MALARIA – An Insight

8/8/2019 MALARIA An Insight

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MALARIA An Insight


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A vector borne disease.

Caused by genus Plasmodium

Widespread in Tropical & Sub-Tropical regions.

Plasmodiumfalciparum, Plasmodiumvivax, Plasmodium

ovale, Plasmodiummalariae& Plasmodiumknowlesi

cause MALARIA in Human.

P.falciparum cause severe morbidity & mortality.

MALARIA


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COMPARISON BETWEEN PARASITEP. falciparum P. vivax P. ovale P. malariae

TISSUE SCHIZOGONY

8 - 25 days 8 - 27 days 9 - 17 days 15 - 30 days

ERYTHROCYTIC PHASE

48 hours 48 hours 48 hours 72 hours

RED CELLS AFFECTEDAll Reticulocytes Reticulocytes Mature RBC's

MEROZOITES PER

SCHIZONT8 - 32 12 - 24 4 - 16 6 - 12

RELAPSE FROMPERSISTENT LIVER

FORMSNo Yes Yes

No, but blood formscan persist up to 30

years

DRUG RESISTANCEYes Yes No No

PERIODICITY

TERTIAN TERTIAN TERTIAN QUARTAN


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Differentiation of Malarial ParasitesP. falciparum P. vivax P. malariae P. ovale

RBC Size Not enlarged Enlarged Not enlarged EnlargedRBC Shape Round, sometimes crenated Round or oval, frequently

bizarre Round Round or oval, oftenfimbriatedRBC

C

olour Normal, but may become

darker; may have a purplerim Normal to pale Normal NormalStipling Maurer's spots, appear aslarge red spots, loops and

clefts; up to 20 or fewer.Schuffner's dots, appear as

small red dots, numerous. Ziemann's dots, few tinydots, rarely detectedSchuffner's dots (James's

dots). Numerous small red

dots.Pigment

Black or dark brown; in

asexual forms as one or twomasses; in gametocytes as

about 12 rodsSeen as a haze of fine

golden brown granulesscattered through the

cytoplasmBlack or brown coarse

granules; scattered Intermediate between P.vivaxand P. malariae

Earlytrophozoite

(ring)

Smallest, delicate;

sometimes two chromatin

dots; multiple ringscommonly found

Relatively large; onechromatin dot, sometimes

two; often two rings in onecell

Compact; one chromatin

dot; single

Compact; one chromatin

dot; single

Schizont

Medium size; compact;

numerous chromatin

masses; coarse pigments;rarely seen in peripheral

blood

Large; amoeboid; numerous

chromatin masses; finepigments

Small; compact; few

chromatin masses; coarsepigments

Medium size; compact; few

chromatin masses; coarse

pigments

GametocyteCrescent shaped, larger and

slender; central chromatinSpherical; compact Similar to P. vivax, but

smaller and less numerous

Like P. vivax, but smaller


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PARASITES

MALARIA CAN BE

CAUSED BY ONE OF

FOUR PROTOZOAN

SPECIES OF THE

GENUS PLASMODIUM

PLASMODIUM EXISTS

IN TWO STAGES

TROPHOZOITE -FEEDING AND

GROWING STAGE

(ASEXUAL LIFE

CYCLE)

SPOROZOITE

INFECTIVE STAGE(SEXUAL LIFE CYCLE)


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LIFE CYCLE- PLASMODIUM


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LIFE CYCLE- PLASMODIUM


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Cold stage Hot stage Sweating stage

Fever* High fever Sweating

Rigors Headache Fall in temp.

Chills Vomiting

Delirium

Symptoms of Malaria may vary on anindividual basis for each patient.

At 10 days to 4 weeks after

infection, mild early symptoms can

be appeared a flu-like illness in few

days before major symptoms

* Caused by release of waste material wheninfected cells rupture in the blood

Anemia often a major contributing factor

to death


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P.falciparumis

less widespread,

but more likely

to result in

severe

complications

and be fatalcompared to P.

vivax.*

P.falciparum

destroysred blood

cells,whichcan

causeacute

anemia.

Adherencetocells

incertaintissues

maycause

problemswithin

thoseorgans,such

asthelungs,

kidneyand brain.

Amajor

complicationofP.falciparum,

cerebralmalaria,

canleadtocoma,

transientor

permanent

neurological

effects,and death.

Almostalldeaths

frommalariaare

dueto Plasmodium

falciparum.*

WHY P.FALCIPARUM

DIAGNOSISISIMPORTANT ?


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Based on the patient's symptoms and on physical findings atexamination

In most cases the early clinical findings are not typical

and need to be confirmed by a laboratory test

History of- traveling/staying in endemic area

- taking anti-malarial/other drugs

- blood transfusion

Documents

MALARIA – An Insight