Prepared by: ALINGAN, MUAMIR A.


‡ A vector-borne infectious disease caused by vector‡


‡ ‡

protozoan parasites. The term MALARIA originates from MEDIEVAL ITALIAN: MALA ARIA ± ³BAD AIR´; and the disease was formerly AIR´; called ague or marsh fever due to its association with swamps. It is widespread in tropical and subtropical regions, including parts of the Americas, Asia, and Africa. Historical records suggest malaria has infected humans since the beginning of mankind. It has been infected humans for over 50,000 years, and may have been a human pathogen for the entire history of our species.

A French army doctor working in the military hospital of Constantine Algeria named Charles Louise Alphonse Laveran observed parasites for the first time, inside the red blood cells of people suffering from malaria. He therefore proposed that malaria was caused by this protozoan, the first time protozoa were identified as causing disease.

Ettore Marchiafava and Angelo Celli, while

studying wet blood smears from malarious patients with the new oiloilimmersion lens, looked at unstained blood and saw an active amoeboid ring in the red blood cells. They then published this finding and named it

A year later 
Carlos Finlay, a Cuban Finlay, doctor treating patients with yellow fever in Havana, first suggested that mosquitoes were transmitting disease to and from humans.

It was Britain's Sir Ronald Ross working in India who finally proved in 1898 that malaria is transmitted by mosquitoes


is a specialized bodily fluid that delivers necessary substances to the body's cells ± such as nutrients and oxygen ± and transports waste products away from those same cells.In vertebrates, vertebrates, it is composed of blood cells suspended in a liquid called blood plasma. Plasma, which constitutes 55% of blood fluid, plasma. is mostly water (90% by volume),[1] and contains dissolved volume),[1] proteins, glucose, mineral ions, hormones, carbon dioxide (plasma glucose, hormones, being the main medium for excretory product transportation), platelets and blood cells themselves. The blood cells present in blood are mainly red blood cells (also called RBCs or erythrocytes) and white blood cells, including leukocytes and platelets. The most cells, platelets. abundant cells in vertebrate blood are red blood cells. These cells. hemoglobin, ironcontain hemoglobin, an iron-containing protein, which facilitates transportation of oxygen by reversibly binding to this respiratory gas and greatly increasing its solubility in blood. In contrast, carbon dioxide is almost entirely transported extracellularly dissolved in plasma as bicarbonate ion. ion. Vertebrate blood is bright red when its hemoglobin is oxygenated. Some animals, such as crustaceans and mollusks, use hemocyanin to carry oxygen, instead of hemoglobin. Insects and some molluscs use a fluid called hemolymph instead of blood, the difference being that hemolymph is not contained in a closed circulatory system. In most insects, this "blood" does not contain oxygen-carrying molecules such as hemoglobin because their bodies are small enough for their tracheal system to suffice for supplying oxygen.

Jawed vertebrates have an adaptive immune system, based system, largely on white blood cells. White blood cells help to cells. resist infections and parasites. Platelets are important in the clotting of blood.[2] Arthropods, using hemolymph, blood.[2] Arthropods, have hemocytes as part of their immune system. system. Blood is circulated around the body through blood vessels by the pumping action of the heart. In animals with lungs, heart. lungs, arterial blood carries oxygen from inhaled air to the tissues of the body, and venous blood carries carbon dioxide, a waste product of metabolism produced by cells, cells, from the tissues to the lungs to be exhaled. Medical terms related to blood often begin with hemo- or hemohematohemato- (also spelled haemo- and haemato-) from the haemohaematoAncient Greek word (haima) for "blood". In terms of (haima) anatomy and histology, blood is considered a specialized histology, form of connective tissue, given its origin in the bones tissue, and the presence of potential molecular fibers in the form of fibrinogen. fibrinogen.

‡Blood performs many important functions within the body including: ‡Supply of oxygen to tissues (bound to hemoglobin, which is carried in red cells) ‡Supply of nutrients such as glucose, amino acids, and fatty acids (dissolved in the blood or bound to plasma proteins (e.g., blood lipids) ‡Removal of waste such as carbon dioxide, urea, and lactic acid ‡Immunological functions, including circulation of white blood cells, and detection of foreign material by antibodies ‡Coagulation, which is one part of the body's self-repair mechanism (the act of blood clotting when one gets cut to stop the bleeding.) ‡Messenger functions, including the transport of hormones and the signaling of tissue damage ‡Regulation of body pH ‡Regulation of core body temperature ‡Hydraulic functions

Constituents of human blood
Blood accounts for 8% of the human body weight,[3] with an weight,[3] average density of approximately 1060 kg/m3, very close to pure water's density of 1000 kg/m3.[4] The average adult has kg/m3.[4] a blood volume of roughly 5 liters (1.3 gal), composed of plasma and several kinds of cells (occasionally called corpuscles); these formed elements of the blood are corpuscles); cells), (white erythrocytes (red blood cells), leukocytes (white blood (red cells), cells), and thrombocytes (platelets). By volume, the red (platelets). blood cells constitute about 45% of whole blood, the plasma about 54.3%, and white cells about 0.7%. Whole blood (plasma and cells) exhibits non-Newtonian fluid nondynamics; its flow properties are adapted to flow effectively through tiny capillary blood vessels with less resistance than plasma by itself. In addition, if all human hemoglobin were free in the plasma rather than being contained in RBCs, the circulatory fluid would be too viscous for the cardiovascular system to function effectively.

Constituents of human blood
Parameter Hematocrit Value 45 ± 7 (38±52%) for males (38± 42 ± 5 (37±47%) for (37± females 7.35± 7.35±7.45 í3 to +3 10± 10±13 kPa (80±100 mm Hg) (80± 4.8± 4.8±5.8 kPa (35±45 mm Hg) (35± 21± 21±27 Mm Oxygenated: 98±99% 98± Deoxygenated: 75%

pH base excess PO2 PCO2 HCO3í Oxygen saturation


4.7 to 6.1 million (male), 4.2 to 5.4 million (female) erythrocytes:[5] In most mammals, mature red blood cells erythrocytes: organelles. lack a nucleus and organelles. They contain the blood's hemoglobin and distribute oxygen. The red blood cells (together with endothelial vessel cells and other cells) are also marked by glycoproteins that define the different blood types. The proportion of blood occupied types. hematocrit, by red blood cells is referred to as the hematocrit, and is normally about 45%. The combined surface area of all red blood cells of the human body would be roughly 2,000 times as great as the body's exterior surface.[6] surface.[6] 4,000± 4,000±11,000 leukocytes:[7] White blood cells are part of leukocytes: the immune system; they destroy and remove old or system; aberrant cells and cellular debris, as well as attack infectious agents (pathogens) and foreign substances. The (pathogens) cancer of leukocytes is called leukemia. leukemia. 200,000± 200,000±500,000 thrombocytes:[7] thrombocytes, also thrombocytes:[7] thrombocytes, called platelets, are responsible for blood clotting platelets, coagulation). fibrin. (coagulation). They change fibrinogen into fibrin. This fibrin creates a mesh onto which red blood cells collect and clot, which then stops more blood from leaving the body and also helps to prevent bacteria from entering the body.

About 55% of whole blood is blood plasma, a fluid that plasma, is the blood's liquid medium, which by itself is straw-yellow strawin color. The blood plasma volume totals of 2.7±3.0 litres 2.7± (2.8± (2.8±3.2 quarts) in an average human. It is essentially an aqueous solution containing 92% water, 8% blood plasma proteins, proteins, and trace amounts of other materials. Plasma glucose, acids, circulates dissolved nutrients, such as glucose, amino acids, and fatty acids (dissolved in the blood or bound to plasma proteins), and removes waste products, such as carbon dioxide, urea, dioxide, urea, and lactic acid. acid. Other important components include:        Serum albumin BloodBlood-clotting factors (to facilitate coagulation) coagulation) Immunoglobulins (antibodies) lipoprotein particles Various other proteins Various electrolytes (mainly sodium and chloride) chloride) The term serum refers to plasma from which the clotting proteins have been removed. Most of the proteins remaining immunoglobulins. are albumin and immunoglobulins.

Narrow range of pH values  Blood pH is regulated to stay within the narrow range of 7.35 to 7.45, making it slightly alkaline.[8][9] alkaline.[8][9] Blood that has a pH below 7.35 is too acidic, whereas acidic, alkaline. blood pH above 7.45 is too alkaline. Blood pH, partial pressure of oxygen (pO2), partial pressure of carbon dioxide (pCO2), and HCO3 are carefully regulated by a number of homeostatic mechanisms, which exert their mechanisms, influence principally through the respiratory system and the urinary system in order to control the acidacidbase balance and respiration. An arterial blood gas will measure these. Plasma also circulates hormones transmitting their messages to various tissues. The list of normal reference ranges for various blood electrolytes is extensive. Bones are especially affected by blood pH as they tend to be used as a mineral source for pH buffering. Consuming a high ratio of animal protein to vegetable protein is implicated in bone loss in women.[ women.[ 

Blood in non-human vertebrates non Human blood is typical of that of mammals, although the precise details concerning cell numbers, size, protein structure, and so on, vary structure, somewhat between species. In non-mammalian nonvertebrates, however, there are some key differences:[11] differences:[11]  Red blood cells of non-mammalian vertebrates are nonflattened and ovoid in form, and retain their cell nuclei  There is considerable variation in the types and proportions of white blood cells; for example, acidophils are generally more common than in humans  Platelets are unique to mammals; in other vertebrates, small, nucleated, spindle cells are responsible for blood clotting instead

Physiology  Cardiovascular system 
Blood is circulated around the body through blood vessels by the pumping action of the heart. In humans, blood is heart. pumped from the strong left ventricle of the heart through arteries to peripheral tissues and returns to the veins. right atrium of the heart through veins. It then enters the right ventricle and is pumped through the pulmonary artery to the lungs and returns to the left atrium veins. through the pulmonary veins. Blood then enters the left ventricle to be circulated again. Arterial blood carries oxygen from inhaled air to all of the cells of the body, and venous blood carries carbon dioxide, a waste product cells, of metabolism by cells, to the lungs to be exhaled. However, one exception includes pulmonary arteries, which contain the most deoxygenated blood in the body, while the pulmonary veins contain oxygenated blood.  Additional return flow may be generated by the movement muscles, of skeletal muscles, which can compress veins and push blood through the valves in veins toward the right atrium. atrium.  The blood circulation was famously described by William Harvey in 1628

Production and degradation of blood cells 
In vertebrates, the various cells of blood are made in the bone marrow in a process called hematopoiesis, hematopoiesis, which includes erythropoiesis, the production of red erythropoiesis, blood cells; and myelopoiesis, the production of white blood cells and platelets. During childhood, almost every human bone produces red blood cells; as adults, red blood cell production is limited to the larger bones: the bodies of the vertebrae, the breastbone (sternum), the ribcage, the pelvic bones, and the bones of the upper arms and legs. In addition, during childhood, the thymus gland, found in the mediastinum, mediastinum, is an important source of lymphocytes.[13] The lymphocytes. proteinaceous component of blood (including clotting liver, proteins) is produced predominantly by the liver, while hormones are produced by the endocrine glands and the watery fraction is regulated by the hypothalamus and maintained by the kidney. kidney. Healthy erythrocytes have a plasma life of about 120 days before they are degraded by the spleen, and the spleen, Kupffer cells in the liver. The liver also clears some acids. proteins, lipids, and amino acids. The kidney actively secretes waste products into the urine. urine. 

Oxygen transport 

About 98.5% of the oxygen in a sample of arterial blood in a healthy human breathing air at sea-level pressure is seachemically combined with the Hgb. About 1.5% is physically dissolved in the other blood liquids and not connected to Hgb. The hemoglobin molecule is the primary transporter of oxygen in mammals and many other species (for exceptions, see below). Hemoglobin has an oxygen binding capacity of between 1.36 and 1.37 ml O2 per gram Hemoglobin,[14] Hemoglobin,[14] which increases the total blood oxygen capacity seventyfold,[15] compared to if oxygen solely seventyfold,[15] was carried by its solubility of 0.03 mL O2 per litre blood per mmHg partial pressure of oxygen (approximately 100 mmHg in arteries).[15] arteries).[15] With the exception of pulmonary and umbilical arteries and their corresponding veins, arteries carry oxygenated blood away from the heart and deliver it to the body via arterioles and capillaries, where the oxygen is consumed; capillaries, venules, afterwards, venules, and veins carry deoxygenated blood back to the heart.  

Under normal conditions in humans at rest, hemoglobin in blood leaving the lungs is about 98± 98± 99% saturated with oxygen. In a healthy adult at rest, deoxygenated blood returning to the lungs is still approximately 75% saturated.[16][17] saturated.[16][17] Increased oxygen consumption during sustained exercise reduces the oxygen saturation of venous blood, which can reach less than 15% in a trained athlete; although breathing rate and blood flow increase to compensate, oxygen saturation in arterial blood can drop to 95% or less under these conditions.[18] conditions.[18] Oxygen saturation this low is considered dangerous in an individual at rest (for instance, during surgery under anesthesia. Sustained hypoxia (oxygenation of less than 90%), is dangerous to health, and severe hypoxia (saturations of less than 30%) may be rapidly fatal.[19] fatal.[19]  A fetus, receiving oxygen via the placenta, is fetus, placenta, exposed to much lower oxygen pressures (about 21% of the level found in an adult's lungs), and, so, fetuses produce another form of hemoglobin with a much higher affinity for oxygen (hemoglobin F) in (hemoglobin F) order to function under these conditions

Carbon dioxide transport  When blood flows through capillaries, carbon dioxide diffuses from the tissues into the blood. Some carbon dioxide is dissolved in the blood. A part of CO2 reacts with hemoglobin and other proteins to form carbamino compounds. The remaining carbon dioxide is converted to bicarbonate and hydrogen ions through the action of RBC carbonic anhydrase. Most carbon anhydrase. dioxide is transported through the blood in the form of bicarbonate ions. Carbon dioxide (CO2), the main cellular waste product is plasma, carried in blood mainly dissolved in plasma, in equilibrium (HCO386± with bicarbonate (HCO3-) and carbonic acid (H2CO3). 86±90% of acid, CO2 in the body is converted into carbonic acid, which can quickly turn into bicarbonate, the chemical equilibrium being important in the pH buffering of plasma.[21] Blood pH is kept plasma.[21] in a narrow range (pH between 7.35 and 7.45 Transport of hydrogen ions Some oxyhemoglobin loses oxygen and becomes deoxyhemoglobin. Deoxyhemoglobin binds most of the hydrogen ions as it has a much greater affinity for more hydrogen than does oxyhemoglobin.Lymphatic oxyhemoglobin.Lymphatic system In mammals, blood is in equilibrium with lymph, which is lymph, continuously formed in tissues from blood by capillary ultrafiltration. Lymph is collected by a system of small duct, lymphatic vessels and directed to the thoracic duct, which drains into the left subclavian vein where lymph rejoins the systemic blood circulation.  


Thermoregulation  Blood circulation transports heat throughout the body, and adjustments to this flow are an important part of thermoregulation. thermoregulation. Increasing blood flow to the surface (e.g., during warm weather or strenuous exercise) causes warmer skin, resulting in faster heat loss. In contrast, when the external temperature is low, blood flow to the extremities and surface of the skin is reduced and to prevent heat loss and is circulated to the important organs of the body, preferentially.Hydraulic preferentially.Hydraulic functions The restriction of blood flow can also be used in specialized tissues to cause engorgement, resulting in an erection of that tissue; examples are the erectile tissue in the penis and clitoris. clitoris. Another example of a hydraulic function is the jumping spider, spider, in which blood forced into the legs under pressure causes them to straighten for a powerful jump, without the need for bulky muscular legs  

Color  Hemoglobin Hemoglobin is the principal determinant of the color of blood in vertebrates. Each molecule has four heme groups, and their interaction with various molecules alters the exact hemoglobincolor. In vertebrates and other hemoglobin-using creatures, arterial blood and capillary blood are bright red, as oxygen imparts a strong red color to the heme group. Deoxygenated blood is a darker shade of red; this is present in veins, and can be seen during blood donation and when venous blood samples are taken. Blood in carbon monoxide poisoning is bright red, because carbon monoxide causes the formation of carboxyhemoglobin. carboxyhemoglobin. In cyanide poisoning, the body cannot utilize oxygen, so the venous blood remains oxygenated, increasing the redness. While hemoglobin-containing blood is hemoglobinnever blue, there are several conditions and diseases wherein the color of the heme groups make the skin appear blue. If methaemoglobin, the heme is oxidized, methaemoglobin, which is more brownish and cannot transport oxygen, is formed. In the rare condition sulfhemoglobinemia, sulfhemoglobinemia, arterial hemoglobin is partially oxygenated, and appears dark red with a bluish hue (cyanosis). cyanosis). Veins in the skin appear blue for a variety of reasons only weakly dependent on the color of the blood. Light scattering in the skin, and the visual processing of color play roles as well.[23] well.[23] Skinks in the genus Prasinohaema have green blood due to a buildup of the waste product biliverdin. biliverdin.   

Hemocyanin The blood of most mollusks ± including cephalopods and gastropods ± as well as some arthropods, arthropods, such as horseshoe crabs, is blue, as crabs, it contains the copper-containing protein copperhemocyanin at concentrations of about 50 grams per litre.[25] Hemocyanin is colorless when litre.[25] deoxygenated and dark blue when oxygenated. The blood in the circulation of these creatures, which generally live in cold environments with low oxygen tensions, is grey-white to pale greyyellow,[25] yellow,[25] and it turns dark blue when exposed to the oxygen in the air, as seen when they bleed.[25] bleed.[25] This is due to change in color of hemocyanin when it is oxidized.[25] Hemocyanin oxidized.[25] fluid, carries oxygen in extracellular fluid, which is in contrast to the intracellular oxygen transport in mammals by hemoglobin in RBCs.[25] RBCs.[25]

‡ Malaria is caused by protozoan parasites of the genus Plasmodium (phylum apicomplexa). ‡ There are several species of Plasmodium Parasites but only four of them are significant to the cause of malaria diseases to humans. Some of these are in to animals. Like birds,reptiles, monkeys, chimpanzees, and rodents.

A female Anopheles mosquito bites, injecting saliva containing sporozoites, the infective form of malaria parasite.

The sporozoites enter the liver and multiply

In the liver, the sporozoites change into merozoites, another form of the parasite.

Merozoites are released from the liver and enter the bloodstream.

Merozoites attack Red Blood Cells.

Red Blood cells burst and release the merozoites which invade other red blood cells and cause recurring chills and fever. (At this point the infected person becomes a reservoir of malaria that infects any mosquito that feeds on him.)




‡ P. Vivax is the most common cause of infection, responsible for about 80% of all malaria cases.

‡ However, P. Falciparum is the most important cause of disease, and responsible for about 15% of infections and 90% of deaths.

The Parasite¶s primary hosts and transmission vectors are female mosquitoes of the Anopheles genus. The disease is transmitted to humans when an infected Anopheles mosquito bites a person and injects the malaria parasites (sporozoites) into the blood.  

Mosquito injects the infective plasmodial sporozoites.  

Ready for another cycle.

Sporozoites enter the liver cells, and transform into merozoites which penetrate RBC.  Once in RBC, merozoites reproduce rapidly, producing many more merozoites, which burst out of the RBC & penetrate new cells.  Some of these merozoites form male & female gametocytes, which can be picked up by another mosquito.  Inside the gut of the mosquito, gametocytes will The zygote then develops into fertilize creating an oocyst and ruptures to zygote. release thousands of sporozoites.  

Only female mosquitoes feed on blood, thus males do not transmit the disease. The females of the Anopheles genus of mosquito prefer to feed at night. They usually start searching for a meal at dusk, and will continue throughout the night until taking a meal. 

Malaria parasites can also be transmitted by blood transfusion, although this is transfusion, rare.

The symptoms characteristic of malaria include flu-like illness with fever, chills, flumuscle aches, joint pain (athralgia), vomiting, anemia caused by hemolysis, hemoglobinuria, convulsions, and headache.  The classical symptom of malaria is cyclical occurrence of sudden coldness followed by rigor and 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 malariae. can have recurrent fever every 36-48 hours 36or a less pronounced and almost continuous fever. 

People with severe P. falciparum malaria can develop bleeding problems, shock, problems, shock, liver or kidney failure, failure, central nervous system problems, coma, and can die problems, coma, from the infection or its complications. Cerebral malaria (coma, or altered mental status or seizures) can occur with severe P. falciparum infection. It is lethal if not treated quickly; even with treatment, about 15%-20% die. 15%- 

The period between the mosquito bite and the onset of the malarial illness is usually one to three weeks (seven to 21 days). This initial time period is highly variable as reports suggest that the range of incubation periods may range from four days to one year.  The usual incubation period may be increased when a person has taken an inadequate course of malaria prevention medications.  Certain types of malaria (P. vivax and P. ovale) (P. ovale) parasites can also take much longer, as long as eight to 10 months, to cause symptoms. These parasites remain dormant (inactive or hibernating) in the liver cells during this time. Unfortunately, some of these dormant parasites can remain even after a patient recovers from malaria, so the patient can get sick again. This situation is termed relapsing malaria. malaria.

Malaria can be a severe, potentially fatal disease (especially when caused by P. Falciparum) and treatment should be initiated as soon as possible.  The Word Health Organization recommends that those in endemic areas, treatment should be started within 24 hours after the first symptoms appear. Treatment of patients with uncomplicated malaria can be conducted on an ambulatory basis (without hospitalization) but patients with severe malaria should be hospitalized if possible.  In areas where malaria is not endemic, all patients with malaria (uncomplicated or severe) should be kept under clinical observation if possible.

Drug Treatment 
The first effective treatment for malaria was the bark of cinchona tree, which tree, contains QUININE. It was first used by the inhabitants of Peru, where these trees mainly grow. Today, there are several antimalarial drugs available for treatment: 
       Chloroquine sulfadoxinesulfadoxine-pyrimethamine (Fansidar®) mefloquine (Lariam®) atovaquoneatovaquone-proguanil (Malarone®) quinine doxycycline artemisin derivatives primaquine  

But, drug treatment of malaria is not always easy. You have to consider some factors in treating different conditions of patients having malaria.

There are three main factors in determining treatment
1. The infecting species of Plasmodium parasites. 
Different species of Plasmodium parasites may vary in treating patients.


The clinical situation of the patient. 
Mild malaria can be treated with oral medication.  Severe malaria (having one or more symptoms of either coma, severe anemia, renal failure, shock, etc.) requires intravenous (IV) drug treatment and fluids.  Malaria may pose a serious threat to a pregnant women and her pregnancy. Infection may be more severe than those women who are not pregnant.


The drug susceptibility of the infecting parasites. 
Determined by the geographic area where the infection was acquired.  Different areas of the world have malaria types that are resistant to certain medications.  Correct drug must be prescribed by the doctor who is familiar with malaria treatment protocol.

MALARIA CONTROL  The goal of malaria control in malariamalaria-endemic countries is to reduce as much as possible the health impact of malaria on a population, using the resources available, and taking into account  Malaria control priorities. to other health does not aim eliminate malaria totally. Complete elimination of the malaria parasite (and thus the disease) would constitute eradication. While eradication is more desirable, it is not currently a realistic goal for most of the countries where malaria is endemic. 

Malaria control is carried out through the following interventions, which are often combined: 
Case Management (diagnosis and treatment) of patients suffering from malaria. 

Persons who are sick should be treated promptly and correctly. It eliminates an essential component of the cycle (the parasite) and thus interrupts the transmission cycle.  WHO recommends that anyone suspected of having malaria should receive diagnosis and treatment with an effective drug within 24 hours of the onset of symptoms. 

Prevention of Infection through vector control. 

Infection is prevented when malaria-carrying malariaAnopheles mosquitoes are prevented from biting humans.  Vector control aims to reduce contacts between mosquitoes and humans.  Some vector control measures like (destruction of larval breeding sites, insecticide spraying inside houses) may houses) require organized teams and resources that are not always available.  Insecticide-treated bed nets could also be an Insecticidealternative in vector control and personal protection. It could be conducted by the community themselves and become a major intervention in malaria control. 

Prevention of Disease by administration of antimalarial drugs to particularly vulnerable population groups such as pregnant women and infants. 
Administration of antimalarial drugs to vulnerable population groups does not prevent infection, which happens through mosquito bites. But drugs can prevent disease by eliminating the parasites that are in the blood, which are the forms that cause disease.  Pregnant women are the vulnerable group most frequently targeted. They may receive, for example, "intermittent preventive treatment" (IPT) with antimalarial drugs given most often at antenatal consultations during the second and third trimesters of pregnancy.

PHILIPPINE SCENARIO The Philippines is one of the Southeast Asian countries plagued with malaria. Although the country contribute does does not contribute significantly to the global mortality attributed to malaria, the disease remains malaria, to be a major cause of ³healthy days of life lost´ endemic areas (HDLL) in the endemic areas of the country. Malaria affects the socioeconomic well-being of the affected socioeconomic well-being population, and the different socioeconomic different socioeconomic transmission, prevention, activities affect transmission, prevention, and control of the disease. Thus, this situation not only situation economic, social generates an enormous economic, social and health burden to these people per se, but also poses a huge and persistent challenge to the health deliverers of the Malaria Control Program. Program.

MALARIA AS A HEALTH PROBLEM  It is the eighth leading cause of morbidity in the Philippines. (HIS 2000)  According to DOH Secretary Reynaldo Duque, ³an average of three Filipinos die daily due to malaria despite the government¶s intensified efforts to control the occurrence of the ailment´.  Malaria has become a health threat.  Although malaria endemicity is now generally moderate to low, the disease continues to be a major impediment to human and economic development in areas where it persists  This disease is still endemic in 65 of the 79 provinces in the country, and around 10 million people who live in these areas are at risk of getting the disease.  Morbidity trend suggest that there might be a cause and effect relationship between the activities which aim to eradicate malaria and its incidence  There is a decreasing number of deaths caused by malaria  Chloroquine, the cheapest medicine against malaria is losing its effectiveness

Malaria as a Health Services Problem  It poses challenges of access to health care for prompt and effective treatment  There are shortages of antimalarial drug supplies, especially in peripheral health centers  The disease still costs the Philippine economy to spend over Php 100 million in order to sustain control efforts  Failures in treatment still occur despite the preventability of malaria.  Causes of Malaria Treatment Failure in the Philippines  Drug resistance  Non-compliance of patients in the treatment regimen Non Deficient drug absorption  Self-medication Self Resorting to herbal remedies  Seeking help when the disease is severe (Malaria is fatal only when it is seen in its later stages.) Epidemiology of malaria is complex, due to  Variety of ecological conditions observed in different island groups  Occurrence of more than one vector species

Malaria Control Program of the Department of Health
For 2007, The Department of Health has developed a malaria control program as a measure to help eradicate the spread of the disease. Some of the program strategies are: 1. Early diagnosis of the disease and prompt treatment. This was achieved through: 
diagnostic centers which serve as cites of microscopy  manning by a RDT (Rapid Diagnostic Test) trained personnel  promotion of the existence of diagnostic centers

2. Controlling the spread of mosquitoes This was achieved through: 
giving out insecticide-treated mosquito nets insecticide indoor spraying which targets houses and not only communities

3. Implementation of community-based malaria control communityThis was achieved through: 
social mobilization  education sessions

Mosquito Nose Transplants Help Fight Malari Main Category: Tropical Diseases Also Included In: Biology / Biochemistry; Aid / Disasters Biochemistry; Article Date: 16 Feb 2010 - 9:00 PDTIn .

a new approach to combating malaria, a disease that affects half a billion people malaria, worlwide, US scientists successfully transplanted most of the "nose" of the diseasedisease-spreading Anopheles mosquito into frogs' eggs and fruit flies so they could analyse the insect's odorant receptors and find out how to lure it into traps and even prevent it being able to detect and thereby target humans. You can read about the two studies by researchers from Yale University in New Haven, Connecticut, and Vanderbilt University in Nashville, Tennessee, in a report in the 3rd February online issue of the journal Nature and there is also a complementary article in the Proceedings of the National Academy of Sciences, PNAS. PNAS. The mosquito Anopheles gambiae is the major route through which humans in subsub-Saharan Africa become infected with malaria. While we know that the insect uses its sense of smell to find human hosts, we know little about the underlying molecular process. A mosquito's "nose" is in its antennae which carry nerve cells covered with odorant receptors that react to different chemical compounds in the insect's environment. These receptors are similar to those that give us our senses of smell and taste in our nose and on our taste buds. CoCo-author Dr Laurence Zwiebel, professor of biological sciences at Vanderbilt, told the press that:"We've successfully expressed about 80 percent of the Anopheles mosquito's odorant receptors in frog's eggs and in the fruit fly

Zwiebel's lab at Vanderbilt is where they successfully transplanted the receptors into frogs' eggs. The transplant into fruit-fly (Drosophila melanogaster) fruiteggs was done at the laboratory of John Carlson, Eugene Higgins Professor of Molecular, Cellular and Developmental Biology at Yale and is written up as a complementary study in PNAS. PNAS. Scientists have previously used frogs' eggs to study olfactory receptors in moths, bees and fruit flies. For this study, the researchers injected DNA that codes for the mosquito's olfactory receptors into a frog egg and waited for it to produce proteins. Eventually the surface of the egg became covered with mosquito odorant receptors. They then tested the engineered egg's reaction to being exposed to various odorant chemicals. They floated the egg in a buffer solution in a voltage clamp (so they could measure changes in the egg's electrical properties) and dissolved the chemicals one by one in the solution. They detected a measurable electrical response in the egg. Guirong Wang, lead author of the PNAS study, and a senior researcher in Zwiebel's lab, said:"The frog egg system is relatively rapid, highly sensitive and allows us to do very precise measurements of odorant response." Wang, who personally conducted several thousand measurements of egg responses to changes in odorant, described this method as a "medium throughput system", because although they could set it up quite quickly, they had to make the odorant solutions by hand, which took much longer.

Antioxidants May Help Prevent Malaria Complications That Damage Brain malaria, Using an experimental mouse model for malaria, an international group of scientists has discovered that adding antioxidant therapy to traditional antimalarial treatment may prevent longlonglasting cognitive impairment in cerebral malaria. Their findings were published online June 24, 2010, in the journal PLoS Pathogens. Pathogens. Malaria, an infection caused by parasites that invade liver and red blood cells, is transmitted to humans by the female Anopheles mosquito. Malaria is one of the leading infectious diseases worldwide, affecting more than 400 million people and causing more than 2 million deaths each year, mainly among African children. Recently, the U.S. Centers for Disease Control and Prevention (CDC) issued a report on 11 laboratory-confirmed cases of malaria among U.S. laboratoryemergency responders and those traveling in the United States from Haiti. Cerebral malaria is a severe, potentially fatal neurologic complication of infection by the mostmostfeared malarial parasite, Plasmodium falciparum. Recent studies of children with cerebral malaria indicate that cognitive deficits, which may impair memory, learning, language, and mathematical abilities, persist in many survivors even after the infection itself is cured. "Cerebral malaria and its molecular mechanisms are under intense study, but the cognitive dysfunction that can persist in survivors in the aftermath of successful treatment has gone unrecognized until recently," says Guy A. Zimmerman M.D., professor and associate chair for research in the University of Utah School of Medicine's Department of Internal Medicine and a contributor to the study. "This complication may impose an enormous social and economic burden because of the number of people at risk for severe malaria worldwide. Our findings demonstrate that, by using experimental models of cerebral malaria in mice, we can explore mechanisms of cognitive damage and also examine potential treatments for reducing or preventing neurologic and cognitive impairment." Zimmerman and colleagues in Brazil studied the persistence of cognitive damage in mice with documented cerebral malaria after cure of the acute parasitic disease with chloroquine, an antimalarial therapy. By administering a battery of behavioral tests to these mice, post-doctoral postfellow Patricia Reis, Ph.D., determined that impairment in memory skills was still present 30 days after the initial malaria infection. Cognitive deficits that persist for years after the episode of cerebral malaria have also been reported in 11 percent to 28 percent of children who survive the infection. "Although we believe that long-term cognitive dysfunction after cerebral malaria is initiated by longinjury to the brain during the initial period of untreated infection, it is possible that the mechanisms

Malaria And Algae Linked To Common Ancestor By 'Little Brown Balls' Unconspicuous "little brown balls" in the ocean have helped settle a long-standing longdebate about the origin of malaria and the algae responsible for toxic red tides, according to a new study by University of British Columbia researchers. In an article published this week in the Proceedings of the National Academy of Sciences Early Edition, UBC Botany Prof. Patrick Keeling describes the genome of Chromera and its role in definitively linking the evolutionary histories of malaria and dinoflalgellate algae. algae. "Under the microscope, Chromera looks like boring little brown balls," says Keeling. "In fact, the ocean is full of little brown and green balls and they're often overlooked in favour of more glamorous organisms, but this one has proved to be more interesting than its flashier cousins." First described in the journal Nature in 2008, Chromera is found as a symbiont inside corals. Although it has a compartment - called a plastid - that carries out photosynthesis like other algae and plants, Chromera is closely related to apicomplexan parasites including malaria. This discovery raised the possibility that Chromera may be a "missing link" between the two. Now Keeling, along with PhD candidate Jan Janouskovec, postdoctoral fellow Ales Horak and collaborators from the Czech Republic, has sequenced the plastid genome of Chromera and found features that were passed down to both apicomplexan and dinoflagellate plastids, linking the two lineages. "These tiny organisms have a huge impact on humanity in very different ways," says Keeling. "The tool used by dinoflagellates and Chromera to do good - symbiosis with corals - at some point became an infection mechanism for apicomplexans like malaria to infect healthy cells. "Resolving their evolutionary origins not only settles a long-standing scientific debate but longcould ultimately provide crucial information for tackling diseases and environmental concerns."

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