Ppt Akun Malaria

8/9/2019 Ppt Akun Malaria

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Prepared by:

ALINGAN, MUAMIR A.


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WHAT IS MALARIA

A vector-borne infectious disease caused by protozoan

parasites.

The term MALARIA originates from MEDIEVAL ITALIAN:MALA

ARIA BAD AIR; and the disease was formerly called

ague or marsh fever due to its association with swamps.

It is widespread in tropical and subtropical regions,

including parts of the Americas, Asia, and Africa.

Historical records suggest malaria has infected humans

since the beginning of mankind.

It has been infected humans for over 50,000 years, and

may have been a human pathogen for the entire history of

our species.


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1880

A French army doctor

working in the military

hospital of Constantine

Algeria namedCharlesLouise Alphonse Laveran

observed parasites for

the first time, inside

the red blood cells of

people suffering from

malaria. He therefore

proposed that malaria wascaused by this protozoan,

the first time protozoa

were identified as

causing disease.


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1884

Ettore Marchiafava and

Angelo Celli, while

studying wet blood

smears from malariouspatients with the new

oil-immersion lens,

looked at unstained

blood and saw an active

amoeboid ring in the

red blood cells. Theythen published this

finding and named it

Plasmodium.


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A yearlater Carlos Finlay, a Cuban

doctor treating patients

with yellow fever in

Havana, first suggested

that mosquitoes weretransmitting disease to

and from humans.

1898

It was Britain's Sir

Ronald Ross working inIndia who finally proved

in 1898 that malaria is

transmitted by mosquitoes


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NORMAL ANATOMY AND

PHYSIOLOGY


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ETIOLOGY

Malaria is caused by protozoan parasites of the

genus Plasmodium (phylum apicomplexa).

There are several species of Plasmodium Parasitesbut only four of them are significant to the cause

of malaria diseases to humans. Some of these are

in to animals. Like birds,reptiles, monkeys,

chimpanzees, and rodents.


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PATHOPHYSIOLOGY

A female Anopheles mosquito bites, injecting saliva containing sporozoites,

the infective form of malaria parasite.

The sporozoites enter the liver and multiply

In the liver, the sporozoites change into merozoites,

another form of the parasite.


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Merozoites are released from the liver and

enter the bloodstream.

Merozoites attack Red Blood Cells.

Red Blood cells burst and release the merozoites

which invade other red blood cells

and cause recurring chills and fever.

(At this point the infected person becomes a reservoir of malaria that infects

any mosquito that feeds on him.)


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PLASMODIUM

VIVAX

PLASMODIUM

MALARIAE

PLASMODIUM

OVALE

PLASMODIUM

FALCIPARUM

P. Vivax is the most common

cause of infection, responsible

for about 80% of all malaria

cases.

However, P. Falciparum is the

most important cause of disease,

and responsible for about 15% ofinfections and 90% of deaths.


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The Parasites primary hosts andtransmission vectors are femalemosquitoes of the Anopheles genus.

The disease is transmitted to

humans when an infectedAnopheles

mosquito bites a person and injects

the malaria parasites (sporozoites)

into the blood.


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Mosquito injects the

infective plasmodial

sporozoites.

Sporozoites enter the liver

cells, and transform into

merozoites which penetrate

RBC.

Once in RBC,

merozoites reproduce

rapidly, producing

many more

merozoites, which

burst out of the RBC

& penetrate newcells.

Some of these

merozoites form male

& female

gametocytes, which

can be picked up by

another mosquito.

Inside the gut of

the mosquito,

gametocytes will

fertilize creating

zygote.

The zygote then develops into

an oocyst and ruptures to

release thousands of

sporozoites.

Ready for

another cycle.


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Only female mosquitoes feed onblood, thus males do nottransmit the disease. Thefemales of the Anopheles genusof mosquito prefer to feed atnight. They usually startsearching for a meal at dusk,and will continue throughoutthe night until taking a meal.

Malaria parasites can also betransmitted by bloodtransfusion, although this israre.


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SIGNS & SYMPTOMS

The symptoms characteristic of malaria includeflu-like illness with fever, chills, muscle aches,joint pain (athralgia), vomiting, anemia caused byhemolysis, hemoglobinuria, convulsions, and

headache. The classical symptom of malaria is cyclical

occurrence of sudden coldness followed by rigorand then fever and sweating lasting four to sixhours, occurring every two days in P. vivaxand P.ovale infections, while every three for P.malariae. P. falciparum can have recurrent feverevery 36-48 hours or a less pronounced and almostcontinuous fever.


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People with severe P.falciparum malaria can developbleedingproblems, shock,liver orkidney failure,central nervoussystemproblems, coma, and can die

from the infection or itscomplications.

Cerebral malaria (coma, oraltered mental status orseizures) can occur withsevere P. falciparuminfection. It is lethal if nottreated quickly; even withtreatment, about 15%-20% die.


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INCUBATION PERIOD

The period between the mosquito bite and the onset ofthe malarial illness is usually one to three weeks(seven to 21 days). This initial time period is highlyvariable as reports suggest that the range of incubationperiods may range from four days to one year.

The usual incubation period may be increased when aperson has taken an inadequate course of malariaprevention medications.

Certain types of malaria (P. vivaxand P. ovale)parasites can also take much longer, as long as eight to10 months, to cause symptoms. These parasites remaindormant (inactive or hibernating) in the liver cellsduring this time. Unfortunately, some of these dormantparasites can remain even after a patient recovers frommalaria, so the patient can get sick again. Thissituation is termed relapsingmalaria.


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TREATMENT

Malaria can be a severe, potentially fatal disease

(especially when caused by P. Falciparum) and treatment

should be initiated as soon as possible.

The Word Health Organization recommends that those in

endemic areas, treatment should be started within 24hours after the first symptoms appear. Treatment of

patients with uncomplicated malaria can be conducted on

an ambulatory basis (without hospitalization) but

patients with severe malaria should be hospitalized if

possible.

In areas where malaria is not endemic, all patients withmalaria (uncomplicated or severe) should be kept under

clinical observation if possible.


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Drug Treatment

The first effective treatment for malaria

was the bark of cinchonatree, which

contains QUININE. It was first used by the

inhabitants of Peru, where these trees

mainly grow.

Today, there are several antimalarial drugs

available for treatment:

Chloroquine

sulfadoxine-pyrimethamine (Fansidar)

mefloquine (Lariam)

atovaquone-proguanil (Malarone)

quinine

doxycycline artemisin derivatives

primaquine

But, drug treatment of malaria is not

always easy. You have to consider some

factors in treating different conditions of

patients having malaria.


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1. The infecting species of Plasmodium parasites. Different species of Plasmodium parasites may vary in

treating patients.

2. The clinical situation of the patient.

Mild malaria can be treated with oral medication.

Severe malaria (having one or more symptoms of either

coma, severe anemia, renal failure, shock, etc.)requires intravenous (IV) drug treatment and fluids.

Malaria may pose a serious threat to a pregnant women

and her pregnancy. Infection may be more severe than

those women who are not pregnant.

3. The drug susceptibility of the infecting parasites.

Determined by the geographic area where the infection

was acquired.

Different areas of the world have malaria types that

are resistant to certain medications.

Correct drug must be prescribed by the doctor who is

familiar with malaria treatment protocol.

Therearethreemain factorsin determiningtreatment


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PUBLIC HEALTH PREVENTION

& NURSING MANAGEMENTS

MALARIACONTROL

The goal of malaria control in

malaria-endemic countries is to reduce

as much as possible the health impact

of malaria on a population, using theresources available, and taking into

account other health priorities.

Malaria control does not aim to

eliminate malaria totally. Complete

elimination of the malaria parasite

(and thus the disease) wouldconstitute eradication. While

eradication is more desirable, it is

not currently a realistic goal for

most of the countries where malaria is

endemic.


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Malaria control is carried out through the following

interventions, which are often combined:

Case Management (diagnosis and treatment) of

patients suffering from malaria.

Persons who are sick should be treated promptly

and correctly. It eliminates an essential

component of the cycle (the parasite) and thus

interrupts the transmission cycle.

WHO recommends that anyone suspected of having

malaria should receive diagnosis and treatment

with an effective drug within 24 hours of the

onset of symptoms.


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Prevention of Infection through vector control.

Infection is prevented when malaria-carrying

Anopheles mosquitoes are prevented from biting

humans.

Vector control aims to reduce contacts between

mosquitoes and humans.

Some vector control measures like (destruction

of larvalbreedingsites,insecticidespraying

insidehouses) may require organized teams and

resources that are not always available.

Insecticide-treatedbed nets could also be analternative in vector control and personal

protection. It could be conducted by the

community themselves and become a major

intervention in malaria control.


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Prevention of Disease by administration ofantimalarial drugs to particularly vulnerablepopulation groups such as pregnant women andinfants.

Administration of antimalarial drugs tovulnerable population groups does not preventinfection, which happens through mosquitobites. But drugs can prevent disease byeliminating the parasites that are in theblood, which are the forms that causedisease.

Pregnant women are the vulnerable group most

frequently targeted. They may receive, forexample, "intermittent preventive treatment"(IPT) with antimalarial drugs given mostoften at antenatal consultations during thesecond and third trimesters of pregnancy.


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MALARIA IN THEPHILIPPINES

The Philippines is one of the Southeast Asian countries

plagued with malaria. Although the country doesnot

contribute significantly to the global mortality

attributed to malaria, the disease remains to be a major

cause of healthy days of life lost (HDLL) in theendemic areas of the country. Malaria affects the

socioeconomic well-being of the affected population, and

the different socioeconomic activities affect

transmission, prevention, and control of the disease.

Thus, this situation not only generates an enormous

economic, social and health burden to these people per

se, but also poses a huge and persistent challenge tothe health deliverers of the Malaria Control Program.

PHILIPPINE SCENARIO


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MALARIA AS A HEALTH PROBLEM

It is the eighth leading cause of morbidity in the

Philippines. (HIS 2000) According to DOH Secretary Reynaldo Duque, an

average of three Filipinos die daily due to malariadespite the governments intensified efforts tocontrol the occurrence of the ailment.

Malaria has become a health threat.

Although malaria endemicity is now generally moderate

to low, the disease continues to be a majorimpediment to human and economic development in areaswhere it persists

This disease is still endemic in 65 of the 79provinces in the country, and around 10 millionpeople who live in these areas are at risk of gettingthe disease.

Morbidity trend suggest that there might be a causeand effect relationship between the activities whichaim to eradicate malaria and its incidence

There is a decreasing number of deaths caused bymalaria

Chloroquine, the cheapest medicine against malaria islosing its effectiveness


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Malariaasa Health ServicesProblem

It poses challenges of access to health care for promptand effective treatment

There are shortages of antimalarial drug supplies,especially in peripheral health centers

The disease still costs the Philippine economy to spendover Php 100 million in order to sustain control efforts

Failures in treatment still occur despite thepreventability of malaria.

Causes of Malaria Treatment Failure in the Philippines

Drug resistance Non-compliance of patients in the treatment regimen

Deficient drug absorption

Self-medication

Resorting to herbal remedies

Seeking help when the disease is severe (Malaria isfatal only when it is seen in its later stages.)

Epidemiology of malariaiscomplex, dueto

Variety of ecological conditions observed in differentisland groups

Occurrence of more than one vector species


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MalariaControlProgram of the Department of Health

For 2007, The Department of Health has developed amalaria control program as a measure to help eradicatethe spread of the disease. Some of the programstrategies are:

1. Early diagnosis of the disease and prompt treatment.

This was achieved through:

diagnostic centers which serve as cites ofmicroscopy

manning by a RDT (Rapid Diagnostic Test) trainedpersonnel

promotion of the existence of diagnosticcenters


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2. Controlling the spread of mosquitoes


giving out insecticide-treated mosquito nets

indoor spraying which targets houses and not onlycommunities

3. Implementation of community-based malaria control


social mobilization education sessions


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JOURNALSMosquito Nose Transplants Help Fight Malari

Main Category: Tropical DiseasesAlso Included In: Biology / Biochemistry; Aid / DisastersArticle Date: 16 Feb 2010 - 9:00 PDTIn .

a new approach to combating malaria, a disease that affects half a billion peopleworlwide, US scientists successfully transplanted most of the "nose" of the disease-spreading Anopheles mosquito into frogs' eggs and fruit flies so they could analysethe insect's odorant receptors and find out how to lure it into traps and even prevent itbeing able to detect and thereby target humans.

You can read about the two studies by researchers from Yale University in NewHaven, Connecticut, and Vanderbilt University in Nashville, Tennessee, in a report inthe 3rd February online issue of the journal Nature and there is also a complementaryarticle in the Proceedings of the National Academy of Sciences, PNAS.

The mosquito Anopheles gambiae is the major route through which humans in sub-Saharan Africa become infected with malaria. While we know that the insect uses itssense of smell to find human hosts, we know little about the underlying molecularprocess.

A mosquito's "nose" is in its antennae which carry nerve cells covered with odorantreceptors that react to different chemical compounds in the insect's environment.These receptors are similar to those that give us our senses of smell and taste in ournose and on our taste buds.

Co-author Dr Laurence Zwiebel, professor of biological sciences at Vanderbilt, toldthe press that:"We've successfully expressed about 80 percent of the Anopheles

mosquito's odorant receptors in frog's eggs and in the fruit fly antennae."


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Zwiebel's lab at Vanderbilt is where they successfully transplanted thereceptors into frogs' eggs. The transplant into fruit-fly (Drosophila melanogaster) eggswas done at the laboratory of John Carlson, Eugene Higgins Professor ofMolecular,

Cellular and Developmental Biology at Yale and is written up as a complementarystudy in PNAS.

Scientists have previously used frogs' eggs to study olfactory receptors in moths,bees and fruit flies. For this study, the researchers injected DNA that codes for themosquito's olfactory receptors into a frog egg and waited for it to produce proteins.Eventually the surface of the egg became covered with mosquito odorant receptors.

They then tested the engineered egg's reaction to being exposed to various odorant

chemicals. They floated the egg in a buffer solution in a voltage clamp (so they couldmeasure changes in the egg's electrical properties) and dissolved the chemicals oneby one in the solution. They detected a measurable electrical response in the egg.

Guirong Wang, lead author of the PNASstudy, and a senior researcher in Zwiebel'slab, said:"The frog egg system is relatively rapid, highly sensitive and allows us to dovery precise measurements of odorant response."

Wang, who personally conducted several thousand measurements of egg responsesto changes in odorant, described this method as a "medium throughput system",because although they could set it up quite quickly, they had to make the odorantsolutions by hand, which took much longer.


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Antioxidants May Help Prevent Malaria Complications That Damage Brain

Using an experimental mouse model formalaria, an international group of scientists hasdiscovered that adding antioxidant therapy to traditional antimalarial treatment may prevent long-lastingcognitive impairment in cerebral malaria. Their findings were published online June 24, 2010, in the

journal PLoS Pathogens.

Malaria, an infection caused by parasites that invade liver and red blood cells, is transmitted to humansby the female Anopheles mosquito.Malaria is one of the leading infectious diseases worldwide, affectingmore than 400 million people and causing more than 2 million deaths each year, mainly among Africanchildren. Recently, the U.S. Centers for Disease Control and Prevention (CDC) issued a report on 11laboratory-confirmed cases of malaria among U.S. emergency responders and those traveling in theUnited States from Haiti.

Cerebral malaria is a severe, potentially fatal neurologic complication of infection by the most-fearedmalarial parasite, Plasmodium falciparum. Recent studies of children with cerebral malaria indicate thatcognitive deficits, which may impair memory, learning, language, and mathematical abilities, persist inmany survivors even after the infection itself is cured.

"Cerebral malaria and its molecular mechanisms are under intense study, but the cognitive dysfunctionthat can persist in survivors in the aftermath of successful treatment has gone unrecognized untilrecently," says Guy A. ZimmermanM.D., professor and associate chair for research in the University ofUtah School ofMedicine's Department of Internal Medicine and a contributor to the study. "Thiscomplication may impose an enormous social and economic burden because of the number of people atrisk for severe malaria worldwide. Our findings demonstrate that, by using experimental models ofcerebral malaria in mice, we can explore mechanisms of cognitive damage and also examine potentialtreatments for reducing or preventing neurologic and cognitive impairment."

Zimmerman and colleagues in Brazil studied the persistence of cognitive damage in mice withdocumented cerebral malaria after cure of the acute parasitic disease with chloroquine, an antimalarialtherapy. By administering a battery of behavioral tests to these mice, post-doctoral fellow Patricia Reis,Ph.D., determined that impairment in memory skills was still present 30 days after the initial malariainfection. Cognitive deficits that persist for years after the episode of cerebral malaria have also beenreported in 11 percent to 28 percent of children who survive the infection.

"Although we believe that long-term cognitive dysfunction after cerebral malaria is initiated by injury to thebrain during the initial period of untreated infection, it is possible that the mechanisms for persistentcognitive deficits are independent of those that cause neurological injury and death during acute cerebralmalaria," says Zimmerman. "Future research is aimed at clarifying this point. However, we have been

able to demonstrate that oxidative stress is present in the brains of mice infected with cerebral malaria."


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Malaria And Algae Linked To Common Ancestor By 'Little Brown Balls'

Unconspicuous "little brown balls" in the ocean have helped settle a long-standing debateabout the origin ofmalaria and the algae responsible for toxic red tides, according to a new studyby University of British Columbia researchers.

In an article published this week in the Proceedings of the National Academy of Sciences EarlyEdition, UBC Botany Prof. Patrick Keeling describes the genome of Chromera and its role indefinitively linking the evolutionary histories of malaria and dinoflalgellate algae.

"Under the microscope, Chromera looks like boring little brown balls," says Keeling. "In fact, theocean is full of little brown and green balls and they're often overlooked in favour of moreglamorous organisms, but this one has proved to be more interesting than its flashier cousins."

First described in the journal Nature in 2008, Chromera is found as a symbiont inside corals.

Although it has a compartment - called a plastid - that carries out photosynthesis like other algaeand plants, Chromera is closely related to apicomplexan parasites - including malaria. Thisdiscovery raised the possibility that Chromera may be a "missing link" between the two.

Now Keeling, along with PhD candidate Jan Janouskovec, postdoctoral fellow Ales Horak andcollaborators from the Czech Republic, has sequenced the plastid genome of Chromera andfound features that were passed down to both apicomplexan and dinoflagellate plastids, linkingthe two lineages.

"These tiny organisms have a huge impact on humanity in very different ways," says Keeling.

"The tool used by dinoflagellates and Chromera to do good - symbiosis with corals - at some pointbecame an infection mechanism for apicomplexans like malaria to infect healthy cells.

"Resolving their evolutionary origins not only settles a long-standing scientific debate but couldultimately provide crucial information for tackling diseases and environmental concerns."


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~ end of presentation ~

Ppt Akun Malaria

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