Malaria

(Plasmodium Malariae)

By: Sharmaine Marie Povananthiran Group 10 5th Year 1st semester Tropical Biology Medical Faculty Dr. Maria

Laveran in 1880 was the first to identify the parasites in human blood. Plasmodium. In 1889. and P. It can be life-threatening. C. Of the four species of malaria. pain and sweating. The other three species of malaria (P. fever. which infects red blood cells. vivax. The name "mal 'aria" (meaning "bad air" in Italian) was first used in English in 1740 by H. ovale) are generally less serious and are not life-threatening. the most serious type is Plasmodium falciparum malaria.Introduction Malaria is an infectious disease caused by a parasite. Malaria is characterized by cycles of chills. Historical records suggest malaria has infected humans since the beginning of mankind. R. P. . Walpole when describing the disease. malariae. The term was shortened to "malaria" in the 20th century. Ross discovered that mosquitoes transmitted malaria.

Plasmodium Plasmodium Malariae A Plasmodium sporozoite traverses the cytoplasm of a mosquito midgut epithelial cell in this false-color electron micrograph. Biduoterian fever. Blackwater fever. . Tertian malaria.Alternative Names: Quartan malaria. Falciparum malaria.

and Central and South America. anyone living in or traveling to a country where malaria is present can get the disease. . Malaria occurs in about 100 countries. approximately 40% of the world population is at risk for contracting malaria.Geographical Distribution Malaria is a particular problem and a major one in areas of Asia. Africa. Unless precautions are taken.

This produces an ookinete that penetrates the gut lining and produces an oocyst in the gut wall. while humans and other vertebrates are secondary hosts.Life Cycle The parasite's primary (definitive) hosts and transmission vectors are female mosquitoes of the Anopheles genus. This type of transmission is occasionally referred to as anterior station transfer. The sporozoites are injected into the skin. it releases sporozoites that migrate through the mosquito's body to the salivary glands. when the mosquito takes a subsequent blood meal. where they are then ready to infect a new human host. Young mosquitoes first ingest the malaria parasite by feeding on an infected human carrier and the infected Anopheles mosquitoes carry Plasmodium sporozoites in their salivary glands. . alongside saliva. When the oocyst ruptures. the parasite gametocytes taken up in the blood will further differentiate into male or female gametes and then fuse in the mosquito gut. A mosquito becomes infected when it takes a blood meal from an infected human. Once ingested.

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and will continue throughout the night until taking a meal. although this is rare. The females of the Anopheles genus of mosquito prefer to feed at night. thus males do not transmit the disease.Only female mosquitoes feed on blood. Malaria parasites can also be transmitted by blood transfusions. . They usually start searching for a meal at dusk.

This situation is termed relapsing malaria. 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. . vivax and P. Unfortunately.Incubation Period The period between the mosquito bite and the onset of the malarial illness is usually one to three weeks (seven to 21 days). some of these dormant parasites can remain even after a patient recovers from malaria. Certain types of malaria (P. to cause symptoms. so the patient can get sick again. These parasites remain dormant (inactive or hibernating) in the liver cells during this time. ovale) parasites can also take much longer. as long as eight to 10 months.

shock. falciparum malaria can develop bleeding problems. Cerebral malaria (coma. coma. cough. fever. Some patients develop nausea. or altered mental status or seizures) can occur with severe P. muscle aches. and diarrhea. about 15%-20% die. liver or kidney failure.Signs & Symptoms The symptoms characteristic of malaria include flu-like illness with fever. even with treatment. coughing. It is lethal if not treated quickly. diarrhea. There can sometimes be vomiting. vomiting. and yellowing (jaundice) of the skin and whites of the eyes due to destruction of red blood cells and liver cells. People with severe P. chills. falciparum infection. two. or three days are typical. central nervous system problems. and headache. . and can die from the infection or its complications. and sweating that repeat every one. Cycles of chills.

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suggest malaria as a diagnosis. Other tests based on immunologic principles exist. Malaria tests are not routinely ordered by most physicians in developed countries so recognition of travel history is essential. correct results are dependent on the technical skill of the lab technician who prepares and examines the slides with a microscope. Some investigators suggest such immunologic based tests be confirmed with a Giemsa blood smear. The classic and most used test is the blood smear on a microscope slide that is stained (Giemsa stain) to show the parasites inside red blood cells. These are not yet widely available a nd are more expensive than the traditional Giemsa blood smear. . including RDT's (rapid diagnostic tests) approved for use in the U. when associated with travel to countries that have identified malarial risk.S.Diagnosis Clinical symptoms listed above. Although this test is easily done. in 2007 and the polymerase chain reaction (PCR) tests.

.Blood smear from a P. falciparum culture(K1 strain). Several red blood cells have ring stages inside them. Close to the center there is a schizont and on the left a trophozoite.

Treatment Three main factors determine treatments: the infecting species of Plasmodium parasite. and the drug susceptibility of the infecting parasites. Since people infected with P. Different areas of the world have malaria types that are resistant to certain medications. Drug susceptibility is determined by the geographic area where the infection was acquired. adult. . falciparum malaria can die (often because of delayed treatment). The correct drugs for each type of malaria must be prescribed by a doctor who is familiar with malaria treatment protocols. the clinical situation of the patient (for example. immediate treatment for P. child. or pregnant female with either mild or severe malaria). falciparum malaria is necessary.

acidosis. and/or parasitemia [parasites in the blood] of > 5%) requires intravenous (IV) drug treatment and fluids. malariae are susceptible to chloroquine. disseminated intravascular coagulation. renal failure. Unfortunately. severe anemia. Chloroquine phosphate is the drug of choice for all malarial parasites except for chloroquineresistant Plasmodium strains. repeated generalized convulsions. Although almost all strains of P. pulmonary edema. P. P. ovale strains have been reported as resistant to chloroquine. resistance is usually noted by drug-treatment failure in the individual patient. Drug treatment of malaria is not always easy. acute respiratory distress syndrome. severe malaria (one or more symptoms of either impaired consciousness/coma. vivax and even some P. hemoglobinur ia[hemoglobin in the urine]. shock. spontaneous bleeding. jaundice. . falciparum.Treatment (cont¶d) Mild malaria can be treated with oral medication.

but if acquired in sub-Sahara African countries. Adoxa. There are specialized labs that can test the patient's parasites for resistance. treatment is usually based on the majority of Plasmodium species diagnosed and its general drug-resistance pattern for the country or world region where the patient became infested.Treatment (cont¶d) There are. however. . is usually resistant to chloroquine. For example. Consequently. quinine sulfate plus doxycycline [Vibramycin. multiple drug-treatment protocols for treatment of drug resistant Plasmodium strains (for example. Atridox] or tetracycline [Achromycin]. but this is not done frequently. falciparum acquired in the Middle East countries is usually susceptible to chloroquine. P. Oracea. or clindamycin [Cleocin]. oratovaquone-proguanil [Malarone]).

the 2008 CDC international travel recommendations suggest the following precautions be taken in malaria infested areas: Avoid exposure to mosquitoes during the early morning and early evening hours between the hours of dusk and dawn (the hours of greatest mosquito activity). If you must go to areas where malaria occurs.N-diethyl-m-toluamide). Wear appropriate clothing (long-sleeved shirts and long pants. for examples) especially when you are outdoors. Apply insect repellent to the exposed skin. take the prescribed preventive medicine. which is the most effective mosquito repellent for adults and children over 2 months of age. . avoid travel to or through countries where malaria occurs. In addition.Prophylactic Methods If possible. The CDC recommended insect repellent should contains up to 50% DEET (N.

.Prophylactic Methods (cont¶d) Spray mosquito repellents on clothing to prevent mosquitoes from biting through thin clothing. Use a permethrin-coated (or similar repellant) mosquito net over your all beds. Have screens over cover windows and doors. Spray permethrin or a similar insecticide in the bedroom before going to bed.

.THE END! Thank You For Your Attention.

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