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Falciparum malaria diagnosis — DTM&H MCQ

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EasyMalariaFalciparum malaria diagnosisDTM&H

A 35-year-old aid worker has fever and myalgia 3 weeks after working in northern Uganda. The first thick and thin films are negative, but the clinician remains concerned because no chemoprophylaxis was taken. What is the most appropriate investigation?

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Correct answer: C — Repeat thick and thin blood films

Repeat thick and thin blood films is the single best answer because malaria microscopy can be negative early or with low parasitaemia, so repeat films are needed if suspicion persists. Stool ova and parasites microscopy is plausible in a related presentation, but it is less appropriate because it does not fit the key discriminator in this vignette. The teaching point is that a negative first film does not safely exclude malaria in a febrile returned traveller.

Reference: WHO Guidelines for malaria, 2025; UKHSA Malaria prevention guidelines for travellers from the UK, 2025; CDC Yellow Book 2026