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Malaria

From Mediwikis
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This parasite is most prevalent in tropical regions, and without proper treatment, can lead to coma or death. There are five varieties of malaria; the vast majority of deaths are caused by P. falciparum and P. vivax, while P. ovale, and P. malariae cause a generally milder form of malaria that is rarely fatal.

Life Cycle

The Plasmodium parasite is transmitted only by the female Anopheles mosquito (males feed on plant nectar).When the mosquito bites a human, the sporozoites travel to the liver and reproduce asexually in hepatocytes to produce thousands of merozoites. These merozoites infect red blood cells, and further multiply, into both more merozoites, gametocytes and hypnocytes. The gametocytes are taken up into the mosquito gut along with the blood of the mosquitos meal, where they fuse to form sporozoites, while the hypnocytes lie dormant and recur every few few years.

Life cycle of Malaria parasite

Symptoms

These begin 8–25 days after infection (later in those taking antimalarials), and include:

  • Paroxysmal fever & chills every two days
  • Flu-like symptoms
  • Headache
  • Fatigue
  • Nausea and Vomiting
  • Dry Cough
  • Splenomegaly

Investigations

  • Thick & Thin Blood Films
  • Antigen card
  • FBC, U&E, LFT,
  • Glucose
  • Blood Culture- superinfection is possible
  • Chest X Ray

If > 5% of RBCs infected with Malaria then Malaria is fulminant

Management

No vaccine exists, though there are some pharmacological therapies:

  • Prophylaxis- Chloroquine may be used where it is still sensitive, but Malarone, a combination of atovaquone and proguanil, is generally reccomended.
  • Treatment- Quinine, Chloroquine, Malarone, Artemisinin

Dormant Malaria may be treated with Primaquine to kill the hypnocytes, but test for G6PD deficiency first, as people with this deficiency have a bad reaction to primaquine.