MALARIA

MALARIAMALARIABy: LAURETE, STEPHANIE O.

MALARIA-is an infectious disease

caused by a parasite that is transmitted by the bite of infected mosquitoes. Common in tropical countries, the disease is characterized by recurring chills and fever.

What are the parasites that cause Malaria?

(GENUS)“Plasmodium” parasites cause Malaria in humans.

*Five species of “Plasmodium”:Plasmodium Vivax

Cause the mildestformPlasmodium Malariae

Plasmodium Falcifarum

Plasmodium Ovale Cause the severest and most deadly form

Plasmodium knowlesi Causes malaria in macaques but can also infect humans

A microscopic image shows parasites of the genus “Plasmodium”

Mode of Transmission

Infected female “Anopheles” mosquitoes transmit Plasmodium parasites from one person

to another in their bites.

There are approximately 2,000 species of mosquitoes ranging from the tropics to the Arctic Circle and from sea level to mountaintops. Female mosquitoes have hypodermic mouthparts which enable them to pierce the skin and suck the blood of mammals, birds, reptiles, and other arthropods. Female mosquitoes of the genus Anopheles are responsible for transmitting the malaria parasite from person to person.

Life Cycle of the Malaria Parasite (MORE EXPLANATIONS)(A) Mosquito

infected with the malaria parasite

bites human, passing cells

called Sporozoites

into the human’s

bloodstream.

(B) Sporozoites travel to the liver. Each sporozoite undergoes

asexual reproduction, in

which its nucleus splits to

form two new cells, called Merozoites.

(C) Merozoites enter the

bloodstream and infect red blood cells.

(D) In red blood cells,

merozoites grow and divide to produce more

merozoites, eventually

causing the red blood cells to rupture. Some of the newly

released merozoites go

on to infect other red blood

cells.

(E) Some merozoites develop into

sex cells known as male and

female gametocytes.

(F) Another mosquito, bites the infected human,

ingesting the gametocytes.

(G) In the mosquito’s

stomach, the gametocytes mature. Male and female

gametocytes undergo sexual reproduction, uniting to form a Zygote. The

zygote multiplies to

form Sporozoites, which travel to the mosquito’s

salivary glands.

(H) If this mosquito bites another human, the cycle begins

again.

Sickled Red Blood Cells is that the hemoglobin in the human bloodstream is

severely altered. The mutation changes the structure of red blood cells to a slender sickle shape. Individuals who inherit two hemoglobin genes with the sickle-cell mutation become ill and often die prematurely, but those who inherit only one gene with the mutation are resistant to malaria.

Normal Red Blood Cells

SYMPTOMS OF MALARIA

The symptoms characteristic of malaria include flu like illness with fever, chills, muscle aches, and headache. Some patients develop nausea, vomiting, cough, and diarrhea. Cycles of chills, fever, and sweating that repeat every one, two, or three days are typical. There can sometimes be vomiting, diarrhea, coughing, and yellowing (jaundice) of the skin and whites of the eyes due to destruction of red blood cells and liver cells.

People with severe P. falciparum malaria can develop bleeding problems, shock, liver or kidney failure, central nervous system problems, coma, and can die from the infection or its complications. Cerebral malaria (coma, or altered mental status or seizures) can occur with severe P. falciparum infection. It is lethal if not treated quickly; even with treatment, about 15%-20% die

How to Prevent Malaria?Apply insect repellent to your skin.Use bednets when sleeping in areas infested with mosquitoes.Use insecticides and flying insect sprays to reduce the number of mosquitoes in areas where you will be spending a significant amount of time.When possible, avoid camping or spending prolonged amounts of time in areas where standing water is present. Keep pots and pans emptied of water. Open vessels for drinking water should be covered. Mosquitoes use areas of standing water to lay their eggs.If you know you will be traveling in areas where malaria is prevalent, ask your doctor for antimalarial drugs.

The CDC recommended malaria drugs include:atovaquone/proguanilchloroquinedoxycyclinemefloquinePrimaquine

It's important to protect yourself with a bug repellent spray that contains no more than 35% of a chemical called DEET.Avoid going outdoors without protection in the evening, when mosquitoes are typically more active.Wear long-sleeved clothing.If possible, stay in screened quarters or quarters with air conditioning.

HERBAL MEDICINEFOR MALARIA TREATMENT:

CINCHONA TREEThe bark of the CINCHONA TREE, native to South America, contains QUININE which is a natural white crystalline alkaloid having antipyretic (fever-reducing), antimalarial, analgesic (painkilling), anti-inflammatory properties and a bitter taste.

Most Common Drugs for Malaria Treatmentand for prevention also:

(ANTIMALARIAL DRUGS)Atovaquone and Proguanil

These drugs are used as a combination to aid preventing ever having to suffer the symptoms of Malaria. Proguanil is also used with Chloroquine for Malaria Prevention. Chloroquine tablets can also be used on their own but this is not as effective.

SIDE EFFECTS: bad stomach pain, back pains, mouth ulceration andlight headedness

DoxycyclineThis drug is a very effective across all countries deemed as Malaria hotspots. SIDE EFFECTS: bad stomach pain, skin irritation, coughing, headaches,

possible vaginal irritation.

MefloquineThis is another drug that is known to be effective across all Malaria hotspots.SIDE EFFECTS: mood swings, sleep disturbance, depression ,

concentration deficit, light headedness, headaches and skin irritation

DO NOT TAKE THIS if you have:epilepsy, mental illness , depression or anxiety.

Malaria vaccines•(Radiation-attenuated Sporozoites) RTS,S/AS01

-when injected by mosquitoes or by needle in large numbers, can induce complete protection against malaria infection in animals and in man for a year or more.

•(Falciparum Malaria Parasite)FMP2.1/AS02A-was developed as part of a longstanding research

collaboration between the Walter Reed Army Institute of Research (WRAIR) GlaxoSmithKline Biologicals (GSK).

-A new vaccine to prevent the deadly malaria infection has shown promise to protect the most vulnerable patients -- young children -- against the disease.

Clinical Diagnosis of Malaria-is confirmed by blood tests and can be divided into:1.MICROCOPIC TEST and 2.NON-MICROSCOPIC TEST

1. Microscopic test- involves staining and direct visualization of the parasite under the microscope, & it includes:

*Peripheral smear study- involves collection of a blood smear, its staining with Romanowsky stains and examination of the Red Blood Cells for intracellular malarial parasites.

*Quantitative Buffy Coat (QBC) test- involves staining of the centrifuged and

compressed red cell layer with acridine orange and its examination under UV light source.

2. Non-microscopic test- involves identification of the parasitic antigen or the antiplasmodial antibodies or the parasitic metabolic

products, & it includes:

*Rapid Diagnostic Tests (RDTs)- detect species-specific circulating parasite antigens targeting either the histidine-rich protein-2 of P. falciparum or a parasite-specific lactate dehydrogenase.

*Polymerase Chain Reaction (PCR)- has also been found useful in unraveling the diagnosis of malaria in cases of undiagnosed fever.

Where is malaria most common?•Malaria is a health problem in many tropical and subtropical countries, including portions of Central and South America, Hispaniola (Haiti and the Dominican Republic), Africa, Eastern Europe, Southeast Asia and the South Pacific.

• It can also be a problem for people visiting these countries.

• If you are traveling to a tropical area or to a country where malaria is common, you should be aware of the risk and take some precautions. 

Temperature is particularly critical. For example, at temperatures below 20°C (68°F), Plasmodium falciparum (which causes severe malaria) cannot complete its growth cycle in the Anopheles mosquito, and thus cannot be transmitted.

Even within tropical and subtropical areas, transmission will not occur:•At high altitudes•During cooler seasons in some areas•In deserts (excluding the oases)•In some islands in the Pacific Ocean, which have no local Anopheles species capable of transmitting malaria•In some countries where transmission has been interrupted through successful eradication.

Generally, in warmer regions closer to the equator:•Transmission will be more intense•Malaria is transmitted year-round•P. falciparum predominates.

*The highest transmission is found in Africa South of the Sahara.

*In cooler regions, transmission will be less intense and more seasonal. There, P. vivax might be more prevalent because it is more tolerant of lower ambient temperatures.

Total Population, Morbidity and Mortality by Year, 1990-2004 (PHILIPPINES)

Tips & Warnings

•Be aware that malaria can be a life-threatening disease, so make sure that you seek medical treatment immediately, rather than trying to self-treat your symptoms. Alternative remedies for malaria should be used in partnership with conventional treatments, not than alone. Never use an alternative remedy without letting your doctor know about it first.

PROGRAMS:1. Malaria Research Program -has provided research activities

on disease epidemiology and immunology, molecular biology of the parasite, vector behavior, social health research on treatment patterns and disease perceptions, clinical trials for antimalarial drugs and malaria diagnostic kits, antimalarial drug resistance and pharmacokinetic studies and community-based strategies to improve disease control.

These studies were invariably carried out in the following areas in the Philippines:

Kalinga, ApayaoMorong, Bataan

Tayabas, Quezon PalawanDavao

del Norte Compostela Valley Agusan del Sur

Tawi Tawi

2. Malaria Foundation International –is to facilitate the development and implementation of solutions to the health, economics and social problems caused by Malaria.3. Global Malaria Programme (GMP) -is responsible for malaria

surveillance, monitoring and evaluation, policy and strategy formulation, technical assistance, and coordination of WHO's global efforts to fight malaria.

4.  Roll Back Malaria (RBM) -is a cabinet-level program launched by the World Health Organization (WHO), with the goal

of reducing the global burden of malaria.5. Movement Against Malaria -has our strategies: early detection

and prompt treatment, use of available technologies designed to prevent the spread of the disease,

strengthening local capability to implement community-based malaria control measures, and building a wide stakeholder network to help curb the disease.