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Malaria

Vector: Anopheles Balabacencis, Leucophyrus, Sundaicus, Maculatus

Mode of transmission: Vector, Transplacental, Transfusion, Shared Syringe

Plasmodium Falciparum, P.malariae invade hepatocytes (then undergo exoerythrocytic schizogony) dvp
merozoite
P. vivax, ovale sporozoite hypnozoite(liver)merozoite (relapse)
Infective stage: sporozoite

P.fal,oval, vivax: Tertian fever (3 day)


P malariae : Quartan fever (3 day)

C/F: paroxysm of chills/rigor, fever, sweating.


Other: myalgia,, malaise, spleno/hepatomegaly
Severe complication: cerebral malaria, Severe autoimmune hemolytic anemia, hyperreactive malarious
splenomegaly

Investigation
Giemsa stain ( thick –identifly, thin – differentiate species)
PCR amplification, ELISA

Drugs
Schizontocidal
Chloroquine/quinine
On pregnancy, quinine for chloroquine resistant falciparum
Mefloquine on later stage
If quinine fails, combine with tetracycline (but no in pregnant lady!)

Prophylaxis
chloroquine
Mefloquine/doxycycline in MDR area
Chloroquine + proguanil in MDR
Gametocidal
Primaquine
Tissue schizontocidal at exoerythrocytic stage
Primaquine (prevent relapse)

 Most of the qn juz ans chloroquine


 If any exoerythrocytic presence, give primaquine

Complication
Cerebral malaria
Deformity of infected cell, adherence of cells to endothelium and to each other
Mechanical microcirculation obstruction
Hypoxia n ischemia
Edema, increase permeability in BBB

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