The most common cause of non-falciparum malaria is Plasmodium vivax, with Plasmodium ovale and Plasmodium malariae accounting for the other cases.

Plasmodium vivax is often found in Central America and the Indian Subcontinent whilst Plasmodium ovale typically comes from Africa.

Plasmodium knowlesi is another non-falciparum species which causes clinical pathology, found predominantly in South East Asia.

Features

• general features of malaria: fever, headache, splenomegaly
• Plasmodium vivax/ovale: cyclical fever every 48 hours. Plasmodium malariae: cyclical fever every 72 hours
• Plasmodium malariae: is associated with nephrotic syndrome.

Ovale and vivax malaria have a hypnozoite stage and may therefore relapse following treatment.

Treatment

• in areas which are known to be chloroquine-sensitive then WHO recommend either an artemisinin-based combination therapy (ACT) or chloroquine
• in areas which are known to be chloroquine-resistant an ACT should be used
• ACTs should be avoided in pregnant women
• patients with ovale or vivax malaria should be given primaquine following acute treatment with chloroquine to destroy liver hypnozoites and prevent relapse