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Malaria Drugs 210

Malaria Drugs 210

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Published by: fombay on Apr 05, 2010
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10/30/2013

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1
Malaria
Plasmodium falciparum
ring-forms and gametocytes in human blood.
Malaria
is a mosquito-borne infectious disease caused by a eukaryotic protist of thegenus
Plasmodium
. It is widespread in tropical and subtropical regions, including parts of the Americas, Asia, and Africa. Each year, there are approximately 350–500 millioncases of malaria, killing between one and three million people, the majority of whom areyoung children in Sub-Saharan Africa. Ninety percent of malaria-related deaths occur inSub-Saharan Africa. Malaria is commonly associated with poverty, but is also a cause of poverty and a major hindrance to economic development.Five species of the plasmodium parasite can infect humans; the most serious forms of thedisease are caused by
Plasmodium falciparum
. Malaria caused by
Plasmodium vivax
,
Plasmodium ovale
and
Plasmodium malariae
causes milder disease in humans that is notgenerally fatal. A fifth species,
 Plasmodium knowlesi
, is a zoonosis that causes malariain macaques but can also infect humans.Malaria is naturally transmitted by the bite of a female
 Anopheles
mosquito.
When amosquito bites an infected person, a small amount of blood is taken, which containsmalaria parasites. These develop within the mosquito and about one week later, when themosquito takes its next blood meal, the parasites are injected into the person being bitten
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2with the mosquito's saliva. After a period of between 2 weeks and several months(occasionally years) spent in the liver, the malaria parasites start to multiply within,causing symptoms that include fever and headache. In severe cases the disease worsensleading to coma, and death.A wide variety of antimalarial drugs are available to treat malaria. In the last 5 yearstreatment of P. falciparum infections in endemic countries has been transformed by theuse of combinations of drugs containing an artemisinin derivative. Severe malaria istreated with intravenous or intramuscular quinine or, increasingly, the
artemisinin 
derivative artesunate. Several drugs are also available to prevent malaria in travellers tomalaria-endemic countries (prophylaxis). Resistance has developed to severalantimalarial drugs, most notably
chloroquine.
 Malaria transmission can be reduced by preventing mosquito bites with mosquito netsand insect repellents, or by mosquito control measures such as spraying insecticidesinside houses and draining standing water where mosquitoes lay their eggs.Although many are under development, the challenge of producing a widely availablevaccine that provides a high level of protection for a sustained period is still to be met
Signs and symptoms
Main symptoms of malaria.Symptoms of malaria include
 fever,shivering,arthralgia
(joint pain),
vomiting,anemia
(caused by
hemolysis
 
),hemoglobinuria,retinal damage
, andconvulsions. Theclassic symptom of malaria is cyclical occurrence of sudden coldness followed by rigorand then fever and sweating lasting four to six hours, occurring every two days in
P.vivax
and
P. ovale
infections, while every three for
P. malariae
.
P. falciparum
can haverecurrent fever every 36–48 hours or a less pronounced and almost continuous fever. For
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3reasons that are poorly understood, but that may be related to high intracranial pressure,children with malaria frequently exhibit abnormal posturing, a sign indicating severebrain damage. Malaria has been found to cause cognitive impairments, especially inchildren. It causes widespread anemia during a period of rapid brain development andalso direct brain damage. This neurologic damage results from cerebral malaria to whichchildren are more vulnerable. Cerebral malaria is associated with retinal whitening,which may be a useful clinical sign in distinguishing malaria from other causes of fever.
Species Appearance PeriodicityPersistent inliver?
Plasmodium vivax
tertian yes
Plasmodium ovale
tertian yes
Plasmodium falciparum
 tertian no
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