This document summarizes information about malaria, including: - Malaria is caused by Plasmodium parasites transmitted via mosquito bites that infect and destroy red blood cells, causing symptoms like fever and fatigue. - There are multiple Plasmodium species that cause malaria in humans. The life cycle involves the parasite reproducing in the liver and blood. - Complications of malaria include organ enlargement, anemia, and other issues. Treatment involves antimalarial drugs with the goal of cure and prevention of transmission.

1. - SHARON VICTOR

2. OVERVIEW..
INTRODUCTION
EPIDEMIOLOGY
LIFE CYCLE
COMPLICATIONS
CLINICAL MANIFESTATION
LAB DIAGNOSIS
TREATMENT

3. INTRODUCTION:
Malarial parasites enter the bloodstream they infect and
destroy and the red blood cells. Destruction of these
red blood cells leads to fever and flu-like symptoms
such as chills, headache, muscle ache, tiredness,
nausea, vomiting and diarrhoea.

4. CLASSIFICATION/ SPECIES
INVOLVED:
 Phylum: Apicomplexa
 Class: Sporozoa
 Order: Haemeosporida
 Genus: Plasmodium
P. vivax
P. malariae
P. ovale
P. falciparum
P. knowelsi

5. EPIDEMIOLOGY:
 Transmitted by bite of female anopheles mosquito
 Parasite undergoes temperature dependent cycle of
development in the gut of the insect
 Also transmitted through contaminated blood
transfusions
 Occasionally seen among drug users sharing needles
 HAI (Hospital Acquired Infection)
 ‘Airport malaria’

6.  Infective form: Sporozoites
 Portal of entry: Skin
 Site of location: First in the liver then in the
erythrocytes
 Transmitting agent: Female Anopheles mosquito

7. LIFE CYCLE OF THE PARASITE:

8. COMPLICATIONS:
 Encephalopathy
 Congestive heart failure
 Hepatomegaly
 Splenomegaly
 Hemoglobinuric nephrosis
 Anaemia
 Cytokine release

9. CLINICAL MANIFESTATION:
 P. vivax or P. ovale infection: anaemia and
hepatosplenomegaly
 P. malariae infection: mild illness, persists for years
with or without symptoms. In children associated with
glomerulonephritis and nephritic syndrome
 P. falciparum infection: cerebral malaria and
blackwater fever, Algid malaria and septicemic
malaria.

10. HYPERREACTIVE MALARIAL
SPLENOMEGALY:
 Seen where malaria is hyperendemic
 Associated with exaggerated immune response to
repeated malarial infections
 Characterized by anaemia, massive splenomegaly and
elevated IgM levels
 Malarial parasites are scanty or absent
 Requires prolonged treatment with antimalarial drugs

11. LABORATORY DIAGNOSIS:
 Demonstration of the parasite by microscopy
1. Thick smears (Fields and Leishman)
2. Thin smears (Leishman, Fields, Giemmsa or JSB)
 Quantitative Buffy coat
 Microconcentration technique
 Culture of malarial parasite
 Serodiagnosis

12. QUANTIFICATION OF PARASITE:
Counting of parasite done to an approximate number by
a thick smear:
+ = 1-10 parasite per 100 thick film fields
++ = 11-100 parasite per 100 thick film fields
+++ = 1-10 parasite per thick film field
++++ = more than 10 parasite per thick film field

13. QUANTITATIVE BUFFY COAT:
 Test developed by Becton-Dickinson, USA simplified
method for diagnosing malaria, where a small quantity
of blood is spun on a QBC centrifuge at 12000 rpm for
5mins.
 RBC containing parasites are less dense than normal
RBC and concentrate below buffy coat of leucocytes at
the top of erythrocytic column
 Pre-coating of tube with acridine orange induces a
fluorescence on the parasites
 Faster and more sensitive than thick blood smear

14. CULTURE OF THE PARASITE:
 Trager and Jensen’s method of petridish culture
employed with a candle jar to provide an atmosphere
of 3% oxygen and 10% carbondioxide and a relatively
simple culture medium supplemented with human,
rabbit or calf serum to maintain infected erythrocytes.
Fresh red cells were added periodically for
continuation and growth of Plasmodium
 Cell lines derived from Aotus monkey or directly from
human patients

15. SERODIAGNOSIS:
 Not much helpful in clinical diagnosis
 Does not help differentiate between an active and past
infection
 Can be used mainly for seroepidemiological surveys
 To identify infected donors in transfusion malaria
 Tests used are: IHA, IFA, ELISA

17. LABORATORY TECHNIQUES:
 Fluoroscence microscopy
 Rapid antigen detection test
 Dual antigen test
 Molecular diagnosis
1. DNA probe
2. PCR
 Other test

18. FLUOROSCENCE
MICROSCOPY:
 Use of fluoroscent dyes like acridine orange or
benzothiocarboxy purine
 Stains DNA as fluorescent green and cytoplasmic RNA
as red
 Examined under fluoroscent microscope
 Method generally used for mass screening in field
laboratory

19. RAPID ANTIGEN DETECTION
TESTS:
 Based on immunochromatographic methods
 Seen in forms such as dipstick, cards and cassette
bearing monoclonal antibody
 Parasite F test: detection of HRP-2 (HISTIDINE RICH
PROTEIN-2)

20. DUAL ANTIGEN TEST:
 Detects parasite lactate dehydrogenase produced by
trophozoites and gametocytes of all Plasmodium
species and PF HRP-2 antigen
 One band is genus specific (Pv) and the other is P.
falciparum specific
 Sandwich immunoassay for differentiation of P.
falciparum and P. vivax malaria

21. MOLECULAR DIAGNOSIS:
 DNA Probe: highly sensitive method for diagnosis of
malaria. It can detect less than
10 parasites / µl of blood
 PCR: used for species specification and for detection of
drug resistance in malaria

22. OTHER TESTS:
 PCV packed cell volume when there is heavy parasitemia
particularly in children and pregnant women
 Total WBC and platelet count in severe falciparum
infection
 Measurement of blood glucose to detect hypoglycemia
particularly in young children and pregnant women with
severe falciparum infection and with patients receiving
quinine
 FDP’S (fibrin degradation products) , PTT (prothrombin
time)
 Urine for hemoglobin
 Blood urea and serum creatinine

23. TREATMENT:
OBJECTIVES:
 Clinical cure
 Prevention of relapse
 Prevention of transmission
 Prophylaxis

24. TREATMENT
 The current tool and eradication of malaria demands a
multifaceted approach. No one tool alone can defeat
the parasite.
 Currently, WHO has recommended first line
treatment for a majority of malaria cases;
ACT ( artemisinin based combination therapy)

25. Thank You..!!