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  1. 1. Five species of Plasmodium can infect and be transmitted by humans. The vast majority of deaths are caused byP. falciparum while P. vivax,P. ovale, and P. malariae cause a generally milder form of malaria that is rarely fatal. The zoonoticspecies P. knowlesi, prevalent in Southeast Asia, causes malaria in macaques but can also cause severe infections in humans. Malaria is prevalent in tropical and subtropicalregions because rainfall, warm temperatures, and stagnant waters provide habitats idealfor mosquito larvae. Disease transmission can be reduced by preventing mosquito bites bydistribution of mosquito nets and insect repellents, or with mosquito-control measures such asspraying insecticides and draining standing water.
  2. 2. The signs and symptoms ofmalaria typically begin 8–25 daysfollowing infection;however,symptoms may occur later inthose who have takenantimalarial medications asprevention. Initial manifestationsof the disease—common to allmalaria species—are similarto flu-like symptoms, and canresemble other conditions suchas septicemia,gastroenteritis,and viral diseases. Thepresentation mayinclude headache, fever,shivering, rthralgia(jointapain),vomiting,hemolyticanemia,jaundice,
  3. 3. There are several serious complications of malaria. Among these is the development of respiratory distress, which occurs in up to 25% of adults and 40% of children with severe P. falciparum malaria. Possible causes include respiratory compensation of metabolic acidosis, noncardiogenic pulmonary oedema, concomitant pneumonia, and severe anaemia. Acuterespiratory distress syndrome (ARDS) may develop in 5–25% in adults and up to 29% of pregnant women but it is rare in young children.[8] Coinfection of HIV with malaria increases mortality.[9] Malaria in pregnant women is an important cause of stillbirths, infant mortalityand low birth weight,[10] particularly in P. falciparum infection, but also withP. vivax.[11]
  4. 4. Malaria parasites belong to thegenus Plasmodium (phylum Apicomplexa). In humans, malaria is causedby P. falciparum, P. malariae, P. ovale, P. vivaxand P. knowlesi.[1 2][13] Among those infected, P. falciparum is the most common species identified (~75%) followed by P. vivax (~20%).[3]P. falciparum accounts for the majority of deaths;[14] non-falciparum species have been found to be the cause of about 14% of cases of severe malaria in some groups.[3] P. vivax proportionally is more common outside of Africa.[15]There have been documented human infections withseveral species ofPlasmodium from higher apes; however, with the exception of P. knowlesi—azoonotic species that causes malaria in macaques[13]—these are mostly of limited public health importance.[16]
  5. 5. The life cycle of malaria parasites: A mosquito causes infection by taking a blood meal. First, sporozoites enter thebloodstream, 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
  6. 6. In the life cycle of Plasmodium, a female Anopheles mosquito (the definitive host) transmits a motile infective form (calledthe sporozoite) to a vertebrate host such as a human (the secondary host), thus acting as a transmissionvector. A sporozoite travels through the blood vessels to liver cells (hepatocytes), where it reproduces asexually (tissue schizogony), producing thousands of merozoites. These infect new red blood cells and initiate a series ofasexual multiplication cycles (blood schizogony) that produce 8 to 24 new infective merozoites, at which point the cells burst and the infective cycle begins anew.[17] In a process called gametocytogenesis, other merozoites develop intoimmature gametes, or gametocytes. When a fertilised mosquito bites an infected person, gametocytes are taken up with the blood and mature in the mosquito gut. The male and female gametocytes fuse and form zygotes(ookinetes), which develop into new sporozoites.The sporozoites migrate to the insects salivary glands, ready to infect a new vertebrate host. The sporozoites are injected into the skin,alongside saliva, when the mosquito takes a subsequent blood meal.This type of transmission is occasionally referred to as anterior station [18]
  7. 7. Only female mosquitoes feed onblood; male mosquitoes feed on plant nectar, and thus do not transmit the disease. The females of the Anopheles genus of mosquito prefer to feed at night. They usually start searching for a meal at dusk,and will continue throughout the night until taking a meal.[19] Malaria parasites can also be transmittedby blood transfusions, although this is
  8. 8. Symptoms of malaria can reappear (recur) after varyingsymptom-free periods. Depending upon the cause, recurrence can be classified as eitherrecrudescence, relapse, or reinfection. Recrudescence is when symptoms return after asymptom-free period. It is caused by parasites surviving in the blood as a result of inadequate or ineffective treatment.[21] Relapse is when symptoms reappear after the parasites have been eliminated from blood but persist as dormant hypnozoites in liver cells. Relapse commonly occurs between 8–24 weeks and is commonly seen with P. vivax and P. ovaleinfections.[3] P. vivax malaria casesin temperate areas often involveoverwintering by hypnozoites, with relapses beginning the year after the mosquito bite.[22] Reinfection means the parasite that caused the pastinfection was eliminated from the body but a new parasite was introduced. Reinfection cannot readily be distinguished from recrudescence, although recurrence of infection within twoweeks of treatment for the initial infection is typically attributed
  9. 9. Methods used to prevent malaria include medications, mosquito elimination and the prevention of bites. Thepresence of malaria in an area requires a combination of high human population density, high mosquito population density and high rates of transmission fromhumans to mosquitoes and from mosquitoes to humans. If any of these is lowered sufficiently, the parasite will eventually disappear from that area, as happened in North America, Europe and much of the Middle East. However, unless the parasite is eliminated from thewhole world, it could become re-established if conditions revert to a combination that favours the parasites reproduction
  10. 10. Many researchers argue that prevention of malaria may be more cost-effective than treatment of the disease in the long run, but the capital costs required are out of reach of many of the worlds poorest people. There is awide disparity in the costs of control (i.e. maintenance of low endemicity) and elimination programs betweencountries. For example, in China—whose government in 2010 announced a strategy to pursue malaria elimination in the Chinese provinces—the requiredinvestment is a small proportion of public expenditure on health. In contrast, a similar program in Tanzania would cost an estimated one-fifth of the public health budget.
  11. 11. Man spraying kerosene oil in Walls where indoor residualstanding water, spraying of DDT has been applied. The mosquitoes remain on the wall until they fall down dead on the floor.
  12. 12. Mosquito nets create aprotective barrier against malaria-carrying mosquitoes thatbite at night.