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- 2. Malaria Vector borneinfectious disease Caused by protozoan parasite Very common infectious disease Transmitted by female anopheles mosquito No vaccines available Can be treated easily with derivatives of quinine and artemisinin (drug resistance common)
- 3. History First recordof “periodic fevers” from China in 2700 BC Term “malaria” derived from Italian for “bad air” – mala aria Also known as “ague” or “marsh fever”
- 4. First effectivetreatment was the bark of the cinchona tree (contains quinine) Grows in the Peruvian Andes Used by the locals to control malaria Jesuits introduced it to Europe in 1640s Active ingredients (quinine) isolated from the bark Named by French chemist Pierre Pelletier and Jean Caventou
- 5. The bloodstage of malaria life cycle was recognized in 19th and early 20th century The latent form of the disease (in the liver) was only recognized in 1980s Explained why apparently “cured” people could have recurrent episodes years later in the absence of new exposure
- 6. Estimation of mortalityand DALYs lost due to malaria world wide (2002) Region Mortality (000) DALYs lost(000) Africa 1136 40855 Americas 1 111 East Medi- terranean 59 1196 Europe 0 21 SEAR 65 2777 Western Pacific 11 371 Total 1272 46481
- 7. Epidemiology Precise statisticsunknown - most cases are rural 400-900 million cases of fever per year Affects about 515 million people per year Kills between 1 – 3 million per year Most deaths occur in children less then 5 years in Sub Saharan Africa (pregnant women also vulnerable) One death every 30 seconds
- 8. 2005 2006 State Malaria cases P.F. cases deathsMalaria cases P.F. cases deaths Jharkha nd 192334 51484 21 33288 8707 1 Haryana 33262 238 0 7558 7 0 Punjab 1883 28 0 58 2 0 Assam 67885 45453 113 85070 60885 271 Orissa 391261 337934 249 63690 55365 49 Uttar Pradesh 105303 3149 0 14590 219 0 State-wise distribution of malaria in India in 2005 and 2006
- 9. Malaria parasite Malariais caused by protozoan parasite of the genus plasmodium In humans the causes include P. Falciparum P. malariae P. ovale P. vivax
- 10. P. vivaxis the most common infection (80% of the cases) P. falciparum causes most deaths (15% of infections and 90% of deaths) Other Plasmodium species also infects birds, reptiles, rodents, monkeys and apes
- 11. Mosquito vectors Primaryhosts and transmission vectors are the female Anopheles mosquito Only the female feed on blood Mosquito ingests parasite from infected human blood whilst feeding Carry sporozoites in the salivary glands There is a complex life cycle within the mosquito
- 12. Parasite relativelyprotected from the human immune system because it hides in the red blood cells or in the liver. Circulating infected cells can be destroyed in the spleen Parasite infected cells stick to blood vessel walls (to avoid the spleen) – can cause strokes in cerebral malaria.
- 13. Exogenous phase(in mosquito) Sexualcycle (sporogony) Sporozoites reach salivary glands Sporozoites from mosquito enter human Human blood enters mosquito Microgamete (fertilization) Macrogamete Zygote Ookinete Outer layer of stomach wall and encysts Oocyst grows Human phase`
- 14. Exo-erythrocytic stage Microgamete (differntiation) Macrogamete Sprozoites Endogenous phase(in human) asexualcycle (schizogony) Merozoites Immature trophozoite Mature Schizont Enter RBC Ring trophozoites Mature trophozoites Erythrocytic cycle Mosquito phase
- 15. References Essentials ofMedical Pharmacology - K.D. Tripathi 6th edition Principles of Pharmacology - Sharma and Sharma 1st edition 2007 Textbook of Preventive and Social Medicine - K .Park 15th edition