Malaria

- is a vector-borne infectious disease

caused by protozoan parasites. It is widespread
in tropical and subtropical regions, including
parts of the Americas, Asia, and Africa
- it is one of the most common infectious
diseases and an enormous public health problem.
The disease is caused by protozoan parasites of
the genus Plasmodium.
 Infective
Female Anopheles Mosquito
the only mosquitoes can transmit malaria,
and they must have been infected through
a previous blood meal taken on an infected
person.
When a mosquito bites an infected person,
a small amount of blood is taken, which
contains microscopic malaria parasites.
Symptoms:
 fever
 shivering
 arthralgia (joint pain)
 vomiting
 anemia (caused by hemolysis)
 hemoglobinuria
 retinal damage
 convulsions
A. Plasmodium vivax
- causes Benign Tertian Malaria
- most endemic in the world
- relapsing/recurrent
- prefer young RBC`S
- Erythrocytic cycle: 48 hours
- serrated/fimbriated
- stippling/granulations: Schuffner`s
dots
B. Plasmodium ovale
- causes Ovale Malaria
- also prefer young RBC`s
- Erythrocytic cycle: 48 hours
- relapsing
- enlarged RBC
- stippling/granulations: Schuffner's
C. Plasmodium Knowlesi
- primate malaria
- different to distinguish from P.
Malariae, microscopically

- Erythrocytic cycle: 24 hour

- Shot gun appearance
D. Plasmodium falciparum
- causes Malignant Tertian Malaria /
Aestivo-autumnal Malaria/ Black fever
- present in all ages of RBC`s
- causative agent of Malaria
- Erythrocytic cycle: 36 hours
- marginal accole/applique forms
- stippling/granulations: Maurer`s dots
E. Plasmodium malariae
- causes Quartan Malaria
- prefer older RBC`s
- Erythrocytic cycle: 72 hours/3 days
- rosette, flower, fruit pie or daisy head
- stippling/granulations: Zeiman`s dots
 Duffy negative people
 Delayed transfusion reaction

 Glucose-6- phosphate dehydrogenase deficiency

 Hemoglobinopathies
 Change in the hemoglobin molecule in RBC`S

 Sickle Cell anemia

 A anemia caused by a hemoglobin defects

that results in irregularly shaped red blood

cells. It is an inherited disorder.
 Sporozoites infect liver cells and mature into
schizonts , which rupture and release
merozoites. (Of note, in P. vivax and P. ovale a
dormant stage [hypnozoites] can persist in the
liver and cause relapses by invading the
bloodstream weeks, or even years later.)  After
this initial replication in the liver (exo-
erythrocytic schizogony ), the parasites undergo
asexual multiplication in the erythrocytes
(erythrocytic schizogony ). Merozoites infect red
blood cells. The ring stage trophozoite.
 Thegametocytes, male (microgametocytes) and
female (macrogametocytes), are ingested by an
Anopheles mosquito during a blood meal. The
parasites’ multiplication in the mosquito is
known as the sporogonic cycle. While in the
mosquito's stomach, the microgametes penetrate
the macrogametes generating zygotes.The
zygotes in turn become motile and elongated
(ookinetes) which invade the midgut wall of the
mosquito where they develop into oocysts.The
oocysts grow, rupture, and release sporozoites ,
which make their way to the mosquito's salivary
glands.  Inoculation of the sporozoites into a new
human host perpetuates the malaria life cycle.
 Cerebral Malaria
 Parasite blocks blood vessels, decreased

oxygen supply to tissue leading to death/

Tissue anoxia.
 Causes organ failure/specifically renal failure

 Black water fever

 sudden intravascular hemolysis leading to

hemoglobinuria.
 Malarial Fever
 Fever that accompanies an infection is the

result of macrophage derived cytokines acting

on the brain.
 Thick Blood Film  Thin Blood Film
 Rapid screening test  For specie
for the presence of identification
malaria species  Geimsa is the
 Dehemoglobinized preferred stain to
RBC use
 Old blood is not  Don`t use blood
advisable with anticoagulant
(distorts the
parasite and alter
staining)
 is a new method for identifying the malarial
parasite in the peripheral blood.
 It involves staining of the centrifuged and
compressed red cell layer with acridine orange
and its examination under UV light source.
 It is fast, easy and claimed to be more sensitive
than the traditional thick smear examination.
 new kit method technique. The stick detects the
Plasmodium protein or parasite-specific Lactate
Dehydrogenase (pLDH) present in P.falciparum
infection.
 This method is a rapid and accurate method for
detection of P. falciparum infection.
 It uses monoclonal antibodies to detect PLDH
 Present in a finger prick sample
 Principle: Immunochromatograpic assay
(dipstick)
 Principle: antigen capture immunoassay,
immunochromatography
 Antigens detected: HRP2 and pLDH
 Sensitive  
Positive control pLDH HRP2
Positive control pLDH HRP2
 is used to detect antibodies against plasmodium.
Due to presence of antibodies for long period in
the blood
 it is not of practical routine diagnostic test for
malaria, but it may be useful for:
- Screening of blood donors prior to blood
transfusion to avoid transmission of infection.
- To monitor the prognosis of the disease and
evaluation of treatment method.
 Principle: Indirect hemeagglutination