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Microbiology > Malaria > Flashcards

Malaria Flashcards

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Biology 101 flashcards
1
Q

What percentage of the world is at risk of contracting malaria?

A

50%

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2
Q

How many million people are infected with malaria per year?

A

250 million

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3
Q

What percentage of deaths due to malaria occur in Africa?

A

90%

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4
Q

How many travelers contract malaria per year?

A

10 000

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5
Q

Which provinces in RSA are malaria infested?

A
  1. Mpumalanga
  2. Limpopo
  3. KwaZulu Natal
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6
Q

Roughly how many cases of malaria where imported from other countries?

A

64% (2011)

just know more than half

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7
Q

What type of mosquito carries the malaria parasite?

A

Female anopheles mosquito

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8
Q

How is the parasite transmitted?

A

By blood. It enters the human host blood stream after a female anopheles mosquito bites the host and transmits the sporozoites

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9
Q

After the initial injection of the sporozoites, where do they migrate to in the human host?

A

Through the blood to the liver where they invade hepatocytes and divide to form multinucleated schizonts (pre-erythrocytic stage)

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10
Q

Explain hypnozoites.

A
  • Quiescent (dormant) stage in the liver
  • Only in plasmodium vivax and plasmodium ovale
  • Assymptomatic
  • Get reactivation relapse months after initial infection
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11
Q

Describe the erythrocytic stage in the plasmodium life-cycle.

A
  • Occurs after the pre-erythrocytic stage
  • Schizonts rupture
  • Release merozoites
  • Merozoites invade red blood cells where they are immature trophozoites
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12
Q

Describe the fate of immature trophozoites.

A

Different paths.

  1. Mature into mature trophozoites and then multi-nucleated schizonts (which again rupture)
  2. Differentiate into male and female gametocytes which are then ingested by female anopheles mosquitos
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13
Q

How do plasmodium gameotcytes mature?

A
  • Ingested by female anopheles mosquito
  • Develop into sporozoites in mosquito midgut
  • Then migrate to the mosquito salivary glands
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14
Q

Briefly describe malarial pathogenesis.

A
  • Digest haemoglobin into haemozoin. RBC’s membrane less deformable whcih leads to haemolysis and splenic clearance (Anaemia)
  • Microvascular sequestration where parasite induces formation of sticky knobs on RBC’s because of the expression of proteins like pfEMP-1 (plasmodium falciparum erythrocyte membrane protein 1). RBC’s bind to vessel walls which leads to obstruction of flow and endothelial damage and inflammation
  • Cytokine release (TNF and IL) which cause systemic inflammation response syndrome (activates coagulation cascade)
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15
Q

What are the uncomplicated clinical features of malaria?

A
  • Ambulant patient
  • Vommiting
  • No jaundice
  • Normal mental state
  • Normal respiratory rate
  • No organ dysfunction
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16
Q

What are the complicated clinical features of malaria?

A
  • Cerebral malaria (microthrombi in brain vessels)
  • Severe anaemia
  • Renal failure
  • Respiratory failure
  • Jaundice (Liver dysfunction)
  • Metabolic acidosis
  • Hypoglycaemia
  • Bleeding
  • Blackwater fever
  • Hyperparasitaemia
17
Q

What are the risk factors in contracting malaria?

A
  • HIV (immunocompromised patients)
  • Pregancy
  • Children (under 5yrs)
  • Splenectomised patients
18
Q

What tests need to be done to confirm the diagnosis of malaria?

A
  • Microscopy (Giema-stained smears)
  • Rapid antigen test
  • PCR
19
Q

In terms of malaria diagnosis, what are important factors to note?

A
  • Febrile illness
  • Travel/exposure to endemic area
  • Fever, chills, myalgia, headache, vomitting and diarrhoea
20
Q

What is the RSA malaria elimination target date? How is it to be met?

A

2018

  • ACT
  • DDT
  • Bednets
  • Improved surveillance
21
Q

How are mosquito bites prevented?

A
  • Repellants (min 30% DEET)
  • Insecticides
  • Protective clothing
  • Insecticide impregnated bednets
22
Q

What is the standard treatment for non-falciparum plasmodium parasites?

A
  1. Oral chloroquine

2. Primaquie (contra-indicated in pregnancy but prevents relapse in liver)

23
Q

What is the standard treatment for uncomplicated plasmodium falciparum parasitic infections?

A
  1. Artemetherlumefantrine (Coartem)
  2. Artemiscin (ACT - prevent drug resistance)
  3. Oral quinine + doxycycline / clindamycin
24
Q

What is the standard treatment for complicated plasmodium falciparum parasitic infections?

A
  1. IV Artesunate (followed by an oral Coartem course)

2. IV Quinine (loading dose and maintenance regieme) + doxycycline / clindamycin

25
Q

List four prophylactic anti-malarial drugs.

A
  1. Mefloquine
  2. Doxycycline
  3. Atovaquone (proguanil)
  4. Malanil

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