Summary

In this study session, you have learned that:

• Knowledge of the signs and symptoms of malaria is important for its clinical diagnosis.
• Different species of the malaria parasite can cause malaria of different severity. Of the two species present in Ethiopia, P. falciparum is more likely to cause a severe and fatal disease. Young children and pregnant women are more at risk of serious infection as they have weaker immunity.
• The most important clinical symptom of malaria is fever (or a history of fever within the last 2–3 days), typically with regular attacks every 2–3 days lasting several hours. Attacks often begin with shivering, followed by fever, then profuse sweating.
• In areas where malaria incidence is low, always ask those who have a fever about their travel history to malaria endemic areas in the last two weeks.
• Carefully observe all suspected or confirmed malaria cases for any signs of severe malaria, which include convulsions, anaemia, repeated vomiting, high fever (above 39°C), severe dehydration, drowsiness or confusion, and reduced urine output.
• Refer severe cases immediately.
• Whenever possible malaria treatment should be based on parasitological diagnosis of malaria rather than on a clinical diagnosis based on symptoms.
• Rapid diagnostic tests (RDTs) for malaria are available at health post level and are effective in diagnosing malaria if correctly used. RDTs cannot distinguish between species of malaria parasites or estimate the number present in the patient’s blood sample.
• In the absence of RDTs, you will need to use clinical symptoms to diagnose malaria. In some cases you may need to refer patients to the health centre or hospital, so a microscopic diagnosis of malaria can be carried out to confirm malarial infection.