Dr orish verner ndudiri MBBS, DTM(RCSI), MPHIL

Dr orish verner ndudiri MBBS,
DTM(RCSI), MPHIL
 MOSQUITOE
BORNE
PARASITIC INFECTIOUS
DISEASE CAUSED BY A
PROTOZOAN ORGANISM
CALLED PLASMODIUM
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Origin from Africa- human infection from
primates
10,000 years ago- major impact in humansscd, thalasemia g6pd.
2700-1700 BC- Ancient Egypt use of bed net
and garlic to prevent malaria.
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460-370 BC- Ancient Greece; Hippocrates
describe malaria using the miasmic theory

ROMAN FEVER-835 AD malaria epidemic in
rome. The name malaria came from the
Italian word malus aria
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WHERE
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Everybody

Children and
pregnant women
 All
year round
 More during the rainy season
Kingdo
m:
Superphylu
m
Phylum:
Class:
Order:
Family:
Chromalveolata
Alveolata
Apicomplexa
Aconoidasida
Haemosporida
Plasmodiidae
PLASMODIUM
PROTOZOA-UNICELLULAR
Genus:
Plasmodium
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ABOUT 200 SPECIES
INFECTS HUMANS, BIRDS REPTILES,RODENTS
AND NON-HUMAN PRIMATES
TEN SPECIES INFECT HUMAN
FIVE IMPORTANT SPECIES
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PLASMODIUM
PLASMODIUM
PLASMODIUM
PLASMODIUM
PLASMODIUM
FALCIPARUM
VIVAX
OVALE
MALARIA
KNOWLESI
MALARIA VECTOR
FEMALE ANOPHELES MOSQITOE
FEED ON BLOOD FOR OOGENESIS
2 MAJOR TYPES
A.
B.
GAMBIAE
FUNESTUS
ANTHROPOPHILC
NOCTURNAL
ENDOPHAGIC AND ENDOPHILC
EXOPAHAGIC AND EXOPHILIC
SEXUAL - MOSQUITOE
ASEXUAL- HUMANS
ASEXUAL CYCLE
PREERYTHROCYTIC/HEPATIC
ERYTHROCYTIC
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Red cell invasion is the hallmark of disease
Symptoms do not manifest until red cell is
invaded
The parasite feeds on the hemoglobin
Structural changes in the red blood cell
Red cell looses its ability to perform its
function
Alteration cell membrane
Protein projections
Knobs
Antigenic properties
Cytoadherance
Rosette formation
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Anti parasite immunity is basically anti body
production.
Active immunity
Partial
Temporary


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Children develop immunity after repeated sub
fatal infections
Pregnant women loose all immunity
developed as a female adult due to variant
form of parasitic antigen that bind to the
placenta
Pregnant women develop adequate immunity
after the 2nd pregnancy
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Fever
Headache
Vomiting
Cough
Diarrhea
Joint pains
Weakness
Drowziness
Convulsion
Coma
Death

Simple/ uncomplicated malaria
fever joint pains etc no signs of complication

Complicated/severe malaria
hypoglycemia, severe vomiting, renal involvement

Cerebral malaria
Drowziness covulsion coma
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
Malaria is considered uncomplicated when
symptoms are present but there are no
clinical or laboratory signs to indicate severity
or vital organ dysfunction. The symptoms of
uncomplicated malaria are non-specific and
include fever.
CAUSED BY ALL STRAINS OF PLASMODIUM
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
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CAUSED BY P FALCIPARUM
The main symptoms of severe malaria
include: coma, severe breathing difficulties,
low blood sugar, and low blood haemoglobin
(severe anaemia)..
Children are particularly vulnerable since they
have little or no immunity to the parasite. If
untreated, severe malaria can lead to death.

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Malaria is classified as cerebral when it
manifests with cerebral symptoms, such as
coma.
CAUSED P FALCIPARUM
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Geimsa microscopy is gold standard
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Rapid diagnostic test RDT
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COMBINATION THEERAPY IS MAIN STAY
ATHEMISININS COMBINATION
ATHEMETHER LUMEFANTRINE
ATHESUNANTATE AMODIAQUINE
SINGLE THERAPY USED IN SEVERE MALARIA
ATHESUNATE
QUININE
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ATHEMETER
CLINDAMYCIN
DOXYCLINE
MEFLOQUINE
PROGUANIL
CHLOROQUINE
PRIMAQUINE
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WHO 3 PRUNG APPROACH
: 1) intermittent preventive treatment;
2) insecticide-treated nets; and
3) effective case management of malaria
illness and anaemia.