When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Malaria

最后审阅: 16 Aug 2025
最后更新: 17 Jan 2025

小结

定义

病史和体格检查

关键诊断因素

  • fever or history of fever
完整详情

其他诊断因素

  • headache
  • weakness
  • myalgia
  • arthralgia
  • anorexia
  • diarrhea
  • seizures
  • nausea and vomiting
  • abdominal pain
  • pallor
  • hepatosplenomegaly
  • jaundice
  • altered level of consciousness
  • hypotension
  • bleeding
  • anuria/oliguria
  • tachypnea
完整详情

危险因素

  • travel to endemic area
  • inadequate or absent chemoprophylaxis
  • insecticide-treated bed net not used in endemic area
  • low host immunity (severe disease)
  • pregnancy (severe disease)
  • age <5 years (severe disease)
  • immunocompromise (severe disease)
  • older age (severe disease)
  • malnutrition (severe disease)
  • iron administration (children)
完整详情

诊断性检查

首要检查

  • Giemsa-stained thick and thin blood smears
  • rapid diagnostic tests (RDTs)
  • CBC
  • clotting profile
  • serum electrolytes, BUN and creatinine
  • serum LFTs
  • serum blood glucose
  • urinalysis
  • arterial blood gas
完整详情

需考虑的检查

  • polymerase chain reaction (PCR) blood for malaria
  • chest x-ray
  • blood culture
  • urine culture
  • sputum culture
  • lumbar puncture
  • HIV test
  • PCR nasopharyngeal swabs for influenza or COVID-19
  • CT head
完整详情

新兴检查

  • loop-mediated isothermal amplification

治疗流程

急症处理

severe disease (or unable to take oral medication initially): all Plasmodium species

Plasmodium falciparum (or unknown species): uncomplicated disease

Plasmodium ovale: uncomplicated disease

Plasmodium vivax: uncomplicated disease

Plasmodium malariae or Plasmodium knowlesi: uncomplicated disease

持续性治疗

Plasmodium falciparum: recurrent infection

撰稿人

作者

Elizabeth Ashley, MB BS, FRCP, FRCPath

Director

Institution Lao-Oxford-Mahosot Hospital - Wellcome Trust Research Unit

Vientiane

Laos

Honorary Consultant in Infectious Diseases and Microbiology

Oxford University Hospitals NHS Foundation Trust

Professor of Tropical Medicine

University of Oxford

Oxford

UK

გაფრთხილება:

EA is an associate editor of Malaria Journal, an academic editor for PLOS Medicine, and is on the Lancet Infectious Diseases International Advisory Board. EA is on the council of the International Society for Infectious Diseases. The Institution Lao-Oxford-Mahosot Hospital - Wellcome Trust Research Unit receives core funding from the Wellcome Trust. EA is an author of a number of references cited in this topic.

Arjun Chandna, BA MRCP AFHEA

Clinical Research Fellow

Centre for Tropical Medicine and Global Health

University of Oxford

Oxford

Specialty Registrar in Infectious Diseases and Medical Microbiology

University College London Hospitals NHS Trust

London

UK

გაფრთხილება:

None.

მადლიერება

Dr Elizabeth Ashley and Dr Arjun Chandna would like to gratefully acknowledge Professor Ron Behrens, Mariyam Mirfenderesky, Dr Signe Maj Sorensen, Dr Joanna Allen, Dr Simon Warren, and Dr Behzad Nadjm, previous contributors to this topic.

გაფრთხილება:

RB acted as a paid expert to the courts on malaria prophylaxis. RB received fees on the Travel Health advisory board for Emergent BioSolutions. RB prepared education material for the Royal College of Physicians and Surgeons of Glasgow. RB is an author of a number of references cited in this topic. MM, SMS, JA, and SW declare that they have no competing interests. BN is an author of a reference cited in this topic.

რეცენზენტები

Blaise Genton, MD

Professor

Head of the Travel Clinic

Consultant of Tropical and Travel Medicine

University Hospital

Project Leader

Swiss Tropical and Public Health Institute

Basel

Switzerland

გაფრთხილება:

BG has received a research grant from Novartis Pharma to assess the impact of the introduction of artemether-lumefantrine (Novartis) as first-line treatment for uncomplicated malaria on mortality of children under 5 years old in 2 districts in Tanzania and travel grants from Novartis Pharma to present the results of the study above. BG is an author of a reference cited in this topic.

David Sullivan, MD

Associate Professor

Malaria Research Institute and Department of Molecular Microbiology and Immunology

Johns Hopkins Bloomberg School of Public Health

Baltimore

MD

გაფრთხილება:

DS has received royalties from antigen provision for a diagnostic test to Inverness. DS with Johns Hopkins University has patents on diagnostic tests that do not require blood.

Walther H. Wernsdorfer, MD

Professor

Institute of Specific Prophylaxis and Tropical Medicine

Medical University of Vienna

Vienna

Austria

გაფრთხილება:

WHW declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

წყაროები

ჩვენი მტკიცებულებებისა და სარედაქციო ჯგუფები თანამშრომლობენ საერთაშორისო ექსპერტებსა და რეცენზენტებთან, რათა უზრუნველვყოთ თქვენი წვდომა კლინიკურად ყველაზე მნიშვნელოვან ინფორმაციაზე.

ძირითადი სტატიები

World Health Organization. WHO guidelines for malaria. Nov 2024 [internet publication].სრული ტექსტი

Centers for Disease Control and Prevention. Clinical guidance: malaria diagnosis & treatment in the U.S. Jun 2024 [internet publication].სრული ტექსტი

გამოყენებული სტატიები

ამ თემაში მოხსენიებული წყაროების სრული სია ხელმისაწვდომია მომხმარებლებისთვის, რომლებსაც აქვთ წვდომა BMJ Best Practice-ის ყველა ნაწილზე.
  • Malaria images
  • Diferenciales

    • Dengue fever
    • Zika virus infection
    • Chikungunya virus
    მეტი Diferenciales
  • Guías de práctica clínica

    • WHO guidelines for malaria
    • Malaria diagnosis and treatment in the US​
    მეტი Guías de práctica clínica
  • Folletos para el paciente

    Malaria prevention

    Más Folletos para el paciente
  • Videos

    Diagnostic lumbar puncture in adults: animated demonstration

    Más vídeos
  • padlock-lockedInicie sesión o suscríbase para acceder a todo el BMJ Best Practice

El uso de este contenido está sujeto a nuestra cláusula de exención de responsabilidad