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Malaria: an update for nurses in general practice

02 April 2023
Volume 34 · Issue 4

Abstract

Malaria is a mosquito-borne, potentially fatal disease that is distributed throughout the tropics. Malaria is caused by the parasite Plasmodium, transmitted to humans by the bite of a female Anopheles mosquito, most active between dusk and dawn. Insect bite avoidance is crucial to prevent bites from infected mosquitoes causing infection. All travellers visiting malaria endemic areas are at risk of exposure. Conducting a pre-travel risk assessment and providing appropriate advice to the individual is essential. The malaria prevention guidance emphasises that effective bite prevention should be the first line of defence against malaria infection, even when chemoprophylaxis is used. Recommendations for antimalarials should be appropriate for the destination, tailored to the individual, and account for the risks and benefits to the traveller.

Malaria is a preventable, but potentially fatal illness. Sandra Grieve provides an update for those providing travel consultations in general practice

Malaria is a serious, potentially fatal, but preventable, febrile illness caused by the parasite Plasmodium, transmitted to humans by the bite of a female Anopheles mosquito, most active between dusk and dawn. Red blood cells are infected with the parasite Plasmodium. Five species of Plasmodium can infect humans (Table 1). Malaria is distributed throughout the tropics. In Africa, P. falciparum causes most severe malaria cases and deaths. P. vivax mostly dominates in countries outside of sub-Saharan Africa. P. knowlesi is usually transmitted from monkeys to humans by mosquito bites in South-East Asia (UK Health Security Agency (UKHSA), 2022a). A pictorial illustration of the malaria life cycle indicating where preventative measures act, is included in the malaria guidelines (UKHSA, 2022a). Insect bite avoidance is crucial to prevent bites from infected mosquitoes causing infection. Causal prophylaxis acts on the parasite in the liver, whereas suppressive prophylaxis acts on parasites in the red blood cells (UKHSA, 2022a).

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