Congenital falciparum malaria.Care & specialists in Brazil

Symptoms typically appear 7 to 30 days after an infected Anopheles mosquito bite, though Plasmodium vivax and P. ovale can present months or even years later because of dormant liver-stage hypnozoites. P. falciparum is usually the fastest, with most cases presenting within 2-4 weeks. Anyone with a fever within 3 months of travel to an endemic area should be tested immediately.

The classic symptoms are fever, chills with shaking rigors, severe headache, muscle and joint aches, fatigue, nausea, and sometimes vomiting and diarrhoea. Many patients describe cyclical fever spikes every 48 or 72 hours. Severe malaria adds confusion, seizures, breathlessness, jaundice, and very dark urine and is a medical emergency.

Sub-Saharan Africa carries 94% of global malaria cases and 95% of deaths. Nigeria, the Democratic Republic of Congo, Uganda, Mozambique, and Niger together account for roughly half of all cases. Parts of South Asia, Southeast Asia, the Amazon basin, and the Horn of Africa also have significant transmission. The WHO and CDC publish updated country-specific maps.

Diagnosis requires parasitological confirmation, usually with a rapid diagnostic test detecting Plasmodium antigens from a finger-prick sample, microscopy of Giemsa-stained thick and thin blood films, or PCR. WHO recommends testing every suspected case before treatment, except where severe malaria requires immediate parenteral artesunate. A single negative test does not exclude malaria, and repeat testing over 72 hours is standard if suspicion persists.

Yes. Uncomplicated malaria is cured in over 95% of patients with a 3-day artemisinin-based combination therapy course. Plasmodium vivax and P. ovale also require radical cure with primaquine or single-dose tafenoquine to clear dormant liver-stage hypnozoites and prevent relapse. Severe malaria is treated with parenteral artesunate followed by a full oral ACT course.

Yes. Plasmodium vivax and Plasmodium ovale form dormant liver-stage hypnozoites that can reactivate weeks to years later, producing relapses. Plasmodium falciparum and P. malariae do not relapse but can recrudesce if the original blood-stage infection was incompletely cleared. Radical cure with primaquine or tafenoquine prevents vivax and ovale relapse.

The WHO defines severe malaria as Plasmodium infection with any of impaired consciousness, repeated seizures, prostration, respiratory distress with acidotic breathing, circulatory collapse, abnormal bleeding, jaundice with parasitaemia, severe anaemia, hypoglycaemia, acute kidney injury, pulmonary oedema, or parasitaemia over 10%. It is a medical emergency requiring parenteral artesunate and intensive care.

Artemisinin-based combination therapy (ACT) is the WHO-recommended first-line treatment for uncomplicated falciparum malaria worldwide. Artemether-lumefantrine and dihydroartemisinin-piperaquine are the most widely used. Severe malaria is treated with intravenous or intramuscular artesunate, followed by a full 3-day oral ACT course once the patient can take oral medication.

Yes. Two vaccines, RTS,S/AS01 (Mosquirix) and R21/Matrix-M, are WHO-recommended for children in moderate-to-high transmission areas. RTS,S/AS01 reduced clinical malaria episodes by ~36% over 4 years in phase 3 trials. R21/Matrix-M reduced clinical malaria by 75% in seasonal settings over 12 months. Both target the Plasmodium falciparum circumsporozoite protein.

Yes. Key prevention measures include sleeping under insecticide-treated nets, indoor residual spraying, mosquito repellents containing DEET or picaridin, chemoprophylaxis for travellers, intermittent preventive treatment in pregnancy, seasonal malaria chemoprevention for children in the Sahel, and now WHO-recommended vaccination with RTS,S/AS01 or R21/Matrix-M in moderate-to-high transmission areas.

Common chemoprophylaxis options include atovaquone-proguanil, doxycycline, mefloquine, and tafenoquine. Choice depends on the destination, length of stay, drug-resistance patterns, pregnancy, and individual tolerance. Start before travel, continue throughout the trip, and complete the post-travel course as directed. A travel-medicine clinician should tailor the regimen to your itinerary.

Yes. Children under five carry roughly three-quarters of malaria deaths in Africa because they lack the partial immunity that develops with repeated exposure. They are especially vulnerable to severe anaemia, cerebral malaria, and hypoglycaemia. Seasonal malaria chemoprevention, insecticide-treated nets, and the new RTS,S/AS01 and R21/Matrix-M vaccines are central to protecting this age group.

Yes. Pregnancy roughly triples the risk of severe malaria and increases maternal anaemia, miscarriage, preterm delivery, low birth weight, and stillbirth. Placental sequestration of Plasmodium falciparum is the underlying mechanism. WHO recommends intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine from the second trimester and use of insecticide-treated nets in endemic areas.

Five Plasmodium species infect humans. Plasmodium falciparum causes nearly all severe disease and most deaths. Plasmodium vivax is the most widespread, especially outside Africa, and forms relapsing liver-stage hypnozoites. Plasmodium ovale is similar to vivax and largely confined to West Africa. Plasmodium malariae causes chronic low-grade infection. Plasmodium knowlesi is a zoonotic simian malaria found in Southeast Asia.

Artemisinin partial resistance is defined as delayed clearance of Plasmodium falciparum from the blood after artesunate or another artemisinin derivative. It is associated with kelch13 gene mutations and was first detected in the Greater Mekong subregion; cases have now been reported in East Africa and the Horn of Africa. WHO surveillance guides regional ACT choice to preserve efficacy.

Malaria is a parasitic infection transmitted by Anopheles mosquitoes; dengue is a viral infection transmitted by Aedes mosquitoes. Malaria produces cyclical fever, parasites on a blood smear, and responds to artemisinin-based combination therapy. Dengue causes a single febrile illness with retro-orbital pain, a rash, low platelets, and is diagnosed by NS1 antigen or IgM. Co-infection occurs in shared endemic regions.

Primaquine and tafenoquine cause severe acute haemolysis in people with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Because G6PD deficiency is common in populations historically exposed to malaria, the WHO recommends quantitative or qualitative G6PD testing before standard-dose radical cure of P. vivax or P. ovale. Reduced-dose primaquine regimens exist for partial deficiency but should be supervised.

In endemic countries, artemether-lumefantrine and other quality-assured ACTs are typically provided free or at heavily subsidised cost through national malaria programmes and the Global Fund. A private 3-day ACT course costs roughly USD 1-5 in Africa and USD 30-60 in the United States. Parenteral artesunate for severe malaria is more expensive but procured through WHO-prequalified suppliers.

Yes. People living in endemic areas often have multiple episodes a year, especially children. Adults gradually develop partial immunity with repeated exposure that reduces disease severity but does not prevent infection. This partial immunity wanes within 1-2 years of leaving an endemic area, which is why returning expatriates and second-generation migrants are at higher risk of severe imported disease.

Most patients with uncomplicated malaria are afebrile within 48-72 hours of starting an ACT and back to baseline within 1-2 weeks. Anaemia and fatigue can persist for 4-8 weeks. Severe malaria with multi-organ involvement requires 1-3 weeks of inpatient care followed by a 6-12 week structured recovery. Cerebral malaria survivors may need neurocognitive rehabilitation lasting months.

No. Malaria does not spread directly from person to person through casual contact, coughing, or sharing food. It is transmitted by the bite of an infected female Anopheles mosquito. Rare exceptions include transmission through blood transfusion, organ transplantation, contaminated needles, and from mother to baby during pregnancy or delivery (congenital malaria).

See a doctor the same day for any fever, chills, headache, or flu-like illness within three months of returning from a malaria-endemic country, even if you took chemoprophylaxis. Mention the travel history at the first encounter. Plasmodium falciparum infection can progress to severe disease within 24 hours, so emergency assessment is appropriate if you feel unwell.