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prevention & cure of malaria

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  1. 1. Made by Vibha bajpai
  2. 2.  Malaria is a mosquito-borne infectious disease of humans and other animals caused by parasitic protozoans (a type of unicellular microorganism) of the genus Plasmodium  the disease is transmitted via a bite from an infected female Anopheles mosquito.  which introduces the organisms from its saliva into a person's circulatory system. In the blood.
  3. 3.  Five species of Plasmodium can infect and be transmitted by humans.  The vast majority of deaths are caused by P. falciparum  P. vivax  P. ovale  P. malariae  P. knowlesi
  4. 4.  The signs and symptoms of malaria typically begin 8–25 days following infection.  however, symptoms may occur later in those who have taken antimalarial medications as prevention.  Initial manifestations of the disease—common to all malaria species—are similar to flu-like symptoms, and can resemble other conditions such as septicemia, gastroenteritis, and viral diseases.  The presentation may include headache, fever, shivering, joint pain, vomiting, hemolytic anemia, jaundice, hemoglobin in the urine,retinal damage, and convulsions.
  5. 5.  The classic symptom of malaria is paroxysm a cyclical occurrence of sudden coldness followed by shivering and then fever and sweating, occurring every two days (tertian fever) in P. vivax and P. ovale infections, and every three days (quartan fever) forP. malariae. P. falciparum infection can cause recurrent fever every 36–48 hours or a less pronounced and almost continuous fever.
  6. 6. respiratory distress  metabolic acidosis  pulmonary oedema,  anaemia.  , acute respiratory distress syndrome  Infection with P. falciparum may result in cerebral malaria 
  7. 7. The life cycle of malaria parasites. A mosquito causes infection by taking a blood meal.  First, sporozoites enter the bloodstream, and migrate to the liver.  They infect liver cells, where they multiply into merozoites, rupture the liver cells, and return to the bloodstream.  Then, the merozoites infect red blood cells, where they develop into ring forms, trophozoites and schizonts that in turn produce further merozoites.  Sexual forms are also produced, which, if taken up by a mosquito, will infect the insect and continue the life cycle 
  8. 8.  To prevent and treat clinical attack of malaria  To completely eradicate the parasite from the patient body  To reduce the human reservoir of infection  Stage of plasmodium in liver called tissue schizontocides…( pre+ exo  - erythcytes.)  stage of plasmodium in blood is called gametocides.
  9. 9.  Chloroquine  Amodiaquine primaquine sulfadoxine artemether halofantrine  Piperaquine sulfamethopyrazine  Mefloquine dapsone atovaquone  Quinine,quinidine tetracycline  proguanil, doxycycline  Pyrimathaqunine artesunate
  10. 10.  1)Causal prophylaxis: the preerythrocytics phase in liver  Proguanil, primaquine.  2)Suppressive prophylaxis: the exoerythrocytics phase in case of vivax and other relapsing malaria continues, clinical disease not appear.  Chloroquine,proguanil,mefloquine,doxy cycline
  11. 11.  3) clinical cure: the erythrocytic, schizontocides are used to terminate an episode of disease.  Fast acitng drug: chloroquine, mefloquine, amodiaquine, quine, halofantrine, atovaquone, artemisinin  Slow acting drug: proguanil,pyrimathamine, sulfonamides, tetracycline.
  12. 12.  4)Radical cure: in this attack the exoerythrocytic stage( hypnozoites) to achieved total eradication of parasite from patient body. Drug primaquine  Adequate for relapsing malaria.  5) gametocidal: this refer to elimination of the male and female gametes of plasmodia from patient blood (reduce the transmission to mosquito.
  13. 13.  Artesunate: 2.4 mg /kg iv or im after 12 to 24 hour.for 7 days  Artemether: 3.2mg/kg on 1st day…then 1.6 mg/kg daily for 7 days  Arteether: 3.2mg /kg on 1st day after 1.6 mg/kg for 4 days  Quinine di hcl: 20 mg /kg loding dose…then 10 ml /kg infused iv over 4 hours.
  14. 14.  Chloroquine:( amodiaquine) acting on erythrocytic schizontocide against all species of plasmodia.  Oral abs is excellent  Dose: 150mg/day  ADR: ocular toxicity seen with prolonged use.  T1/2 3 to 10 days  Safe for pregnancy:no abortifacient and no teratogenic effect.
  15. 15.  Mefloquine: is relatively fast acting erythrocytic schizontocides.  Slower then chloroquine nd quinine  Orally abs  Dose: 1.5gm/daily  T1/2 2-3 week  Mefloquine appears to be safe during pregnancy 
  16. 16.  Quinine , quinidine: used for uncomplicated falciparum malaria  Dose 15mg/kg for 7 days  Orally and iv abs  ADR: cinchonism…  Cause haemolysis
  17. 17.  Primaquine:pyrimethamine: radical treatment of vivax or ovale malaria ( prophylaxis of chloroquine resistant)  Dose: 15mg/daily for 14 days  Supra additive synergistic effect wd sulfonamides antibiotics(dapsone)  T1/2: 2 to 4 days  ADR: dose related haemolysis.
  18. 18.  1) arteether: acute malaria  Dose 150mg/kg for 3 days  Given orally, im(complicated)  T1/2: 23 hours  2)Artemether: f.malaria  80mg/daily  Given by oral iv ,im for every 12 to 24 hours for 5 days  T1/2: 4 to 5 hr
  19. 19.  Artesunate:  2.4 falciparum malaria mg/kg  Given iv or im for every 12 to 24 hours  To treat multi drug resistance malaria
  20. 20.  Artesunate-sulfadoxine  Artesunate pyrimethamine mefloquine  Dihydro artesunate piperaquine…  Artesunate chlorproguanil dapsone….