Malaria

Malaria

LIFE CYCLE
1. Protozan parasites: Plasmodium
CLINICAL
1. uncomplicated malaria
  1. severe flu-like illness
    1. fever
      1. malaria fevers are cyclical; synchronized with the bursting of merozoites into bloodstream
    2. chills + sweating
    3. head + body aches
    4. nausea + vomiting + diarrhead
2. severe malaria
  1. impaired consciousness/cerebral malaria
    1. fits, prostration, coma
  2. severe anaemia
  3. respiratory distress
  4. multi organ failure
    1. renal failure
    2. pulmonary oedema
  5. death: 10-50% of cases
PATHOLOGY
EPIDEMIOLOGY
1. Hypoendemic
  1. little transmission; sporatic, self-limiting outbreaks
  2. little public health importance
  3. poor development of immunity!
  4. disease affects all ages equally
  5. EX: China, Mexico
2. Mesoendemic
  1. present in most areas; variable transmission intensity
  2. generally of ph importance
  3. development of immunity
  4. disease doesn't effect older generations
  5. EX: India, most of SE Asia
3. Hyperendemic
  1. intense, widespread (but still seasonal transmission)
  2. often a ph problem
  3. development of good immunity
  4. disease mainly of children
  5. EX: African Saehl
4. Holoendemic
  1. intense, widespread, seasonal variation is slight
  2. can be #1 ph problem
  3. good immunity
  4. disease mainly <5s
  5. EX: Humid, lowland tropical African
CONTROL
1. Prevention
  1. VC!
    1. IRS
    2. LLINS/ITNs
      1. ITNs provided 17% protective efficacy against mortality
      2. about 5.5 lives saved per 1,000 under nets
      3. treated nets can cut incidence in half
2. Treatment
  1. Drugs!
    1. parenteral
      1. Quinine, artesunate (better)
    2. orals
      1. artesunate, quinine, chloroquine...
      2. ACT: not affordable in African without subsidy
3. Diagnostics
  1. microscopy
    1. most accurate
    2. requires lab and trained staff
  2. rapid diagnostic tests
    1. point of care diagnostic!
    2. doesn't require lab or electricity; minimum training
    3. based on antigen capture
      1. no intensity result: just +/-
    4. 2 types: HRP-2 (persists after cure), LDH- negative 2 days after cure
  3. PCR-based assays
  4. serological tests

	Created by morgculver over 9 years ago

	Copied by ahmed alshaikh over 5 years ago

	Copied by ola shihabi over 4 years ago

	Copied by محمد ابراهيم over 4 years ago

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