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In the UK NHS setting, the indication for a malaria screen in an 11-year-old child who has had mosquito bites, recent travel to Ethiopia, and did not receive malaria prophylaxis would be:
✅ Yes – Screen for Malaria
Reasons:
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Travel to a malaria-endemic area (Ethiopia) – high-risk region for Plasmodium falciparum.
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No prophylaxis taken – increases risk of infection.
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Mosquito bites reported – possible exposure to the malaria parasite.
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Child's age (11 years) – children are at increased risk for complications from malaria.
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NHS guidelines (e.g. UKHSA / NICE / RCPCH) recommend screening any febrile illness or suggestive symptoms after travel to an endemic area, especially without prophylaxis.
Even without symptoms:
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Malaria can present atypically in children, or early symptoms may be mild.
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Consider testing if fever, malaise, headache, GI upset, or myalgia is present — or any unexplained illness in returning travelers.
Would you like a quick summary of what the NHS malaria screen usually includes?
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In the UK NHS, when malaria is suspected, the recommendation is to perform a series of 3 malaria screens (blood films):
✅ Why 3 malaria screens are needed:
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Parasite detection can vary – Malaria parasites may not be visible in a single blood sample due to their lifecycle and intermittent presence in peripheral blood.
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Increases diagnostic sensitivity – Repeated tests improve chances of catching low-level or fluctuating parasitemia.
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Guideline standard – NHS and UKHSA guidance recommends three thick and thin blood films taken 12–24 hours apart over a 48-hour period.
🔍 Summary of the NHS protocol:
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Initial screen: Thick and thin film + rapid diagnostic test (RDT) if available.
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If negative but malaria is still suspected: Repeat 2 more films at intervals (usually every 12–24 hours).
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All samples must be examined by experienced microscopists.
Would you like the current UKHSA or NICE guideline excerpt for documentation?
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