Muskan Agarwal ?

MALARIA
PRESENTED BY: MUSKAN AGARWAL

BAMS 3RD YEAR
UNDER GUIDANCE OF : DR. SHILPA WALKIKAR

Female anopheles mosquito
INTRODUCTION
• Malaria is a mosquito borne disease caused by

plasmodium ,which is transmitted by the bite of infected
female anopheles mosquito.
• The disease is widespread in tropical and subtropical regions
that are present in broad band around the equator. This includes
much of Sub- Saharan Africa,Asian and Latin America.
INTRODUCTION
• Protozoal infections
• Malarial term derived from Italian word Mala aria or bad air.
• Malaria affects over 48% of the world population.
• Malaria remains the World’s most devastating Human
parasitic infection.
HISTORY
• Malaria or the associated disease have been noted 4000 years ago.
• Scottish physician Sir Ronald Ross who proved that the mosquito was
the vector for malaria for this he was awarded the Nobel prize in 1902.
• Scientific studies on Malaria made their first significant advance in
1880,when Alphonse Laveran observed parasit inside the RBCs of
infected people for the first time.
HISTORY
• Charles Louis Alphonse Laveran awarded the 1907

Nobel prize for Physiology or Medicine.
• The first effective treatment for malaria came from the
bark of Chinchona tree, which contains quinine.
The malarial
incidence is
highest in the
central part of
Africa North
and south of
the equator
Epidemiological trends of Malariain India (2000-2019) Pv
(plasmodium vivax);Pf( plasmodium falciparum)
• In 2020,241 million cases of malaria wordwide . Estimated no.
Of deaths 62,7000 in 2020.
• In 2020 The WHO African region was home to 95% of malaria
cases
• Children under 5 years of age accounted for about 80% of all
malarial deaths in the region.
• According to WHO Reports ,global mortality rate has
declined by 90% in 20 th century.
• African people ,younger childrsn ,older
people ,pregnat ,people with low immunity ,people who
live in poverty don’t access healthcare have increased
risk of dying from dying malaria.
• India is the only high endemic country who reported decline of 17•6% in
2019 over 2018.
• Malaria elimination efforts were initiated in the country in 2015.
• National strategic plan for Malaria elimination launched by Health
Minister in 2017. API <1 since 2012.
• HBHI initiative catalysed by WHO &RBM partnership has been started in
India in 4 states – West Bengal, Jharkhand,Chattisgarh & Madhya Pradesh
in 2019. In last 2 years 18% reduction in cases and 20% reduction in death
seen .
AETIOLOGY
• Malarial parasites belong to the genus Plasmodium.
• In humans malaria is caused by P. ovale, P.malariae,
, P.vivax, P.knowlesi,P.falciparum.
• P.vivax is the most common cause of malaria and is found in subtropical
and temperate areas of the world.
• P.falciparum is found in the tropical regions and cause the most severe
and fatal disease.
• P.ovale is the least common malarial species and is endemic in Africa.
EVENTS IN HUMAN START WITH MOSQUITO BITE
• Man- Intermediate host

• Mosquito- Definitive host
• Sporozoites are the infective form of the parasite.
• When the infecteĺd female anopheles mosquito bites the human
then the sporozoites enter the Human alongwith the saliva of
mosquito.
LIFECYCLE
• Sporozoites enter into blood circulation
• Sporozoites undergo devlopmental phase In liver cells.
• Following replication of its nucleus ,the parasite is termed as schizont.
• At last the parasite rupture the liver cells and merozoites are released.
• A schizont contains 20,000 to 50,000 merozoites.
• The merozoites from the liver cells then bind to or enter Red blood cells and further develops
into schizony develops into male and female gametocytes known as microgametocytes and
macrogametocytes respectively. They are sexual form and found in peripheral blood.
LIFECYCLE
• Some of the sporozoites,entering into liver cells do not undergo asexual

multiplication but enter into resting phase called hypnozoite.
• The sexual cycle of Malarial parasite actually start in the human host
by the formation of gametocytes which are then transferred to
mosquito for further development.
• In the midgut of the mosquito,one microgametocyte develops into 4-8
thread like filamentous structures named microgametes.
LIFECYCLE
• The fertilisation occurs and zygote is formed.
• The zygote mature into an ookinete and which further develops into an oocyst.
• A oocyst mature and it increase in size and large number of sporozoites
develops inside it.
• The oocyst rupture and release Sporozoites in the cavity of mosquito.
• The sporozoites are distributed to different organs of the mosquito and they have
special predilection for salivary glands.
• The mosquito is now capable of transmiiting the infection to man.
THE LIFECYCLE OF PLASMODIUM
SYMPTOMS OF MALARIA
• Cough
• Muscle pain Or Back pain or both
• Enlarged spleen
• Episodes of symptoms may appear:
Every 48 hours in case of Plasmodium vivax and P.ovale.
Every 72 hours if you are infected with Plasmodium malariae.
STAGE OF DISEASE
1. Cold stage
2. Hot stage
3. Sweating stage
DIFFERENTIAL TYPE OF MALARIA
• P.falciparum causes Malignant Tertian Malaria.

• P.vivax causes Benign Tertian Malaria.
• P.malariae causes Quartan Malaria.
• P.ovale
WHY FALCIPARUM INFECTIONS ARE
DANGEROUS
Can produce fatal complictions :
1.Cerebral Malaria
2.Malarial Hyperpyrexia
3.Gastrointestinal disorders
4.Algid malaria ( shock)
5.Black water Fever can lead to death
CEREBRAL MALARIA
• Malignant malaria can affect

the brain and rest of the
nervous system.It is change in
level of
consciousness ,convulsions
and paralysis.
BLACK WATER FEVER
• In malignant malaria a large number of red blood

corpuscles are destroyed.
• Haemoglobin from the Blood Corpuscl is excreated in
the urine ,which therefore is dark and almost the colour
of cola.
LABORATORY DIAGNOSIS OF MALARIA
• Blood film examination (microscopy)

• QBC system
• Rapid diagnostic tests ( RDTs)
• PCR
THIN AND ThICK SMEAR
•Thick Blood Smear are useful for detecting

presence of parasites in patient’s blood
•Thin Blood Smear – it identify the species of
the malarial parasite.
QBC SYSTEM
• Quantitative Buffy Coat diagnosing malarial

parasite based on microcentrifugation,density
gradient of infected RBCs.
APPEARANCE OF MALARIAL PARASITE IN
QBC SYSTEM
ANTIGEN DETECTION METHODS ARE RAPID
AND PRECISE
• Provide results in 2-15 minutes
• RDTs are Immunochromatographic Tests based detection of specific
parasite antigens.Test which detect histidine- rich protein 2(HRP2)
specific for P.falciparum while those detect parsite lactate
dehydrogenase(pLDH) Specific to other three plasmodium species.
MOLECULAR DIAGNOSIS
• Parasite nucleic acids are detected using polymerase chain

reaction (PCR).This technique is more accurate than
microscopy .However it is expensive and requires a
specialised laboratory.
• Sensitivity is high. Detect very low level of parasitization.
TREATMENT
• ACTs are the recommended treatments for uncomplicated Falciparum malaria.
• 2nd line antimalarial treatment-alternative ACT known to be effective in the
region.
• Artesunate+tetracyclin/doxycyclin/clindamycin,any of these combinations
should be given for 7 days.
• Quinine(10 mg/kg 3 times daily)tetracyclin(250mg qid)/doxycyclin(100mg
bd)/clindamycin(450mg tds) any of thes combinations should be given for 7
days.
PRECAUTIONS
• Avoid Mosquito bites.

• Wearing long sleeves trousers.
• Insecticide treated bednets.
• Repellent creams Or sprays.
• Chemoprohylaxis- Indicated for the travellers travel to endemic
areas.Mefloquinine 250 MG weeky ( upto 1 year) or doxocycline ( 100mg
daily upto 3 month) ,to start 1week before and Continue till 4 weeks after
leaving.
Mosquito spray
Mosquito bednet
VACCINE NEED
• Children are usually most vulnerable to malaria because they have not built
up a natural immunity like adults.( in Africa one child dies in every 30 sec)
• An effective vaccine is the key step towards eradicating
the disease . In october 2021 ,The RTS,S/AS01 vaccine effective
against Plasmodium falciparum which cause severe disease in chilldren .
World Malaria Day
“25 April 2011”

th
THANK YOU 😊

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MALARIA

PRESENTED BY: MUSKAN AGARWAL

UNDER GUIDANCE OF : DR. SHILPA WALKIKAR

• Malaria is a mosquito borne disease caused by

• Charles Louis Alphonse Laveran awarded the 1907

• Man- Intermediate host

• Some of the sporozoites,entering into liver cells do not undergo asexual

• P.falciparum causes Malignant Tertian Malaria.

• Malignant malaria can affect

• In malignant malaria a large number of red blood

• Blood film examination (microscopy)

•Thick Blood Smear are useful for detecting

• Quantitative Buffy Coat diagnosing malarial

• Parasite nucleic acids are detected using polymerase chain

• Avoid Mosquito bites.

“25 April 2011”

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