Malaria
Malaria is a potentially life-threatening infection caused by Plasmodium parasites and transmitted mainly through the bites of infected female Anopheles mosquitoes. It is preventable and curable, but falciparum malaria can progress rapidly to severe disease if diagnosis and effective treatment are delayed.
At a glance
Quick facts
- Category
- Parasitic infectious disease
- Main vector
- Female Anopheles mosquito
- Highest-risk species
- P. falciparum
- Common symptoms
- Fever · chills · headache
- Diagnosis
- Microscopy or rapid diagnostic test
- Prevention
- Vector control · medicines · vaccines
Names & terminology
How this entity may be named or searched
- Canonical name
- Malaria.
- Cause
- Infection with Plasmodium parasites; five species commonly infect humans.
- Key species
- P. falciparum causes most severe disease and predominates in Africa; P. vivax is also globally important.
- Important distinction
- A positive parasite test should be interpreted with symptoms and clinical context; asymptomatic parasitaemia can occur in endemic settings.
Structured entity profile
Clinical profile
Overview
Malaria is caused by protozoan parasites of the genus Plasmodium. Five species commonly infect humans; P. falciparum and P. vivax account for most disease, and P. falciparum is responsible for most malaria deaths. [1] [2]
WHO estimated 282 million malaria cases and 610,000 deaths worldwide in 2024. The WHO African Region carried about 95% of malaria deaths, and young children accounted for roughly three quarters of malaria deaths in the Region. [1]
Symptoms and warning signs
Early malaria commonly causes fever, chills and headache. Sweating, fatigue, muscle aches, nausea, vomiting and abdominal symptoms can also occur. Because these symptoms overlap with many other febrile illnesses, WHO recommends parasite-based testing rather than diagnosing malaria from symptoms alone when quality-assured testing is available. [1] [3]
SYMPTOM MATRIX
Most malaria starts as a febrile illness; severe disease can evolve quickly
Severe falciparum malaria is a medical emergency and can progress over hours.
- Fever or recent fever
- Chills and sweating
- Headache
- Fatigue and muscle aches
- Nausea or vomiting
- Abdominal discomfort
- Jaundice or anaemia
- Dark urine
- Low platelet count
- Recurrent symptoms with relapsing species
- Confusion or reduced consciousness
- Seizures
- Difficulty breathing
- Shock or severe weakness
- Severe anaemia or hypoglycaemia
- Acute kidney injury
Suspected severe malaria requires immediate treatment and supportive care; testing should not create a dangerous delay.
Diagnosis
WHO recommends prompt parasitological confirmation for suspected malaria using light microscopy or a quality-assured rapid diagnostic test (RDT). Microscopy can identify species and estimate parasite density when performed well; RDTs can provide rapid diagnosis where microscopy is not immediately available. [2] [3]
A negative test should prompt reassessment for other causes of fever. If severe malaria is strongly suspected, treatment should not be delayed because testing is temporarily unavailable or results are delayed. Local guidance also matters where parasite gene deletions reduce the reliability of some HRP2-based RDTs. [2] [3]
Diagnostic pathway
Test suspected malaria — then assess severity immediately
Diagnosis and triage happen together because severe malaria can deteriorate rapidly.
Where quality-assured testing is readily available, patients with a negative malaria test should be evaluated for other causes of fever.
Who is at higher risk of severe malaria
Infants, children under 5, pregnant women and girls, travellers without acquired immunity, and people living with HIV are among the groups at higher risk of severe malaria. Pregnancy also increases the risk of maternal anaemia and adverse fetal outcomes. [1] [2]
Treatment and management
Uncomplicated P. falciparum malaria is treated with an artemisinin-based combination therapy (ACT) selected according to national policy and local resistance patterns. WHO advises against oral artemisinin monotherapy because it contributes to resistance and treatment failure. [2]
Severe malaria requires urgent parenteral antimalarial treatment and supportive hospital care. Management may also include treatment of hypoglycaemia, severe anaemia, seizures, respiratory compromise, shock or kidney injury. For P. vivax or P. ovale, radical cure may require treatment targeting dormant liver stages, with G6PD assessment where required by the regimen. [2]
Treatment & care hub
Treatment depends first on severity, then on species and local resistance
The same fever can require very different management if severe malaria is present.
Use an ACT
Select a WHO-recommended artemisinin-based combination according to national policy and resistance data.
Parenteral treatment + supportive care
Start urgent treatment and manage organ complications without waiting for non-essential investigations.
Address liver-stage parasites
P. vivax and P. ovale may require radical cure after assessment for G6PD-related haemolysis risk.
Reassess response and alternative diagnoses
Persistent fever or deterioration requires review of adherence, resistance, complications and non-malarial illness.
Exact drug regimens and doses should follow current national malaria guidance and WHO recommendations.
Prevention: vector control, chemoprevention and vaccines
Prevention combines insecticide-treated nets, indoor residual spraying and personal protection with preventive medicines for selected populations and settings. WHO also recommends RTS,S and R21 malaria vaccines for children living in malaria-endemic areas, prioritizing moderate- and high-transmission settings. Vaccination complements rather than replaces other malaria-control measures. [2] [4]
Global burden · WHO 2025
Africa carries most of the global malaria burden
WHO estimates for 2024 show how concentrated malaria illness and mortality remain in the African Region.
Common questions
Frequently asked questions
Usually no. Malaria is mainly transmitted by infected Anopheles mosquitoes; uncommon non-mosquito transmission can occur through infected blood, contaminated needles or from mother to child.
WHO recommends parasite-based testing with microscopy or a rapid diagnostic test for suspected malaria whenever quality-assured testing is available.
Yes. Effective antimalarial medicines can cure malaria, but treatment must match the parasite, severity, pregnancy status and local resistance pattern.
Young children in high-transmission settings can deteriorate rapidly from severe anaemia, cerebral malaria, hypoglycaemia or respiratory distress.
No. WHO recommends malaria vaccines as part of a combined prevention strategy that still includes vector control and prompt diagnosis and treatment.
Sources
- WHO — Malaria fact sheet, 4 December 2025
- WHO — WHO guidelines for malaria, 10 September 2026
- WHO Global Malaria Programme — Diagnostic testing for malaria
- WHO — Malaria vaccines (RTS,S and R21): questions and answers, 4 February 2026
This article is based on trusted medical sources and is awaiting clinician review. It is not a substitute for personalized medical advice.