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- -an acute and chronic parasitic dse transmitted by a bite of infected mosquitoes.
- -common: topical and subtropical areas
- there are FOUR species of protozoa:
- Protozoa of genus plasmodia
- 1. Plasmodium Falciparum (malignant tertians)-most serious!
- -(+)development of high parasitic densities in the blood (RBC). This type tends to cause agglutination, resulting in microembolus formation.
- 2. Plasmodium vivax (benign tertian)-non-life threatening, except for the very young and the very old
- -(+) chills every 48 hours on the third day onward.
- 3. Plasmodium malariae (quartan)
- -less frequently seen than the first two others.
- -non-life threatening
- -(+) fever and chills occur every 72 hours (4th day after onset)
- 4. Plasmodium ovale -rare type.
PRIMARY VECTOR OF MALARIA:
- ANOPHELES MOSQUITO:
- -breeds: clear, flowing, and shaded streams (mountains)
- -bigger than ordinary mosquito
- -night-biting mosquito
- -does not bite a person in motion
- -assumes a 36 degree position when it alights on walls, trees, curtains and the like.
- 12 days: P.F
- 14 days: P.V and ovale
- 30 days: P.M
human: (-) treatment ⇒ pt may be a source of mosquito infection
- P.M: more than 3 years
- P.V: one to two years
- P.F: not more than 1 year
- 1. bite of a FEMALE anopheles mosquito.
- 2. can be transmitted through BT
- 3. shared contaminated needles (rare)
- 4. transplacental transmission of congenital malaria (rare)
- -paroxysms with shaking chills
- -rapid: rising fever and headache
- -splenomegaly, hepatomegaly
- -orthostatic hypotension
- -paroxysm may last for 12 hours and attack daily or every two days.
- -continuous fever
- -convulsions and GIT sx
- *Cerebral malaria:
- -(+)severe headache, vomiting and changes in sensorium
- -jacksonian or grand mal seizure
- anapholes mosquito gets parasite from blood of an infected person
- parasites multiply in the mosquito; parasites invade the salivary gland of the mosquito.
- ⇓mosquito bites a human (injects the parasite)
- parasite: invade RBC, where they grow and undergo asexual propagation
- ⇓RBCs rupture and burst, releasing tiny organism (merozoites)
- ⇓merozoites invades a new batch of RBCs to start another schizonic cycle
- (+) coagulation defect
- Malarial Smear:
- film of blood is placed on a slide
- Rapid Dx Test:
- can be conducted outside the lab and in the field; result: 10-15 mins; detect malarial parasite antigen in the body.
- a. ANTI MALARIAL DRUGS:
- ~chloroquine (all species EXCEPT P.M)
- ~sulfadoxine (resistant P.F)
- ~primaquine (relapse of P.V and ovale)
- b. erythrocyte exchange transfusion for rapid production of high levels of parasites in the blood.
- -monitor pt
- -I&O (px pulmonary edema)
- -daily monitoring of serum BUN, bilirubin, crea and parasitic count
- -(+) resp and renal sx: ABG levels and plasma electrolyte
- -febrile: tepid bath, alcohol rubs, and ice cap on the head
- -chilling stage: hot drinks and application of external heat
- -decreased temp and (+) sweating: warm sponge baths
- -WOF: abnormal bleeding
- -severe malaria: EMERGENCY!!!
- -increase OFI
- -bed and clothing should be kept dry
- breeding places must be destroyed
- insect repellents
- people living in malaria-infested areas should NOT donate blood for at least three years
- blood donors: properly screened