PLASMODIUM

FALCIPARUM
MALARIA

THE DISEASE IS CAUSED BY PROTOZOA

PARASITE

THE GENUS IS PLASMODIUM

THE SPREADING OF MALARIA OCCUR BY THE
BITE OF THE PLASMODIUM-INFECTED FEMALE
ANOPHELES

THIS CLASSIC DISEASE IS SIGNED BY

PERIODICAL HIGH-TEMPERATUR FEVER DAN
INTERMITEN TYPE OF FEVER.
THE SPREADING

 VECTOR: ANOPHELES
MOSQUITOS
 BLOOD TRANSFUSION
 ORGAN
TRANSPLANTATION
 CONGENITAL
 THE PICTURE OF
PLASMODIUM FALCIPARUM
PLASMODIUM FALCIPARUM

 THE MOST DANGEROUS MALARIA:

CEREBRAL MALARIA RISK, RENAL
FAILURE, ACUTE DISTRESS SYNDROME,
AND CHRONIC ANEMIA
 EARLIER THERAPY IS VERY IMPORTANT
 IF THE PATIENT IS GIVEN THERAPY AND
GET WELL, THERE’S NO RELAPS RISK
BECAUSE P. FALCIPARUM DOESN’T HAVE
HEPAR DOMAT STADIUM (HYPNOZOITE)
THE HISTORY OF MALARIA
 MALARIA SPREAD IN NIL VALLEY AND
LITTLE ASIA ON 3000-4000 BC
 EXPLAINED ON ANCIENT GREEK TIME ,
400 BC
 1880: CHARLES LAVERAN FOUND MALARIA
PARASITE IN HUMAN BLOOD
 1897: RONALD ROSS DEMONSTRATED THE
SPREADING OF MALARIA BY MOSQUITOS
 1948: SHORTT AND PC. C GAMHAM FOUND
HYPNOZOITES
MALARIA EPIDEMIOLOGY

 300-500 MILLION OF HUMAN IN ALL OVER THE

WORLD ARE INFECTED BY MALARIA
 120 MILLION CLINICAL CASES EVERY YEAR
 40% OF WORLD POPULATION LIVE IN WHERE
ENDEMIC TRANSMISSION HAPPEN, ESPECIALLY
IN SUB-SAHARA AFRICA (92 COUNTRIES)
 DIE IS CAUSED BY ACUTE MALARIA, MULTIPLE
ORGAN FAILURE, CHRONIC ANEMIA, ACUTE
REPIRATORY DISTRESS SYNDROME (ADRS),
AND PLACENTAL MALARIA WHICH IS CAUSED
BY PLASMODIUM FALCIPARUM
MALARIA DISTRIBUTION
THREE STADIUMS OF MALARIA PARASITE
LIFE CYCLE’S

 HEPAR
 ERITROSIT
 MOSQUITOS
LIFE CYCLES OF MALARIA
PARASITE
 INCUBATION PERIOD OF MALARIA

DEPEND ON THE HEPAR STADIUM OF

MALARIA PARASITE
 P. FALCIPARUM 12 DAYS
 P. VIVAX 14 DAYS*
 P. OVALE 14 DAYS*
 P. MALARIAE 30 DAYS

*IN SOME STRAINS, IT CAN TAKE 8-10

MONTHS
CLINICAL SYMPTOM(S) OF MALARIA:

 BLOOD PARASITE STADIUM IS RESPONSIBLE

FOR CLINICAL MANIFESTATION
 FEVER IS THE MOST COMMON SYMPTOM
 CLASSIC PAROKSISMAL SIKLIK SYMPTOM
  COLD STADIUM: SHIVER AND WOBBLE
  HOT STADIUM: WARM BODY, HEADACHE,
VOMIT
 SWEATY STADIUM: WEAK
 OTHER SYMPTOMS: QUEASY, DIARHEA,
MUSCLE PAIN, AND THE CHANGE OF
MENTAL STATUS
 FEEL HEALTH ON THE CERTAIN PERIOD OF
TIME, AND THEN THE CYCLE RECUR BY
ITSELF.
ACUTE MALARIA

ACUTE MALARIA INCLUDE OF:

1. ANEMIA:
 CAUSED BY P. FALCIPARUM
 DESTRUCTION OF ERITROSIT WHICH CONTAINS
PARASITES BECAUSE OF THE DECREASING OF OXYGEN
TRANSPORT CAPABILITY
 THE INCREASING OF TRANSFORMATION VELOCITY OF
ERITROSIT WHICH IS INFECTED FROM CIRCULATION
 ENTHROPOIESIS SUSPRESSION
 THE DESTRUCTION OF ERITROCHYTE IMMUNITY
 IT USUALLY HAPPENS IN <2 YEARS OLD CHILDREN
2. CEREBRAL MALARIA:

 THE SYNDROM WHICH IS DEFINED AS

“KOMA” THAT IS NOT CAUSED BY
ANOTHER REASON, WITH VARIOUS
PARASITEMIA LEVEL OF P. FALCIPARUM
 1% INFECTION OF P. FALCIPARUM
CONTINUES TO CEREBRAL MALARIA AND
10%-20% FROM THIS CASES CAUSES
DEADNESS.
 IT USUALLY HAPPENS TO <2 YEARS OLD
CHILDREN
CEREBRAL MALARIA
 RESPIRATORY DISTRESS SYNDROME (RDS):

 A DESCRIPTION OF MALARIA THAT INFECT

CHILDREN IN AFRICA AND ADULT IN ASIA
 IT CAN BE CAUSED BY INJURY OF LUNGS
ENDOTEL MICROVASKULER AND ALVEORAL
EPITEL TROUGH THE MECHANISM OF
PROINFLAMASI
 IT CAN BE CAUSED BY HEART FAILURE, THE
PARASITE’S CROCKERY, OR THE INCREASING
OF RESPIRATION NEEDS.
 OFTEN RELATED TO METABOLIK ASIDOSIS
 THE FACTOR(S) WHICH CAUSE THE
INCREASING OF MALARIA INCIDENT:

 MEDICINE RESISTANCE
 INSECTICIDE RESISTANCE
 ECONOMIC FACTOR
 POLITICAL CONFUSION
 LACK OF SOCIAL HEALTH
INFRASTRUCTURE
 LACK OF INTEREST GLOBALLY
 HUMAN BEHAVIOUR
 THE PROTECTION PRINCIPAL FROM
MALARIA:

 WARY OF THE RISKS, INCUBATION PERIOD,

AND PROMINENT SYMPTOM
 AVOID FROM MOSQUITOS BITE,
ESPECIALLY FROM TWILIGHT TO DAWN.
 CONSUME ANTI MALARIA MEDICINES AS
THE KEMOPROFILAKSIS TO PRESSURE
INFECTION, IF NEEDS
 LOOK FOR THE DIAGNOSIS AND GET
EARLIER THERAPY IF YOU SUFFER FEVER
FOR ONE WEEK OR MORE AFTER
ENTERING REGION WHICH HAS MALARIA
RISK UNTIL ONE YEAR AFTER LEAVING
THE REGION.
 PERSONAL PROTECTION FROM MALARIA:

 AVOID THE MALARIA REGION

 STAY AT HOME FROM TWILIGHT UNTIL
DAWN, ESPECIALLY IN ROOM WITH
MOSQUITO NET OR IN AIR CONDITIONED-
ROOM.
 USE THE INSECT SPRAY TO THE ROOM AND
MOSQUITO NET
 WEAR LONG-ARM SHIRT AND PANTS
 APPLY DEET LOTION ON THE SURFACE OF
THE SKIN
 USE MOSQUITO NET
THE FACTORS WHICH INFLUENCE THE CHOOSING
OF MALARIA KEMOPROFILAKSIS MEDICINE:

 MALARIA TYPE
 MEDICINE RESITANCE IN CERTAIN AREA
 INDONESIA IS INCLUDED OF THE REGION
WHERE P. FALCIPARUM, P. VIVAX, AND P.
MALARIAE HAVE BEEN RESISTANCE FROM
CHIROQUINE
 ALLERGYC HISTORY OR OTHER REACTION
OF THE CHOOSEN ANTIMALARIA
MEDICINE
 THE SPECIAL CONDITION OF MEDICINE
USING, RELATED TO JOBS
 E.G: MEFIOQUINE IS FORBIDDEN FOR
PILOT AND DIVERS
 THE MEDICINES FOR PRIMAIR
MALARIA KEMOPROFILAKSIS
 KLOROKUIN

 MEFLOQUINE

 DOXYCYCLINE

 ATOVAQUONE-PROGUANI
(MALARONE)
 FIRST LINE THERAPY OF P.
FALCIPARUM FOR ADULT:

DAY 1: 4 TABLETS OD ARTESUNATE

4 TABLETS OF AMODIAKUIN
2-3 TEBLETS OF PRIMAKUIN
DAY 2: 4 TABLETS ARTESUNATE
4 TABLETS AMODIAKUIN
DAY 3: 4 TABLETS ARTESUNATE
4 TABLETS AMODIAKUIN
 SECOND LINE THERAPY OF P.
FALCIPARUM FOR ADULT:

DAY 1: KINA 3X2 TABLETS

TETRASIKLIN/DOKSISIKLIN 4x1CAPSULES
PRIMAKUIN 2-3 TABLETS

DAY 2-7: KINA 3x2 TABLETS

TETRASIKLIN/DOKSISIKLIN 4x1CAPSULES