1.

PLASMODIUM PARASITOLOGY
PLASMODIUM
Species : Plasmodium falcifarum, Plasmodium vivax, Plasmodium
malariae, and Plasmodium ovale
Definitive host : Anopheles mosquito
Intermediary Host : Human

(Bariah Ideham, 2014)

A. PLASMODIUM FALCIPARUM
Disease: Tropical Malaria or Falcifarum Malaria or Benign Malaria
Morphology :
Eradication preparation with Giemsa painting
- This parasite attacks old and young erythrocytes
- Maurer dots are red and they are large and irregular in shape
Stadia
a. Trophozoite (ring shape)
- Red nucleus, ring-shaped protoplasm or blue line on the edge of erythrocytes,
parasite-infected erythrocytes do not enlarge
- The size of the parasite is approximately 2 microns, often a ring with 2 cores,
double infection and marginal infection.

b. Schizonts (seen only in severe infections)

- Plasma with core has been divided
- Merozoites number 18-24
c. Gametocytes
- Typical shape like a banana (banana form), dark brown pigment appears
around the core
- Macrogametocytes slender banana-shaped, dense nucleus surrounded by
pigment, cytoplasm blue; Microgametocytes are banana-shaped, slightly
fat, blunt ends, nucleus surrounded by pigment, pale red cytoplasm

Preparation of thick drops with Giemsa painting

- The preparation shows trophozoites, red rings and banana-shaped
gametocytes
- In severe infection the number of trophozoites is more, red dots are
seen called "sterren hemel" or starry sky
[CITATION Bar14 \l 1033 ]
B. PLASMODIUM VIVAX
Disease: Tertiana Malaria
Morphology :
Preparations remove with Giemsa painting
- In the preparation of erythrocytes infected with this parasite, larger
than normal erythrocytes and pale, Schuffner's dots appear red and
evenly distributed in erythrocytes.
Stadia
a. Young trophozoites (ring or ring form)
- The nucleus is red, the protoplasm is ring-shaped, the color is blue.
b. Trophozoite
- Protoplasm blue and irregular shape (amoeboid)
- Visible vacuole, larger nucleus.

c. Skizon
- Solid protoplasm (nucleus already divided) into merozoites
- Merozoites numbered 12-24 pieces

d. Gametocytes
 - Fills all erythrocytes, blue protoplasm and solid nucleus

Preparation of thick drops with Giemsa painting

- Erythrocytes are not visible due to hemolysis
- Schuffner's point appears around the red parasite (red zone)
Parasite
Young trophozoites appear as rings or red dots with little
cytoplasm
- The leukocyte nucleus is dark purple and larger
- As a dosage conscious, the stroma of erythrocytes is light
purple in color

(Bariah Ideham, 2014)

PLASMODIUM MALARIAE
Disease: Quartana Malaria
Morphology :
Preparations remove with Giemsa painting
- Parasites attack old erythrocytes, pigment dots appear
inside erythrocytes
Stadia
a. Trophozoite
- Ring and ribbon or band form
- Coarse and dark brown pigment

b. Skizon
- Plasma in the nucleus has divided, into merozoites
- Merozoites numbered 8-12 pieces
- Coarse pigments gathered in the center surrounded by
merozoites that are arranged in a row called a "rosette"

c. Gametocytes
- Coarse pigment, scattered in the cytoplasm of the parasite
Preparation of thick drops with Giemsa painting
- The number of parasites is small, surrounded by a dark
brown coarse pigment
- In the schizont, the pigment in the middle is surrounded by
merozoites arranged like a flower.
(Bariah Ideham, 2014)
PLASMODIUM OVALE
Disease: Malaria Ovale or Malaria Tertiana
Morphology :
Infected erythrocytes are oval in shape or have fimbriae at their
ends.
Stadia
a. Trophozoite
- 1 dot chromatin, ring-shaped, solid nucleus
- Mature trophozoites have coarse pigment

b. Skizon
- The number of merozoites is usually 8 pieces
- The chromatin mass is a little rough pigment
Preparation of thick drops with Giemsa painting
Schuffner's point appears around the red parasite (red zone), the
parasite is smaller than the leukocyte nucleus.
[CITATION Bar14 \l 1033 ]
CYCLE LIFE MALARIA (Plasmodium spp)
2. MALARIA PATHOGENESIS
After passing through the liver, P. falciparum releases 18-24 merozoites into the
circulation. The released merozoites enter the RES cells in the spleen and undergo phagocytosis
and filtration. Merozoites that escape filtration and phagocytosis in the spleen will invade
erythrocytes. Furthermore, the parasite reproduces asexually in erythrocytes. Parasites in
erythrocytes (EP) generally experience 2 stages, namely the ring stage at 24 hours I and the
mature stage at 24 hours to IL. The surface of the EP ring stage will display the RESA antigen
(Ring-etythrocyte paradise antigen) which disappears after the parasite enters the mature stage.
(Harijanto, 2010)
CYTOADHERENCE. Cytoaderence is the attachment of mature stage EPs to the surface
of the vascular endothelium. Adhesion occurs by means of adhesive molecules located on the
surface of the EP knob attached to adhesive molecules located on the surface of the vascular
endothelium. The adhesive molecules on the surface of the EP knob are collectively termed
PfEMP-1, P.falciparum erythrocyte membrane protein-l. (Harijanto, 2010)
SEQUESTRATION. Cytoadherens prevent mature EP from circulating back into the
circulation. Parasites in mature erythrocytes residing in microvascular tissue are termed
sequestered mature EPs. Only P. falciparum undergoes sequestration, because in other
plasmodium the entire cycle occurs in peripheral blood vessels. Sequestration occurs in vital
organs and almost all tissues in the body. The highest sequestration was in the brain, followed by
the liver and kidneys, lungs, heart, intestines and skin. This sequestration is thought to play a
major role in the pathophysiology of severe malaria. (Harijanto, 2010)
ROSETTING. Rosetting is the clustering of mature EPs surrounded by 10 or more non-
parasitic erythrocytes. Plasmodium which can perform cytoadherence can also do rosetting.
Rosetting causes local/tissue obstruction of blood flow, thereby facilitating cytoadherence.
(Harijanto, 2010)
CYTOKINES. Cytokines are formed from endothelial cells, monocytes and macrophages
after being stimulated by malaria toxins (LPS, GPI). These cytokines include TNF-o" (tumor
necrosis factor-alpha), interleukin-L QL-L), interleukin-6 (IL-6), interleukin-3 (IL-3), LT
(lymphotoxin) and interferongamma (INF). -g). (Harijanto, 2010)
NITRITE OXIDE. Recently, the role of nitric oxide (NO) mediators has been widely
studied, both in the growth of severe malaria, especially cerebral malaria, and on the contrary,
NO actually has a protective effect because it limits the development of parasites and reduces the
expression of adhesion molecules. (Harijanto, 2010)

(Husna & Prasetyo, 2016)

DAFTAR PUSTAKA

Bariah Ideham, S. P. (2014). Penuntun Praktis Parasitologi Kedokteran Edisi 2. Surabaya:

Airlangga University Press.

Harijanto, P. N. dalam PAPDI. 2010. Buku Ajar Ilmu Penyakit Dalam Jilid III Edisi V.

Husna, M., & Prasetyo, B. H. (2016). Aspek Biomolekuler dan update terapi Malaria Serebral.
Jurnal MNJ, (02)(02), 79–88.