MALARIA

MALARIA

 an acute and chronic parasitic disease

transmitted by the bite of infected
mosquitoes and confirmed mainly to
tropical and subtropical areas
 causes more disability and heavier
economic burden than any other
parasitic disease
MALARIA
ETIOLOGIC AGENT: Protozoa of genus
plasmodia
Caused by 4 species of protozoa:
1. Plasmodium falciparum (malignant tertian)
 most serious malarial infection because of
the development of high parasitic densities
in the blood (RBC)
 tends to cause agglutination, resulting in
microembolus formation
 most common in the Philippines
MALARIA
2. Plasmodium vivax (benign tertian)
 non-life-threatening, except for the very
young and the very old
 S/S: chills every 48 hours on the 3rd day
onward, especially if untreated
 
MALARIA
3. Plasmodium malariae (quartan)
 less frequently seen than the first two types
 non-life threatening
 Fever and chills usually occur every 72 hours,
usually on the 4th day after onset
 
4. Plasmodium ovale
 rare type of protozoan species
 rarely seen in the Philippines
MALARIA

Primary vector: female Anopheles mosquito

 breeds in clear, flowing and shaded streams
usually in the mountains
 bigger in size than ordinary mosquitoes
 brown in color
 a night-biting mosquito
 usually does not bite a person in motion
 assumes a 36 degree position when it alights on
walls, trees, curtains and the like
Female Anopheles Mosquito
MALARIA

INCUBATION PERIOD:
 12 days for P. Falciparum
 14 days for P. vivax and ovale
 30 days for P. malariae 

PERIOD OF COMMUNICABILITY
 more than 3 years in P. malariae
 1 to 2 years in P. vivax
 not more than 1 year on P. falciparum
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MODE OF TRANSMISSION
 mechanically through the bite of an
infected female Anopheles mosquito
 parenterally through blood transfusion
 shared contaminated needles (rare)
 transplacental transmission (rare)
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CLINICAL MANIFESTATIONS
 Paroxysms with shaking chills
 Rapidly rising fever with severe headache
 Profuse sweating
 Myalgia with feelings of well-being in between
 Splenomegaly, hepatomegaly
 Orthostatic hypotension
 Paroxysms may last for 12 hours and may attack
daily or every two days
MALARIA

In children:
 Fever may be continuous
 Convulsions and gastrointestinal symptoms are
prominent
 Splenomegaly
In cerebral malaria:
 severe headache, vomiting and changes in
sensorium
 Jacksonian or grand mal seizure
MALARIA

DIAGNOSTIC PROCEDURE
 Malarial smear – a film of blood is placed
on a slide, stained and examined
microscopically
 Rapid diagnostic test (RDT) – blood test to
detect malaria parasite antigen (can be
conducted outside the laboratory and in
the field); result in 10-15min
MALARIA
MANAGEMENT

1. Medical Management
 Anti – malarial drugs
 Chloroquine (all species, except for P. malariae)
 Quinine
 Sulfadoxine for the resistant P. falciparum
 Primaquine for relapses of P. vivax and ovale
 Erythrocyte exchange transfusion for rapid
production of high levels of parasites in the blood
 MALARIA
2. Nursing Management
 Close monitoring
 Monitor I/O
 Daily monitoring of serum bilirubin, BUN creatinine
and parasitic count
 If with respiratory and renal symptoms, determine
the ABG and plasma electrolyte
 tepid sponges, alcohol rubs and ice cap on the head
 external heat and hot drinks for chills
 provide comfort and psychological support
 encourage plenty of fluids
 MALARIA
 as the temperature falls and sweating begins,
warm sponge baths may be given
 keep bed and clothing dry
 monitor neurologic toxicity (from quinine
infusion) like muscular twitching, delirium,
confusion, convulsion and coma
 evaluate the degree of anemia
 watch for any signs, especially abnormal bleeding
 consider severe malaria as medical emergency
that requires close monitoring of vital signs
MALARIA

COMMON NURSING DIAGNOSES

 Hyperthermia
 Activity intolerance
 Knowledge deficit
 Altered nutrition: Less than body
requirement
 MALARIA
PREVENTION AND CONTROL
 Report all cases
 Thorough screening of all infected persons from
mosquitoes
 Destroy breeding places of mosquitoes
 Spray homes with effective insecticides that have
residual actions on the walls
 Mosquito nets should be used, especially in infected
areas
 Use insect repellents
 People living in malaria-infested areas should not
donate blood for at least three years
 Blood donors should be properly screened
Thank You!