Malaria

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Cause

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Plasmodium species (P. falciparum, P. vivax, P. ovale, P. malariae)

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Vector

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Female Anopheles mosquito

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16 Terms

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Cause

Plasmodium species (P. falciparum, P. vivax, P. ovale, P. malariae)

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Vector

Female Anopheles mosquito

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At risk

  • Children (immature immunity)

  • Travelers from non-endemic → endemic areas (no immunity)

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P. vivax, P. ovale

  • 48 hour cycle (tertian)

  • Forms hypnozoites → relapse (Dormant liver stage)

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P. malariae

  • 72 hour cycle (quartan)

  • Chronic infection

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P. falciparum

  • 48 hour cycle (tertian)

  • Most severe, fatal, cerebral malaria

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Life Cycle of Plasmodium: In Human (Asexual)

1. Exo-erythrocytic (Liver) Stage

2. Erythrocytic Cycle (Blood Stage)

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Exo-erythrocytic (Liver) Stage

  • Mosquito injects sporozoites

  • Sporozoites travel via bloodstream to liver

  • Invade hepatocytes → multiply → form schizont

  • Schizont ruptures → merozoites released

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2. Erythrocytic Cycle (Blood Stage)

  • Merozoites invade RBCs

  • Develop:
    Ring stage (immature trophozoite)trophozoiteschizont

  • Schizont ruptures → more merozoites

  • Some trophozoites → gametocytes

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Life Cycle of Plasmodium: In the Mosquito (Sexual Phase)

  • Gametocytes (from human blood) ingested

  • Male gametocyte produces 8 microgametes

  • Fusion of male + female gametes → zygote (only diploid stage)

  • Zygote → ookinete (motile)

  • Ookinete → oocyst on midgut wall

  • Oocyst → sporozoites (1000+ each)

  • Sporozoites migrate to salivary glands

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Pathophysiology & Symptoms

  • Fever: from synchronized RBC rupture

  • Anaemia: due to RBC destruction and suppressed erythropoiesis

  • Hypoglycaemia: due to parasite glucose consumption

  • ARDS: in severe malaria

  • Organ effects:

    • Hepatomegaly (liver enlargement)

    • Splenomegaly (spleen enlargement)

  • Blackwater fever: haemoglobinuria

  • Capillary blockage: via cytoadhesion of iRBCs to endothelium

  • Immunosuppression: increased risk of sepsis

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Diagnosis

Blood smear (Giemsa-stained) to detect and identify Plasmodium species

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Treatment: Chemotherapy

  • Chloroquine:

    • Enters parasite’s food vacuole (FV)

    • Acidified FV traps CQ → inhibits haemozoin formation

    • Free haem is toxic → kills parasite

  • Chloroquine resistance is widespread

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Treatment: Vaccination

RTS,S/AS01: approved for use in children in high-P. falciparum transmission regions

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Prevention

  • Take antimalarials for a few weeks after leaving endemic area

  • Use of mosquito nets, repellents, and vector control

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Transmission routes

  • Mosquito bite (most common)

  • Airport malaria: mosquito travels by plane

  • Blood transfusion

  • Shared needles

  • Congenital (mother → baby)

  • Introduced malaria: local mosquitoes bite infected traveler