Page 200 - policy and procedure infection control

Policies and Procedures on Infection Control

13.6 Malaria

13.6.1 Introduction
Humans are infected with Plasmodium protozoa when bitten by an infective female
Anopheles mosquito vector.

The mosquito larvae develop within a few days, escaping their aquatic environment before
it dries out. It is difficult, if not impossible, to predict when and where the breeding sites
will form, and to find and treat them before the adults emerge.

13.6.2 Patient’s Isolation
Malaria patient need not be nursed in isolation room. However, an air-conditioned or a
naturally-ventilated room is preferred.
If a naturally-ventilated room is used, it is suggested to put mosquito nets to all the
windows in the room.
If both facilities are not available, then the patients can be nursed in the general ward.
Specific measures to avoid mosquito bites should be considered (see under Prevention of
vector transmission).

13.6.3 Prevention of vector transmission

1. Source elimination/reduction for Malaria fever
Source elimination or reduction is the method of choice for mosquito control (refer to
Source elimination/reduction for Malaria fever).
2. Avoidance from mosquito bite
Specific measures on the avoidance from mosquito bite should be followed.

Measures that have been described to avoid mosquito bites are:
• insect repellents containing N,N-diethyl-3-methylbenzamide (DEET), Adult-dose
95% DEET lasts as long as 10-12 hours, and 35% DEET lasts 4-6 hours. For
children, use concentrations of less than 35% DEET. Use sparingly and only on
exposed skin. Remove DEET when no longer exposed. (Please refer to PROPER
APPLICATION OF REPELLANT).
• protective clothing (the most effective is permethrin-impregnated). Avoid
mosquitoes by limiting exposure during times of typical blood meals. Wearing
long-sleeved clothing may also prevent infection.
• insecticide-treated bed nets The use of insecticide-treated bed nets at night is
useful as Anopheles mosquitoes bite during dawn and dusk.
• insecticides- “knockdown resistance” may occur in some locations.

Ministry of Health Malaysia 189