Malaria

Once treatment has started, patients with Plasmodium falciparum infection usually improve rapidly over a few days. Daily blood films should be performed until parasites are undetectable by microscopy. Any laboratory abnormalities should be monitored to ensure they are resolving. At discharge from hospital, the patient should be advised to finish any outstanding medications as prescribed. It is not usually necessary to perform a follow-up film post-treatment unless symptoms recur. In addition, it is not usually necessary to follow up a patient routinely unless there were complications of malaria (e.g., anemia, renal impairment) or other conditions have been detected (e.g., HIV infection).

Hemoglobin should be checked 2-4 weeks after starting treatment in patients treated with intravenous artesunate to check for late-onset hemolysis.[49]World Health Organization. WHO guidelines for malaria. Nov 2024 [internet publication]. https://www.who.int/publications/i/item/guidelines-for-malaria

To prevent relapses, patients with Plasmodium vivax or Plasmodium ovale infection should be given a 14-day course of primaquine if not contraindicated, which will treat the hypnozoite forms. It is not usually necessary to perform a follow-up blood film post-treatment.

Following treatment of Plasmodium malariae or Plasmodium knowlesi infection, no further follow-up is required.