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Malaria - Coggle Diagram

- - - - The geographic region visited - destination
      - The type of traveler.
      - Type of accommodation (eg, open air, tented, air conditioned, or screened), the season (rainy versus dry)
      - The elevation, and the duration of exposure.
    - - Travelers born in regions with endemic malaria who relocate outside the endemic area but subsequently return to visit friends and relatives.
      - Pregnant travelers should be advised to defer travel until after delivery whenever feasible.
      - Military personnel represent another important risk group; these individuals may have inadequate protection from mosquito bites given prolonged periods of night-time exposure to biting Anopheles mosquitoes with accommodations that have inadequate screens or bednets.
      - HIV-infected travelers warrant the same approach to prevention of malaria as HIV-uninfected travelers.
  - - - Prevention measures include: Avoiding mosquito bites, adhering to antimalarial chemoprophylaxis.
        
        However, travelers should also understand that no chemoprophylaxis regimen guarantees complete protection and that fever during or after travel is a medical emergency requiring urgent medical attention.
        
        Other symptoms may include
        
        headache
        
        myalgia
        
        cough
        
        nausea
        
        abdominal pain
        
        vomiting, and diarrhea.
    - - Travelers planning prolonged visits to endemic areas should continue prophylaxis throughout their stay.
      - Travelers who become ill should be advised to seek expert advice concerning malaria diagnosis and therapy.
      - In such cases, the chemoprophylactic regimen should be continued together with treatment offered locally, unless there are significant drug-drug interactions (such as mefloquine with halofantrine).
      - If the initial evaluation demonstrates negative blood films, thick and thin blood films or rapid diagnostics should be repeated twice (12 to 24 hours apart).
      - Pregnant women are an important risk group, as malaria can be a life-threatening infection for both mother and fetus.
      - Risk of stillbirth, spontaneous abortion, and other adverse pregnancy outcomes are increased in the setting of malaria; pregnant women should be advised to defer travel until after delivery whenever feasible.
  - - - Listings of regions where malaria transmission occurs, the presence of antimalarial drug resistance, and recommended chemoprophylaxis for specific destination are available in the CDC publication.
        
        Suggested approach
        
        Selection of chemoprophylaxis must be tailored to individual itineraries and circumstances.
        
        For patients traveling to several destinations with different malaria transmission patterns, it may be simplest to select a single agent that will be effective for the entire duration of exposure.
- - - - While P. falciparum is most likely to result in severe disease, all malaria species can cause severe disease and death.