Malaria

What are the five parasite species that cause Malaria in Humans?

1. P. falciparum

2. P. vivax

3. P. ovale

4. P. malariae

5. P. knowlesi

Which parasite causes malaria?

Plasmodium

Basic overiview of cycle of infection

sporozoites from mosquito → Liver → merozoites → gametocytes

which stage of their life cycle allows for maintenacne of transmission?

Gametocytes

Which plasmodium species is more prevalent in Africa

P. Falciparum

Which plasmodium species is more prevalent in the Americas?

P. vivax

WHO Africa region: children under 5 accounted for about __% of all malaria deaths

80

Malaria trends (3)

• shifts in species predominance (ex. Costa Rica)

• decrease in incidence

• decrease in mortality rate

Malaria symptoms

• first

  • fever

  • chills

  • headache

• other

  • myalgia

  • arthalgia

  • fatigue

  • abdominal pain

  • diarrhea

  • vomitting

  • altered mental status

symptom onset is typically

10-15 days after bite

If P. falciuparum is not treated WITHIN 24 hours, it can lead to

severe illness and death

severe malaria

• impaired consciousness/coma

• severe anemia

• acute kidney injury

• acute respiratory distress syndrome

• circulatory collapse/shock

• dissmeniated intravscular coagulation

• spontaneous bleeding

• acidosis/jaundice

• parasite density of >= 5%

severe childhood malaria is a ______-system disease

multi

• cerebral malaria

• severe malarial anemia

• respiratory distress

predictors of death (severe childhood malaria)

• coma

• markers of metabolic imbalance

  • acidosis

  • hypoglycemia

• renal failure

2 main malaria diagnostic methods

1. light microscopy (thick and thin smear)

2. rapid diagnostic tests

thick smear

higher sensitivity for detecting parasites

thin smear

species differentiation and quantification

Rapid diagnostic tests

can ONLY detect antigens not if there are and how many parasites

uncomplicated malaria regimen factors (4)

• Plasmodium species

• rick of cholorquine-resistance

• drug availability

• geographic area of acquisition

uncomplicated malaria that is likely chloroquine sensitive

chloroquine

hydroxichloroquine

uncomplicated malaria that is likely chloroquine resistant

• Atovaquone-proguanil (Malarone)

• Artemether-lumefantrine

• Quinine plus (doxycycline, tetracycline or clindamycin)

• Mefloquine (Lariam)

relapse prevention (P. vivax or P. ovale)

add primaquine

severe malaria should be managed in the __________

HOSPTIAL

• parenteral treatment w/ chemotherapy

• blood smears should be repeated every 12-24 hours

challenges to eradicating malaria

• lack of sustainable and predictable intl funding

• risks posed by conflict in malaria endemic zones

• anomalous climate patterns

• emergence of parasite resitance to antimalarial medicines

• insecticide resistance

parasitic disease is transmitted by __________ mosquitos

anopheles

the most important plasmodium species

1. P. falciparum

2. P. vivax

Which continent has the highest global malaria burden?

Africa

acute febrile Illness (3 symptoms)

fever

headache

chills

Which demographic is the most vulnerable and has the higher mortality?

children under 5

how is malaria diagnosed?

• blood smears

• RDT

treatment depends on the ________ _______ (1 main factor)

geographic area