Management of Malaria (Plasmodium)

Management of Malaria (Plasmodium)

CDC Reporting

Malaria is a nationally notifiable disease

  • It is encouraged that all clinicians report all cases of laboratory-confirmed malaria to their state health department to help CDC’s surveillance efforts
  • Refer to the information on the Malaria Case Surveillance Report Form for instructions on how to report a malaria case

Mon-Fri 9am-5pm EST:

After hours, weekends, and holidays:

Clinical Considerations

Consider Malaria If:

  1. Fever and history of travel to malaria-endemic area
  2. Clinical suspicion of malaria

Malaria Information and Prophylaxis by Country; United States has no known resistance per CDC

Uncomplicated Malaria:

  • Fever
  • Chills
  • Sweats
  • Nausea
  • Vomiting

Severe Malaria:

  • Serious organ failure or abnormalities in the patient’s blood or metabolism i.e.:
    • Hemolysis
    • Acute kidney injury
    • Seizures
    • Coma
    • Cardiovascular collapse
    • Respiratory failure
    • Etc.


  • Rapid diagnostic test, if smear not immediately available (confirm with smear)
  • Thick and thin blood smears STAT
    • If negative, repeat every 12–24 hours for a total of 3 sets
    • If positive, calculate parasitemia and determine species


  • Treatment should be guided by four main factors:
    1. Infecting Plasmodium species
    2. Clinical status of the patient
    3. Expected drug susceptibility based on area of infection
    4. Previous antimalaria treatment (including chemoprophylaxis)
  • If a medication is taken for chemoprophylaxis, a different drug should be used for treatment
  • Pediatric doses not to exceed adult doses
  • For oral therapy options, if oral therapy is not tolerated, administer via alternative enteral route or give after antiemetic

Special Population Considerations

Additional Information