Malaria

Question 1

What organism causes the most severe form of malaria?

Answer 1

Plasmodium falciparum – responsible for over 95% of infections and nearly all malaria deaths in children.

Question 2

What is the mode of transmission of malaria?

Answer 2

Through the bite of an infected female Anopheles mosquito that injects sporozoites into the bloodstream.

Question 3

Which age group is most vulnerable to malaria?

Answer 3

Children under 5 years and pregnant women due to incomplete immunity and physiological susceptibility.

Question 4

What is meant by malaria endemicity?

Answer 4

It measures the intensity of malaria transmission in an area based on spleen or parasite rate in children aged 2–9 years.

Question 5

Which form of malaria is holoendemic?

Answer 5

When >75% of adults and >50% of children are infected—indicates constant intense transmission and early immunity.

Question 6

Summarize the malaria parasite life cycle.

Answer 6

Sporozoites enter liver → form merozoites → infect RBCs → trophozoites → schizonts → RBC rupture → fever and inflammation.

Question 7

Why does P. falciparum cause severe malaria?

Answer 7

Infected RBCs become sticky and adhere to capillary endothelium causing microvascular occlusion and organ dysfunction.

Question 8

What are protective genetic factors against malaria?

Answer 8

Sickle cell trait (HbAS), G6PD deficiency, and thalassemia – they inhibit parasite survival in RBCs.

Question 9

What is the difference between uncomplicated and severe malaria?

Answer 9

Uncomplicated malaria has fever and non-specific symptoms; severe malaria includes vital organ dysfunction such as coma, anaemia, or acidosis.

Question 10

What is cerebral malaria?

Answer 10

A form of severe malaria with unarousable coma (>30 min) in a patient with P. falciparum parasitaemia and no other cause of coma.

Question 11

What is the WHO definition of severe anaemia in malaria?

Answer 11

Haemoglobin <5 g/dL or haematocrit <15% in the presence of P. falciparum infection.

Question 12

List major complications of severe malaria.

Answer 12

Cerebral malaria, severe anaemia, hypoglycaemia, metabolic acidosis, renal failure, jaundice, pulmonary oedema, and shock.

Question 13

How is malaria diagnosed?

Answer 13

By microscopy of thick and thin blood films to identify and quantify Plasmodium species (gold standard).

Question 14

What are the advantages of rapid diagnostic tests (RDTs)?

Answer 14

Detect malaria antigens such as HRP-2 or LDH; useful when microscopy is unavailable; give results in 15–20 minutes.

Question 15

Why must every malaria case be confirmed before treatment?

Answer 15

To avoid unnecessary antimalarial use, prevent resistance, and ensure correct diagnosis—WHO recommendation.

Question 16

What is the first-line treatment for uncomplicated malaria?

Answer 16

Artemisinin-based Combination Therapy (ACT) such as Artemether-Lumefantrine or Artesunate-Amodiaquine.

Question 17

Why is combination therapy preferred in malaria?

Answer 17

It combines drugs with different mechanisms to enhance cure rate and delay development of resistance.

Question 18

What is the first-line treatment for severe malaria?

Answer 18

Intravenous Artesunate 2.4 mg/kg at 0, 12, and 24 hours, then daily until oral therapy can be tolerated.

Question 19

What are the alternatives to IV Artesunate?

Answer 19

Intramuscular Artemether or intravenous Quinine (if Artesunate unavailable).

Question 20

List key supportive treatments for severe malaria.

Answer 20

Maintain airway, treat hypoglycaemia, transfuse if Hb <5 g/dL, manage seizures, correct acidosis, and monitor urine output.

Question 21

Which drug is used for seizure control in cerebral malaria?

Answer 21

Diazepam or phenobarbital; avoid chloroquine due to risk of neurotoxicity.

Question 22

Why is Artesunate preferred over Quinine?

Answer 22

It clears parasites faster, is safer, reduces mortality, and causes fewer side effects like hypoglycaemia and cardiac toxicity.

Question 23

What preventive strategies reduce malaria in children?

Answer 23

Use of insecticide-treated nets (ITNs), indoor residual spraying, environmental control, intermittent preventive therapy, and vaccination.

Question 24

What is the name of the malaria vaccine and its efficacy?

Answer 24

RTS,S/AS01 (Mosquirix) – provides about 30% protection against P. falciparum malaria in children.

Question 25

What is intermittent preventive treatment (IPT)?

Answer 25

Administration of full therapeutic antimalarial doses at specified intervals to high-risk groups like pregnant women or infants.

Question 26

List key public health measures for malaria control.

Answer 26

Prompt diagnosis and treatment, ITN distribution, community education, vector control, and surveillance.

Question 27

What are the high-yield facts about malaria management for exams?

Answer 27

P. falciparum causes almost all deaths; Artesunate is best for severe malaria; ACT for uncomplicated cases; ITNs and vaccines prevent disease.