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; P. falciparum, P. vivax, P. ovale and P. malariae. The microbiological and clinical features
vary between species (
Table 1). The prevalence of malaria in African refugees arriving in Australia was between 5-15%1-3 and as high as 25% in children from sub-Saharan Africa3 in the mid 2000s. This reduced with the introduction of pre-departure screening in 2005 (known as the Departure Health Check (DHC) since 2012). This is a voluntary health check for refugee entrants 3-7 days prior to departure for Australia. The DHC includes a rapid
diagnostic test (RDT) for malaria and treatment if positive,4 however screening is voluntary, and uptake is incomplete. Recent arrivals from Afghanistan have not had a DHC.
2016 ASID 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). In 2017-2018, clinicians noted presentations of African children with P. falciparum malaria in South Australia and Victoria. We have seen cases of P. vivax in arrivals from Afghanistan.
countries of origin and transit and recent treatment on pathology
Therapeutic 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 from7)
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.
South and North Asia, Eastern Europe, Central America parts South America
Immigrant health clinic resources. Author: Georgie Paxton, reviewed June 2020.