Understanding Malaria: Symptoms, Diagnosis, and Treatment

1. Malaria Plasmodium Malariae JT April/May/2010

2. Malaria • Parasite disease, killing ~1 million/year • Passed on by the bite on an infected female anopheles mosquito • 4 types of the malaria parasite in the genus Plasmodium: • Plasmodium falciparum • Plasmodium vivax • Plasmodium ovale • Plasmodium malariae

3. Plasmodium falciparum • Responsible for most deaths/year • Responsible for: cerebral (severe) malaria, kidney failure, severe anemia and respiratory distress • Can be deadly within couple hours of first symptom • Changes the adhesive properties that the red blood cells inhabit

4. Cerebral (severe) malaria • Occurs when malaria parasites clog small blood vessels in brain • Leads to abnormal behaviour, seizures, unconsciousness, coma, and/or neurological abnormalities if left untreated.

5. Plasmodium vivax • Complications caused by the Plasmodium vivax parasite include: anemia, splenomegaly (enlargement of spleen), and cause spleen to rupture splenomegaly Plasmodium vivax

6. Plasmodium malariae • Repeated infections of plasmodiummalariae can cause Nephritic syndrome: A severe kidney disease, resulting in high levels of protein in urine and fluid build up around eyes, hands, legs, and feet. Swollen eye from nephritic syndrome

7. Symptoms of Malaria • Majority of symptoms causes by release of merozoites into blood stream • Problems occur from the large amount of free hemoglobin getting released into blood circulation after red blood cells rupture *hemoglobin: protein in the red blood cells the carries oxygen

8. Symptoms cont.. • Can occur at 8 days, but usually don’t appear for 10 days to 4 weeks after parasite enters body • Symptoms usually occur in cycles of 48-72 hours • People with little or no immunity to parasite-usually follow classic pattern of chills, fever and sweating. Occurring in cycles every 2-4 days • Length of cycle depends on type of parasite

9. Other symptoms • Simple cases of malaria: headache, nausea, vomiting, enlarged spleen, and muscle pain • This not usually leading to death • In more severe cases: anemia, reddish urine, kidney failure, fluid build up in lungs, abnormal blood clotting, and low blood sugar. • Will usually lead to death if left untreated • 2 other rare but severe symptoms: cardiovascular shock and metabolic acidosis. • *Cardiovascular shock: blood flow through body is inadequate • *Metabolic acidosis: build up in poisons in the blood and tissues

10. Life cycle of malaria parasite • Bite of female anopheles mosquito • parasites (sporozoites) travel to liver • At liver mature and release another form, merozoites. • Merozoites enter the blood stream, infecting red blood cells • Multiply within red blood cells for 48-72 hours, the rupturing, infecting more red blood cells • Finally, a bite of a mosquito infects the mosquito with the parasite, therefore passing it on.

11. Cont.. • The parasites go threw different stages as well. • The ring stage: When the parasite has a “ring” look. When parasite begins to metabolize hemoglobin • The trophozoite stage: when the parasite metabolizes most hemoglobin, grows, and prepares to produce more parasites • Finally the last stage is when the parasite divides asexually. Ring stage

12. Range of Malaria • ~3.3 million people in 109 countries • Not seen widely throughout North America • Africa/South Sahara Desert: 90% of deaths. • 35 countries account for 98% of deaths. (30 in Africa, 5 in Asia)

13. Diagnosing Malaria • Very long and difficult process • Plasmodium vivax and Plasmodium ovale can hide in person’s lungs for months-years • Classic diagnosis method: • Blood taken by prick on finger • Blood is put on a microscope and stained • The stain is taken up by all the cells and becomes concentrated in any Malaria parasites that could be in the cell • Malaria parasites appear blue with a red dot. • A newer diagnostic method is the Dipstick diagnostic kit. Results in 2-10 minutes • Very expensive and takes very specialized lab equipment

14. Treatment • Most cases can be cured with prescription drugs • Some cases, hospitalization is required • Type of drug used depending on parasite your infected with and where your infection is • Many different drugs are used, such as: Clindamycin; or atovaquone and proguanil (malarone), or mefloquine or artesunate; or a combination of pyrinethamine and sulfadoxine. • A popular drug that is used as an anti-malarial medicine: Chloroquine

15. Quotes • “economists believe that malaria is responsible for perpetuating low rates of economic growth, sociologists cite the impact of malaria on the productivity of the children and adults in these countries” • “malaria is said to be both a disease of poverty and a cause of poverty” • ^^^^ meaning, poor countries=more malaria because less people to work+ less money for treatments+ less kids going to school for education, to grow and earn good money

16. Futureoutlook • Roll back malaria • Save 4,000,000 lives by 2015 • Collect and distribute $5 billion a year over at least 2 years to multiply the distribution of treatments

17. Facts • During WWII, malaria caused more hospital visits for US army troops from July 9th-September 10th, 1943: battle casualties- 17,375….. Malaria cases-21,482 • “malaria” comes from Italian words mala and aria, meaning “bad air” because people believed it was caused by bad air from swamps in Rome. • Malaria is the 2nd leading cause of death from infectious disease in Africa, and 5th leading cause of death from infectious disease worldwide. • In some countries, mosquitoes carrying malaria parasite have become immune to insecticides and some parasites have become immune to antibiotics

18. More facts • Female anopheles mosquito usually only out at night • When malaria infects a child, they can suffer from convulsions or lose consciousness • Experts estimate a child dies from malaria every 30 SECONDS

19. Works cited • . (2009). Malaria Overview. Retrieved from http://www.umm.edu/ency/article/000621.htm • . (2010). Centres for disease control and prevention. Retrieved from http://www.cdc.gov/malaria/about/facts.html • Abramovitz, M. (2006). Malaria. New York: Thomson gale • Grushkin-Daniel. (Feb 2009). The end of Malaria. National Geographic. Retrieved from EBSCO • Klein, J. (1995-2010). Malaria. Retrieved from http://kidshealth.org/parent/infections/parasitic/malaria.html# • Moxon, E. (August 10th/2001). Life cycle of malaria parasite. Retrieved from http://www.lbl.gov/MicroWorlds/xfiles/malariawhatis.html

20. pictures • http://static.guim.co.uk/sys-images/Environment/Pix/pictures/2007/10/16/mosquito460.jpg • http://sickle.bwh.harvard.edu/malariacycle.jpg • https://istgeography.wikispaces.com/file/view/MH_L1_facts_map.gif/31235479/MH_L1_facts_map.gif • http://workforce.cup.edu/Buckelew/images/Plasmodium%20malariae%20ring.jpg • http://webdoc.nyumc.org/nyumc/files/communications/u3/Carlton_1.jpg • http://www.worldmalariaday.org/images/uploaded/user_photos/large_rbm_new.jpg • http://bepast.org/docs/photos/malaria/P.%20falciparum%20macrogametocyte.jpg • http://www.sciencedaily.com/images/2007/05/070503100808-large.jpg • http://media-2.web.britannica.com/eb-media/87/38187-004-A26FBE54.jpg • http://bms.brown.edu/pedisurg/images/ImageBank/Spleen/SpherocytosisSplenomegaly.jpg • http://3.bp.blogspot.com/_G1bIniL1clw/SOoqwMvSp8I/AAAAAAAAAbg/YmTmkDPSHxA/s320/swollen-eyes.JPG • http://seattletimes.nwsource.com/news/local/links/malaria/newrotate/img0.jpg • http://treeofglory.net/Malaria-Child.JPG