Spectrum: Local Antimicrobial Stewardship, for Yangon Children's Hospital

Malaria

Clinical Features

  • Febrile illness (continuous or remittent fever in an endemic area without any other focal infection)

  • Febrile convulsions (common in young children)

  • Non-specific symptoms in early stages (similar to acute viral illness)

  • Enlarged liver and spleen

Danger Signs

  • Unable to drink or breast feed

  • Excessive vomiting

  • Lethargic or unconscious

  • Unable to sit or stand up

Most Common Complications

  • Cerebral malaria

  • Severe anemia

  • Respiratory distress (acidosis)

  • Hypoglycemia

Confirmation of Diagnosis

Disease Type

Uncomplicated Malaria

Criteria:

  • Symptomatic malaria without signs of severity or evidence of vital organ dysfunction

  • Parasitemia of <2% and no schizonts

Severe Complicated Malaria

Symptoms (one or more):

  • Hyperpyrexia (axillary temperature >39.5°C)

  • Impaired consciousness or unrousable coma

  • Prostration (i.e. generalized weakness so that the patient is unable to walk or sit up without assistance)

  • Failure to feed

  • Multiple convulsions (two episodes in 24 hours)

  • Circulatory collapse or shock

  • Clinical jaundice plus evidence of other vital organ dysfunction

  • Haemoglobinuria

  • Abnormal spontaneous bleeding

Additional Information

Please see MPS Guidelines or WHO Guidelines for further information on the treatment of Malaria