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Plasmodium vivax

Plasmodium vivax

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Published by: SUTHAN on May 30, 2009
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Plasmodium vivax
From Wikipedia, the free encyclopedia
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 Plasmodium vivax 
 P. vivax
 P. vivax 
 Plasmodium vivax 
 Plasmodium vivax 
is a  protozoal  parasiteand a human pathogen.The most frequent and widely distributed cause of recurring (tertian) malaria,
 P. vivax
is one of four species of malarial parasitethat commonly infect in humans. It is less virulent than 
,the deadliest of the four, and seldom fatal.
 P. vivax
is carried by the female
 mosquito, since it is theonly sex of the species that bites.
[edit] Health
[edit] Epidemiology
 P. vivax
is found mainly in Asia, Latin America, and in some parts of Africa.
 P. vivax
can causedeath due tosplenomegaly (a pathologically enlarged spleen), but more often it causes debilitating – but non-fatal – symptoms.
[edit] Treatment
Chloroquineremains the treatment of choice for 
malaria, except in Indonesia's Irian Jaya(Western New Guinea) region and the geographically contiguousPapua New Guinea, where chloroquine resistance is common (up to 20% resistance). When chloroquine resistance iscommon or when chloroquine is contraindicated, thenartesunateis the drug of choice, except inthe U.S., where it is not approved for use;
 mefloquineis a good alternative and in somecountries is more readily available.
 Atovaquone-proguanilis an effective alternative in patientsunable to tolerate chloroquine.
 Quininemay be used to treat
malaria but is associatedwith inferior outcomes.Thirty-two to 100% of patients will relapse following successful treatment of 
 P. vivax
infection if a radical cure (eradication of liver stages) is not given.
Eradication of the liver stages isachieved by giving primaquine, after checking the patients G6PD status to reduce the risk of haemolysis.
Recently, this point has taken particular importance for the increased incidence of vivax malaria among travelers.
[edit] Eradication Efforts in Korea
 P. vivax
is the only indigenousmalaria  parasiteon the Korean peninsula. In the years following theKorean War (1950-53), malaria-eradication campaigns successfully reduced the number of new cases of the disease in North Korea and South Korea. In 1979,World Health Organization  declared the Korean vivax malaria-free, but the disease unexpectedly re-emerged in the late1990s and still persists today. Several factors contributed to the re-emergence of the disease,including reduced emphasis on malaria control after 1979, floods and famine in North Korea,  emergence of drug resistance and possibly global warming. Most cases are identified along the Korean Demilitarized Zone. As such, vivax malaria offers the two Koreas a unique opportunityto work together on an important health problem that affects both countries.
[edit] Biology
 P. vivax
can reproduce both asexually and sexually, depending on its life cycle stage.Asexual forms:
Immature trophozoites (Ring or signet-ring shaped), about 1/3 of the diameter of a RBC.
Mature trophozoites: Very irregular and delicate (described as
); many pseudopodial processes seen. Presence of fine grains of brown pigment (malarial pigment) or hematin probably derived from the haemoglobin of the infected red bloodcell.
Schizonts(also called meronts): As large as a normal red cell; thus the parasitizedcorpuslce becomes distended and larger than normal. There are about sixteen merozoites.Sexual forms: Gametocytes: Round. The gametocytes of P. vivax are commonly found in the peripheral blood at about the end of the first week of parasitemia.
[edit] Life Cycle
Theincubation periodfor the infection usually ranges from ten to seventeen days and sometimesup to a year. Persistent liver stages allow relapse up to five years after elimination of red bloodcell stages and clinical cure.
] Human Infection
The infection of 
 Plasmodium vivax
takes place in human when an infected female anophelesmosquito sucks blood from a healthy person. During feeding, mosquito injects saliva to preventclotting of blood and along with the saliva, thousands of Sporozoites are inoculated into human blood and reproduce asexually giving rise to thousands of merozoites(Plasmodium daughter cells) in the circulatory system including liver.
[edit] Liver Stage
 P. vivax
sporozoite enters a hepatocyte and begins its exoerythrocytic schizogony stage. Thisis characterized by multiple rounds of nuclear division without cellular segmentation. After acertain number of nuclear divisions, the parasite cell will segment andmerozoitesare formed.There are situations where some of the sporozoites do not immediately start to grow and divideafter entering the hepatocyte, but remain in a dormant,hypnozoitestage for weeks or months.The duration of latency is variable from one hypnozoite to another and the factors that willeventually trigger growth are not known; this explains how a single infection can be responsiblefor a series of waves of parasitaemia or "relapses".
Different strains of 
 P. vivax
have their owncharacteristic relapse pattern and timing.
[edit] Erythrocytic Cycle

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