Malaria

For a lay person:

Malaria is a parasitic infection spread by mosquito bites in tropical and subtropical regions. It causes bouts of fever, chills and sweating, and the most dangerous form can quickly become life-threatening, especially in children, pregnant women and travellers.

For a trained medical person:

Caused by Plasmodium falciparum, vivax, ovale, malariae and knowlesi; falciparum can cause severe malaria with cerebral involvement, severe anaemia, acidosis, kidney injury and respiratory distress. Diagnosis is urgent with thick and thin blood films or rapid diagnostic tests, repeated if negative. Treatment follows species, severity and local resistance: artemisinin-based combination therapy for uncomplicated falciparum, intravenous artesunate for severe malaria, and primaquine or tafenoquine for vivax and ovale liver stages after G6PD testing.

In Chinese medicine:

Liu and Tseng's textbook differentiates this condition into these patterns: Zheng Nue (Primary Malaria); Wen Nue (Warm Malaria); Han Nue (Cold Malaria); Shi Nue (Damp Malaria); Zhang Nue (Miasmic Malaria); Lao Nue (Taxation Malaria); Li Nue (Dysentery Malaria); Nue Mu (Mother of Malaria). Treatment follows the pattern a patient presents with, not the Western diagnosis alone.

When to get help: Any fever during or after travel to a malaria area needs same-day medical testing; malaria needs antimalarial drugs, is notifiable in many countries, and Chinese medicine is adjunctive at most. Do not rely on herbal artemisia (qing hao) preparations in place of standard antimalarial treatment.