微生物與疾病

MALARIA
第七組成員：翁正恆 00973056
謝承恩 00956024
王文玄 01153010
呂昌泰 0116F045
1. HISTORY, OUTBREAKS AND
EPIDEMIOLOGY
(1)HISTORY
Over millennia, its victims have included Neolithic
dwellers, early Chinese and Greeks, princes and paupers.

Many historians speculate that falciparum malaria

( deadliest form) contributed to the fall of Rome. The
malaria epidemic of 79 AD devastated the fertile, marshy
croplands surrounding the city, causing local farmers to
abandon their fields and villages.

In the 20th century alone, malaria claimed between

150 million and 300 million lives. Its chief sufferers today are
the poor of sub-Saharan Africa, Asia, the Amazon basin, and
other tropical regions.
 In the mid-20th century, the
development of new drugs such as
chloroquine and DDT insecticide
greatly reduced the burden of
malaria in many parts of the world.
However, in recent decades, the
emergence of drug-resistant strains
of the parasite and insecticide-
resistant mosquitoes has posed new
challenges in the fight against
malaria.
(2)OUTBREAKS
Major malaria outbreaks in history
1.The Great Malaria Epidemic of 1927-1938 in the Soviet Union:
This epidemic was one of the largest in history, with an estimated 13 million cases and 600,000
deaths. It affected large areas of the Soviet Union, particularly in the Volga River region.

2.The Malaria Epidemic of World War II:

During World War II, malaria was a major problem for military forces fighting in tropical and
subtropical regions. The disease affected soldiers on both sides of the conflict, with an estimated 500,000
cases among Allied troops in the Pacific theater alone.

3.The Malaria Epidemic in Sub-Saharan Africa:

Malaria has been endemic in sub-Saharan Africa for centuries, and has had a significant impact on
human populations in the region. In recent decades, there have been several major outbreaks, including
the epidemic in East Africa in the 1990s that affected millions of people and resulted in hundreds of
thousands of deaths
(3)EPIDEMIOLOGY
◦ Malaria is a major public health problem in many parts of the world, particularly in sub-Saharan Africa where the
disease is endemic. According to the World Health Organization (WHO), there were an estimated 229 million cases of
malaria worldwide in 2019, with 94% of these cases occurring in the WHO African region.

◦ The burden of malaria falls disproportionately on children under the age of 5 and pregnant women, who are
particularly vulnerable to severe forms of the disease. In 2019, an estimated 409,000 people died from malaria, with the
majority of these deaths occurring in sub-Saharan Africa.

◦ Malaria is caused by Plasmodium parasites, which are transmitted to humans through the bites of infected female
Anopheles mosquitoes. The disease can be prevented through the use of insecticide-treated bed nets, indoor residual
spraying, and other vector control measures. Treatment typically involves the use of antimalarial drugs, which can cure the
disease if administered promptly and appropriately.
Symptoms
●Fever and Flu-like illness
●Fatigue
●Headache and Confusion
●Muscle and joint pain
●Nausea and Vomiting
●Difficulty breathing, Seizures
and Organ Failure
Microbes and pathogenesis
microbes
-Malaria is caused by protozoa of the genus Plasmodium.
-Four species cause disease in humans: P falciparum, P vivax, P ovale
and P malariae.
-Other species of plasmodia infect reptiles, birds and other mammals. -
Malaria is spread to humans by the bite of female mosquitoes of the
genus Anopheles.
Microbes and pathogenesis
pathogenesis
-Clinical illness is caused by the erythrocytic stage of the parasite.
-In the case of falciparum malaria (the form that causes most deaths),
infected erythrocytes adhere to the endothelium of capillaries and
postcapillary venules, leading to obstruction of the microcirculation
and local tissue anoxia.
-In the brain this causes cerebral malaria; in the kidneys it may cause
acute tubular necrosis and renal failure; and in the intestines it can
cause ischemia and ulceration, leading to gastrointestinal bleeding and
to bacteremia secondary to the entry of intestinal bacteria into the
systemic circulation.
-The severity of malaria-associated anemia tends to be related to the
degree of parasitemia.
-The pathogenesis of this anemia appears to be multifactorial.
-Hemolysis or phagocytosis of parasitized erythrocytes and ineffective
erythropoiesis are the most important factors, and phagocytosis of
uninfected erythrocytes and an autoimmune hemolytic anemia have
also been implicated.
-Massive intravascular hemolysis leading to hemoglobinuria and renal
failure is referred to as blackwater fever.
-It was described more frequently in the past than currently. Hemolysis
may also occur after the use of certain antimalarials (especially
primaquine) in patients with glucose 6-phosphate dehydrogenase
deficiency.
-The fever and chills of malaria are associated with the rupture of
erythrocytic-stage schizonts.
-In severe falciparum malaria, parasitized red cells may obstruct
capillaries and postcapillary venules, leading to local hypoxia and the
release of toxic cellular products.
-Obstruction of the microcirculation in the brain (cerebral malaria) and
in other vital organs is thought to be responsible for severe
complications.
-Cytokines (e.g., tumor necrosis factor) are also felt to be involved, but
at present their role is unclear.
4. TREAMENT (POTNETIAL)
 (1)DIAGNOSIS
To diagnose malaria, your doctor will likely review patient’s
medical history and recent travel, conduct a physical exam, and
order blood tests. Blood tests can indicate:

● The presence of the parasite in the blood, to confirm

that you have malaria
● Which type of malaria parasite is causing your
symptoms,like plasmodium falciparum ,P.vivax……
● If your infection is caused by a parasite resistant to
certain drugs
● Whether the disease is causing any serious
complications
(2)CLASSIFICATION

Treatment is depended on diagnosis result,because every patient’s condition may be different.Following

shows some ways to classify:

● Which type of malaria parasite you have

● The severity of your symptoms
● Your age
● Whether you're pregnant
(3)MEDICATION
The most common antimalarial drugs include:

● Chloroquine phosphate. Chloroquine is the preferred treatment for any parasite that is
sensitive to the drug. But in many parts of the world, parasites are resistant to
chloroquine, and the drug is no longer an effective treatment.
● Artemisinin-based combination therapies (ACTs). ACT is a combination of two or
more drugs that work against the malaria parasite in different ways. This is usually the
preferred treatment for chloroquine-resistant malaria. Examples include artemether-
lumefantrine (Coartem) and artesunate-mefloquine.

Other common antimalarial drugs include:

● Atovaquone-proguanil (Malarone)
● Quinine sulfate (Qualaquin) with doxycycline (Oracea, Vibramycin, others)
● Primaquine phosphate
(4)OTHER POINTS

● All severe cases must treat with quinine or artemisinin by injection ,not by mouth
● In the period of treatment,it is critical to count the number of parasites til cure.Generally
speaking, if the value of parasites numers in people’s body in the non-epidemic area is
higher than 25% of the initial value or parasites aren’t killed totally after 7 days from
getting treatment,it may be malaria with resistance.
SOURCE MATERIAL:
https://www.ncbi.nlm.nih.gov/books/NBK215638/#:~:text=Many%20historians%20speculate%20that%20falciparum,abandon%20their%
20fields%20and%20villages.

https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.cdc.gov%2Fmalaria%2Fabout%2Fdistribution.html&psi
g=AOvVaw0p-kx5mzmjwx2qeAiKs8wX&ust=1683047732773000&source=images&cd=vfe&ved=0CBMQjhxqFwoTCID2
rMTP1P4CFQAAAAAdAAAAABAf

https://ourworldindata.org/malaria

https://www.who.int/news-room/fact-sheets/detail/malaria

https://www.wanda.be/en/a-z-index/malaria-world-map/

https://samedaydoctor.org/new-treatment-for-malaria/
https://samedaydoctor.org/new-treatment-for-malaria/

https://www.mayoclinic.org/diseases-conditions/malaria/diagnosis-treatment/drc-20351190

https://www.verywellhealth.com/how-malaria-is-diagnosed-4160747

https://www.ncbi.nlm.nih.gov/books/NBK8584/#:~:text=Malaria%20is%20caused%20by%20protozoa,mosquitoes%20
of%20the%20genus%20Anopheles
.
Thank You