This document summarizes the natural history of malaria. It discusses how the malaria parasite and mosquito vectors adapt over time, influencing transmission rates. It also outlines the clinical course of malaria in humans, from initial symptoms like fever and headaches, to potential long-term effects like organ dysfunction, mental depression, and even death. The document maps out the disease process at different stages, from early pathogenesis to advanced stages. It also notes factors influencing transmission at various levels like the host, environment, and application of preventive measures.

1. THE NATURAL HISTORY OF DISEASE OF MALARIA
RALPH JULIUS G. BAWALAN
Agent
> Modification of Microbial/ Vector
Chronic State
Adaptation
> Swamp and stagnant water
> Mosquito flight behavior THE COURSE OF DISEASE IN MAN > Acute renal failure, chronic
renal failure,
> Changes in biting habits
> High Temperature  (↑ blood meal;↑ > mental depression
no. of time mosquito will lay eggs) > profound anemia,
> ↓ Rainfall  ↓transmission > edema
Disabilities > profound muscular weakness,
> FTT, chronic
and Defects lymphadenopathy
> stunted growth, apathy,
CLINICAL HORIZON > Malaria can be long-term indifference,
Host incapacity to work or go to > abortion, growing drug
school resistance
> Innate and Acquired Host Resistance > multi-organ dysfunction
> Home Treatment of Cases Signs and > socio-economic burden
> Drug resistance
> Traditional beliefs Symptoms,
> Increase in poverty levels Illness
> Incidence of HIV/AIDS
> Presence of Local IVC Program
> Insecticide treated bed nets > Headache, Fatigue, Abdominal
discomfort, muscle aches
> Population growth
> Fever, chest pain, abdominal pain,
Immunity and Resistance DEATH
> Access to healthcare
arthralgia, myalgia, or diarrhea
> Food production
> Nausea, vomiting, orthostatic RECOVERY
hypotension
> Lack of a sense of well-being,
Stimulus Established, Myalgia , classic malarial
Environment Tissue and paroxysms, in which fever spikes,
chills, and rigors occur at regular
Physiologic Changes
intervals (unusual and suggest
> Climate and seasonality infection with P. vivax or P. ovale.).
> Reduction of Aquatic Habitats > malaria parasites induce Malaria antigen– > Fever is usually irregular at first (in
> Presence of bushes or Garbage Heaps related IgE complexes, therefore, a release of
falciparum malaria it may never
cytokines
> Environmental Modification (massive > Sequestration: Erythrocytes with P. falciparum become regular). febrile convulsions
deforestation, ↑ irrigation, blocked adhere to microvascular endothelium in childhood, Splenic enlargement,
(“cytoadherence”)  stocked RBC anaerobic
swamp drainage) glycolysis, lactic acidosis, and cellular Slight enlargement of the liver, Mild
dysfunction jaundice (adults)
> The PfEMP1 expression alters the red cell
membrane components
> CD36 (sticky proteins present on the surface of
vascular endothelium) shall therefore bind
Disease Provoking parasitized red cells
Stimulus Early Pathogenesis Discernable Early Lesion Advanced Stage Convalescence
LEVELS OF APPLICATION OF PREVENTIVE MEASURES