Malaria sign symptoms prevention treatment

malaria

1. Malaria

2. Name means “bad air”-
A life-threatening parasitic disease
40% of the world’s population is at risk
90% of the deaths due to Malaria occur in
Sub-Sahara Africa, mostly among young
children.
Around 400-900 million people are affected
At least 2.7 million deaths annually.
It is one of the major public health concerns

3. Organism

Malaria is caused by species of Plasmodium.

The genus Plasmodium contains 172 species

only four species are known to infect humans.

Plasmodium falciparum

Plasmodium malariae

Plasmodium ovale

Plasmodium vivax

Plasmodium parasites are highly
specific with female Anopheles mosquitoes

4. 
Transmission occurs when the mosquito,
requiring blood for the development of her eggs,
bites the human host and injects sporozoites into
the bloodstream

which then invade hepatocytes, where they
develop into liver schizonts.

When each schizont ruptures, thousands of
merozoites are released

which invade red blood cells and initiate that part
of the cycle responsible for all the clinical
manifestations of the disease.

5. Liver stage
Sporozoites
Mosquito Salivary
Gland
Malaria Life
Cycle
Gametocyte
s
Oocyst
Red Blood
Cell Cycle
Zygote

6. MALARIA
FACTORS INFLUENCING
-SEASONAL

TEMP
HUMIDITY

RAINFALL

ALTITUDE
WIND

HUMAN ACTIVITY

7. MALARIA – clinical syndromes
Chronic Disease
Chronic or Recurrent
Asymptomatic
Infection
Placental
Malaria
& Anemia
Anemia
Infection
During
Pregnancy
Developmental
Disorders
Transfusions
Death
Low
Birth weight
Increased
Infant
Mortality
Acute Disease
Non-severe
Acute Febrile
disease
Cerebral
Malaria
Death

9. Malaria Diagnosis &
Treatment

10. Clinically Mild malaria
An abrupt onset of an initial 'cold stage'
associated with dramatic rigors in which
the patient visibly shakes;
 An ensuing 'hot stage' during which the
patient may have a temperature of well
over 104°F (40°C), may be restless and
excitable, and may vomit or convulse; and
Finally, the sweating stage, during which
the patient defervesces and may fall
asleep.

11. 
WHO criteria for severe malaria of the disease.

One or more of:

cerebral malaria (CM)

respiratory distress (RD)

severe normocytic anaemia

renal failure

hyperparasitaemia

pulmonary oedema

hypoglycaemia

circulatory collapse

spontaneous bleeding/DIC

repeated generalized convulsions

acidosis

malarial haemoglobinuria

12. Thick blood films
One or two drops of blood from a fingerprick are
stirred in a circle on a glass slide, allowed to air
dry and then stained with Giemsa or Field's .
With this method, the red cells lyse whereas the
white cells and parasites remain intact. Parasites
are identified by recognizing both the eosinophilic
nucleus and the basophilic cytoplasm of the
malarial parasite. Parasite density can be related
to the number of white cells present. This method
has far greater sensitivity than the thin blood film.
Diagnosis

13. Thin blood films

A thin film is produced by spreading a small
drop of blood across a slide using the edge of a
second slide, thereby producing a monolayer of
red cells.

The thin blood film allows accurate speciation of
the parasite and quantitation, in which the
number of parasites is related to the number of
red cells present.

15. Recent Diagnostic Tests
Malaria PF antigen capture tests use a monoclonal
antibody to the P. falciparum and are very useful
tests in those who have not had malaria
before .can only detect the presence of P.
falciparum.
 The OptiMAL test detects parasite lactate
dehydrogenase (pLDH) which can be distinguished
from human LDH. This test can also distinguish
falciparum from vivax infections.
The polymerase chain reaction is useful for making
an accurate species diagnosis and detecting low
level parasitemias

16. Principles of Malaria Control

Awareness of risk to tps and families.

Avoidance of mosquito bite.

Early diagnosis & treatment.

Chemoprophylaxis.

17. Avoidance of mosquito bite.

Avoidance of mosquito bite.

Screening of living accn

Remain indoors in dusk & dawn.

Use of repellent every 3-4 hours.

Use of mosquito-net with pyrethroid
impregnation.

Spray indoors, coils, mats, vaporisers

18. Chemoprophylaxis

Chloroquine

5 mg/kg weekly for 50 kg man
100mg 3 tab or 150mg 2 tab.

Proguanil (Poludrine) 3mg/kg daily

2 tab per week

Mefloquine 5mg/kg 1 tab per week

Doxy 1.5mg/kg daily 1 tab daily

19. MALARIA
TREATMENT

CHLOROQUINE

QUININE
METACALFIN

MEFLOQUINE
PRIMAQUINE

PYRIMETHAMINE

PROGUANIL

20. RECOMMENDED THERAPEUTIC
DOSES OF ANTI-MALARIALS
Drug Uncomplicated Malaria Severe Malaria
( Oral Therapy ) ( Parental Therapy )
Chloroquine 10 mg base/kg on day 1 10 mg of base/kg in
5 mg base/kg at 12, 24, 500 ml of 5%
36 hours ordextrose over 8 hrs
10 mg base/kg on day 1 followed by 15 mg/kg over
10 mg base/kg 24 hours later 24 hrs.
5 mg base/kg 48 hours after
day 1

21. RECOMMENDED THERAPEUTIC
DOSES OF ANTI-MALARLIAS
Primaquine0.25 mg of base/kg/d for 5 days for ____
P. vivax and ovale
Sulfadoxine/ 20/1 mg/kg. single oral dose (three
Pyrimethamine tablets for adults)
Quinine 10 mg of salt/kg 8 hourly for 7 20 mg of salt/kg y
days combined with Tetracycline IV infusion over 4
(4 mg/kg QID) or Doxycycline hours (or 7 mg of
(3 mg/kg OD) for 7 dayssalt/kg over 30 minutes
can be followed by 10 mg of salt/kg over 4 hrs)

22. RECOMMENDED THERAPEUTIC
DOSES OF ANTI-MALARLIAS
Drug Uncomplicated Malaria Severe Malaria
(Oral Therapy) (Parental Therapy)
Artesunate Day1 4 mg/kg. Day 2 & 3 2 mg/kg 2.4 mg/kg IV or IM stat
Day 4-7-1 mg/kg In combination with followed by 1.2
mg/kg at
25 mg of Mefloquine/kg 10-12 mg/kg 12 and 24 hours and
then
given in divided doses over 3-5 days daily
(eg. 4 mg/kg for 3 days or 4 mg/kg
followed by 1.5 mg/kg per day for 4
days)
Artemether Same regime as for Artesunate 3.2 mg/kg IM stat
followed
by 1.6 mg/kg/d
Mefloquine 15 mg base/kg followed 8-12 hours ___
later by 10 mg/kg

23. MALARIA
ANTI LARVAL ACTIVITY

ENGR PLANNING

DISCARDED TINS

WATER COLLECTION

OHT

SEPTIC TANK

FILLING

DRAINAGE

MT DISP

DRY DAY

24. MALARIA

ANTI LARVAL ACTIVITY

BAYTEX GRALUNES

BAYTEX CONC

ABATE

GAMBUSIA

SECTORS

SEPTIC TANKS

25. MALARIA

PERS PROTECTION

‘SUN DOWN SLEEVE DOWN’

BED NET

RECREATIONAL BATHING

STAY INDOOR

ROLL CALL TIMINGS

APPLY REPELLANT CREAM

26. MALARIA
ANTI ADULT

RESIDUAL SPRAY

MALATHION

DDT

BAYGON

SYNTH PYRETHRIODS
FOGGING

SPACE SPRAY
BED NET IMPREGNATION

31. exchange transfusion
CDC recommends that exchange transfusion
be strongly considered for persons with a
parasite density of more than 10% or if
complications such as cerebral malaria, non-
volume overload pulmonary edema, or renal
complications exist.
Its beneficial effect by removing infected red
cells, improving the rheological properties of
blood, and reducing toxic factors such as
parasite derived toxins, harmful metabolites,
and cytokines.

32. Malaria Prophylaxis

Chloroquine treatment should be
started one week before travelling to,
and continued for four weeks after
leaving, a malaria endemic area.
(Adult dose 300mg weekly taken with
a meal, at the same time and on the
same day each week).

33. Malaria Prophylaxis For PF

Doxycycline - Adult dose 100mg daily.
Start 1-2 days before travelling to a
malarious area and continue for 2-4
weeks after leaving.

34. Vaccination

An effective and safe malarial vaccine is still not
available. A live attenuated whole sporozoite vaccine
has been shown to work, but only on a very small
scale and is impractical for widespread use. Results
with the SPf66 vaccine, a synthetic peptide, have
proved disappointing.


Most recently a vaccine using part of the
circumsporozoite protein linked to hepatitis B
surface antigen and administered in a formulation
with a novel adjuvant has shown preliminary
promise but protection appears short-lived.

A DNA-based vaccine has also been tested

43. Conclusion
Malaria is a global problem that lends itself
to a multilayered investigation with
bioinformatics as a major component.
The wealth of materials and the ongoing
sequencing process make it possible to
continually expand the investigation to
encompass
increasingly
sophisticated
students.