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USMLE Guide: Malaria


Malaria is a life-threatening mosquito-borne disease caused by the Plasmodium parasite. It is prevalent in tropical and subtropical regions, affecting millions of people worldwide. This USMLE guide aims to provide essential information about malaria, including its epidemiology, etiology, clinical presentation, diagnosis, treatment, and prevention.


  • Malaria is endemic in many areas of Africa, Asia, and South America.
  • Over 200 million cases and nearly 400,000 deaths occur annually, with the majority being children under the age of five.
  • Travelers to endemic regions are at risk of acquiring malaria.


  • Malaria is caused by the Plasmodium parasite, which has five species: P. falciparum, P. vivax, P. ovale, P. malariae, and P. knowlesi.
  • P. falciparum is the most severe and prevalent species worldwide, responsible for the majority of malaria-related deaths.
  • Anopheles mosquitoes transmit the parasite when they bite an infected individual.

Clinical Presentation

  • Malaria typically presents with flu-like symptoms, including fever, chills, headache, muscle aches, and fatigue.
  • Other symptoms may include nausea, vomiting, abdominal pain, and anemia.
  • P. falciparum infection can lead to severe complications, such as cerebral malaria, renal failure, respiratory distress, and death.


  • Diagnosis is confirmed by identifying the Plasmodium parasite in a blood smear or using rapid diagnostic tests (RDTs).
  • Polymerase chain reaction (PCR) can be used for species identification and to determine drug resistance.


  • Antimalarial medications are used to treat malaria, and the choice depends on the species and the area of infection.
  • Artemisinin-based combination therapies (ACTs) are the first-line treatment for uncomplicated P. falciparum malaria.
  • Severe malaria cases require hospitalization and intravenous treatment with quinine or artesunate.


  • Vector control measures, such as insecticide-treated bed nets and indoor residual spraying, help reduce mosquito bites.
  • Chemoprophylaxis with antimalarial medications is recommended for travelers to endemic regions.
  • Malaria vaccines, such as RTS,S/AS01, are being developed but are not yet widely available.


Malaria is a significant global health concern, particularly in endemic regions. Understanding its epidemiology, etiology, clinical presentation, diagnosis, treatment, and prevention is essential for healthcare professionals. This USMLE guide provides a concise overview of malaria, aiding in exam preparation and reinforcing crucial knowledge for clinical practice.

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