Medical Parasitology/2nd year/ Lec.9 Dr.

Hamzah Abdulrahman
Dept. of Medical Analysis Techniques/ Al-Esraa University College, Baghdad

Malaria
Apicomplexa/ Sporozoa
The Apicomplexa (Sporozoa) are unicellular spore-forming parasites. It is a group of parasitic
protozoans, in general without flagella, cilia, or pseudopods.

All species are obligate endoparasites. Malaria or (The term malaria originates from Italian: mala
aria—"bad air) has long been recognized as an important parasitic disease of humans, having
been described by the early Egyptians in the third millennium B.C.

Epidemiology
About 41% of the world’s population lives in areas where malaria is transmitted (e.g., parts of
Africa, Asia, the Middle East, Central and South America, Hispaniola, and Oceania). Recent
estimates suggest that 1.5 billion persons live in areas of the world where malaria is an endemic
disease, that the number of infected humans exceeds 500,000,000, and that 1-3 million persons
die each year, including about 1 million children under 5 years old (3,000 per day).

There are four important species that infect humans, causing malaria;
Plasmodium falciparum (1890)- malignant tertian malaria accounts for ~50% cases
P. vivax (1890)- benign tertian malaria - accounts for ~43% of cases
P. malariae (1881-1890)- benign quartan malaria - accounts for ~7% of cases
P. ovale (1922)- mild tertian malaria - accounts for < 1% of cases.

Transmission:
Malaria parasites are transmitted from one person to another by the female Anopheles Mosquito.
The males do not transmit the disease as they feed only on plant juices.
Medical Parasitology/2nd year/ Lec.9 Dr. Hamzah Abdulrahman
Dept. of Medical Analysis Techniques/ Al-Esraa University College, Baghdad

Anopheles sp. vector

Reproduction:
1. Sexual reproduction: in anopheles mosquito (sporogony), definitive host.
2. Asexual reproduction: in human (intermediate host) Schizogony.

Habitat
After passing through hepatic cells, the parasites reside within red blood cells (RBCs) and
carried by blood to various organs.
Medical Parasitology/2nd year/ Lec.9 Dr. Hamzah Abdulrahman
Dept. of Medical Analysis Techniques/ Al-Esraa University College, Baghdad

Life cycle of Plasmodium sp.

Pathogenesis & clinical features
1. Host inflammatory response:
• Produces chills and fever.
• Correlated with maturation of merozoites, rupture of RBCs
• Toxins released from burst RBCs can stimulate secretion of tumor necrosis factor (TNF) by
macrophages
2. Anemia: Caused by destruction of RBCs.
3. Hepatomegaly and splenomegaly due to the increased numbers of macrophages in these organs,
especially the spleen.
4. Local hemorrhaging and anoxia in many tissues, with the brain being the most severely affected.
5. In severe disease, intravascular hemolysis in the kidney can cause hemoglobinemia and
hemoglobinuria and dark colored urine called blackwater fever.
Medical Parasitology/2nd year/ Lec.9 Dr. Hamzah Abdulrahman
Dept. of Medical Analysis Techniques/ Al-Esraa University College, Baghdad

Fever consisted of three stages

Diagnosis
1. Microscope examination by visualization of parasitized erythrocytes in thick or thin
peripheral blood smears stained with Wright or Giemsa stain. It considered as a gold
standard method.
Thick and thin blood smears will let doctors know the percentage of red blood cells that
are infected (parasite density) and what type of parasites are
present. Thin blood smears helps doctors discover what species of malaria is causing the
infection.

2. Serology includes agar diffusion, passive hemagglutination, immunofluorescence, and an

ELISA.
3. MOLECULAR DIAGNOSIS: • DNA probe. • PCR.
Medical Parasitology/2nd year/ Lec.9 Dr. Hamzah Abdulrahman
Dept. of Medical Analysis Techniques/ Al-Esraa University College, Baghdad
4. Card / cassette/ dipstick/ malaria kit test: it’s a rapid test by applying a small drop of the
blood into the kit.

Treatment
• Treatment of malaria focuses on eradication of the blood parasites
– Several drugs can be administered, such as
• Chloroquine
• Quinine
• Doxycycline
• Malarone
• Lariam
• Fansidar and primaquine

Treatment is dependent on several factors, including:

– Type of malaria
– Drug-resistance
• Nearly all strains of P. falciparum are now chloroquine resistant.
• P. vivax has also developed resistance to chloroquine and primaquine.

Prevention
Vector control: mechanical and chemical.
Malarial vaccine such as RTS,S (Mosquirix) which is the most successful vaccine.
Education.
Medical Parasitology/2nd year/ Lec.9 Dr. Hamzah Abdulrahman
Dept. of Medical Analysis Techniques/ Al-Esraa University College, Baghdad