Malaria is caused by a protozoan parasite called Plasmodium, which is transmitted via the bites of infected female Anopheles mosquitoes. The most common symptoms are fever, chills, and sweating that occurs in intermittent periodic cycles. Left untreated, malaria can cause anemia and enlargement of the spleen. There are four types of malaria parasites that can infect humans, with Plasmodium vivax and Plasmodium falciparum being the most prevalent. Malaria is prevalent in tropical and subtropical regions and is controlled through measures that eliminate the parasite reservoir in humans, interrupt mosquito-borne transmission, and protect susceptible individuals.

1. MALARIA
Dr. P I Muhammed Safeer
Assistant Professor
Department of PG Studies in Swasthavritta & Yoga
VPSV Ayurveda College, Kottakkal
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2. • Mala – Bad, Aria – Air
• Caused by Protozoal parasite – Plasmodium.
• Transmitted from person to person by the bite
of infected female anophelin mosquito.
• Fever with rigors, profuse sweating &
headache.
• Repeated episodes with intermittent
periodicity
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3. • Results in Splenomegaly and secondary
anaemia
• Mortality is not high, incapacitation of
affected human resources.
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4. History
• Hippocrates BC 5th Century
• Caraka & Susruta  diseases spread by
mosquitoes
• 1880 – discovered malarial parasite
• 1987 – Ronald Ross illustrated the devpt of
parasite in the mosquito
• 1953 – NMCP
• 1958 – NMEP
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5. • 1977 – Modified Plan of Operation
• 1999 – National Antimalaria Programme
• 2003 -04, included under National Vector
Borne Disease Control Program.
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6. Agent factor
• Pl. vivax  70% cases
• Pl. falciparum  25-30%
• Pl. malaria  less than 1%
• Pl. ovale  rarely affect human being
• Mixed infection  4-8%
• Pl. malariae is endemic to Hassan & Tumkur
Dt of Karnataka
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7. • Life history of Agent
– Development in 2 hosts, man & mosquito
– Man, intermediate host, asexual phase of dvpt.
– Female anopheline mosquito  sexual phase.
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9. Reservoir of infection
• Only human reservoir, case or carrier
• Criteria of a carrier
– Should have both sexes of gametocyte in blood
– Gametocytes must be matured, viable and in
sufficient numbers
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10. Host factors
• Age incidence: young children at high risk
• Sex incidence: more in men (outdoor work&
less clothed)
• Pregnancy: increases the risk & severity
• Occupation: more in rural, agricultural society
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11. Predisposing factors
• Poor standard of housing – ill lighting, ill
ventilation  mosquito resting
• Industrialization, urbanization, irrigation &
agriculture activities, deforestation
• ‘man made malaria’
• Out door sleeping habits
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12. Environmental factors
• Season: high incidence, July – Nov (low temp,
high humidity)
• Atm temperature: favourable for parasitic
devpt  200 – 300 C
• Humidity: Relative humidity 60% and above
• Rainfall: increase humidity, breeding places
• Altitude: mosquito won’t survive above
2500m
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13. • Vector: Anopheles mosquito
• Breeding habits: freshwater as in ponds, wells,
cisterns, over-head tanks, pools etc
• Resting habit: mostly indoor, after blood meal.
• Density: above critical level is needed for
active disease transmission
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14. • Mode of transmission:
– from person to person by the bite of infected
mosquito
– Accidentally through contaminated syringes
– Vertical transmission can occur but very rare
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15. Incubation period
Period between the bite of mosquito and the
onset of the first symptom, i.e. fever
• Pl. vivax  14 days
• Pl. falciparum  12 days
• Pl. malaria  28 days
• Pl. ovale  17 days
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16. Clinical features
• Clinically 4 types of malaria
1. Benign tertian malaria (Vivax malaria)
3 stages;
A. Cold stage
B. Hot stage
C. Sweating stage
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17. Cold stage –
Sudden onset of acute fever with rigors & sensation
of extreme cold
Teeth chatter
Desires to cover with several blankets
Severe head ache, vomiting
Lasts for 15 – 30 minutes
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18. Hot stage –
high fever 103 -1040 F
Feels burning heat, removes blankets &
clothes
Headache persists, vomiting can occur
Lasts for 2 – 6 hours
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19. Sweating stage –
Fever comes down by itself with profuse
sweating
Feels comfortable and falls asleep due to
exhaustion
Lasts for 2 –4 hours
Next day the patient feels normal and attends
to duties
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20. • In vivax malaria
– Fever reappears every third day
– Rupture of RBCs & release of merozoite is
associated with rigors.
– Repeated episodes results in spleenomegaly &
secondary anaemia.
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21. 2. Malignant tertian malaria (Falciparum
malaria)
Gradual rise of temperature, increasing daily,
becomes high and almost continuous
Cold, hot & sweating stages rarely occur
Vomiting & Headache are common
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22. • Highly fatal because of following
complications
– Cerebral malaria – convulsions, paralysis
– Black water fever – black coloured urine
– Algid malaria – with shock
– Septicemic malaria – septicemia & circulatory
failure
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23. 3. Quartan malaria
Caused by Pl. mlaria
Fever appears once in 4 days
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24. 4. Ovale malaria
Caused by Pl. Ovale
common only in Africa
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25. Investigations
• Blood smear for malarial parasite
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26. Measurement of Malaria/
Malariometry
• To know the magnitude of the problem
• By prevalence and incidence rates and
entamological parameters (vector indices)
together known as malariometric indicators
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27. Prevention & Control
• Elimination of reservoir
• Breaking the channel of transmission
• Protection of susceptibles
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28. Elimination of reservoir
• Presumptive treatment
• Mass treatment
• Chemoprophylaxis
• Revised National Policy
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29. Breaking the channel of transmission
a. Antiadult measures
b. Antilarval measures
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30. a. Antiadult measure
a. Residual spraying – spraying DDT, malathion,
fenitrothion in indoor surfaces like houses, cattle
sheds etc
b. Space spraying - outdoor spraying in the form of
fog, mist
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31. • Antilarval measures – bioenvironmental
control
1. Source reduction – elimination of nonessential
water bodies.
2. Environmental modification & manipulation –
levelling of land, filling of depression.
3. Biological control – natural enemies like fish,
bacteriae
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32. • Personal protection –
– 1. bed nets
– 2. use of mosquito repellents
– 3. malaria vaccines
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