Plasmodiasis by prof.Galadima University of Maiduguri

This is one of the protozoan

1. Plasmodiasis BY Prof Galadima Gadzama

2. Outline Introduction Epidemiology Transmission Pathogenesis Clinical presentation Complications Socioeconomic impact of plasmodiasis Laboratory diagnosis Treatment Prevention and control

3. Introduction Plasmodiasis is a parasitic disease caused by a protozoa called plasmodium spp Belonging to phyllum epicomplexa It has a complex structure for its movement Spore forming phylum The generic name for plasmodiasis is malaria It has three distinct process in its lifecycle Sporogony,merogony and gametogony

4. Epidemiology Globally plasmodiasis cause 249 million cases and about 608 000 deaths in about 85 countries annually Plasmodiasis occurs primary in tropical and some subtropical regions of Africa ,central and south America,Asia ,and oceanis In these areas there is tremendous variation in the intensity of transmission of infection

5. Epidemiology

6. African distribution

7. Nigeria

8. Transmission Plasmodiasis is transmitted by the bite of an infected female anopheles' mosquitoes It introduces the infectious stage into susceptible host-sporozoite The different species of plasmodium that are pathogenic to human are: Plasmodium falciparum Plasmodium malariae Plasmodium ovale Plasmodium vivax Plamodium knowlesii -zoonotic Human is the intermediate host while mosquitoe is the definitive host

9. Other means of transmissions are Blood transfusion Transplacental Airport plasmodiasis Iatrogenic route-shared needle

10. Plasmodium endemicity in Africa The determinants of endemicity are parasitemic level among children between 2-9 years of age Level of palpable spleen size Hypo endemic ---1 to 10 % of the children sampled Mesoendemic 11 to 50% Hyperendemic 51 to 75% Holoendemic >75 %

11. Pathogenesis continue Schizonts inside the live hepatocytes as it enlarges the entire liver will be enlarge - hepatomegaly merozoites release from the liver will move to blood stream to invade red blood cell making the red abnormal in shape The abnormal red cell in circulation goes to spleen and will be removed Other abnormal red cell will go to capillaries and causes stasis leading anoxia to the tissues Most infected red cell will burst to release merozoites – haemolysis In cerebral malaria ,it causes cerebral oedema ,confusion and vomiting

12. Inside the vector

13. Clinical presentation of plasmodiasis Stages of plasmodiasis Cold stage- shivering and feeling cold Hot stage – fever, flush ,dry skin, headache ,nausea and vomiting Severe stage –abnormal behavior ,altered consciousness

14. Complications of plasmodiasis Cerebral malaria- commonly caused by plasmodium fasciparum Pulmonary oedema Acute renal failure Hypoglycemia Jaundice Liver failure Hypotension Bleeding disorder Anemia

15. Socio-economic impact It affect the GDP of community or country Absenteeism at work leading to lower workers productivity Premature death Economic savings –lower household income Education

16. Use of blood smear for diagnosis of malaria

17. Thin smear for diagnosing malaria parasite

18. RDT Rapid diagnostic test for malaria has also been recommended by WHO Especially in countries living in malaria endemic region Histidine rich protein and pLDH Its limitation is enormous Sametime can be false positive

19. Polymerase chain reaction in diagnosis of malaria parasite This is more sensitive Specific Can diagnosed mixed infections Can also identify resistant genes But takes longer time Lees ideal for initial treatment Not for mass screening of population

20. Treatment of plasmodiasis Simple plasmodiasis case Resistance case Recurrent case In pregnancy In a child In a patient with co- mobidity In a patient with haemoglobinopathy In a patient with G-6-pd deficiency

21. Drug treatment Use of chloroquine phosphate Artemether-lumefantrine Malarone Proguanil Atovogune Quinine Doxycycline Tretracycline Mefloquine Daraprime

22. Infection prevention and control No vaccine Is available as of now Vector control Use of treated net Preventive chemotherapy Mass drug administration Use of monoclonal antibodies

23. Thank you for listening