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Jay Lee

on 3 July 2014

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Transcript of Malaria

An infectious disease
Caused by pathogens, the protoctist known as Plasmodium
Four species :
Method of transmission
From a week to a year
Depends on partial immunity and medication taken against malaria
Incubation Period
Site of Action of Pathogen
Flu- aches and pain
Fever (Cold, shivering, sweating)

Clinical Features and Symptoms
Blood films (Thin and thick)
Rapid Diagnostic Test
Molecular methods
Detection of iron crystal byproduct in the haemoglobin
Rolling Circle-Enhanced Enzyme Activity Detection (REEAD)

Methods of Diagnosis
Global Patterns of Distribution and Factors that Influence Them
Current Treatment
Factors in prevention and control of disease -Social Factor

Thin and thick blood films
Rapid Diagnostic Test
Plasmodium vivax, ovale and malariae
• an intermittent mild fever
• headache
• muscle aches and chills
• a general feeling of illness (malaise).
Plasmodium falciparum
• high fever
• severe headache
• drowsiness
• delirium and confusion
P. falciparum
P. vivax
P. ovule
P. malariae
Malaria cases and deaths in africa
Malaria report 2012
Red blood cells
Factors influence them
Deforestation & new habitation
Water development projects
Agricultural practices in poor countries
Human travel trade & migration
Increasing temperature associated with climate change
are very abundant
Increased use of pesticides in modern agricultural practice
Deficiencies in local public health services
Infects the blood so, can be transmitted through :-
Blood transfusions
organ transplants
From mother to unborn child
Preventing mosquito bites
Reduced disease transmission
Reduced infection rates
Mosquito Nets
Forms barrier -To stop mosquitoes
Treated with insecticide -Kills mosquitoes before they get through the net
insect repellents
-Uses high frequency sounds to keep mosquitoes away
Community Participation
Reducing mosquito breeding grounds
-e.g removing sites/containers with stagnant water
Anti malarial medication (chemoprophylaxis)
-used for short durations due to:
i) high cost
ii) side effects of long term use
(nausea, diarrhea)
Spreading awareness about mosquito breeding sites
Teaching the public about malaria symptoms
Promoting malaria preventive measures

-controls conversion of toxic heme to hemozoin(disposable product formed from digestion of blood by parasites e.g malaria) by inhibiting the biocrystallization of hemozoin; kills parasite by poisoning through excess levels of toxic heme

-most widely used anti malarial (it is the least expensive and safest anti-malarial)until recent years due to emergence of chloroquine-resistant parasitic strands

-side effects: intolerable itching and can be a provocation factor of psorasis (a common, chronic relapsing/remitting immune-mediated skin disease characterized by red, scaly patches, papules, and plaques, which usually itch)

Mefloquine (A.K.A Larium)
-developed during the Vietnam War to protect American troops from multi-drug resistant

-side effects: nausea vomiting, diarrhea abdominal pain and dizziness
-one of the more prevalent anitimalarials due to its effectiveness and cheapness

-Mechanism: Inhibits protein synthesis

-Used primarily in areas where chloroquine resistance exists

-side effects: increased levels of photosensitivity, gastrointestinal disturbances, transient depression of bone growth and permanent enamel hypoplasia (defect of the teeth in which the enamel is hard but thin and deficient in amount)
-combination of:
i)atovaquone-treats falciparum malaria
ii)proguanil- inhibits sexual reproduction of Plasmodium
Best tolerated antimalarial combination to date:
Doxycycline +atavoquone+proguanil
-acts to inhibit biocrystallization of hemozoin(like choroquine)
-used to treat severe malaria besides preventing malaria
-side effects: rashes, vertigo, nausea, vomiting, abdominal pain, hypoglycemia(as qunine stimulates insulin secretion), renal failure, tinnitus(a hearing impairement)
-derivative of artemisin(a chinese herb)
-effective in treating uncomplicated P.falparicum
-resistance to artemisin has been detected in Cambodia Myanmar, Thailand and Vietnam
-Use antimalarials
-Medication against fever symptoms
-No vaccine available as of yet

-Numerous vaccines however are now at the clinical trial stage but many show insufficient immunogenicity(ability of a substance to provoke an immune response in the body)
Malaria Symptoms appear
9 to 14 days for Plasmodium (P.) falciparum.
12 to 18 days for P. vivax and P. ovale.
18 to 40 days for P. malariae.
11 to 12 days for P. knowlesi.
MOst symptoms caused by:
The release of merozoites into the bloodstream
Anemia resulting from the destruction of the red blood cells
Large amounts of free hemoglobin being released into circulation after red blood cells break open
World Malaria Day
-15 April
-recognizes global efforts to control malaria
- established to provide "education and understanding of malaria" and spread information on "year-long intensified implementation of national malaria-control strategies, including community-based activities for malaria prevention and treatment in endemic areas."

-e.g Centers for Disease Control and Prevention (CDC) has developed accurate diagnostic tests and high-quality effective drugs
-anti malarial drugs are losing their effectiveness e.g chloroquine
Plasmodium species
has a very high rate of replication, allowing surviving plasmodium(after drug is administered) to reproduce and eventually develop resistance
NYVAC-Pf7 multi-stage vaccine
-incorporates seven
antigenic genes
-when tested on Rhesus monkeys 4 out of the 7 produced specific human antibody responses (CSP, PfSSP2, MSP 1, PFs25)
-In humans, 90% of candidates had poor antibody responses while 10% gained complete protection against
Agents under developement
-Circum-Sporozoite Protein (CSP)
-Sporozoite surface protein 2 (PfSSP2)
-Liver stage antigen(LSA1)
-Merozoite surface protein 1
-Serine repeat antigen
-25-kDa Pfs25
The Seven antigens
-very successful
-our of 194 candidates. none developed any malaria symptoms
-consist of schizont export protein(5.1) and 19 repeats of sporozoite surface protein[NANP]
- Community in endemic areas are not receptive to treatment given by the goverment.

- Civil war in Africa and South-East Asia

- Migration of people from areas where malaria is endemic to non endemic areas.

Enviromental Factors
- Exploiting rainforest for agriculture

-Anopheles gambiae mosquito breed in Sunlight exposed pools of standing water

- Deforestation causes soil errosion forming newly formed swamp

- Use of certain chemicals contribute to mosquito resistance to DDT
Ways Of Prevention
- People in endemic areas should cooperate with control program.
- Pass laws on excessive deforestation.
-Put posters and advertisment on malaria.
- Stocking ponds, irrigation and drainage ditches and other permanent water bodies with fish which feed on mosquito larvae.
red blood cell infected with malaria
Anopheles gambiae mosquito
Full transcript