The current focus on COVID-19 has led to malaria being missed. Early symptoms of malaria and COVID-19 are similarly non-specific – fever, headache, fatigue, and muscle and joint pains; more severe signs and symptoms also shared between these infections, e.g. respiratory difficulties, including ARDS.
Unrecognised and untreated malaria can rapidly progress to severe illness with a high mortality.
It is mandatory to check for malaria in all persons presenting with fever and flu-like illness if they are residents in, or have travelled within the last six weeks from a malaria-risk area. Check regardless of suspected COVID-19 condition (pending COVID-19 tests or even a positive COVID-19 test) using a rapid diagnostic test or blood smear microscopy, and obtain results urgently.
‘Taxi malaria’ should be considered in a patient with a progressively worsening febrile illness of unknown cause even if no travel history to a malaria-endemic area.