malaria is vector born disease caused by plasmodium spp.

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BY
OMPRAKASH KADAM
DIGAMBARRAO BINDU ACS COLLEGE BHOKAR

2. Introduction
Malaria is a mosquito borne-disease caused by
plasmodium, which is transmitted by the bite of
infected female anopheles mosquito.
The term malaria originates from Italian word: mala
aria — "bad air"
The disease is widespread in tropical and
subtropical regions that are present in a broad band
around the equator. This includes much of Sub-
Saharan Africa, Asia, and Latin America. The World
Health Organization estimates that in 2012, there
were 207 million cases of malaria.
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3. History
Malaria or the associated disease have been
noted 4000 years ago.
 References to the unique periodic fevers of
malaria are found throughout recorded
history, beginning in 2700 BC in China.
 Malaria may have contributed to the decline
of the Roman Empire, and was so pervasive in
Rome that it was known as the "Roman fever"
 MALARIA - major public health problem – 1.5
million confirmed cases (India ,2010)
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4. EPIDEMIOLOGY
Transmission: malaria is transmitted through the bites of female
Anopheles mosquitoes. There are more than 400 different species
of Anopheles mosquito; around 30 are malaria vectors of major
importance. In the environment.Anopheles mosquitoes lay their
eggs in water, which hatch into larvae, eventually emerging as
adult mosquitoes.
The female mosquitoes seek a blood meal to nurture their eggs.
Each species of Anopheles mosquito has its own preferred aquatic
habitat; for example, some prefer small, shallow collections of
fresh water, such as puddles and hoof prints.
Transmission also depends on climatic conditions that
may affect the number and survival of mosquitoes, such as rainfall
patterns, temperature and humidity.
In many places, transmission is seasonal, with the peak during
and just after the rainy season
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5. Trophozoite –
• ( mature feeding and growing
intracellular parasite in man)
• It is amoeboid ,uninucleate form,
enveloped by double layered
plasmolemma.
• Cytoplasm is granular& vacuolated
• It contains ER ,GC ,ribosomes , food
vacuole ,mitochondria
• Food vacuole contain haemozoin
• Concentric body which is attached to
double layered plasmolemma, have
mitochondrial function
MORPHOLOGY
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6. Epidemiology
The WHO estimates that in 2010 there were 219
million cases of malaria resulting in 660,000 deaths.
Others have estimated the number of cases at
between 350 and 550 million for falciparum
malaria and deaths in 2010 at 1.24 million up from 1.0
million deaths in 1990.
The majority of cases (65%) occur in children under 15
years old.
 About 125 million pregnant women are at risk of
infection each year; in Sub-Saharan Africa, maternal
malaria is associated with up to 200,000 estimated
infant deaths yearly
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7. Etiology
Malaria parasites belong to the
genus Plasmodium (phylum Apicomplexa).
 In humans, malaria is caused by P. falciparum, P. malariae, P.
ovale, P. vivax and P. knowlesi.
 Among those infected, P. falciparum is the most common
species identified (~75%) followed by P. vivax (~20%).
 Although P. falciparum traditionally accounts for the
majority of deaths, recent evidence suggests
that P. vivax malaria is associated with potentially lifethreatening
conditions about as often as with a diagnosis
of P. falciparum infection.
 P. vivax proportionally is more common outside of Africa
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8. Life cycle of malarial parasite
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9. Lifecycle
The malaria life cycle is a complex system
with both sexual and asexual aspects .
cycle of all species that infect humans is
basically the same. There is an exogenous
sexual phase in the mosquito called sporogony
during which the parasite multiplies.
There is also an endogenous asexual phase
that takes place in the vertebrate or human host
that is called schizogeny
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Lifecycle

11.  The malaria life cycle starts when a mosquito carrying the malaria
parasite bites a human, injecting the parasite (in its sporozoite form)
in its saliva into the human bloodstream.
 Once injected into the blood, the sporozoites head straight to the
liver and within 30 minutes they have invaded the liver cells. Here
they develop from sporozoites into merozoites and multiply rapidly to
produce thousands of merozoites. They are usually in the liver cells
for 10 days.
 In some malaria species, such as Plasmodium vivax and Plasmodium
ovale, the malaria parasites can lie dormant for months or years in the
liver. This dormant form, the hypnozoite, can then become reactivated
and continue its life cycle causing disease.
 This dormant stage does not happen in Plasmodium falciparum.
The merozoites burst out of the liver and invade red blood cells in the
bloodstream. Here, they multiply further.
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12.  After 48 hours, the merozoites have multiplied so much that the
red blood cells burst, releasing more merozoites into the
bloodstream, which can then infect more red blood cells.
 Over 10 days some merozoites will develop into gametocytes.
This is the sexual form of the parasite.
 When another mosquito sucks up blood from an infected human
they take up the gametocytes. Once inside the mosquito gut, the
gametocytes mature into gametes.
 Male and female gametes fuse together during sexual reproduction
resulting in the formation of ookinete.
 The ookinete burrows through the mosquito’s stomach wall.
The ookinete then forms an oocyst on the other side of the stomach
wall. Within this oocyst a thousand new sporozoites form.
 After about 5-7 days the oocyst bursts, releasing the sporozoites.
These then migrate up to the mosquito’s salivary gland, ready to be
injected into the next individual it bites.
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13. Clinical signs and symptoms
Fever and rigors
● Chills
● Sweats
● Headaches
● Nausea and
vomiting
● Body aches
● General malaise
Severe Malaria
Symptoms
● Enlarged spleen and
liver
● Mild jaundice
● Cerebral malaria
● Anemia
●Haemoglobinuria
Stage 1(cold stage)
Chills for 15 mt to 1 hour Caused due to
rupture from the host red cells escape into
Blood Preset with nausea,
vomitting,headache
Stage 2(hotstage)
Fever may reach upto 40c may last for
several hours starts invading newer red
cells.
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14. Prevention
 There is currently no commercial vaccine available
to prevent malaria.
 Doxycycline: 100 mg daily in adults and 1.5 mg/kg
body weight for children > 8 years • started 2 days
before travel and continued for 4 weeks after leaving
the malarious area Greater than 6 weeks .
Mosquito elimination: Insecticides, vector control
 Prevention of bite: use Mosquitoes nets , Sleeping
under bed nets, These should cover all of the bed down
and Apply insect repellent to all exposed skin.
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15.  Peripheral blood film examination (Thick and Thin Film).
The most accurate way to diagnose malaria is by taking a drop of
blood, smearing it on a slide and then examining it under a
microscope to look for malaria parasites inside the red blood cells
 Rapid diagnostic testing
rapid diagnostic tests have been introduced. These involve
dipping a test stick into a drop of blood to test for the presence of
proteins from the parasite. If the malaria parasite is present in the
blood sample bands appear on the test stick . Some of these tests
are even able to identify which species of Plasmodium is present.
These are convenient and a result can be generated within 15
minutes.
Diagnosis
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17. Treatment
 Artemisinin combination based therapy(ACT) has been adopted by
the World Health Organization as a first-line treatment for
uncomplicated Plasmodium falciparum malaria.
 Artemisinin and its derivatives (artesunate, artemether, artemotil,
dihydroartemisinin) produce rapid clearance of parasitaemia and rapid
resolution of symptoms.
 Combinational drugs eg Amodiaquine, lumefantrine, mefloquine.
 Dihydroartemisinin and piperaquine
The most commonly used medications are
chloroquine (Aralen),
doxycycline (Vibramycin, Oracea, Adoxa, Atridox),
quinine (Qualaquin),
mefloquine (Lariam),
atovaquone/proguanil (Malarone),
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