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Malaria(Plasmodium falciparum)- Epidemiology,
Life Cycle, Prevention and
Eradication
Sarath
Epidemiological Triad
Host
1.Sex-Male
2.Race-Sickle cell trait
3.Occupation-
Labourers,Farmers,Tribals
4.Socio Economic status
5.Human Habits -Nomadism
Environment
1.Seasons
2.Temperature
3.Humidity
4.Rainfall
5.Altitude
Agent Factors
1.Parasites
2.Reservoirs
3.Relapses
Vector
Anopheles Mosquito
Organism
Plasmodium Falciparum
Phylum : Apicomplexa
Class : Sporozoea
Subclass : Coccidia
Order : Eucoccidia
Suborder : Haemosporina
Features of plasmodium falciparum
Forms in the peripheral blood- Rings and
crescents only.
Ring form- Cytoplasm fine and regular. Often
with 2 nuclei. Form accole.
Merozoites- 18 to 24 or more. Arranged in a
grape like cluster.
Gametocyte- Banana shaped. Larger than the
red blood cell.
Life Cycle
Exogenous Phase(in Mosquito)
Sexual Cycle (sporogony)
Endogenous Phase(in Human)
Asexual Cycle(Schizogony)
Sporozoites pass through
body cavity,salivary glands
Exoerythrocytic cycle multiplication
in liver parenchymal cells
Merozoites
Enter RBC
Ring Trophozoite
Mature Trophozoite
Immature Schizont
Mature Schizont
Microgametocyte
(differentiation)
Macrogametocyte
Human blood
enters mosquito
Microgamete
(fertilization)
Macrogamete
Zygote
Ookinete(motile
Zygote)
Penetrates to outer layer of
stomach wall of mosquito and
encysts
Oocyst grows(multiple division stage:
cyst bursts to release sporozoites
Sporozoites in
saliva injected into
human host
Malaria Life Cycle in Humans
Reservoir
Conditions :
1. The person must harbour both sexes of
gametocyte in blood
2. Gametocytes must be mature
3. Gametocytes must be viable
4. Gametocytes must be present in suffcient
quantity
Reservoir Contd…
Humans
1. One who harbours the sexual forms of
parasite.
2. Children are more likely to be gametocyte
carriers than adults. Hence better reservoir.
Transmission
1. Vector Transmission
Anopheles culicifacies – Rural and per urban areas
Anapheles stephensi -- Urban and Industrial areas
Anopheles fluviatilis -- Hilly areas
Anopheles epiroticus -- Only in Andaman and Nicobar
2. Direct Transmission
By sharing syringes, blood transfusion etc.
Parasites keep their infective activity during at
least 14 days in bottles stored at -4 0C
Persons who have lived in endemic area and
anyone who has had malaria should not be
accepted as a blood donor until 3 years
afterwards.
3. Congenital Malaria
Congenital infection from mother to newborn also
occur, but it is comparatively rare
Prevention
All that we have to do is to break this chain
 Insecticide treated
nets
 Repellents
 protective clothing
 screening of houses
 Environmental
sanitation
 water
management
 drainage
 Larviciding of water
surfaces
 intermittent irrigation
 slucing,
 biological control
 Indoor
residual
spraying
 Space
spraying
 Ultra low
volume
sprays
 Health
education
 Community
participation
 Prophylaxis for
susceptible
population
 Gametocidal
drugs
Prevention
Action For Individual and Family protection
Reduction of Human-Mosquito contact Insecticide treated nets, repellents,
protective clothing, screening of houses
Destruction of mosquito larva Peri-Domestic sanitation
Source reduction Small scale drainage
Social participation Motivation for personal and family
protection
Destruction of Adult Mosquitoes Indoor residual spraying
Prevention
Action For Community protection
Reduction of Human-Mosquito contact Insecticide treated nets, zooprophylaxis
Destruction of mosquito larva Larviciding of water surfaces, intermittent
irrigation, sluicing, biological control
Source reduction Environmental sanitation, water
management, drainage
Destruction of Adult Mosquitoes Indoor residual spraying, Space spraying,
ultra low volume sprays
Social participation Health Education, Community
participation
Biological Control-Gambusia
Insecticide treated nets
Can malaria be Eradicated???
Agent
Source
Susceptible
Population
Vector
Eradication Elimination Control
Current answer is NO 
Why??
Despite progress, the burden of malaria is still
great and it is widespread.
Drug and insecticide resistance are on the
rise. In South East Asian countries, resistance
of Plasmodium falciparum, to Artemisinin, has
been detected.
Although new drugs and insecticides are being
sought, none are expected to be available in
the near future.
Ref: Malaria eradication:Is it possible?Is it worth it?Should we do it?Should we do it?
Jenny Liu,Sepideh Modrek,Roly D Gosling,Richard GA Feachem
Increased mobility of people not only makes
containment of resistance difficult, but also
threatens the introduction or reintroduction
of malaria parasites to receptive areas.
New strains are emerging- ex. Plasmodium
knowlesi
Zoonotic reservoirs
Ref: Malaria eradication:Is it possible?Is it worth it?Should we do it?Should we do it?
Jenny Liu,Sepideh Modrek,Roly D Gosling,Richard GA Feachem
How can we bring eradication in the
future???
Malaria is biologically and ecologically different
throughout the world. So Malaria eradication
strategies should be developed and implemented on
a local or regional level.
Eradication can be accelerated by new drug regimens
and strategies that lead to complete parasitologic
cure of the individual.
The majority of malaria infections occur in
asymptomatic people, who are a source of continued
transmission. A successful and accelerated
eradication effort will target asymptomatic infections
through community-based efforts.
ThankYou

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Malaria(Plasmodium falciparum)- Epidemiology, Life Cycle, Prevention and Eradication

  • 1. Malaria(Plasmodium falciparum)- Epidemiology, Life Cycle, Prevention and Eradication Sarath
  • 2. Epidemiological Triad Host 1.Sex-Male 2.Race-Sickle cell trait 3.Occupation- Labourers,Farmers,Tribals 4.Socio Economic status 5.Human Habits -Nomadism Environment 1.Seasons 2.Temperature 3.Humidity 4.Rainfall 5.Altitude Agent Factors 1.Parasites 2.Reservoirs 3.Relapses Vector Anopheles Mosquito
  • 3. Organism Plasmodium Falciparum Phylum : Apicomplexa Class : Sporozoea Subclass : Coccidia Order : Eucoccidia Suborder : Haemosporina
  • 4. Features of plasmodium falciparum Forms in the peripheral blood- Rings and crescents only. Ring form- Cytoplasm fine and regular. Often with 2 nuclei. Form accole. Merozoites- 18 to 24 or more. Arranged in a grape like cluster. Gametocyte- Banana shaped. Larger than the red blood cell.
  • 5. Life Cycle Exogenous Phase(in Mosquito) Sexual Cycle (sporogony) Endogenous Phase(in Human) Asexual Cycle(Schizogony) Sporozoites pass through body cavity,salivary glands Exoerythrocytic cycle multiplication in liver parenchymal cells Merozoites Enter RBC Ring Trophozoite Mature Trophozoite Immature Schizont Mature Schizont Microgametocyte (differentiation) Macrogametocyte Human blood enters mosquito Microgamete (fertilization) Macrogamete Zygote Ookinete(motile Zygote) Penetrates to outer layer of stomach wall of mosquito and encysts Oocyst grows(multiple division stage: cyst bursts to release sporozoites Sporozoites in saliva injected into human host
  • 6. Malaria Life Cycle in Humans
  • 7. Reservoir Conditions : 1. The person must harbour both sexes of gametocyte in blood 2. Gametocytes must be mature 3. Gametocytes must be viable 4. Gametocytes must be present in suffcient quantity
  • 8. Reservoir Contd… Humans 1. One who harbours the sexual forms of parasite. 2. Children are more likely to be gametocyte carriers than adults. Hence better reservoir.
  • 9. Transmission 1. Vector Transmission Anopheles culicifacies – Rural and per urban areas Anapheles stephensi -- Urban and Industrial areas Anopheles fluviatilis -- Hilly areas Anopheles epiroticus -- Only in Andaman and Nicobar
  • 10. 2. Direct Transmission By sharing syringes, blood transfusion etc.
  • 11. Parasites keep their infective activity during at least 14 days in bottles stored at -4 0C Persons who have lived in endemic area and anyone who has had malaria should not be accepted as a blood donor until 3 years afterwards.
  • 12. 3. Congenital Malaria Congenital infection from mother to newborn also occur, but it is comparatively rare
  • 13. Prevention All that we have to do is to break this chain
  • 14.  Insecticide treated nets  Repellents  protective clothing  screening of houses  Environmental sanitation  water management  drainage  Larviciding of water surfaces  intermittent irrigation  slucing,  biological control  Indoor residual spraying  Space spraying  Ultra low volume sprays  Health education  Community participation  Prophylaxis for susceptible population  Gametocidal drugs
  • 15. Prevention Action For Individual and Family protection Reduction of Human-Mosquito contact Insecticide treated nets, repellents, protective clothing, screening of houses Destruction of mosquito larva Peri-Domestic sanitation Source reduction Small scale drainage Social participation Motivation for personal and family protection Destruction of Adult Mosquitoes Indoor residual spraying
  • 16. Prevention Action For Community protection Reduction of Human-Mosquito contact Insecticide treated nets, zooprophylaxis Destruction of mosquito larva Larviciding of water surfaces, intermittent irrigation, sluicing, biological control Source reduction Environmental sanitation, water management, drainage Destruction of Adult Mosquitoes Indoor residual spraying, Space spraying, ultra low volume sprays Social participation Health Education, Community participation
  • 19. Can malaria be Eradicated??? Agent Source Susceptible Population Vector Eradication Elimination Control
  • 20. Current answer is NO  Why?? Despite progress, the burden of malaria is still great and it is widespread. Drug and insecticide resistance are on the rise. In South East Asian countries, resistance of Plasmodium falciparum, to Artemisinin, has been detected. Although new drugs and insecticides are being sought, none are expected to be available in the near future. Ref: Malaria eradication:Is it possible?Is it worth it?Should we do it?Should we do it? Jenny Liu,Sepideh Modrek,Roly D Gosling,Richard GA Feachem
  • 21. Increased mobility of people not only makes containment of resistance difficult, but also threatens the introduction or reintroduction of malaria parasites to receptive areas. New strains are emerging- ex. Plasmodium knowlesi Zoonotic reservoirs Ref: Malaria eradication:Is it possible?Is it worth it?Should we do it?Should we do it? Jenny Liu,Sepideh Modrek,Roly D Gosling,Richard GA Feachem
  • 22. How can we bring eradication in the future??? Malaria is biologically and ecologically different throughout the world. So Malaria eradication strategies should be developed and implemented on a local or regional level. Eradication can be accelerated by new drug regimens and strategies that lead to complete parasitologic cure of the individual. The majority of malaria infections occur in asymptomatic people, who are a source of continued transmission. A successful and accelerated eradication effort will target asymptomatic infections through community-based efforts.

Editor's Notes

  1. Add family and class