cost and complexity.[15] The risk of disease can be reduced by preventing mosquito bites through the use of mosquito nets and insect repellents or with mosquito-control measures such as spraying insecticides and draining standing water.[1] Several medications are available to prevent malaria for travellers in areas where the disease is common.[3] Occasional doses of the combination medication sulfadoxine/pyrimethamine are recommended in infants and after the first trimester of pregnancy in areas with high rates of malaria.[3] As of 2023, two malaria vaccines have been endorsed by the World Health Organization.[16] The recommended treatment for malaria is a combination of antimalarial medications that includes artemisinin.[17][18][1][3] The second medication may be either mefloquine (noting first its potential toxicity and the possibility of death), lumefantrine, or sulfadoxine/pyrimethamine.[19] Quinine, along with doxycycline, may be used if artemisinin is not available.[19] In areas where the disease is common, malaria should be confirmed if possible before treatment is started due to concerns of increasing drug resistance.[3] Resistance among the parasites has developed to several antimalarial medications; for example, chloroquine-resistant P. falciparum has spread to most malarial areas, and resistance to artemisinin has become a problem in some parts of Southeast Asia.[3] The disease is widespread in the tropical and subtropical regions that exist in a broad band around the equator.[20][1] This includes much of sub-Saharan Africa, Asia, and Latin America.[3] In 2022, some 249 million cases of malaria worldwide resulted in an estimated 608,000 deaths, with 80 percent being five years old or less.[21] Around 95% of the cases and deaths occurred in sub-Saharan Africa. Rates of disease decreased from 2010 to 2014, but increased from 2015 to 2021.[18] According to UNICEF, nearly every minute, a child under five died of malaria in 2021,[22] and "many of these deaths are preventable and treatable".[23] Malaria is commonly associated with poverty and has a significant negative effect on economic development.[24][25] In Africa, it is estimated to result in losses of US$12 billion a year due to increased healthcare costs, lost ability to work, and adverse effects on tourism.[26] The malaria caseload in India was slashed by 69 per cent from 6.4 million (64 lakh) in 2017 to two million (20 lakh) in 2023. Similarly, the estimated malaria deaths decreased from 11,100 to 3,500 (a 68-per cent decrease) in the same period.[27]

1. Malaria
An Overview of
Life-cycle, Morphology and
Clinical Picture

2. Malaria Species
Five species of malaria infect humans:
– Plasmodium falciparum
– Plasmodium vivax
– Plasmodium ovale
– Plasmodium malariae
– Plasmodium knowlesi

3. Malaria –Endemic Countries

4. Malaria –Endemic Countries

7. Exo-erythrocytic
(hepatic) cycle
Hypnozoites
Sporozoites
Salivary Gland
LIFE CYCLE OF MALARIA
Gametocytes
Erythrocytic
Cycle
Zygote
Oocyst
Stomach Wall
Pre-erythrocytic
(hepatic) cycle
sporozoites

8. Components of the Malaria Life Cycle
Mosquito Vector
Human Host
Sporogonic cycle
Infective
Period
Mosquito bites
gametocytemic
person
Mosquito bites
uninfected
person
Prepatent
Period
Incubation Period
Clinical Illness
Parasites visible
Recovery
Symptom onset

9. CLINICAL
SIGNS &
SYMPTOMS
OF MALARIA
Fever
Chills
Sweating

10. Plasmodium
falciparum:
Plasmodium
vivax,
Plasmodium
ovale
Plasmodium
malariae:

11. Chronic Disease
Chronic
Asymptomatic
Infection
Placental
Malaria
Anemia
Infection
During
Pregnancy
Developmental
Disorders;
Transfusions;
Death
Low
Birth weight
Increased
Infant
Mortality
Acute Disease
Non-severe
Acute Febrile
disease
Severe
malaria
e.g.
Cerebral
Malaria
Death
CLINICAL PICTURE

12. Definition
Severe malaria is defined as symptomatic malaria in a patient with
P. falciparum with one or more of the following complications:
– Cerebral malaria (unrousable coma not attributable to other causes).
– Generalized convulsions (> 2 episodes within 24 hours)
– Severe normocytic anaemia (Ht<15% or Hb < 5 g/dl)
– Hypoglycemia (blood glucose < 2.2 mmol/l or 40 mg/dl )
– Metabolic acidosis with respiratory distress (arterial pH < 7.35 or
bicarbonate < 15 mmol/l)
– Fluid and electrolyte disturbances
– Acute renal failure (urine <400 ml/24 h in adults; 12 ml/kg/24 h in children)
– Acute pulmonary edema and adult respiratory distress syndrome
– Abnormal bleeding
– Jaundice
– Haemoglobinuria
– Circulatory collapse, shock, septicaema (algid malaria)
– Hyperparasitaemia (>10% in non-immune; >20% in semi-immune)

14. CCMOVBD
Plasmodium falciparum CCMOVBD
Plasmodium vivax
CCMOVBD
Plasmodium malariae Malaria Tutorials, Wellcome Trust Plasmodium ovale
Laboratory diagnosis of malaria

15. Initial merozoite binding
Initial merozoite binding involves
reversible interactions between merozoite
surface proteins and the host erythrocyte.
The exact roles of MSP1 and other
merozoite surface proteins are not known

16. Cytokines & toxins
 Malaria produces a strong Th-1 type response
 Elevated serum levels of IFNg and TNFa
 Cytokines can induce (mimic) many of the
symptoms and signs of malaria (shivering,
headache, chills, spiking fever, sweating,
vasodilation, hypoglycemia)