Malaria

Overview

Malaria is not routinely screened in asymptomatic refugees, but it should be considered in any febrile patient from an endemic area.

When to Test

• Any fever in a patient from an endemic area
• Unexplained anemia
• Pregnant patients from endemic areas (consider screening)

Diagnosis

• Thick and thin blood smears - Gold standard
• Rapid diagnostic tests (RDTs) - Useful for initial diagnosis
• PCR available for confirmation

Treatment

Treatment depends on species and severity. Refer to current guidelines for specific regimens.

Uncomplicated P. falciparum

• Artemether-lumefantrine (Coartem)
• Atovaquone-proguanil (Malarone)

P. vivax/ovale

• Chloroquine (if sensitive) PLUS
• Primaquine for radical cure (check G6PD first!)

Special Considerations

Always check G6PD status before prescribing primaquine to prevent hemolytic anemia.