Lecture 01 - Malaria and Babesia Flashcards
What is the scientific name of malaria
plasmodium
Why are pregnant woman at increased risk for malaria
severe maternal anemia, death, miscarriage
How does malaria cause miscarriage
placenta gets plugged up with organisms and RBCs so baby cannot get nutrients and dies
What is the most severe form of malaria
falciparum
What is the least harmful form of malaria
malariae
What is Plasmodium knowlesi
a type of malaria from long tailed Maques that is now being seen in humans
What is the vector for malaria
Anopheles gambesi
What are the symptoms of malaria
headache, nausea, chills, diarrhea, fever, anemia and splenomegaly
What is the gold standard for diagnosis of malaria
microscopic analysis
How do rapid diagnostic tests for malaria work
detects an antigen
What antigens are seen with falciparum
HRP2, pLDH-Pf, pLDH-pan, aldolase
What antigens are seen with vivax
pLDH-pan, pLDH-Pvom, pLDH-Pv, aldolase
What antigens are seen with malariae
pLDH-pan, pLDH-Pvom, aldolase
What antigens are seen with ovale
pLDH-pan, pLDH-Pvom, aldolase
Why is treatment different for ovale and vivax
they are hypnozites
What does hypnozite mean
they remain latent in the liver
Why is falciparum the most deadly
it can infect all ages of red blood cells and can cause cerebral malaria, blackwater fever and severe anemia
What is cerebral anemia
cerebral anoxia associated with increased glucose catabolism and lactate production by infected sticky RBC clumps
What is the clinical presentation of cerebral anemia
altered states of consciousness, confusion, hallucinations, seizures, motor abnormalities and coma
What is blackwater fever
hemoglobinuria secondary to massive hemolysis
What are exosomes
formed by the endocytosis of segments of the plasma membrane they infect RBCs and act as intracellular communication mediators
What allows falciparum to sequester in deep vasculature
the formation of rosettes
What is pfEMP1
it is expressed on the surface of mature RBCs infected with falciparum and undergoes antigenic variation to allow it to bind to several different cell receptors
What does pfEMP1 bind to
CR1, CD36, ICAM-1, CSA and blood group antigen A
How is anemia caused by malaria
lysis of RBC, splenic removal of infected cells and the release of TNF-a decreasing erythropoeitin
What is the best way to prevent malaria
a bed net to prevent getting bitten in the first place
What were the first malaria treatments
quinine and chloroquine
What is the current malaria treatment
a combination therapy called artemisinin based combination therapy
Why is a vaccine not very effective
it needs to target every part of the lifecycle
What vaccine is somewhat effective in babies
anti-sporozoite vaccine RTS.S/A01
When is the malaria vaccine given to children
between 6-12 weeks and again between 5-7 months
How effective is the malaria vaccine
shows a 63% reduction in severe deadly disease but wane to 11% at 1 year and 3% at 5 years
What animal did babesia originally effect
cows
What does babesia cause
nantucket fever
What is the vector of babesia
Ixodes scapularis
Who is most susceptible to babesia
> 50 years old, diabetics, immunocompromised
What are the symptoms of babesia
fever, headache, myalgia, anorexia, abdominal pain
When do symptoms of babesia occur
1-4 weeks after a tick bite
How is babesia diagnosed
giemsa stain, PCR, serology
How does babesia cause disease
sporozoites injected by the tick attach to the RBC (AMA1 on sporozoites attach to glycosylphosphatidylinositol anchored proteins on RBC, they then develop into trophozoites and then undergo fission to become 2-4 merozoites which when released cause hemolysis
What is the treatment for babesia
antimalarial and an antibiotic like clindamycin or azithromycin
