Малярия. Узнать заново. Заметки российского врача в Африке

Abstract. There were registered the small numbers of cases of imported malaria in the Russian Federation last decades. This leads to the lost of skills to recognize this disease by the general practitioners and they make many mistakes in the cases of the contact with malaria patients. In African countries, by contrast, the widespread prevalence of malaria tends to evaluate any symptom in individuals who get a positive malaria test as symptoms of malaria without a differential diagnosis from other diseases. The clinical manifestations of malaria are nonspecific, different systems are involved in the process, in addition, different types of malaria plasmodia cause different changes. The most studied in malaria are hematological disorders, pathology of the kidneys, the central nervous system, and respiratory complications. All of them can occur both in uncomplicated and in severe malaria, in different periods of the diseases. The clinical manifestations of malaria are differ between immune and non-immune individuals. In the latter case, symptoms may appear with a lower level of parasitemia, severe malaria is more often recorded, and mortality is higher. The diagnosis of malaria must necessarily be confirmed by the detection of parasitemia. In Russia, microscopic examination of a blood is used for this, abroad immunological (express tests) and molecular biological methods may be used. However, laboratory testing does not reveal the stage of parasite developing in the liver and may give negative or questionable results in the cases with a low level of parasitemia, therefore, if there is clinical suspicion, it must be repeated. Improving the diagnosis of malaria requires constant vigilance and careful collection of the patient's epidemiological history. In endemic regions with high rates of asymptomatic parasitemia, newly emerging symptoms should be classified as malaria after differentiation with the other causes. In non-endemic, for example, the Russian Federation, regions the cases of the patients with an appropriate history (even in people who visited areas of possible infection several years ago) must be rule out as malaria first of all. For citation: Temnikova E. A. Malaria. Learn again. Notes from the Russian doctor in Africa // Lechaschy Vrach. 2021; 1 (24): 50-55. DOI: 10.26295/OS.2021.14.69.011