Current RMA Instruments
| Reasonable Hypothesis SOP | 46 of 2017 |
| Balance of Probabilities SOP | 47 of 2017 |
Changes from previous Instruments
ICD Coding
- ICD-9-CM Codes: 084
- ICD-10-AM Codes: B50, B51, B52, B53, B54
Brief description
Malaria is a mosquito-borne parasitic infection that is widespread in tropical and sub-tropical areas, particularly in Africa. The SOP covers the regular forms of malaria as well as rare infections with Plasmodium knowlesi or other types acquired from monkeys.
Confirming the diagnosis
The diagnosis may be suspected on clinical grounds based on symptoms, signs and potential for exposure to the parasites, but confirmation requires positive diagnostic testing. The standard diagnostic tool is visualisation of parasites by microscopy on a stained blood smear. Rapid diagnostic tests that detect malaria antigens or antibodies can also be used. The species of malaria needs to be known to apply the SOP factors. If there is a history of malaria many years ago and the condition is no longer present the appropriate diagnosis may be "Malaria – resolved".
The relevant medical specialist is an infectious diseases physician.
Additional diagnoses covered by SOP
- Plasmodium falciparum infection
- Plasmodium knowlesi infection
- Plasmodium malariae infection
- Plasmodium ovale infection
- Plasmodium vivax infection
- Other malaria infection from simians
Additional diagnoses that may be covered by SOP
- Jungle, marsh, or swamp fever - may be covered (further information required).
Clinical onset
Malaria typically presents with a flu-like illness, but also with a cyclical pattern of shivering and then fever every two or three days. Clinical onset is typically within a month after exposure, but may be delayed in some cases. Once diagnosis is confirmed clinical onset can be dated from when the characteristic symptoms and signs first manifest. A return of symptoms after a symptom-free period may be due to inadequate treatment (generally occurs within 6 months), a new infection, or a relapse. Plasmodium vivax or P. ovale malaria can relapse, typically within two or three years. P. falciparum and P. malariae do not relapse.
Clinical worsening
Various serious complications of malaria can develop as part of the natural course of the condition and deaths can occur. Circumstances meeting requirements for clinical worsening are unlikely to occur in connection with the initial presentation. Worsening could apply in relation to relapsing disease. With appropriate treatment, the usual course of malaria is complete recovery.