Your SlideShare is downloading. ×
0
Malaria
Malaria
Malaria
Malaria
Malaria
Malaria
Malaria
Malaria
Malaria
Malaria
Malaria
Malaria
Malaria
Malaria
Malaria
Malaria
Malaria
Malaria
Malaria
Malaria
Malaria
Malaria
Malaria
Malaria
Malaria
Malaria
Malaria
Malaria
Malaria
Malaria
Malaria
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×
Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply

Malaria

1,898

Published on

Published in: Health & Medicine, Technology
0 Comments
1 Like
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total Views
1,898
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
114
Comments
0
Likes
1
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide

Transcript

  • 1. Malaria
  • 2. INTRODUCTION <ul><li>MALARIA IS A WORLDWIDE PROBLEM </li></ul><ul><li>2/3 of the world’s population living in this area </li></ul><ul><li>Could increase to 3/4 by 2010 </li></ul><ul><li>There are 250 million new infections per year </li></ul><ul><li>Problem: drug resistance, less money and effort for mosquito eradication programs </li></ul>
  • 3. GENERAL INFORMATION <ul><li>Malaria is caused by plasmodia </li></ul><ul><li>Transferred by the female anopheles mosquito </li></ul><ul><li>There are 4 species of the malaria parasites: </li></ul><ul><li>a) P. Vivax - most wide spread in the world </li></ul><ul><li>b) P. Falciparum - most FATAL </li></ul><ul><li>c) P. Malariae - not common </li></ul><ul><li>d) P. Ovale - rare </li></ul><ul><li>These are all found in South East Asia </li></ul>
  • 4. LIFE CYCLE OF MALARIA
  • 5. CHARACTERISTIC OF PLASMODIUM
  • 6.  
  • 7.  
  • 8. TYPICAL SYMPTOM OF MALARIA <ul><li>1. A VIOLENT FEVER: </li></ul><ul><li>Lasting 6-8 hours </li></ul><ul><li>Recurring every 2 or 3 days </li></ul><ul><li>Different species cause 2 types of intermittent fever: </li></ul><ul><li>a) A tertian fever has 1 day free of fever paroxysms </li></ul><ul><li>b) A quartana fever has two </li></ul>
  • 9. TYPICAL SYMPTOM OF MALARIA <ul><li>2) ANAEMIA </li></ul><ul><li>3) ENLARGEMENT OF THE SPLEEN </li></ul><ul><li>notes: </li></ul><ul><li>2&3 develop as the diseases progresses </li></ul>
  • 10. SIGNS & SYMPTOMS OF MALARIA VIVAX, MALARIAE OR OVALE <ul><li>There are no symptoms at first </li></ul><ul><li>8-30 days after the bite: feeling cold, aches, pains, weariness, nausea. </li></ul><ul><li>Attacks of fever, usually in 3 distinct phases </li></ul><ul><li>a) Cold stage; </li></ul><ul><li>Shivers and rigors for 1/4-1 hour as temperature rises, skin is cold , pale. Pulse rises, also often BP, diarrhea and urinary frequency may occur. </li></ul>
  • 11. SIGNS & SYMPTOMS OF MALARIA VIVAX, MALARIAE OR OVALE <ul><li>b) Hot stage: </li></ul><ul><li>Patients feel hot for about 1 hour, temp. 40 o C or more, skin is hot and dry, pulse rises, BP often falls, headache, delirium, thirst and vomiting are common (“crisis”). </li></ul><ul><li>c) Sweating stage: </li></ul><ul><li>temperature, BP, and pulse become normal (“lysis”) </li></ul><ul><li>After 1-2 hours patient often goes to sleep and feels well on waking up </li></ul>
  • 12. SI GNS & SYMPTOMS OF FALCIPARUM MALARIA <ul><li>There are no symptoms at first </li></ul><ul><li>8-14 days after bite, some hours to a few days: feeling cold, headache, backache, and pains all over, nausea, vomiting & diarrhea </li></ul><ul><li>The attack then occurs. The patient may appear to be very sick: </li></ul><ul><li>- pains in the head, bones and muscles are severe </li></ul><ul><li>- vomiting and diarrhea, mental confusion and delirium are common </li></ul>
  • 13. SIGNS & SYMPTOMS OF FALCIPARUM MALARIA <ul><li>- temperature is usually raised but rigors may not occur </li></ul><ul><li>- sweating is often severe </li></ul><ul><li>- pulse is usually fast, BP is usually low </li></ul><ul><li>- respiration rate is usually fast </li></ul><ul><li>- anemia quickly develops, jaundice sometimes present </li></ul><ul><li>- spleen is usually enlarged and tender liver is often enlarged </li></ul>
  • 14. COMPLICATIONS OF FALCIPARUM MALARIA <ul><li>Febrile fits (only in children) </li></ul><ul><li>Convulsions, unconsciousness, paralysis, psychotic behavior - CEREBRAL MALARIA </li></ul><ul><li>Acute anemia: - hypoxemia </li></ul><ul><li>Severe gastro intestinal disturbances </li></ul><ul><li>Shock </li></ul><ul><li>Hemolysis </li></ul><ul><li>Renal failure </li></ul><ul><li>Hypoglycaemia </li></ul>
  • 15. PREVENTING COMPLICATIONS OF FALCIPARUM MALARIA <ul><li>If treatment is given, there is usually a good response within a few hours. If it is not given or not correct or if it is not given quickly enough, complications can occur. </li></ul>
  • 16. DIAGNOSIS OF MALARIA <ul><li>History and clinical examination may suggest a likely parasite species candidate </li></ul><ul><li>Blood film microcopy </li></ul><ul><li>Take a precise travel history from the patient ( up to 2 years of history). Determine : </li></ul><ul><ul><li>when and where </li></ul></ul><ul><ul><li>was chemoprophylaxis taken </li></ul></ul><ul><ul><li>any previous attacks of malaria </li></ul></ul>
  • 17. ANTI MALARIA PROPHYLAXIS <ul><li>GENERAL RULES </li></ul><ul><li>Fansidar as a prophylactic is no longer recommended due to side effect </li></ul><ul><li>Mefloquine (Larium) should be considered of the lack of consistent local availability, incidence of psychological and fine motor control side-effects (for short term is quite useful) </li></ul><ul><li>Always check for allergy to medication </li></ul><ul><li>Should be commenced 1-2 weeks before entering a malarious area and should be continued for 4 weeks after returning (except Doxycycline ) </li></ul>
  • 18. ANTI MALARIA PROPHYLAXIS <ul><li>Doxycycline (Vibramycin) : alternative for short stays (up to 6 weeks) can be supplemented with weekly Chloroquine (it is not for children & pregnant women) </li></ul><ul><li>Taking supplements of vitamin B 2 weeks before hand </li></ul><ul><li>The medicine should enough to last trip (stay) </li></ul>
  • 19.  
  • 20. SUMMARY OF TREATMENT MALARIA VIVAX,MALARIAE, OVALE <ul><li>Chloroquine 10mg/kg BW for adult, followed by chloroquine 300 mg 6 hours later </li></ul><ul><li>Then Chloroquine 300 mg day 2, 300 mg day 3 </li></ul><ul><li>PLUS Primaquine 15 mg daily for 14 days </li></ul><ul><li>OR Primaquine 45 mg weekly for 8 weeks if G6PD deficient </li></ul>
  • 21. SUMMARY OF TREATMENT MALARIA FALCIPARUM <ul><li>Quinine 10 mg/kgBW three times a day for 7-10 days </li></ul><ul><li>PLUS Fansidar 3 tablets on day 2 </li></ul><ul><li>OR Mefloquine 750 mg (3 tablets) at once & 500 mg 6 hours later </li></ul>
  • 22.  
  • 23. SPECIAL CONSIDERATIONS <ul><li>The following drugs should not be used if there is a : </li></ul><ul><li>Fansidar and similar drugs if it is a history of allergy to sulfa drugs </li></ul><ul><li>Chloroquine if there is history of psoriasis </li></ul><ul><li>Mefloquine or quinidine if taking beta blockers, digoxin, calcium-channel blockers. </li></ul>
  • 24. SPECIAL CONSIDERATIONS <ul><li>If mefloquine prophylaxis is used, do not use mefloquine or Quinine for treatment </li></ul><ul><li>After mefloquine treatment, patient should not drive, operate machinery, or pilot aircraft for 3 weeks </li></ul><ul><li>People with a history of psychiatric or epileptic disorder should not take mefoqluine </li></ul><ul><li>People with a history of epilepsy should not take chloroquine </li></ul>
  • 25. LABORATORY DETECTION OF MALARIA PARASITES <ul><li>When to draw blood for a smear ? </li></ul><ul><li>Do a fingerstick anytime you suspect malaria </li></ul><ul><li>Don’t worry about fever spikes or time of day </li></ul><ul><li>If you really suspect, but the smears are negative, keep doing smears </li></ul><ul><li>The worse the symptom are the more frequent the smears to be done </li></ul><ul><li>Once an hour should be the maximum frequency </li></ul>
  • 26. LABORATORY DETECTION OF MALARIA PARASITES <ul><li>Obtaining blood : </li></ul><ul><li>Freshly drawn blood is required </li></ul><ul><li>The blood may be obtained by fingerstick or venous puncture </li></ul><ul><li>Wipe the area with a dry cotton/sterile gauze </li></ul><ul><li>Lance the finger with a sterile lancet </li></ul><ul><li>Allow the blood freely, do not milk the finger </li></ul><ul><li>Wipe the first drop and touch the next drop to slide </li></ul>
  • 27. LABORATORY DETECTION OF MALARIA PARASITES <ul><li>Making Malaria Slide: </li></ul><ul><li>for routine malaria microscopy,a thin and a </li></ul><ul><li>thick film are made on the same slide. </li></ul><ul><li>for the procedure see hand out. </li></ul>
  • 28. LABORATORY DETECTION OF MALARIA PARASITES <ul><li>Thick smears </li></ul><ul><li>Using the corner of a clean slide, spread blood from the first slide to about the size of a dime. </li></ul><ul><li>The drop should be just thick enough to read newspaper print through it. </li></ul>
  • 29. LABORATORY DETECTION OF MALARIA PARASITES <ul><li>Thin smears </li></ul><ul><li>It is best to spread this slide first </li></ul><ul><li>After obtaining the second the slide,immediately smear it. </li></ul><ul><li>Intact red blood cells are important because they are needed to compare with the size of malarial parasites. </li></ul>
  • 30. LABORATORY DETECTION OF MALARIA PARASITES <ul><li>Examination thin films </li></ul><ul><li>Put immersion oil on the slide </li></ul><ul><li>Switch to oil-immersion objectives </li></ul><ul><li>Focus with 100x10 objectives on the thin terminal </li></ul><ul><li>end of the film where the red blood cells are in one </li></ul><ul><li>cells are in one layer </li></ul><ul><li>For examining malaria parasites,at least 200 field </li></ul><ul><li>field should be examined </li></ul>
  • 31. LABORATORY DETECTION OF MALARIA PARASITES <ul><li>Examination thick films </li></ul><ul><li>Put immersion oil on the slide </li></ul><ul><li>Focus on the film with 100X10 objective </li></ul><ul><li>Search for the plasmodium at least 100 fields. </li></ul><ul><li>Malaria parasites can be found (see leaflet as your guidance) </li></ul>

×