ABSTRACT
Malaria presents along a continuum from mild to severe disease, and clinical management is influenced by the species causing infection and the existence of naturally acquired immunity. Malaria infection may also be transmitted across the placenta, via blood transfusion or solid organ transplantation, and via contaminated medical equipment. Malaria transmission is a function of the interactions among the anopheline mosquito vector, Plasmodium spp., human hosts, and the environment. Infection with Plasmodium falciparum carries the highest risk of a fatal outcome but severe illness is also recognised to occur with P. knowlesi and P. vivax. P. ovale and P. malariae usually cause milder disease. Treatment of falciparum malaria requires combination therapy. Two or more blood schizonticidal compounds with independent modes of action are administered simultaneously with the aim of avoiding or slowing down the development of drug resistance. Artemisinin combination therapies eliminate the blood stages of all Plasmodium species and have the fastest parasite clearance times of any antimalarial.
