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Malaria An Overview of Life-cycle, Morphology and Clinical Picture.

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Presentation on theme: "Malaria An Overview of Life-cycle, Morphology and Clinical Picture."— Presentation transcript:

1 Malaria An Overview of Life-cycle, Morphology and Clinical Picture

2 Malaria Species Five species of malaria infect humans:
Plasmodium falciparum Plasmodium vivax Plasmodium ovale Plasmodium malariae Plasmodium knowlesi

3 Malaria –Endemic Countries

4 Malaria –Endemic Countries

5

6 LIFE CYCLE OF MALARIA sporozoites Stomach Wall Pre-erythrocytic
Oocyst Stomach Wall Sporozoites Salivary Gland Zygote Gametocytes sporozoites Pre-erythrocytic (hepatic) cycle Hypnozoites Exo-erythrocytic (hepatic) cycle Erythrocytic Cycle

7 Plasmodium falciparum::
Plasmodium vivax, Plasmodium ovale Plasmodium malariae:

8 Components of the Malaria Life Cycle
Sporogonic cycle Infective Period Mosquito bites uninfected person Mosquito Vector Parasites visible Human Host Mosquito bites gametocytemic person Prepatent Period Symptom onset Recovery Incubation Period Clinical Illness

9 CLINICAL SIGNS & SYMPTOMS OF MALARIA
Fever Chills Sweating

10 feeling of intense cold vigorous shivering lasts 15-60 minutes
Malarial Paroxysm cold stage feeling of intense cold vigorous shivering lasts minutes hot stage intense heat dry burning skin throbbing headache lasts 2-6 hours   sweating stage profuse sweating declining temperature exhausted and weak → sleep lasts 2-4 hours

11

12 CLINICAL PICTURE Chronic Disease Acute Disease Infection During
Pregnancy Non-severe Acute Febrile disease Chronic Asymptomatic Infection Severe malaria e.g. Cerebral Malaria Placental Malaria Anemia Low Birth weight Developmental Disorders; Transfusions; Death Increased Infant Mortality Death

13 Definition Severe malaria is defined as symptomatic malaria in a patient with P. falciparum with one or more of the following complications: Cerebral malaria (unrousable coma not attributable to other causes). Generalized convulsions (> 2 episodes within 24 hours) Severe normocytic anaemia (Ht<15% or Hb < 5 g/dl) Hypoglycemia (blood glucose < 2.2 mmol/l or 40 mg/dl ) Metabolic acidosis with respiratory distress (arterial pH < 7.35 or bicarbonate < 15 mmol/l) Fluid and electrolyte disturbances Acute renal failure (urine <400 ml/24 h in adults; 12 ml/kg/24 h in children) Acute pulmonary edema and adult respiratory distress syndrome Abnormal bleeding Jaundice Haemoglobinuria Circulatory collapse, shock, septicaema (algid malaria) Hyperparasitaemia (>10% in non-immune; >20% in semi-immune)

14 Definition Uncomplicated malaria is defined as:
Symptomatic infection with malaria parasitemia without signs of severity and/or evidence of vital organ dysfunction.

15 Complications of malaria :
Cerebral malaria

16 Complications of malaria :
Pulmonary oedema

17 Complications of malaria :
anaemia Child with severe malaria anaemia and no other malaria complication

18 Child with severe malaria anaemia in conjunction with acidosis and respiratory distress

19 Malarial haemoglobinuria
Clinical Picture : Haemoglobinuria associated with malaria (“blackwater fever”) is uncommon and malarial haemoglobinuria usually presents in adults as severe disease with anemia and renal failure.

20 Common methods for parasitological diagnosis of malaria
The two methods common in use : 1: Light microscopy 2: Rapid diagnostic tests (RDTs).

21

22 Microscopy is the gold standard for diagnosis of malaria
Parasite density Species diagnosis Monitoring response to treatment

23 Laboratory diagnosis of malaria
CCMOVBD Plasmodium vivax CCMOVBD Plasmodium falciparum CCMOVBD Plasmodium malariae Malaria Tutorials, Wellcome Trust Plasmodium ovale

24 Laboratory diagnosis of malaria
Rapid diagnostic tests detect malaria antigens

25 Rapid diagnostic tests detect malaria antigens
Plastic cassette format of RDT

26 Rapid diagnostic tests detect malaria antigens

27 Wellcome Trust (Modified)
ACTION OF ANTIMALARIAL DRUG IN THE DIFFERENT LIFE STAGES OF THE MALARIA PARASITE Sporontocides Primaquine Pyrimethamine Proguanil Tissue Schizontocides Primaquine Pyrimethamine Tetracycline Proguanil Gametocyide Primaquine Anti-relapse (P.vivax) primaquine Blood Schizontocides Chloroquine Sulfadoxine/Pyrimethamine Quinine Artemisinins Wellcome Trust (Modified)

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