Differential diagnosis

Malaria must be distinguished from other febrile illnesses to avoid mistreatment. In malaria-endemic areas, comorbidities exist where malaria parasitaemia may be coincidentally present in patients with other acute pathology such as bacterial meningitis and hepatitis. This is because such individuals, after repeated bouts of malaria, are able to tolerate parasites without being symptomatic, i.e. they have developed ‘anti-disease’ rather than ‘anti-parasite’ immunity. 

Possible causes of symptoms resembling malaria 

Fever

• Visceral leishmaniasis
• Trypanosomiasis
• Rickettsial infections
• Relapsing fevers

Coma

• Viral encephalitis
• Bacterial meningoencephalitis
• Fungal and protozoal meningoencephalitis
• Cerebral typhoid
• Brain abscess
• Heat stroke
• Cerebrovascular events
• Hypertensive encephalopathy

Renal Failure

• Leptospirosis
• Traditional herbal medicines
• Snake bite
• Glomerulonephritis
• Hypertension

Jaundice and hepatomegaly

• Viral hepatitis
• Yellow fever
• Cytomegalovirus and Epstein–Barr infections
• Leptospirosis
• Biliary disease
• Drug-induced diseases
• Intoxication

Cough and Diarrhea

• Upper respiratory tract infection
• Gastroenteritis