This document summarizes malaria, including its history, symptoms, treatment, and complications. It notes that malaria was described in ancient Chinese and Greek literature and that the parasite was discovered in 1880. Symptoms include cyclic fevers, chills, and sweats. Treatment depends on the malaria species and severity, ranging from chloroquine for uncomplicated cases to intravenous quinine, artemisinins, or exchange transfusion for severe cases. Complications can include cerebral malaria, renal failure, and death if not promptly treated.

1. MALARIA
DR. AHMED ELAMIN AWADELAKARIM
Medical Resident

2. ∗ Disease was unknown.
∗ Symptoms was written in Chinese medical literature
(Nei Ching)2700 B.C .
∗ Hippocrates was the first one to describe malaria
symptoms.
∗ Mal-aria = mal air =bad air.
History and events

3. ∗ 1880 - Charles Louis Alphose Lavern discovered
malarial parasite in wet mount.
∗ 1883 - Methylene blue stain
∗ 1891 - Polychrome stain
∗ 1898 - Roland Ross - Life cycle of parasite.
∗ 1948 - Site of Exoerythrocytic development in Liver by
Shortt and Garnham.
∗ 1937 - Chloroquine discover in bayyer labs, but realesd
on 1946 .
History and events

6. ∗ Malaria caused by plasmodium parasites:
1. P. falciparum.
2. P. vivax.
3. P. ovale.
4. P. malarie.
5. P. knowlesi.

8. ∗ Un complicated malaria.
symptoms only.
∗ Complicated malaria
parasitemia 5-10%.
organ dysfunction.

9. Symptoms
∗ First stages:
• Cold – chills.
• Headache.
• Nausea .
• Vomiting.
• Malaise.
• Due to rupture of RBCs.
• Less than hour.

10. ∗ Second stage:
• Fever upto 40 c
• Nausea.
• Vomiting.
• Headache.
• Several hours
• Due to invasion of new RBCs
Symptoms

11. ∗ Third stage:
• Sweating.
• Nausea.
• Vomiting.
• Headache.
Symptoms

12. ∗ These symptoms cycling every:
∗ 72 hours for malarie.
∗ 48 hours for vivax.
∗ 48 hours for ovale.
∗ Irregular and tends
to be continuous for
falciparum.
Symptoms

13. Oral
Parenteral
Generally chloroquine and ACTs
Treatment of
un-complicated malaria

14. Treatment of
uncomplicated malaria

15. Treatment of
uncomplicated malaria

16. ∗ Artemether-lumefantrine.
∗
∗ Artesunate + Amodiaquin.
∗ Artesunate + Mefloquine.
∗ Artesunate + sulfadoxine–pyrimethamine. (fansidar)
Treatment of
uncomplicated malaria

17. ∗ P. vivax and p. ovale
∗ Chloroquine and primequine.
∗ ACTs and primequine.
Treatment of
uncomplicated malaria

19. Malignant malaria
Complicated malaria
Severe malaria

21. ∗ Altered mental status with or without convulsions.
∗ Hyperparasitemia.
∗ No alternative cause of coma.
Plus
∗ Malaria retinopathy.
∗ Blantyre coma scale ≤ 2. (paedia)
Cerebral malaria

22. Malaria retinopathies

24. ∗ Severe illness.
∗ Recurrent illnesses.
∗ Degree of anemia and parasitemia define needs of
BTX.
∗ Exchange transfusion no longer recommended to be
used for treatment of severe malaria.
Severe anaemia

26. ∗ Pathology unclear.
∗ Dehydration.
∗ Sequstration of RBCs.
∗ Vasoadherance.
Renal failure

28. ∗ Typhoid fever.
∗ Haemorrhagic fever.
∗ Meningitis.
∗ Pneumonia.
∗ Septicemia.
∆ ∆
D D

29. ∗ Good history: recent travel, duration of fever.
∗ physical assessment: ABC, pallor, jaundice, fundscopy
∗ Supportive measures : pulse oximeter, monitoring, O2
antipyretics, antiemetic,
rehydration….
∗ L.P should be done for all comatose pts to role out
meningitis.
Initial measures

31. ∗ Chinese medicine used for treatment of fever called
(qinghaosu).
∗ First line.
∗ Rapid in clearing parasitemia than quinine.
∗ More tolerable than quinine.
∗ No need to adjust the dose in renal and hepatic
failure.
∗ Side effects include: n&v, anorexia, dizziness and
delayed onset anemia.
Artemisinins

32. ∗ Extracted from cinchona tree.
∗ Induce insulin oversecretion.
∗ Hypoglycemia.
∗ Should be mixed with dextrose prep.
∗ QT prolongation.
∗ I.V only infusion and over 4 hours.
∗ Can be combined with deoxcycline, tetracycline or
clindamycin.
Quinine and Quinidine

33. ∗ Cinchonism
mild tinnitus, impaired hearing, headache,
nausea, disturbed vision, severe vomiting, abd
pain, diarrhoea, severe vertigo

34. 25th
of April

35. FEEL FREE TO CLAP