Paludisme à Plasmodium falciparum

Malaria is caused by Plasmodium parasites, and infection with P. falciparum can advance quickly to severe or life-threatening illness ^[1]. The species is distinguished by its capacity for rapid deterioration and severe organ involvement compared with other forms of malaria ^[1][4].

Affected individuals may experience fever, chills, headache, and gastrointestinal symptoms, with anemia and neurologic manifestations possible as the disease worsens ^[1]. The asexual blood-stage parasites release waste products such as hemozoin that stimulate cytokine production and produce fever and rigors ^[1]. Severe disease may include organ complications, and the incubation period after an infective mosquito bite typically ranges from 7 to 30 days, often shorter for P. falciparum ^[1][2].

P. falciparum is widespread in many endemic countries, with the greatest burden and severe-disease risk concentrated in sub-Saharan Africa ^[1][3]. Over five decades the parasite has sequentially developed resistance to all major antimalarial drug classes, with resistance spreading in prevalence and geographic range ^[3].

The principal route is the bite of infected female Anopheles mosquitoes, which introduces sporozoites that later develop in the blood stage ^[1][3]. Rare alternative routes include blood transfusion, organ transplantation, needle sharing, and congenital passage ^[1]. Drug-resistance determinants such as K13 mutations alter parasite biology but do not change the mosquito-borne transmission mechanism ^[5].

Avoiding mosquito bites and using indicated antimalarial prophylaxis are central travel-prevention measures, with prophylaxis effective when taken as prescribed ^[1]. Whole sporozoite vaccine approaches have demonstrated high-level protective immunity in humans and may substantially reduce morbidity if licensed ^[4]. In contexts of emerging or established drug resistance, vector control, early diagnosis, and new drug combinations are recommended to disrupt transmission ^[3][5].

1. 1 US Centers for Disease Control and Prevention. Clinical Features of Malaria | Malaria | CDC [Internet]. cited 23 Oct 2026. Available from: https://www.cdc.gov/malaria/hcp/clinical-features/index.html
2. 2 Fairhurst RM et al. Artemisinin-Resistant Plasmodium falciparum Malaria. Microbiol Spectr. 2016 Jun. PMID: 27337450. doi: 10.1128/microbiolspec.EI10-0013-2016. PubMed: https://pubmed.ncbi.nlm.nih.gov/27337450/
3. 3 Thu AM et al. Combating multidrug-resistant Plasmodium falciparum malaria. FEBS J. 2017 Aug. PMID: 28580606. doi: 10.1111/febs.14127. PubMed: https://pubmed.ncbi.nlm.nih.gov/28580606/
4. 4 Epstein JE et al. The whole parasite, pre-erythrocytic stage approach to malaria vaccine development: a review. Curr Opin Infect Dis. 2013 Oct. PMID: 23982233. doi: 10.1097/QCO.0000000000000002. PubMed: https://pubmed.ncbi.nlm.nih.gov/23982233/
5. 5 Wicht KJ et al. Molecular Mechanisms of Drug Resistance in Plasmodium falciparum Malaria. Annu Rev Microbiol. 2020 Sep 8. PMID: 32905757. doi: 10.1146/annurev-micro-020518-115546. PubMed: https://pubmed.ncbi.nlm.nih.gov/32905757/