Malaria is caused by Plasmodium parasites transmitted via Anopheles mosquitoes. It affects over 200 million people annually and kills over 400,000, mainly young children in Africa. The disease causes flu-like symptoms and periodic fevers. If untreated, it can lead to severe complications affecting the brain, kidneys, and fetus. Diagnosis is via blood smear microscopy or rapid tests. Treatment depends on the Plasmodium species but includes chloroquine and artemisinin combination therapies. Control relies on mosquito elimination, bed nets, antimalarial drugs, and vaccination research.

1. Malaria
By Gunchmaa.N

2. Malaria is caused by genus Plasmodium
P. vivax
P. ovaleP.malariae
P.falciparum

3. Anopheles

4. Malaria reports
• 40% of the world population are at risk
• 216 million cases every year
• 100+ countries with a risk of transmission
• 125 million travellers every year
• 10.000 reports after returning home
• Malaria kills in one year what AIDS kills
in 15 years

6. Events in Mosquitos
• Fertilization
• ZYGOTE
• ZYGOTE matures into OOKINETE
• OOKINETE to OOCYST

7. Mosquito cycle

8. Human cycle
1 Pre erythrocytic
schizogony
2 Erythrocytic
Schizogony
3 Gametogony
4 Exoerythrocytic
schizogony

13. Exo Erythrocytic Schizogony
• Some Sprozoites do not undergo sporogony
• Resting stage called as Hypnozoites
• Within 2 years reactivates
• This stage is absent in P.falciparum

14. Symptoms
Begins with flu-like symptoms. Incubation period:
- 9-14 days P.falciparum
- 12-18 days P. vivax and P.ovale
- 18-40 days P.malariae

15. Prodromal Symptoms
 End of incubation period
 2-3 days before 1st paroxysm
 Includes: malaise, fatigue, headache, myalgia,
nausea, anorexia (i.e., flu-like symptoms)
 Can range from none to mild to severe

16. Febrile Attack (Malaria Paroxysm)
 Periodic febrile episodes alternating with symptom-
free periods
 Initially fever may be irregular before developing
periodicity
 May be accompanied by splenomegaly,
hepatomegaly, anemia

17. Cycles differs in different species
Cycle repeats every 48 hours in
1 P.falciparum
2 P.ovale
3 P.vivax
Repeats every 72 hours in P.malariae

18. Cold stage
• feeling of intense cold
• vigorous shivering, rigor
• lasts 15-60 min

19. Hot stage
• intense heat
• dry burning skin
• throbbing headache
• lasts 2-6 hours

20. • profuse sweating
• declining temperature
• exhausted, weak  sleep
• lasts 2-4 hours

21. PATTERN OF
FEVER
The fever
paroxysm
corresponds
to the period
of infected
erythrocyte
rupture and
merozoite
invasion.

22. sweating
rigor

23. Preference
• P.falciparum – all erythrocytes
• P.ovale and P.vivax – reticulocytes
• P.malariae – senescent erythrocytes

25. Cerebral malaria

26. Cerebral Malaria
• Coma
• diffuse symmetric encephalopathy
• Unusual focal neurological signs
• Primitive reflexes absent
• Retinal haemorrhage with puillary dilatations
• Hemiplegia, CP
• Blindness, deafness
• Impaired cognition and learning

27. Black water fever
In malignant malaria a large number of the red
blood cells are destroyed. Hemoglobin is
excreted in the urine

28. Malaria in pregnancy
• Fetal
▫ Still birth
▫ Prematurity  increased risk
of neonatal death
▫ Fetal distress
• Maternal
▫ Anemia  risk of maternal
mortality
• Mortality due to cerebral
malaria is higher

29. Prognosis
• Without treatment P.falciparum will terminate
in less than 1 year.
• But in P.vivax and P.ovale persist as hypnozoites
after the parasites have disappeared from blood.
• Can produce periodic relapses up to 5 years
• In P.malariae may last for 40 years
( Called as recrudescence X relapse )

30. Diagnosis
• Giemsa stain
• QBC system
• Antigen detection
• Serology
Thick smear – parasite detection
Thin smear – strain detection
Plasmodium Glutamate
Dehydrogenase – a marker enzyme

31. Rapid diagnostic test

32. Treatment
• Choroquine
• 1.8 grams of Chloroquine in over 4 days.
• In children dose to be calculated according to
weight
• In cases of P.falciparum leading to coma need
to be treated with Quinidine gluconate until
oral treatment is feasible.
• Artemisine based combination therapy

33. Suppressive Prophylaxis
• Popular drugs include, Chloroquine,
Amodiaquine.
• Mefloquine is drug of choice in Chloroquine
resistant areas of the world

34. Other Alternatives
1 Quinine plus Doxycycline or Tetracycline
2 Quinine plus Clindamycin
Newer alternatives
1 Mefloquine and Halofantril.

35. Control of Malaria
• Elimination of Mosquito breeding places,
• National improvements on health and hygiene.
• Use of Mosquito nets, treated with Pyrithrin
• Clothing with sleeves, and long trousers
• Use of Mosquito repellents

37. World Malaria Day
• World Malaria Day (previously Africa Malaria
Day) will now be commemorated every year on
25 April.