malaria Flashcards
what is the vector for malaria ?
female Anopheles mosquito, carrying plasmodium parasite
when the parasitee enteers thee blood stream what is it called ?
sporozite that travels to the liver, they then mature and infect red blood cells
what is the incubation period for. thee plasmodium ?
2 weeks
when the RBC burst and release the parasite what form are they released in ?
Merozoites
what are the clinical manifestations of uncomplicated malaria ?
non specific symptoms
physical findings may include a palpable spleen and anemia
may also be associated with mild jaundice
febrile convulsions occur at irregular intervals each day
high temperature may be associated with tachycardia and/or delirium
what is the pathogenesis for the clinical findings associated with severe malaria ?
cytoadherence
what is blackwater fever ?
associated with severe malaria where there is renal failure and hemoglobinuria
which strain of plasmodium is associated with generalized seizures ?
falciparum , associated with cerebral malaria
what is the presentation of cerebral malaria ?
gradual or sudden onset of impaired consciousness, delirium/ seizures
what are the risk factors associated with cerebral malaria ?
age
pregnancy
poor nutritional status
HIV infection
history of splenectomy
what are the findings in CSF aspiration in cerebral malaria ?
may be normal or may show elevated total protein level and cell count
what is the standard tool for the diagnosis of malaria ?
giemsa stained blood smears by light microscopy, 3 samples over 3 consecutivee days
what are the two types of blood smears used for the diagnosis of malaria ?
thin smear - for parasite density
thick smear - presence or absence of parasite and to estimate parasite density
what quick test can be used in absence of blood smear ?
rapid diagnostic test
if you want to test for multiple antigens what is the best test to use ?
antigen based test
what are the antigens found in the antigen based test ?
HRP2
pLDH
Aldolase
which area has the greatest burden of malarial disease ?
sub-saharan Africa
what are the differential diagnosis of malaria ?
dengue fever
Chikungunya
meningitis
pneumonia
sepsis due to bacteremia
typhoid fever
leptospirosis
viral haemorrhagic fever
how is a diagnosis of typhoid fever confirmed ?
blood or stool culture
what is leptospirosis usually associated with ?
petechial haemorrhage in the skin or mucous membrane
what are the indications for hospitalizations of patients with malaria ?
- young children
- immunocompromised patients
- individuals with no acquired immunity
- patients with hyperparasitemia but no signs of severe infection
what is the treatment for uncomplicated malaria ?
if P.vivax - chloroquine 3 days , Primaquine
P.falciparum - Rest of India: ASP , PQ on day 2
NE state: AL and PQ on day 2
Mixed - ACT, PQ 14 days
what is the treatment for severe malaria ?
parenteral artemisinin
what is the next best step in management if artemisinin is unavailable ?
quinine saltt
doxycycline
clindamycin
( also applies for children and pregnancy )
what is the prophylaxis for malaria ?
chloroquine-resistant P. falciparum malaria : atovaquone-proguanil, mefloquine, doxycycline, and tafenoquine
chloroquine- sensitive P. falciparum malaria: Chloroquine
P. vivax : Primaquine or tafenoquine
when should antimalarial drugs be started ?
prior travel , continued regularly during exposure and for a period of time following departure
