COVID-19 currently imposes an additional burden to the already overstretched, resource strapped health services which are grappling to bring under control the high burden of existing infectious and non-infectious diseases, including TB, HIV, and malaria. Proactive screening for COVID-19 is ongoing in high malaria endemic African countries.
A case of COVID-19 is deemed ‘confirmed’ based on a positive laboratory test result for SARS-Cov-2 virus infection regardless of symptoms. Health care workers and community members alike are faced with an important challenge of quickly identifying symptoms and taking appropriate steps for laboratory investigation in line with the case definition based on surveillance or clinical characterization.
Key steps to identifying a COVID-19 case ultimately involves symptomatic or high risk patients presenting to health providers with complaints of any of the following symptoms or travel history: fever, cough, shortness of breath, fatigue, headache and others of acute onset or history of travel to affected areas or contact with an infected person.
Malaria shares some of the highly recognizable symptoms with COVID-19 such as: fever, difficulty in breathing, fatigue and headaches of acute onset. Thus, a malaria case may be misclassified as COVID-19 if symptoms alone are used to define a case during this emergency period and vice versa. Malaria symptoms appear within 10-15 days after an infective bite; multi-organ failure is common in severe cases among adults while respiratory distress is also expected in children with malaria, mimicking what is usually reported in patients with COVID-19.
Human travel history is also a significant consideration, like with COVID-19, when screening for a suspected case of malaria as well as a means of curbing. Also, both COVID-19 and malaria infected individuals may be asymptomatic for a long time while transmitting the infections through their respective modes.
Globally, all countries are at very high risk of COVID-19 while half of the world is at risk of malaria, with sub-Saharan countries bearing the blunt of malaria cases and deaths.
Thus COVID-19 and malaria converge symptomatically and geographically in most WHO regions. The definitive way to correctly identify the underlying infectious aetiology is through laboratory investigation and therefore availability of appropriate diagnostic capacity is essential for accurate surveillance and clinical management of cases.
Countries are struggling to meet the testing demand for COVID-19, while the malaria test kits are widely available at each point of care including the community level.
There is need therefore for enhanced sensitization on the potential of COVID-19/malaria co-infections and further guidance to clinicians on the importance of testing for other causes of illness more so in this period when there is much emphasis to early detect and isolate COVID-19 in a bid to contain further spread of the disease.
Amid the COVID-19 pandemic, the challenge remains on how to ensure the progress made in malaria control is not setback.
Source: https://www.ijidonline.com/article/S1201-9712(20)30223-X/fulltext
