The document summarizes information about malaria, including that it is caused by parasites transmitted via mosquito bites, with 350-500 million cases annually. It discusses the four Plasmodium species that cause malaria and their incubation periods. Malaria symptoms include febrile paroxysms with chills, fever, and sweating stages. Complications include cerebral malaria, anemia, and blackwater fever. Diagnosis involves blood film examination, and treatment depends on parasite species and disease severity, usually requiring around two weeks.

1. MALARIA
NURUL HIDAYU | NASHRIQ AIMAN | AUDI ADIBAH

2.  Malaria is a life-threatening disease caused by parasites that are
transmitted to people through the bites of infected
female Anopheles mosquitoes.
 It is widespread in tropical and subtropical regions
 350 – 500 million cases per year
INTRODUCTION

4. Parasite :
I. P. vivax
II. P. falciparum
III. P. malariae
IV. P. ovale
ETIOLOGY
Vectors :
INCUBATION PERIOD
 P. falciparum: 9 – 14 days
 P. vivax: 12-17 days
 P. ovale: 16 – 18 days
 P. malariae: 18 – 40 days

5. Life cycle of malarial parasite
 Hepatic phase / Tissue phase
 Erythrocytic phase
 Sexual reproduction
2 HOSTS–
 DEFINITE HOST– Anopheles Mosquito
 INTERMEDIATE HOST– Human

9. CLASSIFICATION
UNCOMPLICATED MALARIA SEVERE MALARIA
 Symptomatic malaria without
signs of severity or evidence
(clinical or laboratory) of vital
organ dysfunction.
 The sign and symptoms are
nonspecific
 Evidence (clinical or
laboratory) of vital organ
dysfunction.
 Usually due to Falciparum or
mixed infections.

10. All four species can exhibit non-
specific prodromal symptoms
few days before the first febrile
attack.
Prodromal symptoms are
generally described as 'flu-like'
and include: headache, slight
fever, muscle pain, anorexia and
nausea.
Other symptoms : anemia,
splenomegaly, jaundice and
dehydration
CLINICAL MANIFESTATIONS

11. FEBRILE PAROXYSMS
COLD STAGE
1. CHILLS
2. RIGORS
3. NAUSEA
4. MALAISE
5. ANOREXIA
6. 20mins – 1 hr.
HOT STAGE
1. DRY & FLUSHED SKIN
2. RAPID RESPIRATION
3. MARKED THIRST
4. 1 – 4 hrs.
SWEATING STAGE
1. TEMPERATURE FALLS
BY CRISIS
2. 2 – 3 hrs.
3. NO FEVER – 24-48
HOURS
CLINICAL MANIFESTATIONS

13. DIFFERENTIAL DIAGNOSIS
1. Dengue
2. Typhoid fever
3. Leptospirosis
4. Septicemia

14. COMPLICATIONS
Cerebral malaria
Anemia
Gastrointestinal illness
Algid malaria
Blackwater fever
Renal lesions
Splenic rupture
Hypoglycemia
Hyperpyrexia
Convulsions
Spontaneous bleeding &
coagulopathy
Aspiration pneumonia
COMPLICATIONS

16. CEREBRAL
MALARIA

17. Severe form of malaria
Caused by P. Falciparum
Most common non-traumatic
encephalopathy
Common in children and non-
immune adults
Adhering of P. falciparum infected
erythrocytes to brain capillaries
causing coma & death.
Manifested with:
— Coma
— Convulsion
— Hemoglobinuria
on investigation : CSF is normal
on examination : Splenomegaly

19. BLACKWATER
FEVER

20. also known as malarial hemoglobinuria , one of the less common
yet most dangerous complications of malaria.
Sudden hemolysis caused by P. falciparum
Leads to Hemoglobinemia & Hemoglobinuria (‘cola-coloured
urine’)
Other clinical features:
— Rapid pulse
— High fever and chills
— Extreme prostration
— Rapidly developing anemia
Causes jaundice and eventually renal failure
High mortality

21. 1. Blood Film Examination for Malaria Parasite (BFMP)
• Thick blood film : detection of even low levels of parasitaemia
• Thin blood film : to identify parasite morphology
2. Quantitative Buffy coat test
• It involves staining of the centrifuged & compressed red cell layer with acridine
orange & its examination under UV light source
3. Rapid diagnostic tests
• Detects malarial antigens (PfHRP2/PMA/pLDH) from asexual &/or sexual forms
of the parasite.
4. Polymerase chain reaction:-
• specific test for detecting all species of malaria
INVESTIGATIONS

22. 5. Other investigations:
Complete blood counts
Blood levels of glucose
Renal Profile
Urine Analysis
Liver Function Test
Other’s rapid test to rule out dengue or leptospirosis

24. THIN AND THICK
SMEAR

25. Treatment of malaria depends on the number of
different factors that include disease severity, the
particular species of Plasmodium infecting the
patient and the potential for drug resistance of the
various species and strains of Plasmodium. In
general, it takes about two weeks of treatment to
be cured of malaria.
How long will it take to recover from
malaria?

26. TREATMENT
 ANTI-MALARIAL THERAPY
1. Cinchona alkaloids : Quinine, Quinidine
2. Artemisinin derivatives : Artemether & Artesunate
3. Other antimalarials : halofantrine, Mefloquine, atavaquone,
doxycycline and tetracycline
 SUPPORTIVE TREATMENT : to manage the complications

27. Clinical diagnosis/
plasmodium
species
Recommended drugs
Uncomplicated
malaria/
p.falciparum
Chloroquine
sensitive
Chloroquine phosphate
Chloroquine
resistant
A)Quinine sulphate+
doxycycline, or
tetracycline, or
Clindamycin
B).Atovaquone-Proguanil
C) Mefloquine

28. Clinical diagnosis/
plasmodium species
Recommended drugs
Uncomplicated malaria/
p.malariae
Chloroquine phosphate
Uncomplicated malaria/
p.vivax or p.ovale
Chloroquine phosphate +
primaquine phosphate
Uncomplicated malaria/
p.vivax  chloroquine
resistant
A). Quinine sulphate +
(doxycycline or tatracycline)
+ primaquine phosphate
B). Mefloquine +
primaquine sulphate

29. Clinical diagnosis Recommended drugs
SEVERE MALARIA Artesunate IV or IM
Quinine IV
Artemether IM
 give parenteral antimalarial for min
of 24hrs once started & there after
complete treatment by giving a
complete course of
artesunate + clindamycin or
doxycycline
quinine + clindamycin or doxycycline

30. IMMUNITY
 Sickle cell and malaria
Sickling of the RBC causes a disruption in the reproductive cycle of
Plasmodium, resulting in lower parasite levels and less severe symptoms
 G6PD deficiency and malaria
Plasmodium oxidizes RBC NADPH from the Pentose Phosphate pathway
for its metabolism  deficiency of RBC GSH  peroxide-induced
hemolysis curtails the development of Plasmodium