It's a plasmodium lecture very well explained

2. a member of the phylum Apicomplexa, a large group of parasitic eukaryotes
The genus of the class of Sporozoa that includes the parasite that causes malaria
a type of protozoa, a single-celled organism that is able to divide only within a host cell.

3. Plasmodium falciparum is responsible for the majority of
malaria deaths globally and is the most prevalent species in sub-
Saharan Africa.
Plasmodium vivax, is the second most significant species and is
prevalent in Southeast Asia and Latin America.
Plasmodium ovale have the added complication of a dormant
liver stage, which can be reactivated in the absence of a
mosquito bite, leading to clinical symptoms.
Plasmodium malariae represent only a small percentage of
infections.

4. ASEXUAL PHASE
- takes place in man asexual
multiplication is called
schizogony.
- This takes place in 2 location
in RBC (erythrocytic
schizogony)* and in the liver
cells (exo-erythrocytic
schizogony)*
SEXUAL PHASE
- takes place in the Anopheles
mosquito in the form of
gametocytes
- sexual multiplication is called
sporogony*

6. INCUBATION PERIOD - the interval between the entry of the sporozoites into the host and
the earliest clinical manifestation.

7. P. vivax and ovale
undergo latent
stage in the form
of hypnozoites
release merozoites
4 species develop
in the liver

9. STAGES P. vivax P. ovale P. malariae P. falciparum
RING FORM
Large, single
prominent
thicker chromatin
Similar with P.
vivax but
compact
Similar with P.
vivax but
thicker
Delicate,small,
double chromatin
maurer’s dots and
multiple rings
TROPHOZOITE
Large irregular
vacuole
prominent
chromatin as
Schuffner’s dots
or threads
Compact rough
pigment large
irregular clumps
of chromatin
Characteristic
band form,
vacuole
inconspicuous
compact small
vacuole,
inconspicuous ,
seldom seen in
smear

10. P. vivax P. ovale P. malariae P. falciparum
SCHIZONT
Compact
pigment
Erythrocyte
persisting
Centrally clump
daisy form
Centralized
pigment
GAMETES
Round, dense
chromatin
Round
gametocytes
Female- Compact
chromatin
Male- diffuse
chromatin
Crescent shape
Common stages
found in smear
Trophozoites,
schizont,
gametocytes
Same as P. vivax Same as P. vivax Rings and
gametocytes

11. Sporogony phase
Anopheles mosquito ingest parasitized
erythrocytes.*
Gametocytes will go to the midgut of the
mosquito*
The gametes will produce 8 microgametes
Exflagellating male gametocytes*( 15 mins)
The female gametocytes* does not divide
but undergo maturation to become female
gamete
Fertilization will occur to form a zygote (1/2
to 2 hours)

12. Within 18-24hrs will become motile
(ookinete –travelling vermicule)*
Penetrates the epithelial lining of the
stomach wall become an oocyst*
within is numerous sporozoites
Mature oocyst goes to salivary
glands becomes infective
sporozoite*
Sporogony completes in 1-4 weeks

13. It is the periodic febrile response is caused by rupture of mature schizonts.
In P vivax and P ovale malaria, a brood of schizonts matures every 48 hr, so the
periodicity of fever is tertian (“tertian malaria”)
In P malariae disease, fever occurs every 72 hours (“quartan malaria”).
In falciparum malaria may occur every 24 - 48 hr, but is usually irregular, showing no
distinct periodicity.
Species P. vivax P. ovale P. malariae P. falciparum
Periodicity Tertian Tertian Quartan Irregular/tertian
Attacks Typical Typical Typical Intermittent/irregular
Recrudescence No No Yes Yes
Relapse Yes Yes No No
Complications Rare Rare Common Common

14. Recrudescene Relapse
Occurs within a few weeks or months of a
previous attack
Occurs within 24 weeks to 45 years after
the primary attacks
Can be prevented by adequate drug
therapy or use of newer antimalarial drugs
in case of drug resistance
Can be prevented by giving primaquine to
eradicate hypnozoites

17. The febrile paroxysm comprises
of 3 successive stage:
Cold stage- 15-60 minutes of
uncontrollable shivering
Hot stage - lasting for 2-6hours
temp goes 41 or higher
Sweating stage – temperature
drops rapidly, patient falls asleep
and wake up fresh

28. Burkitt lymphoma is named after British surgeon Denis Burkitt.
First identified this unusual disease in 1956 among children in
Africa.
In Africa, Burkitt lymphoma is common in young children who
also have malaria and Epstein-Barr, the virus that
causes infectious mononucleosis.
One mechanism may be that malaria weakens the immune
system's response to Epstein-Barr, allowing it to change infected
B-cells into cancerous cells.
About 98% of African cases are associated with Epstein-Barr

31. Prior to examination, the specimen is stained (most often with the Giemsa stain) to give the
parasites a distinctive appearance.**
This technique remains the gold standard for laboratory confirmation of malaria.*
It depends on the quality of the reagents, of the microscope, and on the experience of the
laboratorian.

33. PARALENS ADVANCE
LED FLOURESCENT
MICROSCOPE
ATTACHMENT

34. Antigen Detection

35. Antigen Detection
Serology detects antibodies against malaria parasites, using either indirect
immunofluorescence (IFA)* or enzyme-linked immunosorbent assay (ELISA).*

36. Various test kits are available to detect antigens derived from malaria parasites.
Such immunologic (“immunochromatographic”) tests most often use a dipstick or cassette
format, and provide results in 2-15 minutes.
These “Rapid Diagnostic Tests” (RDTs) offer a useful alternative to microscopy in
situations where reliable microscopic diagnosis is not available.
Malaria RDTs are currently used in some clinical settings and programs.

37. Parasite nucleic acids are detected using polymerase chain reaction
(PCR).
This technique may be slightly more sensitive than smear microscopy,
Limited utility for the diagnosis of acutely ill patients in the standard
healthcare setting.
PCR results are often not available quickly enough to be of value in
establishing the diagnosis of malaria infection.
PCR is most useful for confirming the species of malarial parasite after
the diagnosis has been established by either smear microscopy or RDT.

43. TREATMENT :
P. vivax, P. ovale, P. malariae –
CHLOROQUINE 25mg/kg
divided over 3 days
Prevention of relapse –
PRIMAQUINE 0.25mg/kg daily
x 14 days
Chloroquine resistance –
QUININE 600mg q 8 x 7 days
DOXYCYCLINE 100mg/day

44. TREATMENT :
Chloroquine Resistant falciparum Malaria – CHLOROQUINE + PRIMAQUINE
45mg (0.75mg/kg) single dose (gametocidal)
Chloroquine Resistance – ARTEMESININ COMBINED THERAPY (ACT) should be
given
ACT consist of ARTEMESININ derived combined with long acting anti-malarial
drugs (amodiaquine, lumefantrine, mefloquine or sulfadoxine-
pyrimethamine)
Artemesinin should not be given as monotherapy in uncomplicated malaria to
prevent development of parasite resistance to these drugs

46. For pregnant women diagnosed with uncomplicated malaria caused by P. malariae, P. vivax, P.
ovale, or chloroquine-sensitive P. falciparum infection
Treatment with CHLOROQUINE (treatment schedule as with non-pregnant adult patients) is
recommended.
Alternatively, HYDROXYCHLOROQUINE, may be given instead.
For second or third trimesters, ARTEMETHER-LUMEFANTRINE is an additional option.
All trimesters, MEFLOQUINE or a combination of QUININE SULFATE and CLINDAMYCIN is
recommended
DOXYCYCLINE and TETRACYCLINE are generally not indicated for use in pregnant
women.

48. Infants with suspected malaria should have prompt parasitological
confirmation of the diagnosis before treatment begins.
Chloroquine is the drug of choice for treatment
Primaquine is not required for congenital malaria, because there is no
persistent liver phase in congenital acquired infection
Artemisinin-based combination therapy (ACT) is the recommended
treatment for complicated malaria in infants
Artemisinin derivatives are safe and well tolerated by young children, so the
choice of ACT will be determined largely by the safety and tolerability of the
partner drug.
For infants weighing less than 5 kg with uncomplicated P. falciparum, WHO
recommends treatment with an ACT at the same mg/kg body weight dose
as for children weighing 5 kg.

49. WHO recommends the following package of
interventions for the prevention and control
of malaria in infants:
•use of long-lasting insecticidal nets (LLINs)
•intermittent preventive therapy with sulfadoxine-pyrimethamine for
infants (IPTi) in areas of moderate to high transmission in sub-
Saharan Africa
•prompt diagnosis and effective treatment of malaria infections.

50. Artemesinin sulfadoxine
pyrimethamine
Artemether-
Lumefantrine

55. MALARIA VACCINE
is a vaccine that is used to prevent malaria.
The only approved vaccine as of 2015 is RTS,S, known by the trade name Mosquirix.
It requires four injections, and has a relatively low efficacy.
Due to this low efficacy, the World Health Organization (WHO) does not recommend
the routine use of the RTS,S vaccine in babies between 6 and 12 weeks of age

58. 1. Get a piece of paper and ballpen
2. Write your name, ID number and section
3. Answer the question as it flash on the screen. Avoid copying the
question.
4. Take a picture of your answer.
5. Send it to my viber number (09178877968)
6. You have 3minutes to send it
7. Late submission have deductions 1point per minute late
8. No name, ID number, section deduction of 1 point
9. Delete message deduction of 1 point

59. 1.What causes periodic fever
2-4.What are the 3 successive stage in febrile paroxysm
5. Reason that relate Malaria as one of the factor that
promote infection with lymphoma virus
6-8. Give the 3 clinical feature of malarial quartan
nephropathy
9. Advantage of antibody based techniques
10.Give 1 chemoprophylactic drug used in areas with resistant
strains