In this section
For severe or acute malaria see the statewide Malaria Clinical Practice Guideline
Malaria is caused by infection with protozoan parasites of the
genus Plasmodium, transmitted by female mosquitos of the
genus Anopheles. Four species cause nearly all infections
in humans; Pl. falciparum, Pl. vivax, Pl. ovale and
Pl. malariae. The microbiological and clinical features
vary between species (Table
1). The prevalence of malaria in refugees arriving in Australia was between 5-15%[1-3] and as high as 25% in children
arriving from sub-Saharan Africa during the peak wave of Humanitarian entrants from African source countries in the mid 2000s. This has reduced since the introduction of a 'Pre-Departure Medical Screen' (PDMS) in 2005 (known as the Departure Health Check (DHC) since 2012). This is a voluntary health check for refugee entrants, that occurs 3-7 days prior to departure for Australia. The DHC includes a rapid
diagnostic test (RDT) for malaria and treatment if positive, however
screening is voluntary, and uptake is incomplete.
2016 ASID refugee health guidelines recommend malaria screening in people travelling from/through endemic areas (Bangladesh, Bhutan, Burma, India, Pakistan, Sri Lanka, African source countries. Note: not Egypt, Middle East, Afghanistan). In 2017, South Australian colleagues have noted increased presentations of African children with Pl falciparum malaria.
country of origin and transit and recent treatment on pathology
guidelines for malaria are available (see RCH library drug information - intranet access required).
Additional considerations include:
Outpatient management may
be considered if all the following criteria are met
[adapted from ]
Even if all criteria are
met, home-based nursing/Hospital in the Home should be considered for medication and
clinical supervision. There are additional considerations in
malaria-receptive areas in Northern Australia.
Patients should be seen in
Infectious Diseases outpatients at 28 days with repeat thick/thin
films and RDT, or immediately if symptoms recur.
Immigrant health clinic resources. Author: Georgie Paxton, reviewed August 2017.