Severe Malaria

Q: Which of the following is responsible for 90 percent of severe malaria cases? (select one)

A) Plasmodium falciparum 

B) Plasmodium vivax 

C) Plasmodium knowlesi

Answer: A

The objective of this question is to highlight the fact that it is important to establish the diagnosis of "severe malaria" as, without intervention, death can occur within 24 hours. Severe malaria is defined as one or more of the following criteria occurring in the presence of malaria infection and in the absence of an identified alternative cause:

• Impaired consciousness
• Prostration
• Convulsions
• Acidosis
• Hypoglycemia
• Severe anemia
• Renal impairment
• Jaundice
• Pulmonary edema
• Significant bleeding
• Shock
• Hyperparasitemia

(Readers are advised to refer to other sources as each of the above criteria has further detailed sub-specifications)

90 percent of cases of severe malaria are attributable to P. falciparum.

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References:

1. World Health Organization. Guidelines for malaria. WHO: Geneva 2022. Available at: https://apps.who.int/iris/handle/10665/351995 (Last accessed on January 10, 2023).

2. Severe malaria. Trop Med Int Health 2014; Suppl 1:7.

3. https://www.cdc.gov/malaria/about/disease.html.(Last accessed on January 10, 2023)

4. World Health Organization World Malaria Report 2017. http://apps.who.int/iris/bitstream/handle/10665/259492/9789241565523-eng.pdf;jsessionid=7CE964134B0D083EA92FBB9F1F9D4775?sequence=1 (Last accessed on January 10, 2023).