CONTENTS

1] INTRODUCTION KEY
2] FACTS
3] CAUSES
4] TRANSMISSION
5] PREVENTION
6] TREATMENT
7] WHO responses…
8] CASE STUDY
9] CONCLUSION
10] BIBLIOGRAPHY
 INTRODUCTION

Malaria is a mosquito-borne infectious disease affecting humans and other animals caused
by parasitic single-celled microorganisms belonging to the Plasmodium group. Malaria
causes symptoms that typically include fever, tiredness, vomiting, and headaches. In severe cases it can
cause yellow skin, seizures, coma, or death. Symptoms usually begin ten to fifteen days after being

bitten by an infected mosquito. If not properly treated, people may have recurrences of the disease
months later. In those who have recently survived an infection, reinfection usually causes milder
symptoms. This partial resistance disappears over months to years if the person has no continuing
exposure to malaria.
The disease is most commonly transmitted by an infected female Anopheles mosquito. The mosquito
bite introduces the parasites from the mosquito's saliva into a person's blood. The parasites travel to
the liver where they mature and reproduce. Five species of Plasmodium can infect and be spread by
humans. Most deaths are caused by P. falciparum because P. vivax, P. ovale, and P. malariae generally
cause a milder form of malaria. The species P. knowlesi rarely causes disease in humans. Malaria is
typically diagnosed by the microscopic examination of blood using blood films, or with antigen-
based rapid diagnostic tests. Methods that use the polymerase chain reaction to detect the
parasite's DNA have been developed, but are not widely used in areas where malaria is common due to
their cost and complexity.

KEY FACTS
 Malaria is transmitted when a mosquito infected with the plasmodium parasite bites a

person. The mosquito acts as a carrier of the plasmodium meaning when a mosquito
bites a person infected with malaria, there is a high chance that the parasite can be
spread to a healthy individual when this mosquito bites that person.
 Did you know that malaria can be caused by four variants of the same parasite?
 Malaria is especially dangerous for pregnant women as the parasite can pass into the

mother’s womb and infect the foetus as well. Once the foetus has been infected with
malaria, it can lead to the baby being born with a low birth weight and may lead to
death.
 CAUSES
Malaria is caused by the Plasmodium parasite. The parasite can be spread to humans through
the bites of infected mosquitoes.
There are many different types of plasmodium parasite, but only 5 types cause malaria in
humans.
These are:
 Plasmodium falciparum – mainly found in Africa, it's the most common type of malaria parasite


and is responsible for most malaria deaths worldwide
Plasmodium vivax – mainly found in Asia and South America, this parasite causes milder
symptoms than Plasmodium falciparum, but it can stay in the liver for up to 3 years, which can
result in relapses
 Plasmodium ovale – fairly uncommon and usually found in West Africa, it can remain in your
liver for several years without producing symptoms

Plasmodium malariae – this is quite rare and usually only found in Africa.

Plasmodium knowlesi – this is very rare and found in parts of southeast Asia.
 TRANSMISSiON
The plasmodium parasite is spread by female Anopheles mosquitoes, which are known as "night-
biting" mosquitoes because they most commonly bite between dusk and dawn.
If a mosquito bites a person already infected with malaria, it can also become infected and
spread the parasite on to other people. However, malaria can't be spread directly from person
to person.

Once you're bitten, the parasite enters the bloodstream and travels to the liver. The infection
develops in the liver before re-entering the bloodstream and invading the red blood cells.
The parasites grow and multiply in the red blood cells. At regular intervals, the infected blood
cells burst, releasing more parasites into the blood. Infected blood cells usually burst every 48-
72 hours. Each time they burst, you'll have a bout of fever, chills and sweating.
Malaria can also be spread through blood transfusions and the sharing of needles, but this is
very rare.
 PREVENTION
There's a significant risk of getting malaria if you travel to an affected area. It's very
important you take precautions to prevent the disease.
Malaria can often be avoided using the ABCD approach to prevention, which stands for:

Awareness of risk – find out whether you're at risk of getting malaria.

Bite prevention – avoid mosquito bites by using insect repellent, covering your arms and legs,
and using a mosquito net.

Check whether you need to take malaria prevention tablets – if you do, make sure you take
the right antimalarial tablets at the right dose, and finish the course.

Diagnosis – seek immediate medical advice if you have malaria symptoms, including up to a
year after you return from travelling.
These are outlined in more detail below.

Being aware of the risks

To check whether you need to take preventative malaria treatment for the countries you're
visiting, see the Fit for Travel website.
It's also important to visit your GP or local travel clinic for malaria advice as soon as you know
where you're going to be travelling.
Even if you grew up in a country where malaria is common, you still need to take precautions to
protect yourself from infection if you're travelling to a risk area.
Nobody has complete immunity to malaria, and any level of natural protection you may have
had is quickly lost when you move out of a risk area.

Preventing bites

It's not possible to avoid mosquito bites completely, but the less you're bitten, the less likely
you are to get malaria.
To avoid being bitten:
 Stay somewhere that has effective air conditioning and screening on doors and windows. If this

isn't possible, make sure doors and windows close properly.
 If you're not sleeping in an air-conditioned room, sleep under an intact mosquito net that's
been treated with insecticide.

Use insect repellent on your skin and in sleeping environments. Remember to reapply it
frequently. The most effective repellents contain diethyltoluamide (DEET) and are available in
sprays, roll-ons, sticks and creams.

Wear light, loose-fitting trousers rather than shorts, and wear shirts with long sleeves. This is
particularly important during early evening and at night, when mosquitoes prefer to feed.
There's no evidence to suggest homeopathic remedies, electronic buzzers, vitamins B1 or B12,
garlic, yeast extract spread (such as Marmite), tea tree oils or bath oils offer any protection
against mosquito bites.

Antimalarial tablets

There's currently no vaccine available that offers protection against malaria, so it's very
important to take antimalarial medication to reduce your chances of getting the disease.
However, antimalarials only reduce your risk of infection by about 90%, so taking steps to avoid
bites is also important.
When taking antimalarial medication:
 make sure you get the right antimalarial tablets before you go – check with your GP or

pharmacist if you're unsure
 follow the instructions included with your tablets carefully
depending on the type you're taking, continue to take your tablets for up to 4 weeks after
 returning from your trip to cover the incubation period of the disease

Check with your GP to make sure you're prescribed a medication you can tolerate. You may be
more at risk from side effects if you:
 have HIV or AIDS
 have epilepsy or any type of seizure condition
are depressed or have another mental health condition
 have heart, liver or kidney problems

take medicine, such as warfarin, to prevent blood clots


use combined hormonal contraception, such as the contraceptive pillor contraceptive patches
 If you've taken antimalarial medication in the past, don't assume it's suitable for future trips.
The antimalarial you need to take depends on which strain of malaria is carried by the

mosquitoes and whether they're resistant to certain types of antimalarial medication.

In the UK, chloroquine and proguanil can be bought over-the-counter from local pharmacies.
However, you should seek medical advice before buying it as it's rarely recommended
nowadays. For all other antimalarial tablets, you'll need a prescription from your GP.

Read more about antimalarial medication, including the main types and when to take them.
 TREATMENT
Malaria is treated with antimalarial medications; the ones used depends on the type and

severity of the disease. While medications against fever are commonly used, their effects on

outcomes are not clear.

Simple or uncomplicated malaria may be treated with oral medications. The most effective
treatment for P. falciparum infection is the use of artemisinins in combination with other
antimalarials (known as artemisinin-combination therapy, or ACT), which decreases resistance
to any single drug component. These additional antimalarials
include: amodiaquine, lumefantrine, mefloquine or sulfadoxine/pyrimethamine.[94] Another
recommended combination is dihydroartemisinin and piperaquine. ACT is about 90% effective
when used to treat uncomplicated malaria. To treat malaria during pregnancy, the WHO
recommends the use of quinine plus clindamycin early in the pregnancy (1st trimester), and
ACT in later stages (2nd and 3rd trimesters). In the 2000s (decade), malaria with partial
resistance to artemisins emerged in Southeast Asia. Infection
with P. vivax, P. ovale or P. malariae usually do not require hospitalization. Treatment
of P. vivax requires both treatment of blood stages (with chloroquine or ACT) and clearance of
liver forms with primaquine. Treatment with tafenoquine prevents relapses after confirmed P.
vivax malaria.
Severe and complicated malaria are almost always caused by infection with P. falciparum. The
other species usually cause only febrile disease. Severe and complicated malaria are medical
emergencies since mortality rates are high (10% to 50%). Cerebral malaria is the form of severe
and complicated malaria with the worst neurological symptoms. Recommended treatment for
severe malaria is the intravenous use of antimalarial drugs. For severe
malaria, parenteral artesunate was superior to quinine in both children and adults. In another
systematic review, artemisinin derivatives (artemether and arteether) were as efficacious as
quinine in the treatment of cerebral malaria in children. Treatment of severe malaria involves
supportive measures that are best done in a critical care unit. This includes the management
of high fevers and the seizures that may result from it. It also includes monitoring for poor
breathing effort, low blood sugar, and low blood potassium.
 WHO response…
The WHO Global Technical Strategy for Malaria 2016-2030 – adopted by the World Health

Assembly in May 2015 – provides a technical framework for all malaria-endemic countries. It is
intended to guide and support regional and country programmes as they work towards malaria

control and elimination.

The Strategy sets ambitious but achievable global targets, including:


Reducing malaria case incidence by at least 90% by 2030.

Reducing malaria mortality rates by at least 90% by 2030.

Eliminating malaria in at least 35 countries by 2030.

Preventing a resurgence of malaria in all countries that are malaria-free.
This Strategy was the result of an extensive consultative process that spanned 2 years and
involved the participation of more than 400 technical experts from 70 Member States. It is
based on 3 key pillars.


ensuring universal access to malaria prevention, diagnosis and treatment;

accelerating efforts towards elimination and attainment of malaria-free status; and

Transforming malaria surveillance into a core intervention.
The WHO Global Malaria Programme (GMP) coordinates WHO's global efforts to control and
eliminate malaria by:

setting, communicating and promoting the adoption of evidence-based norms,
standards, policies, technical strategies, and guidelines;

keeping independent score of global progress;

developing approaches for capacity building, systems strengthening, and surveillance;
and

Identifying threats to malaria control and elimination as well as new areas for action.
GMP is supported and advised by the Malaria Policy Advisory Committee (MPAC), a group of 15
global malaria experts appointed following an open nomination process. The MPAC, which
meets twice yearly, provides independent advice to WHO to develop policy recommendations
for the control and elimination of malaria. The mandate of MPAC is to provide strategic advice
and technical input, and extends to all aspects of malaria control and elimination, as part of a
transparent, responsive and credible policy setting process.
 Conclusion
Malaria is an enormous global disease burden, and its

eradication is an ambitious goal.

The disease, caused by mosquito-borne parasites, is present in
102 countries and is responsible for over 100 million clinical cases
and 1 to 2 million deaths each year. Over the past two decades,
efforts to control malaria have met with less and less success.
 CASE STUDY
Clinical Case Study 1: Fever 6 months after a visit to Pakistan

A 44-year-old man is seen at a physician’s office in the United States, during a week-
end, for suspected malaria.

The patient was born in Pakistan but has lived in the United States for the past 12 years.
He travels frequently back to Pakistan to visit friends and relatives. His last visit there
was for two months, returning 11 months before the current episode. He did not take
malaria prophylaxis then.

Five weeks ago, he was diagnosed with malaria and treated at a local hospital. The
blood smear at that time was reported by the hospital as positive for malaria, species
undetermined. He was then treated with 2 days of IV fluids (nature unknown) and
tablets (nature unknown), and recovered.

The patient now presents with a history of low grade fever for the past few days, with no
other symptoms. A blood smear is taken and examined at a hospital laboratory by the
technician (no pathologist is available on this week-end). Through a telephone
discussion, the technician states that she sees 4 parasites per 1000 red blood cells, with
rings, “other forms with up to four nuclei,” and that some of the infected red blood cells
are enlarged and deformed.
 BIBLIOGRAPHY
I am able to make this project and collect the information from the following resources:


NCERT BIOLOGY TEXTBOOK CLASS XII

OUR BIOLOGY TEACHER: MRS. MINI MATHUR

http://www.who.int/news-room/fact-sheets/detail/malaria

KIMS BHUBANESWAR