Malaria Diagnosis

Malaria diagnosis be established as any other disease diagnosis based on anamnesis, physical examination and laboratory examination.
Definitive diagnosis of malaria must be established by microscopic examination of blood supply or quick diagnostic tests.

A. Anamnesis
1. In anamnesis very important note :

a. The main complaint: Fever, chills, sweating and can be accompanied by headache, nausea, vomiting, diarrhea and muscle pain.

            b. History and overnight visit 1-4 weeks ago to malaria endemic areas.

            c. History lives in malaria endemic areas

            d. History of malaria illness

            e. History malaria medication last month

            f.  History gets a blood transfusion

B. Physical examination

* Uncomplicated Malaria :

            1. Fever (measured with a thermometer> 37.5 ° C

            2. Pale conjunctiva or palms of hands

            3. Enlarged spleen (splenomegaly)

            4. Liver enlargement

*. Malaria with complications can be found in the following circumstances :

1. Disorders of consciousness in varying degrees

2.General state of the weak (not able to sit / stand)

3.Convulsions

4.Very high heat

5.Yellow eyes or body

Note: Patients with suspected severe malaria should be referred immediately to get certainty in Microscopic diagnosis and further treatment

C. Diagnosis based on laboratory examination

1. Examination with a microscope

Examination of thick and thin the blood supply in the community health service   center / field or in hospitals to determine:

                        - There is absence of malaria parasites (positive or negative)
                        - Species and stage plasmodium
                        - The density of parasites 

For patients with suspected severe malaria need to consider the following matters:

 a. When the first negative blood inventory inspection, need re-examined ever 6 hours to 3 days     row

b.When the results of thick blood supply for 3 days in a row is not found  then the diagnosis of    malaria parasites removed

2. Examination with rapid diagnostic tests

Mechanism of action of this test beradasrkan malaria parasite antigen detection, using methods imunokromatografi, in the form dipstik. This test is very useful in       the emergency room, in the event of extraordinary events and in remote areas that are not available laboratory facilities as well as specific surveys. Another       important thing is the storage RDT should be in the refrigerator but not in cooler Frezzer

     3. Supporting examination for severe malaria

         - Routine blood

a. Other blood chemistry (blood sugar, serum bilirubin, SGOT, SGPT, alkaline

fostase, albumin / globulin, urea, creatinine, sodium and potassium, blood gas    analysis)

b. EKG

c. Chest radiograph

d. Analisisis fluid serebrospenalis

e. Blood cultures and serologic tests

f. Urianalisis

D. The differential diagnosis of malaria

Clinical manifestations of malaria varies widely from mild symptoms to severe

1. Uncomplicated malaria must be distinguished from other infectious diseases as follows :

      - Typhoid Fever
      - Dengue Fever
      - Acute Respiratory Infection
      - Leptospirosis light
      - Other acute viral infection

2.   Severe malaria or malaria with complications distinguished from other infectious diseases as follows:

- Inflammation of the brain
- Stroke
- Typhoid encephalopathy
- Hepatitis
- Leptospirosis weight
- Dengue Fever