後新冠病毒疫情下古老傳染病之威脅：瘧疾之回顧與預防

Threat of Ancient Infectious Diseases in the Post-COVID-19 era: Malaria Review and Prevention

瘧疾是一種由瘧原蟲導致的感染性疾病，由瘧蚊傳播，瘧蚊主要生活在熱帶地區，主要疫區發生在撒哈拉以南的非洲，曾經因為戰爭跟殖民反向傳染到歐洲與北美。臨床症狀包括發燒、頭痛、疲勞、肌肉痠痛，重症則可能出現意識改變、抽搐、休克、低血糖、酸中毒、腎衰竭、黃疸；肺水腫、出血、血栓等等，嚴重者會導致死亡。診斷大多使用光學顯微鏡。治療則需區分輕症與重症，使用的藥物以青蒿素為主。本篇文章從一位瘧疾病例切入，回顧瘧疾的歷史、流行病學、微生物學、臨床表現、診斷與治療，包括感染控制。期待未來在面對此疾病時，能達到及早診斷、準確治療的目的。

Malaria is an infectious disease caused by the Plasmodium parasite, and is transmitted by Anopheles mosquitoes which mainly live in tropical regions. Clinical symptoms include fever, headache, fatigue, and muscle aches. In severe cases, patients may present with altered consciousness, convulsions, shock, hypoglycemia, acidosis, renal failure, jaundice, pulmonary edema, hemorrhage, thrombosis, and even death. Diagnosis is mostly done using light microscopy. Treatment needs to distinguish between uncomplicated malaria and severe malaria, and the drug used for treatment is mainly artemisinin. This article begins with a malaria case and reviews the history, epidemiology, microbiology, clinical manifestations, diagnosis, and treatment of malaria, including infection control. We look forward to achieving early diagnosis and accurate treatment for this disease in the future.