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By
      A.S.ARUL LAWRENCE
Principal, St.Joseph College of Education,
     Nanguneri-627108, Tamil Nadu.
    E-mail : arullawrence@gmail.com.
                                             1
Causal Agents:

•    Blood parasites of the genus
    Plasmodium.
•    There are approximately 156 named
    species of Plasmodium which infect
    various species of vertebrates.
•    Four are known to infect humans:
    P. falciparum, P. vivax , P. ovale and
    P. malariae.
                                             2
What is a Malarial Parasite?
The malarial parasite, Plasmodium, is a
 very small, single-cell blood organism, or
 'protozoan'.
 It lives as a parasite in other
 organisms, namely man and mosquito. The
 parasite is the cause of the tropical disease
 Malaria.
The Plasmodium parasite is dependent on
 a single species of
 mosquito, Anopheles, which is the only
 species capable of serving as host for it. 3
Male & Female Plasmodium.




                            4
Classification
   Phylum           :   Protozoa
   Sub- Phylum     :    Sporozoa
   Class          :     Telosporea
   Sub-Class     :      Coccidia
   Order         :      Eucoccida
   Sub-Order      :     Hamosporidiidea
   Family        :      Plasmodiidae
   Genus         :      Plasmodium
                                           5
Geographic Distribution.

 Worldwide, malaria usually
 restricted to tropical and subtropical
 areas and altitudes below 1,500 m.
 P. vivax is more common in Central

 America and the Indian subcontinent

                                      6
7
8
Infection rate.
   WHO estimates that yearly 300-500
    million cases of malaria occur and
    more than 1 million people die of
    malaria.
    P. vivax and P. falciparum are the most
    common.


                                           9
Mode of
Infection.



         10
Vector & Parasite.




                     11
Life cycle.
 A malaria-infected female Anopheles
  mosquito inoculates sporozoites into the
  human host during a blood meal.
 Sporozoites infect liver cells and mature into
  schizonts, which rupture and release
  merozoites (exo-erythrocytic schizogony).
 In P. vivax and P. ovale a dormant stage
  (hypnozoites) can persist in the liver for
  weeks, or even years. The merozoites infect
  red blood cells.

                                                   12
Life cycle…


• The ring stage trophozoites mature into
  schizonts, which rupture releasing merozoites
  (erythrocytic schizogony).
• Some parasites differentiate into sexual
  erythrocytic stages (gametocytes).
• The gametocytes are ingested by an Anopheles
  mosquito during a blood meal.
• The microgametes penetrate the macrogametes
  generating zygotes in the mosquito's stomach.
                                              13
Life cycle…..


• The zygotes become ookinetes and invade the
  midgut wall where they develop into oocysts.
• The oocysts grow, rupture, and release
  sporozoites, which make their way to the
  mosquito's salivary glands (sporogonic cycle).




                                                   14
15
Sporozoite Invasion.




                       16
Erythrocytic Schizoite.




                          17
Amoeboid Stage.




                  18
Ring Stage.




              19
Male Gamete.




               20
Female Gamete.




                 21
Fertilization.




                 22
Mature Oocyst.




                 23
Rupturing of Oocyst.




                       24
MALARIAL PARASITE’S
      DIFFERENT CYCLES
                CYCLES OF PARASITE



         HUMAN - ASEXUAL MOSQUITO - SEXUAL
          (SCHIZOGONY)     (SPOROGONY)



EXOERYTHROCYTIC ENDOERYTHROCYTIC
      CYCLE           CYCLE
     (LIVER)         (BLOOD)

                                      25
Sickle cell anaemia and malaria
   A genetic disorder, called sickle cell anaemia, happens
    when a person inherits two faulty genes to make the
    haemoglobin in their red blood cells which then break
    open and cause serious damage due to blood clots.
   Carriers who possess one faulty haemoglobin gene and one
    normal gene do not suffer from anaemia but are found to
    have some protection against infection by the malaria
    parasite.
   In areas where malaria is common, the amount of sickle
    cell carriers is higher than in other parts of the world.
    In an unusual example of Darwin's principle of survival of
    the fittest, carriers of the genetic disorder are actually
    more likely to survive than people with two unaffected
    genes for haemoglobin.
                                                              26
Plasmodiu
                                                         Plasmodiu
                                       Plasmodium                          m        Plasmodium
             Species                                           m
                                            vivax                        malaria       falciparum
                                                             ovale
                                                                           e
  Pre-erythrocytic cycle (days)1             8               9           13             5.5-6

     Pre-patent period (days)2             11-13           10-14        15-16           9-10
                                      13 (12-17) or up   17 (16-18)   28 (18-40)
     Incubation period (days)3              to 6-12            or           or        12 (9-14)
                                            months           longer       longer
                                                                      Present in
                                                                          some
Exo-erythrocytic cycle (secondary)4       Present         Present                     Absent
                                                                         strains
                                                                            ?

Approximate number of merozoites
                                       Over 10,000        15,000        2000           40,000
         per tissue schizont


    Erythrocytic cycle (hours)5             48             49-50         72              48

 Parasitemia (per l (mm3) Average         20,000           9000         6000       20,000-500,000

            Maximum                       50,000          30,000       20,000        2,000,000

                                                                                   Severe in non-
      Primary attack severity         Mild to severe       Mild         Mild
                                                                                       immunes

    Febrile paroxysm (hours)6              8-12            8-12         8-10       16-36 or longer

             Relapses                       ++              ++           +++              -

      Period of recurrence7                Long            Long       Very long        Short
                                                                                                27
   Duration of infection (years)           1.5-3           1.5-3        3-50            1-2
1.   Vivax malaria

2.   Tertian malaria




                       28
Symptoms:
   The most frequent symptoms include
    fever and chills, which can be
    accompanied by headache, myalgias,
    arthralgias, weakness, vomiting, and
    diarrhea.
   Other clinical features include
    splenomegaly, anemia, thrombocytopenia,
    hypoglycemia, pulmonary or renal
    dysfunction, and neurological changes.

                                          29
Laboratory Diagnosis:
   Microscopy Microscopic identification is the
    method most frequently used to demonstrate an
    active infection.
   Comparison of Plasmodium species
   Molecular diagnosis techniques can complement
    microscopy, especially in species identification.
   Antibody Detection can detect past (not
    necessarily active) infections.
   Immunologic/Biochemical detection of malaria
    parasite products are available and under
    evaluation                                      30
Treatment:
• Treatment varies according to the
  infecting species, the geographic
  area where the infection was
  acquired, and the severity of the
  disease.
• A complete guide for treatment of
  malaria can be found in The Medical
  Letter (Drugs for Parasitic
  Infections), as well as on the Division
  of Parasitic Diseases Web site.
                                        31
Prevention.

• Personal protection against
  mosquito bites is the first line of
  defence against malaria.
• In addition, travellers should
  take chemoprophylaxis where
  appropriate


                                   32
33

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Plasmodium malarial parasite

  • 1. By A.S.ARUL LAWRENCE Principal, St.Joseph College of Education, Nanguneri-627108, Tamil Nadu. E-mail : arullawrence@gmail.com. 1
  • 2. Causal Agents: • Blood parasites of the genus Plasmodium. • There are approximately 156 named species of Plasmodium which infect various species of vertebrates. • Four are known to infect humans: P. falciparum, P. vivax , P. ovale and P. malariae. 2
  • 3. What is a Malarial Parasite? The malarial parasite, Plasmodium, is a very small, single-cell blood organism, or 'protozoan'.  It lives as a parasite in other organisms, namely man and mosquito. The parasite is the cause of the tropical disease Malaria. The Plasmodium parasite is dependent on a single species of mosquito, Anopheles, which is the only species capable of serving as host for it. 3
  • 4. Male & Female Plasmodium. 4
  • 5. Classification  Phylum : Protozoa  Sub- Phylum : Sporozoa  Class : Telosporea  Sub-Class : Coccidia  Order : Eucoccida  Sub-Order : Hamosporidiidea  Family : Plasmodiidae  Genus : Plasmodium 5
  • 6. Geographic Distribution.  Worldwide, malaria usually restricted to tropical and subtropical areas and altitudes below 1,500 m.  P. vivax is more common in Central America and the Indian subcontinent 6
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  • 9. Infection rate.  WHO estimates that yearly 300-500 million cases of malaria occur and more than 1 million people die of malaria.  P. vivax and P. falciparum are the most common. 9
  • 12. Life cycle.  A malaria-infected female Anopheles mosquito inoculates sporozoites into the human host during a blood meal.  Sporozoites infect liver cells and mature into schizonts, which rupture and release merozoites (exo-erythrocytic schizogony).  In P. vivax and P. ovale a dormant stage (hypnozoites) can persist in the liver for weeks, or even years. The merozoites infect red blood cells. 12
  • 13. Life cycle… • The ring stage trophozoites mature into schizonts, which rupture releasing merozoites (erythrocytic schizogony). • Some parasites differentiate into sexual erythrocytic stages (gametocytes). • The gametocytes are ingested by an Anopheles mosquito during a blood meal. • The microgametes penetrate the macrogametes generating zygotes in the mosquito's stomach. 13
  • 14. Life cycle….. • The zygotes become ookinetes and invade the midgut wall where they develop into oocysts. • The oocysts grow, rupture, and release sporozoites, which make their way to the mosquito's salivary glands (sporogonic cycle). 14
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  • 25. MALARIAL PARASITE’S DIFFERENT CYCLES CYCLES OF PARASITE HUMAN - ASEXUAL MOSQUITO - SEXUAL (SCHIZOGONY) (SPOROGONY) EXOERYTHROCYTIC ENDOERYTHROCYTIC CYCLE CYCLE (LIVER) (BLOOD) 25
  • 26. Sickle cell anaemia and malaria  A genetic disorder, called sickle cell anaemia, happens when a person inherits two faulty genes to make the haemoglobin in their red blood cells which then break open and cause serious damage due to blood clots.  Carriers who possess one faulty haemoglobin gene and one normal gene do not suffer from anaemia but are found to have some protection against infection by the malaria parasite.  In areas where malaria is common, the amount of sickle cell carriers is higher than in other parts of the world.  In an unusual example of Darwin's principle of survival of the fittest, carriers of the genetic disorder are actually more likely to survive than people with two unaffected genes for haemoglobin. 26
  • 27. Plasmodiu Plasmodiu Plasmodium m Plasmodium Species m vivax malaria falciparum ovale e Pre-erythrocytic cycle (days)1 8 9 13 5.5-6 Pre-patent period (days)2 11-13 10-14 15-16 9-10 13 (12-17) or up 17 (16-18) 28 (18-40) Incubation period (days)3 to 6-12 or or 12 (9-14) months longer longer Present in some Exo-erythrocytic cycle (secondary)4 Present Present Absent strains ? Approximate number of merozoites Over 10,000 15,000 2000 40,000 per tissue schizont Erythrocytic cycle (hours)5 48 49-50 72 48 Parasitemia (per l (mm3) Average 20,000 9000 6000 20,000-500,000 Maximum 50,000 30,000 20,000 2,000,000 Severe in non- Primary attack severity Mild to severe Mild Mild immunes Febrile paroxysm (hours)6 8-12 8-12 8-10 16-36 or longer Relapses ++ ++ +++ - Period of recurrence7 Long Long Very long Short 27 Duration of infection (years) 1.5-3 1.5-3 3-50 1-2
  • 28. 1. Vivax malaria 2. Tertian malaria 28
  • 29. Symptoms:  The most frequent symptoms include fever and chills, which can be accompanied by headache, myalgias, arthralgias, weakness, vomiting, and diarrhea.  Other clinical features include splenomegaly, anemia, thrombocytopenia, hypoglycemia, pulmonary or renal dysfunction, and neurological changes. 29
  • 30. Laboratory Diagnosis:  Microscopy Microscopic identification is the method most frequently used to demonstrate an active infection.  Comparison of Plasmodium species  Molecular diagnosis techniques can complement microscopy, especially in species identification.  Antibody Detection can detect past (not necessarily active) infections.  Immunologic/Biochemical detection of malaria parasite products are available and under evaluation 30
  • 31. Treatment: • Treatment varies according to the infecting species, the geographic area where the infection was acquired, and the severity of the disease. • A complete guide for treatment of malaria can be found in The Medical Letter (Drugs for Parasitic Infections), as well as on the Division of Parasitic Diseases Web site. 31
  • 32. Prevention. • Personal protection against mosquito bites is the first line of defence against malaria. • In addition, travellers should take chemoprophylaxis where appropriate 32
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