This document summarizes information about malaria. It describes the causative parasites Plasmodium vivax, P. falciparum, P. ovale, and P. malariae. It outlines the parasite's life cycle between human and mosquito hosts. It also discusses the disease's geographic distribution, incubation period, clinical presentation, complications, diagnosis and prevention strategies.
Arthropods form a major group of disease vectors with mosquitoes, flies, sand flies, lice, fleas, ticks and mites transmitting a huge number of diseases.
Arthropods form a major group of disease vectors with mosquitoes, flies, sand flies, lice, fleas, ticks and mites transmitting a huge number of diseases.
Many such vectors are haematophagous, which feed on blood at some or all stages of their lives.
Arthropods form a major group of disease vectors with mosquitoes, flies, sand flies, lice, fleas, ticks and mites transmitting a huge number of diseases.
Arthropods form a major group of disease vectors with mosquitoes, flies, sand flies, lice, fleas, ticks and mites transmitting a huge number of diseases.
Many such vectors are haematophagous, which feed on blood at some or all stages of their lives.
Epidemiology and control measures for Yellow fever AB Rajar
It is an acute infectious disease of short duration, with sudden
onset,fever,headache,prostration,nausea,epistaxis,buccal bleeding,hematemesis,malena and jaundice
This lecture presentation contains description of arbovirus particularly detailing Dengue virus infections. Lecture outlined general characteristics of Arbovirus, classification of Arboviruses, salient features of Dengue virus, dengue pathogenesis, clinical course, laboratory diagnosis, complications of secondary dengue and some recent aspect of dengue vaccine preparation.
Chikungunya (chik-un-GUN-yuh) is a viral illness transmitted by mosquitoes that causes the sudden onset of fever and severe joint pain. Other signs and symptoms may include fatigue, muscle pain, headache and rash. Signs and symptoms of chikungunya usually appear within two to seven days after being bitten by an infected mosquito.
wuchereria bancrofti can causes serious diseases that attack our world . so this presentation gives us some information about this worm , methods of avoiding it and what are diagnostic tests that doctors ask .
Epidemiology and control measures for Yellow fever AB Rajar
It is an acute infectious disease of short duration, with sudden
onset,fever,headache,prostration,nausea,epistaxis,buccal bleeding,hematemesis,malena and jaundice
This lecture presentation contains description of arbovirus particularly detailing Dengue virus infections. Lecture outlined general characteristics of Arbovirus, classification of Arboviruses, salient features of Dengue virus, dengue pathogenesis, clinical course, laboratory diagnosis, complications of secondary dengue and some recent aspect of dengue vaccine preparation.
Chikungunya (chik-un-GUN-yuh) is a viral illness transmitted by mosquitoes that causes the sudden onset of fever and severe joint pain. Other signs and symptoms may include fatigue, muscle pain, headache and rash. Signs and symptoms of chikungunya usually appear within two to seven days after being bitten by an infected mosquito.
wuchereria bancrofti can causes serious diseases that attack our world . so this presentation gives us some information about this worm , methods of avoiding it and what are diagnostic tests that doctors ask .
Invasion of the skin or mucous membranes by a pathogenic organism or parasite.
Infection in which entrance of the pathogenic organism (or the parasite) occurs through the skin or mucus membranes.
Some infectious agents can invade the intact (undamaged) skin or mucous membranes, but the majority needs injured surfaces in the form of abrasions, scratches, wounds or ulcers.
Filariases is commonly known as Elephantiasis. it is a tropical disease which is caused by parasitic worm filariae. it is a microscopic roundworm that dwells in the blood and tissues of human. Its main causative agent is Wuchereria bancrofti and Brugia malayi. The host is man. This disease is most prominent in Africa and in India it is most prominent in the state Kerala. 90% of filariases is caused by Wuchereria bancrofti and only 10%-15% is caused by Brugia malayi.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
3. Typhus: The name comes from the Greek tûphos
(τύφος) meaning hazy, describing the state of mind of
those infected. While "typhoid" means "typhus-like"
4. Epidemic typhus Endemic typhus Q fever
Causative
organism
Rickettsia prowazeki R. mooseri Coxiella Burnetti
“Camp, Jail, War” fever
Reservoir Man: cases in febrile
stage.
Rat Small wild mammals, cattle,
sheep, goats, birds and man.
Vector Louse, "pediculus
humanus"
Rat flea Ticks, human body lice
Modesof
transmission
- Skin contamination
with faeces of infected
louse.
- Inhalation of dried
faeces of infected louse.
Skin contamination
with faeces of the
infective fleas.
- Air borne: dust contaminated
by placental tissues, birth fluids
& excreta of infected animals.
- Ingestion of raw milk
IP 2 weeks 1-2 week 2-3 weeks
5. Epidemic typhus Endemic typhus Q fever
C/P - High fever, rigors, body aches.
- Face flushing then cyanosis
- Meningoencephalitis: Dullness & confusion.
- Skin rash: on the 5th day on folds of axilla, anterior
part of forearms then trunk and back.
-Sudden chills, FHMA,
weakness & severe
sweats.
-Pneumonitis or hepatitis.
Complications
Untreated cases are often fatal
Broncho-pneumonia, thrombotic
changes, gangrenes of fingers,
toes & genitalia.
Rare Miscarriage, stillbirth, pre-
term delivery or low birth
weight.
Diagnosis C/P
Lab: Weil-Felix reaction
(agglutination test)
- Serological tests with a
rising titre.
- Weil-Felix reaction (-ve).
6. Prevention Epidemic typhus Endemic typhus Q fever
General - Health education.
-Delousing by washing
facilities & dusting with
a suitable insecticide.
- Eradication &
control of rats.
- Control of fleas.
-Control in domestic animals:
vaccination or antibiotics.
-Milk pasteurized at high temp..
-Health education.
Specific Madrid E typhus vaccine
(live attenuated), a
single IM dose, giving
immunity for 5 years.
No specific
prevention.
Inactivated vaccine Q 34, 1ml
dose as 3 weekly SC.
For high risk workers: lab workers
& veterinarians, meat processing,
sheep & dairy workers & farmers
7. Control Epidemic typhus Endemic typhus Q fever
Cases - Notification to LHO.
- Isolation in hospital after dusting.
- Terminal disinfection by dusting (to
kill any lice) & steam disinfection for
clothes & bedding (to kill rickettsia).
-ttt: tetracycline 500 mg / 6hs
for 7 days.
- Release after clinical recovery.
- LHO
- Treatment
- Disinfection
- LHO
- ttt: Tetracycline or
Chloramphenicol.
-Disinfection:
Concurrent of
sputum, blood and
articles
Contacts - Delousing by bathing & dusting.
- Surveillance for 2 weeks.
No special measures, Search for cases.
Epidemic
measures
- Delousing of confined groups &
underdeveloped communities by
washing facilities & dusting.
- Vaccination of high risk groups.
- Searching for source of infection.
10. TICK- BORNE “TBRF” LOUSE- BORNE “LBRF”
Causative
organism
Borrelia duttoni (Spirochete)
“Endemic”
Borrelia recurrentis
“Epidemic”
Reservoir Rodents & accidentally man Man
Vector Tick Human louse
Modes of
transmission
Bite (through the saliva) or coxal fluid of
an infected tick
Contamination of the wound with
the louse's body fluid, following
crushing of the louse on the skin.
IP 2-10 days
C/P FHMA: Fever attacks alternating by a febrile period. Each febrile period
terminates by crisis. No. of relapses varies from 1 to >10.
Transitory petechial rashes are common. skeletal & abdominal tenderness with
palpable liver & spleen, jaundice & purpura. the disease lasts for >16 days.
Complications Hyperpyrexia, Bronchitis, nerve palsies, hepato-splenomegaly, renal failure,
hypotension and cardiac failure
11.
12.
13.
14. TICK- BORNE LOUSE- BORNE
Diagnosis Blood films (during the febrile attack): the circulating Borrelia duttoni.
Intraperitoneal inoculation or culture in lab animals.
Prevention
General 1) Control of ticks & rodents: benzene
hexachloride or dieldrin.
2) Personal protection measure: repellents &
protective clothes.
1) Delousing.
2) Protection of susceptible: use of
repellents & protective clothes.
Specific Chemoprophylaxis with tetracycline after exposure
Control
Cases Notification: to LHO
Isolation: precautions with blood & body fluids.
Treatment: tetracycline
Contacts Case findings.
Epidemic
measures
Apply insecticides to clothes & houses.
Coxiella Burnetti
“Camp, Jail, War” fever
15.
16.
17.
18.
19. Elimination program started
in 2002.
Endemic in Egypt.
Qalyobia
(Sandanhour)
Menoufia (Kafr al
Hemma & Shenawaii)
Sharkia (El-Korain
village)
Dakahlia
Kafr el sheikh
Gharbia
Giza (Badrashin) &
Assuit
20. Elimination of lymphatic filariasis in Egypt
• WHO has launched a global program for the elimination of lymphatic filariasis
worldwide.
• Elimination of lymphatic filariasis means a reduction of the disease incidence
close to zero as a result of continued and coordinated activities.
• WHO's strategy comprises two components: interruption of transmission, and
care for those who already have the disease.
To interrupt the transmission, the entire population at risk must be covered by
mass drug administration (MDA) for a period long enough to ensure that the level
of microfilaria in the blood remains below that which is necessary to sustain
transmission.
• Egypt started the program for elimination since 2000 following WHO
recommendation of administering DEC and Albendazole.
21. Causative
agent
• Nematode: Wuchereria bancrofti
Reservoir of
infection
• Human with microfilaria in their blood.
• Man is definitive host
• Mosquito is intermediate host.
Period of
communicability
• Human can infect mosquito when microfilaria is present in peripheral blood.
• They can persist for 5-10 ys or longer after infection, mesquite becomes infective
after about 2 weeks
Mode of
transmission
• Bite of infective mosquito “Culex, Anopheles & Aedes”
• Egypt: female Culex pipiens,.
22.
23. Microfilaria appears in
large no. during night
with max. density in
blood between
10 p.m - 2 a.m
(Nocturnal periodicity)
24. SUSCEPTIBILITY & RESISTANCE:
• Filariasis appears only in small % of infected persons. Many mosquito bites
over several months to years are needed.
• Living for a long time in tropical or sub-tropical areas is the greatest risk.
• Short-term tourists have a very low risk.
General susceptibility
• Man may develop resistance only after many years of exposure to infection.
Immunity
• Unsanitary planning with inadequate sewage disposal, where breeding
places of culex & collection of water for other species.
Environment:
25. CLINICAL FEATURE:
Asymptomatic
• Fever, Lymphangitis & Lymphadenitis
Acute form
• Fibrosis & obstruction of lymphatics after repeated attacks “10 ys”.
• Swelling of limbs, breast & genitalia “hydrocele” & severe eosinophilia.
• Swelling + ↓ function of the lymph system → ↑bacterial infections in skin
& lymph system → Skin hardening & thickening “Elephantiasis”
Chronic obstructive form
26. DIAGNOSIS:
Blood smears
• Microfilariae by microscopic
exam. during max. presence
(nocturnal)
• Thick smear & stained with
Giemsa
Antifilarial IgG4
• ↑ with active filarial
infection
Because lymphedema may develop many years
after infection, lab tests are most likely to be –ve.
27. PREVENTION
• Eradication or control of mosquito vector
• Human protection against mosquitoes: e.g. protective clothing, bed nets, repellents.
Usually bite between dusk and dawn
Environmental sanitation
• Modes of transmission & Protection against mosquito bites.
Health education
• MDA as an annual single dose, of combinations of diethylcarbamizine citrate
(DEC) 6mg/kg body weight + 400 mg of albendazole for 4-6 years, or the regular
use of DEC-medicated cooking salt for 1-2 years.
• 2 fold purpose of preventing future cases of lymphatic filariasis & helping those
people who are already suffering from the disease.
Mass drug administration “WHO”
28. CONTROL OF CASES:
• LHO.
Notification
• Not practical.
Isolation
• DEC (Banocid, Hetrazan) → rapid suppression of most or all microfilaria + some adult
worms. Low level of microfilaria may reappear. So, ttt repeated yearly + lab follow up.
• Ivermectin kills only microfilariae, but not the adult worm; the adult worm is responsible
for the pathology of lymphedema & hydrocele. Some studies have shown adult worm
killing with ttt with Doxycycline (200mg/day for 4–6 weeks).
• Lymphedema & Elephantiasis: DEC not indicated “No active infection”.
• Hydrocele: Surgery.
Specific treatment
30. Vector
Several species of sandflies.
Reservoir
Man, dogs, wild rodents & foxes.
Definition
Group of diseases due to infection with Leishmania which is transmitted
by sandflies.
31.
32. LEISMANIASIS IN EGYPT
A focus of visceral leishmaniasis was
discovered in El Agamy, in 1982. Last
case there was reported in 2005.
Only one more case of visceral
leishmaniasis was reported, in the Suez
region in 2008.
However, due to a lack of awareness
among medical practitioners, visceral
leishmaniasis is suspected to be
underreported.
Import of cases from Libya & Sudan
may occur regularly & go unnoticed.
33. Cutaneous leishmaniasis has been an increasing problem in Egypt.
Known foci are among nomads in North Sinai.
Reported no. of cases is estimated to be 4-5 times lower than the real no.
People at risk are soldiers, laborers, & immuno-compromised adults.
35. CUTANEOUS LEISHMANIASIS (ORIENTAL SORE)
• New world cutaneous Leishmaniasis: L. mexicana.
• Old world cutaneous Leishmaniasis: L. tropica, L. major & L. aethiopica.
Types
• Bites of infective sandfly.
• Contact with skin lesions of case.
Modes of transmission
• L. Mexicana: Mexico & Peru.
• L. tropica: Central Asia, India & West Africa. “Egypt: Alexandria”
• L. major: Mediterranean & Southwest Asia.
• L. aethiopica: Ethiopia & Kenya
Occurrence
• Starts with a papule & enlarges to become an indolent ulcer on the exposed parts of body which either
heals or lasts for many years
C/P
36.
37. MUCOCUTANEOUS
LEISHMANIASIS
• L. Braziliensis
• Central & south America
• C/P: Nasopharyngeal
destruction & deformities.
VISCERAL
LEISHMANIASIS (Kala
Azar)
• L. donovani
• C/P: chronic infection with
fever, hepato-splenomegaly,
lymphadenopathy &
anemia. Progressive
emaciation & weakness
40. General Prevention
• Vector control e.g. by insecticides.
• Protection of man from sandflies: e.g.
repellents, protective clothes.
• Proper control of domestic animals
especially dogs
• Rodent control
• Health education.
Specific Prevention
• Active immunization: Live attenuated vaccine
“↓severity of disease in endemic areas”.
• International measures: non
41. Cases
Early case finding &
ttt.
Skin lesions: covered
to avoid infection of
vector & contact
infection of exposed
individuals.
Contacts
Health education.
Examination.
CONTROL
43. A parasitic re-emerging disease
1 million deaths/year in world
“Mostly young African children”
Still a major health problem in
Tropical & subtropical areas.
Recently multiple foci of drug
resistant malaria are encountered in
different areas.
45. • Protozoan parasites with asexual & sexual phase
• Plasmodium vivax, P. falciparum, P. ovale & P. malaria.
• Mixed infections: Not infrequent in endemic areas.
Causative agent
• Humans: only important reservoir of human malaria.
• Case may have several plasmodia species at same time.
• Infective stage to vector is gametocytes which have to be: mature,
both sexes, sufficient density & viable.
• Antimalarial drugs lose viability of gametocytes.
• Female anopheline mosquito is definitive host
• Infective stage to man is sporozoite.
Reservoir
46. PERIOD OF COMMUNICABILITY:
As long as infective macro gametes are present in blood of patients.
Varies with parasite species.
In untreated cases it may reach up to 3 years
Antimalarial drugs shorten the period greatly.
Transfusion transmission occur as long as asexual forms remain in
circulating blood
Stored blood can remain infective for at least a month.
47.
48.
49. MODE OF TRANSMISSION:
Congenital transmission
Rare. However, pregnant women are vulnerable than others to falciparum malaria (and possibly other
plasmodium species).
Blood-borne pathogen
Infection or transfusion of infected blood or use of contaminated needles & syringes.
Bite of infective female anophiline mosquito
Sporozoite in salivary glands. Most species feed at night; some important vectors also bite at dusk or
in the early morning.
50. INCUBATION PERIOD:
Time between infective bite
& appearance of clinical
symptoms is 9-40 days
according to type of malaria
species.
With infection through
blood transfusion, IP
depend on the no. of
parasites infused & are
usually short, but may range
up to about 2 months.
51. SUSCEPTIBILITY:
Age
• All ages are affected.
• Tolerance among adults
in highly endemic areas
“exposure to infective
anopheline is continuous
over many years”.
Sex
• ↑ Males “outdoor life”.
Immunity
• No natural immunity.
• Infection induces species
specific immunity.
• Some sort of active
immunity develops in
endemic areas.
Genetic
• African population: natural
resistance to P.vivas
“absence of Duffy factor on
RBCs”.
• Sickle cell trait
(heterozygotes): Relatively
protected from severe
diseas.
HIV infection
• ↑ Risk of symptomatic
falciparum malaria.
Sociocultural &
environmental factors
• Low socioeconomic
standard, outdoor sleeping,
agricultural societies &
vitiated air.
• Suitable environment for
mosquito breeding
“hot+humid+rainfall”
52.
53.
54. COMPLICATIONS:
Anemia. Splenomegaly.
Abortion & fetal infection.
Falciparum malaria
• Respiratory distress, pulmonary edema
• Jaundice, liver failure,
• Encephalopathy, cerebral edema, coma &
death.
Relapses may occur after a period of cure without parasitaemia at
irregular interval up to 5 years.
55. DIAGNOSIS:
Common methods
• Malaria parasites in thick blood film.
• Repeated microscopic exam.: every 12-24 hs to cover all
parasite species.
New methods
• Rapid diagnostic tests: plasmoidal antigens in blood.
• PCR: most sensitive method.
• Demonstrating antibodies which appear after 1st week of
infection but may persist for years denoting past malaria
infection.
56.
57. General Prevention
• Eradication of larval stages by spraying crude oil & larvicides
on water surface.
• Destruction of adult mosquitoes by using suitable insecticides
(liquid aerosol, pyrethrium).
• Avoid taking blood from any individual giving history of
malaria or a history of travel to, or residence in, a malarious
area.
Specific Prevention
Chemoprophylaxis for international travelers to endemic areas.
• Chloroquine or hydrroxy chloroquine 5 mg /kg/week or chloroquine phosphate (500
mg for average adult). Continued for 4-6 weeks after leaving.
• Areas with chloroquine-resistant P. falciparum, Mefloquine (5mg/kg/week) for adults, 1-
2 week before travel, during stay & 4 weeks after leaving.
58. CONTROL
Cases
• Early case finding: Survey +
Campaigns.
• ttt: Antimalarial drugs
“chloroquine or mefloquine”.
Contacts
• Investigation for early case
findings.
• Investigation for source of
infection or exposure.
59. MALARIA SURVEY
Field study in endemic areas to find out magnitude of problem, ecological
factors & to plan for prevention & control.
• Mapping area: water channels, collections, cultivated lands, houses & climatic conditions.
• Study population characteristics e.g age, sex, occupation, habits etc.
• Study vector; types of mosquitoes, density, species, life span, breeding places, resistance to
insecticides.
• Choose suitable representative sample.
• Preparation of: Team of work + Equipment+ Transportation facilities.
Planning
• Clinical &Lab examination.
Investigation
• Malariometric indices.
Statistical analysis
60. HUMAN “MALARIOMETRIC” INDICES
Splenic
Non-specific: % of
children between 2-6ys
showing splenomegaly
“excluding other
causes”.
Interpretation:
<10% low endemicity,
10-25% moderate
endemicity,
25-50% hyperendemic.
Parasitic
Specific: % of infants
<1 y. showing malaria
parasites in their blood
Most sensitive index of
recent infection.
Gametocytic index; is %
of those having
gametocytes in their
blood.
Vector
“Oocytic”
% of oocytes or
ookinetes in stomach
wall of female
anopheles.
Sporozoite
% of female anopheles
having sporozoites in
salivary glands.
61. MALARIA ERADICATION
Eradication is the highest level of disease control.
Aiming at elimination of reservoir of infection, complete cure of cases & prevention of
disease transmission by destruction of vectors.
To eradicate malaria in certain area 4 phases have to be done:
Preparatory phase
Preparation,
Survey
planning:
study vector
& magnitude
of problem.
Attack phase
Complete
coverage of area
by insecticides.
D.D.T. is applies
twice a year
during period of
malaria
transmission.
Surveillance system
Early case
finding & ttt with
chloroquine of
any case with
fever &
completion of ttt
in +ve blood film
cases.
Consolidation
phase
Insecticides
are stopped &
continue with
presumptive
& radical ttt.
Editor's Notes
6-12 months after infection
MDA where lymphatic filariasis is endemic WHO recommends MDA
Patients with microfilaria in the blood and treated with antifilarial should be protected from mosquitos to reduce transmission.
Relapses may occur after a period of cure without parasiteamia at irregular intervals up to 5 years