K24-Malaria Blok Tropmed

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    Malaria

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    Exo-erythrocytic(hepatic) cycle

    Sporozoites

    Mosquito SalivaryGland

    Malaria LifeCycleLife Cycle

    Gametocytes

    ocyst

    ErythrocyticErythrocyticCycleCycle

    !y"ote

    Schizogony

    Sporogony

    #ypnozoites(for P. vivaxand P. ovale)

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    Plasmodium spp.1.Plasmodium vivax : Benign Tertian,Tertian Malaria

    2.Plasmodium ovale : Ovale tertianMalaria

    3.Plasmodium malariae : Quartan malaria

    4.Plasmodium faliparum : MalignantTertian malaria.

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    Afnity o Parasite toErythrocytes

    P.vivax P.malariae Inectes only young

    or P.ovale Old Erythocytes

    P.alciparum Inects all agegroups

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    AAlteration olteration o HHostost CCellsells

    ! variet" of strutural #anges, $#i# alterits funtion, appearane or antigeniit".

    T#ese alterations are a onse%uene ofparasite gro$t#

    !dvantage to t#e parasite &e.g. inreasedmem'rane permea'ilit", inreased seletiveinta(e of nutrients, or esape from immunit"

    '" se%uestration). T#e nature of t#e alterations indued are

    varia'le from one speies to anot#er.

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    1.! visi'le #ange of s#apeand redued deforma'ilit"

    2.T#e presene of eletron*dense protrusions or

    +(no's3.T#e presene of small

    depressions, or-aveolae-, at t#e surfae

    of t#e red ell, onneted'" a net$or( of smallvesiles and lefts in P.vivaxand P. ovale

    he alterations identi!edhe alterations identi!ed

    include "include "

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    4.4. TT#e "toad#erene to#e "toad#erene to

    endot#elial ellsendot#elial ells

    .. TT#e ad#erene to normal#e ad#erene to normal

    er"t#ro"tes &-rosetting-) or toer"t#ro"tes &-rosetting-) or toot#er infetedot#er infeteder"t#ro"teser"t#ro"tes&-auto*agglutination/&-auto*agglutination/oror

    lumpinglumping))

    0.0. TT#e presene of ne$ meta'oli#e presene of ne$ meta'oli#annels evidene of ne$#annels evidene of ne$

    parasite*spei antigensparasite*spei antigens

    assoiated $it# t#e red ellassoiated $it# t#e red ell

    mem'ranemem'rane

    he alterations identi!edhe alterations identi!ed

    include "include "

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    Pathogenesis

    elated to er"t#ro"ti infetion '" t#e asexual

    stages, ameto"tes not involve inpat#ogenesis

    Pat#olog" is assoiated $it#:Haemolysis

    * 5iret invasion 6 rupture of B7 during er"t#ro"ti "le

    * 8nreased osmoti fragilit" of B7

    Increased adhesiveness o inected #$C* 8nreases $it# t#e maturit" of t#e parasite &s#i9ont trop#o9oite)

    * ;no' t#eor"#elease o pyrogens% toxin and cyto&ines

    Immunological responses

    Capillary permea'ility

    issue hypoxia

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    Rosetting

    Sludging

    Sequestration

    PathoPathogenesisgenesis

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    Pathogenesis

    7"to(ines an indue &mimi) man" of s"mptoms7"to(ines an indue &mimi) man" of s"mptomsand signs of malaria &s#ivering, #eada#e, #ills,and signs of malaria &s#ivering, #eada#e, #ills,spi(ing fever,s$eating, vasodilation,spi(ing fever,s$eating, vasodilation,#"pogl"emia)#"pogl"emia)

    !d#erene and in

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    Immunity

    8n

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    Immunity

    8nnate ed ell pol"morp#isms assoiated $it#

    some protetion =emoglo'in @ si(le ell trait or disease

    =emoglo'in 7 and #emoglo'in A

    T#alessemia C and D

    luose 0 p#osp#ate de#"drogenasedeien" &0P5)

    ed ell mem'rane #anges

    !'sene of ertain 5uE" oat antigensimproves resistane to P.v.

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    Immunity

    !%uired

    Transferred from mot#er to #ild 3*0 mont#s protetion

    T#en #ildren #ave inreased susepti'ilit"

    8nreased susepti'ilit" during earl" #ild#ood

    ="per* and #oloendemi areasB" age atta(s usuall" F fre%uent and severe

    7an #ave parasite densities $it# fe$er s"mptoms

    Meso* or #"poendemi areas ?ess transmission and repeated atta(s

    Ma" a%uire partial immunit" and 'e at #ig#er ris( fors"mptomati disease as adults

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    Immunity

    !%uired Go omplete immunit"

    7an 'e parasitemi $it#out linial disease

    Geed long period of exposure for indution

    Ma" need ontinued exposure formaintenane

    8mmunit" an 'e unsta'le 7an $ane as one spends time outside endemi

    area 7an #ange $it# movement to area $it#

    diEerent endemiit"

    5ereases during pregnan", ris( improves$it# inreasing gravidit"

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    Immune Mechanisms

    @tage spei :

    !nti sporo9oite anti'odies in adults inendemi areas* 'lo(s liver invasion

    !nti sporo9oiteHmero9oite anti'odies *

    'lo( r' invasion 7"to(ines : TGI 'lo(s mero9oite

    development 8?1 8?1J

    Ar"t#ro"te learane * liver and spleen

    Blo( "to*ad#erene An#ane learane t#roug# opsonisation

    !577 li(el"

    G; ativit" 15

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    T#an( Kou