MALARIA

#17 Gales,Bea Trixia

#18 Gepulango, Ethel Princess
The word malaria comes from 18th century
Italian mala meaning "bad" and aria meaning "air".

the term was first used by Dr. Francisco Torti, Italy,
when people thought the disease was caused by foul
air in marshy areas.

Malaria is a disease of the blood that is caused by the
Plasmodium parasite, which is transmitted from
person to person by a particular type of mosquito.


THE ANOPHELES MOSQUITO
The female Anopheles mosquito is the only mosquito
that transmits malaria.
Serve as the vector that carries and transfers the
infectious agent (Plasmodium)
primarily bites between the hours of 9pm and 5am,
which is why sleeping under a mosquito net at night is
such an important method of prevention.



Plasmodium falciparum - the most serious form of the
disease. It is most common in Africa, especially sub-
Saharan Africa.
Plasmodium vivax - milder form of the disease,
generally not fatal. This species is most commonly
found in Asia, Latin America, and parts of Africa.
Plasmodium malariae - milder form of the disease,
generally not fatal. known to stay in the blood of some
people for several decades.



Plasmodium ovale. - rarely found outside Africa or the
western Pacific islands. Symptoms are similar to those
of P. vivax.
Plasmodium knowlesi -causes malaria in macaques but
can also infect humans.occurs in certain forested areas
of South-East Asia.





Kingdom Protista
Subkingdom Protozoa
Phylum Apicomplexa

Class Sporozoasida

Order Eucoccidiorida

Family Plasmodiidae

Genus Plasmodium

Species falciparum, malariae, ov
ale, vivax


The morphology of P. knowlesi parasites in human
infections:
closely resembled those of P. falciparum in the early
trophozoite stage
and P. malariae in the later stages of the erythrocytic
cycle.
Malaria commonly occur s in Central America, South America,
Caribbean, Africa, and Asia
The Malaria Control Program has categorized these 79 provinces based on the
5-year average .This helps the program in prioritizing resources in Categories A
& B provinces. Out of the 79 provinces, 57 are malaria endemic provinces. In
2007, 6 provinces have been added in the list of Category D provinces.
Involves two hosts,
Human and Anopheles
mosquitoes

The disease is transmitted
to humans when an
infected female
Anopheles mosquito bites
a person and injects the
malaria parasites
(sporozoites) into the
blood.

Sporozoites travel through
the bloodstream to the
liver, mature, and
eventually infect the
human red blood cells.


While in red blood cells,
the parasites again develop
until a mosquito takes a
blood meal from an
infected human and
ingests human red blood
cells containing the
parasites.
Then the parasites reach
the Anopheles mosquitos
stomach and eventually
invade the mosquito
salivary glands.
When an Anopheles
mosquito bites a human,
these sporozoites complete
and repeat the complex
Plasmodium life cycle.

Incubation means the time between becoming infected
and the appearance of symptoms. This generally
depends on the type of parasite:

P. falciparum - 9 to 14 days
P. vivax - 12 to 18 days
P. ovale - 12 to 18 days
P. malariae - 18 to 40 days

However, incubation periods can vary from as short as
7 days, to several months for P. vivax and P. ovale.

The first symptoms include fever, headache and
vomiting. . It is extremely uncommon for malaria to
cause skin lesions or rash.

If not treated within 24 hours, P. falciparum malaria
can progress to severe illness often leading to death.
Children with severe malaria
frequently develop one or more
of the following symptoms:
severe anaemia, respiratory
distress in relation to metabolic
acidosis, or cerebral malaria.

In adults, multi-organ
involvement is also frequent. In
malaria endemic areas, persons
may develop partial immunity,
allowing asymptomatic
infections to occur.

Demonstration of the parasites in peripheral blood is
important to a diagnosis

Several effective methods of diagnosis have been
developed:
Fluorescent dye staining
DNA probe specific for P. falciparum
PCR diagnostics
ELISA detection of P. falciparum antigen
WHO recommends that all cases of suspected malaria be
confirmed using parasite-based diagnostic testing (either
microscopy or rapid diagnostic test) before administering
treatment. These tests take less than 30 minutes to
perform.

Rapid tests can detect proteins called antigens that are
present in Plasmodium. However, the reliability of rapid
tests varies significantly from product to product. Thus, it
is recommended that rapid tests be used in conjunction
with microscopy.

the polymerase chain reaction (PCR) ,which detects
malaria DNA. Because this test is not widely available, it is
important not to delay treatment while waiting for results.

According to the CDC, the following drugs are commonly
used for treating malaria:
artemether-lumefantrine (Coartem)
atovaquone-proguanil (Malarone)
chloroquine
clindamycin (used in combination with quinine)
doxycycline (used in combination with quinine)
mefloquine (Lariam)
quinidine
quinine
artesunate

Most medications are available only as tablets or pills.
Intravenous treatment with quinidine may be needed
in severe malaria or when the patient cannot take oral
medications.

Patients with P. vivax or P. ovale may not be completely
cured by the above medications, even though the
symptoms resolve. This is because the parasites can
hide in the liver. A medication called primaquinine is
used to eradicate the liver form, but this drug cannot
be given to people who are deficient in an enzyme
called G6PD.






The best available treatment, particularly for P.
falciparum malaria, is artemisinin-based combination therapy
(ACT).

Artemether-lumefantrine: Coartem as the 1st line treatment of
uncomplicated P. falciparum cases, followed by Primaquine on
the 4th day of treatment.

Treatment of severe P.falciparum is a combination therapy of
quinine ampule/tablet plus any of the following antibiotics:
Tetracycline, Doxycycline or Clindamycin.

P. vivax cases are treated with Chloroquine for 3 days and
Primaquine for 14 days


PfSPZ, an unusual experimental malaria vaccine, developed
by Sanaria Inc. of Rockville, Maryland, USA, has shown
great promise in an early-stage clinical trial.
Trial researchers said the vaccine may provide 100%
protection against malaria infection in healthy adults.It is
said that PfSPZ has the best result for a malaria vaccine so
far.
. It uses weakened forms of the whole, immature
"sporozoite" phase of the parasite, and not an assortment
of parasite proteins to induce an immune response.

On October 10th, 2013, that a large-scale Phase III African
trial using the experimental malaria vaccine RTS,S
continued protecting young children up to 18 months after
vaccination.
The trial showed that RTS,S reduced cases of clinical
malaria in young children by 46% after the first vaccine,
compared to children of the same aged (5-17 months) who
received a control vaccine.
Babies aged six to twelve weeks had a 27% lower clinical
malaria incidence.

Vector control is the main way to reduce malaria
transmission at the community level

Two forms of vector control are effective in a wide range of
circumstances.

Insecticide-treated mosquito nets (ITNs)
Long-lasting insecticidal nets (LLINs) are the preferred form of ITNs
for public health distribution programmes.
The most cost effective way to achieve this is through provision of free
LLINs, so that everyone sleeps under a LLIN every night.


Indoor spraying with residual insecticides
Indoor residual spraying (IRS) with insecticides is a powerful way to
rapidly reduce malaria transmission. Its full potential is realized when
at least 80% of houses in targeted areas are sprayed. Indoor spraying is
effective for 36 months, depending on the insecticide used and the
type of surface on which it is sprayed.
Longer-lasting forms of existing IRS insecticides, as well as new classes
of insecticides for use in IRS programmes, are under development.

Antimalarial medicines can also be used to prevent
malaria:
For travellers, malaria can be prevented through
chemoprophylaxis, which suppresses the blood stage
of malaria infections, thereby preventing malaria
disease.
WHO recommends intermittent preventive treatment
with sulfadoxine-pyrimethamine for pregnant women
living in high transmission areas, at each scheduled
antenatal visit after the first trimester.
In 2012, WHO recommended Seasonal Malaria
Chemoprevention as an additional malaria prevention
strategy for areas of the Sahel sub-Region of Africa.

administration of monthly courses of amodiaquine
plus sulfadoxine-pyrimethamine to all children under
5 years of age during the high transmission season.

The vision of the Malaria Control Program is a malaria-free
Philippines by 2020. Strategies of the MCP include the
following:
1) Early diagnosis and prompt treatment
2) Vector control insecticide-treated mosquito net as main
vector control strategy, complemented by indoor residual
spraying
3) early management and disease surveillance
4) monitoring and evaluation drug and insecticide
resistance monitoring; drug quality monitoring (pilot study
to determine the baseline profile); Quality Assurance for
microscopy (GF sites) and Philippine Malaria Information
System at the provincial level.
Health services, including malaria control program
has been devolved to the local government units
(Local GovernmentCode of 1991).
The Department of Health has further undergone
reorganization to address its new role and mandate
under a decentralized set-up. The functions of the
DOH are policy formulation, advocacy, program
development, standard setting, technical assistance,
regulation and monitoring.


Gardner, MJ; Hall, N; Fung, E; White, O; Berriman, M; Hyman, RW; Carlton, JM; Pain, A;
Nelson, KE (2002). "Genome sequence of the human malaria parasite Plasmodium
falciparum". Nature 419 (6906): 498
511.Bibcode:2002Natur.419..408G.doi:10.1038/nature01097.PMID 12368864.
World Heath Organization http://www.who.int/mediacentre/factsheets/fs094/en/
Taxonomical Classification http://www. Msu.edu/course/zol/316/ pspptax.htm
Spread of malaria signs and symptoms http://www.cambodiafirstclinic.com/malaria/
Malaria in the Philippines
http://www.actmalaria.net/downloads/pdf/info/2008/Philippines%20Malaria%20Count
ry%20Profile%202008.pdf
Types of Malaria http://www.medicalnewstoday.com/articles/150670.php
Malaria http://www.emedicinehealth.com/malaria/page2_em.htm
Morphological Classification of Plasmodium
http://www.tulane.edu/`wiser/protozoology/notes/pl_sp.html
Morphological Classification of P.
knowlesihttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC2676309/