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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.
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.
These begin 8–25 days after infection (later in those taking antimalarials), and include:
- Paroxysmal fever & chills every two days
- Flu-like symptoms
- Nausea and Vomiting
- Dry Cough
- Thick & Thin Blood Films
- Antigen card
- FBC, U&E, LFT,
- Blood Culture- superinfection is possible
- Chest X Ray
If > 5% of RBCs infected with Malaria then Malaria is fulminant
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.