)

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References

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