Pharmacotherapeutics of Malaria define, Epidemiology, Risk Factors, Etiology, Sign and Symptoms, Pathophysiology, Diagnosis, Treatment, Prevention and Patient Counselling

1. MAL ARIA

2. D I V Y A N S H U R A J P U T
R O L L N O . 1 8 1 3 7 5 8
C L A S S - P H A R M D 3 R D Y E A R
D E P T . O F P H A R M A C Y P R A C T I C E
ISF COLLEGE OF PHARMACY
E M A I L : D I V Y A N S H U R A J P U T D R @ G M A I L . C O M

3. CONTENTS
• Define
• Epidemiology
• Risk Factors
• Etiology
• Sign and Symptoms
• Pathophysiology
• Diagnosis
• Treatment
• Prevention
• Patient Counselling

4. DEFINITION
• Malaria is an infectious disease in which intermittent and
remittent fever caused by protozoan parasites from the
Plasmodium family that can be transmitted by the bite of
the Anopheles mosquito, which invades the RBC .
• There are 5 species of the protozoal parasite Plasmodium,
found in most parts of India and other tropical countries.
• Plasmodium vivax
• Plasmodium ovale
• Plasmodium falciparum
• Plasmodium malaria
• Plasmodium knowlesi

5. EPIDEMIOLOGY
• Precise statistics unknown - most cases are rural and at Tropical
Regions In INDIA.
• 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.
• P. vivax is the most common infection (80% of the cases).
• P. falciparum causes most deaths and is very Fatal to Human Host
(15% of infections and 90% of deaths).
• Other Plasmodium species also infects birds, reptiles, rodents,
monkeys and apes.

6. RISK FACTORS-
• The biggest risk factor for developing malaria is to live in or to visit
areas where the disease is common. There are many different varieties
of malaria parasites. The variety that causes the most serious
complications is most commonly found in:
 African countries south of the Sahara Desert
 The Asian subcontinent
 New Guinea, the Dominican Republic and Haiti
• People at increased risk of serious disease include:
 Young children and infants
 Older adults
 Travelers coming from areas with no malaria
 Pregnant women and their unborn children

7. SIGNS & SYMPTOMS -
• shaking chills that can range
from moderate to severe
• high fever
• profuse sweating
• headache
• nausea
• vomiting
• abdominal pain
• diarrhoea
• Anaemia
• muscle pain
• convulsions
• coma
• bloody stools

8. ETIOLOGY -
Malaria is caused by the Plasmodium parasite. The parasite can be spread to
humans through the bites of infected mosquitoes. Also, if the Human which
is infected is bitten by mosquito, the mosquito also carries the parasite and
infect other people.
There are many different types of plasmodium parasite, but only 5 types
cause malaria in humans.
These are :
• Plasmodium falciparum – mainly found in Africa, it's the most common type of
malaria parasite and is responsible for most malaria deaths worldwide
• Plasmodium vivax – mainly found in Asia and South America, this parasite causes
milder symptoms than Plasmodium falciparum, but it can stay in the liver for up to 3
years, which can result in relapses
• Plasmodium ovale – fairly uncommon and usually found in West Africa, it can
remain in your liver for several years without producing symptoms
• Plasmodium malariae – this is quite rare and usually only found in Africa
• Plasmodium knowlesi – this is very rare and found in parts of southeast Asia

11. PATHOPHYSIOLOGY-
• After a mosquito takes a blood meal, the malarial
sporozoites enter hepatocytes (liver phase) within minutes
and then emerge in the bloodstream after a few weeks.
These merozoites rapidly enter erythrocytes, where they
develop into trophozoites and then into schizonts over a
period of days (during the erythrocytic phase of the life
cycle). Rupture of infected erythrocytes containing the
schizont results in fever and merozoite release. The
merozoites enter new red cells, and the process is repeated,
resulting in a logarithmic increase in parasite burden.

12. DIAGNOSIS -
General measures
• History: recent or distant travel to regions where malaria is endemic.
• CBC - Hemolytic anemia, ↓ Hb, ↓ haptoglobin, ↑ LDH, ↑ indirect
bilirubin, ↑ reticulocytes.
Blood smear -
• Description: confirms suspected cases by visualizing parasites within RBCs.
• Best initial test: thick blood smear
– High sensitivity
– Detects the presence of parasites
• Confirmatory testing: thin blood smear
– Lower sensitivity than thick blood smear, but higher specificity.
– Parasites are visible within red blood cells since the morphology
of erythrocytes is preserved
– Allows determination of Plasmodium species
– Schuffner granules (fine, brick-red dots) within the cytoplasm of P. vivax
and P. ovale.

13. • Evaluation of negative test results.
– If parasite densities are very low, malaria may be initially undetectable.
– If an initial test result is negative, blood smears should be repeated three
times every 12–24 hours
– If all three sets are negative, malaria can be ruled out.
• If symptoms persist despite negative microscopy and rapid testing, blood
smears should be repeated 3 times every 12-24 hours.
Other tests
• Rapid diagnostic tests (RDTs)
– Determination of specific malaria antigens, e.g., HRP2, pLDH, and Aldolase
– Benefits: quick determination of malaria infection in areas
lacking high-quality malaria microscopy
– All RDT results should be confirmed via microscopy (if available).
• Serological tests
– Not appropriate for acute diagnosis of malaria because antibodies are
undetectable for 1–2 weeks after primary infection
– Positive serological results indicate prior exposure to Plasmodium.

14. COMPLICATIONS-
Malaria can cause a number of life-threatening complications.
The following may occur:
• swelling of the blood vessels of the brain, or cerebral malaria.
• an accumulation of fluid in the lungs that causes breathing
problems, or pulmonary edema.
• organ failure of the kidneys, liver, or spleen.
• anemia due to the destruction of red blood cells.
• low blood sugar.

15. TREATMENT-

18. NON-PHARMACOLOGICAL
TREATMENT -
• Using insecticide-treated nets or clothing in non-pregnant
adults may be beneficial.
• Long-lasting insecticidal nets (LLINs) are likely to have an
extended duration of action compared with conventionally
treated bed nets.
• There is a consensus that skin-applied chemical repellents
containing diethyltoluamide (DEET) reduce the risk of
insect bites.
• Picaridin is a newer and possibly more effective repellent
than DEET, but it has not yet been evaluated against
clinical outcomes.

19. PREVENTION OF MALARIA-
• Use an insect repellant. Apply an insect repellant to your skin,
clothing, and other fabrics, such as blankets. Ask your healthcare
provider which insect repellant is best to use.
• Cover your skin. Wear long-sleeved shirts and pants to keep your
skin covered.
• Sleep under a mosquito net. Spray insect repellant on your
mosquito net. Check your net for holes often.
• Protect your home. Put screens on your windows and doors to
keep mosquitoes out. Use insecticide inside your home to kill
mosquitoes that come into your house.
• Remove all standing water around your home. Mosquitoes
lay their eggs and mature in water.
•

20. REFERENCE-
• https://www.pharmacytimes.com/
• https://www.amboss.com/
• https://reference.medscape.com/
• https://www.drugs.com/
• https://www.who.int/
• https://www.mayoclinic.org/
• https://www.webmd.com/
• KD Tripathi's Essentials of Medical Pharmacology 7th Edition.
• Goodman and Gilman’s The Pharmacological Basis of
Therapeutics

21. THANK
YOU