Case study
A 12-year-old boy from a very remote village in
Orissa attended the Debagarh CHC hospital with the
complaint of repeated history of fever with no other
complications.
At the time of admission, he gave history of 4 days
fever and his body temperature was recorded as 100.8°F
with chills & rigors. H/o Headache and vomiting +. His
pulse rate was 101/min and his respiratory rate was
28/min. The laboratory findings of blood test at the time
of admission were Hb≤12 gm/dL,
total leukocyte count-TLC- 4,000/mm3,
differential leukocyte count (DLC)- neutrophils-52%,
lymphocyte -45%, eosinophils -2%, monocyte-1%.
• Widal test- Negative
• Dengue rapid test- Negative
• Malaria rapid test (Pan & Pf)- Positive
• PS- showed normocytic normochromic anaemia
With P.falciparum ring forms & gametocytes.
MALARIA
• Morphology
• Life cycle
Objectiv • Pathogenesis
es
• Clinical features
• Treatment & prevention
Five species of Plasmodium can infect humans
and cause illness:
• Plasmodium falciparum(P. falciparum)
The • Plasmodium malariae (P. malariae)
Causativ
e Agent • Plasmodium vivax (P. vivax)
• Plasmodium ovale (P. ovale)
• Plasmodium knowlesi (P. knowlesi)
• A.culicifacies -
is the vector of
rural malaria
• A.fluviatilis -
in hilly regions
• A.Stephensi
The Vector urban malaria.
Anopheles
mosquito
Plasmodium completes life
cycle in two hosts.
Life • Definitive host:
Cycle Female Anopheles mosquito
• Intermediate host:
Man
• Sporogony Sporozoites
Life • Schizogony Merozoites
cycle Pre erythrocytic Schizogony
Erythrocytic Schizogony
Gametogony
How
malaria is
transmitt
ed
• Benign malaria
Clinical
features • Malignant tertian
Malaria(Falciparum malaria)
Febrile paroxysm
• Cold stage
• Hot stage
• Sweating stage
• Anaemia
• Splenomegaly
Malignan
t Tertian
Malaria
• Cerebral malaria
• Pernicious malaria
• Black water fever
• Algid malaria
Complicatio
• Pulmonary edema & adult respiratory
ns of distress syndrome
Falciparum • Hypoglycemia
Malaria • Renal failure
• DIC
• Severe jaundice
• Anaemia
• Tropical splenomegaly syndrome
Chronic
complicati • Quartan malarial nephropathy
ons of
malaria • Burkitt’s lymphoma??
• Transfusion malaria
Malaria in
special • Malaria in pregnancy
situations
• Malaria in children
• Innate
• Age of RBCs
• Hb nature
• Hereditary ovalocytosis/ G6PD
Immunit deficiency
• Nutritional status
y
• Acquired
• Infection immunity
Epidemiology
• Peripheral blood smear
Laborat • Fluorescence microscopy
ory • QBC
diagnosi
s of • RDTs
malaria • Culture
• Molecular diagnosis
• Specimen
1.Periphe
ral • Types
blood
smear • Advantages
2.
Fluorescence
microscopy
• Blood smears stained with
acridine orange
• Nuclear DNA stains- Green
3. Quantitative buffy
coat
Detect following antigens of
malaria
4.Rapid • pLDH
diagnost
• Parasite aldolase
ic tests
• Pf-HRP-II
• For preparation of Ag
5. • RPMI 1640, 1630
Culture • Dulbecco’s modified medium
• Nested multiplex PCR
6.
Molecular • Real time PCR
methods
• LAMP assay
• ESR
• Haematocrit assay
• CRP
7. Other • PT,APTT
methods • Blood sugar levels
• LFT, RFT
• Serum electrolytes
TREATMENT
• For Vivax malaria
• For Falciparum malaria
• For severe malaria
• Chemoprophylaxis
Prophylax • Vector control strategies
is
• vaccination
The Government of India has unveiled a plan to eliminate
Malaria by 2030.
‘National Framework for Malaria Elimination’
• Malaria month is
observed in June
every year
