Malaria

Question 1

what is the vector for malaria?

Answer 1

female anopheles

Question 2

what is the life cycle of malaria in the human body?

Answer 2

bite to live to RBC…they grow in liver and rupture and they also grow and rupture in the RBCs

Question 3

four common types of malaria

Answer 3

plasmodium falciparum, vivax, ovale and malariae

Question 4

what plasmodium is most common outside of africa?

Answer 4

plasmodium vivax

Question 5

what RBCs can falciparum, vivax, malariae, and ovale infect?

Answer 5

falciparum is all RBCs
Vivax and Ovale is reticulocytes
Malariae is old RBCs

Question 6

which two plasmodium have liver dormancy and can infect later?

Answer 6

vivax and ovale

Question 7

prepatent period of malarial infection

Answer 7

early infection…asymptomatic…division in liver

Question 8

paroxysm period of infection with malaria

Answer 8

fever and chills…RBCs are infected now

Question 9

which plasmodium causes severe malaria and how does it do it?

Answer 9

falciparum…sticks to all endothelial cells by reorganizing a protein to allow it to stick to any endothelial cell

Question 10

what is the protein that allows falciparum to stick to any endothelial cell?

Answer 10

PfEMP1

Question 11

what is the gene that can lead to pregnancy specific falciparum malaria

Answer 11

the falciparum parasites can turn on a gene called VAR2CSA that helps it stick to placental endothelial cells

Question 12

3 ways malaria kills kids

Answer 12

low birth weight, febrile illness, chronic episodes causes severe anemia

Question 13

in areas of high incidence of malaria, are adults immune? and if they are how long does the immunity last?

Answer 13

yes they are immune, and immunity only lasts short period of time

places with low incidence like asia and SA you see more adults with infection because they have less exposure to develop immunity

Question 14

3 blood disorders that inhibit malaria

Answer 14

sickle cell

thalassemias

G6PD deficiency

Question 15

Duffy antigen receptor for chemokines importance for Vivax malaria

Answer 15

it is the primary receptor for vivax malaria and is absent in the african population

Question 16

P ovale and P vivax dormancy…why do these vary in length?

Answer 16

due to seasonality and temperature changes where they are

Question 17

rapid diagnostic test for malaria

Answer 17

antibodies against different plasmodiums

Question 18

PCR testing for malaria

Answer 18

using species specific primers

Question 19

ITNs for malarial prevention

Answer 19

insecticide treated bednets…not great but used where bad infrastructure

Question 20

IRS malarial prevention

Answer 20

indoor residual spraying to selectively kill female anophelines

Question 21

DDT

Answer 21

best IRS malarial prevention

Question 22

progression of malarial treatment through drugs

Answer 22

Quinine to Chlorquinine to Fansidar to Artemisinin combination therapies (coartem)

Question 23

what is the gold standard for malaria with falciparum treatment now?

Answer 23

artemisinin combination therapy

Question 24

what is the gold standard for vivax malaria treatment now?

Answer 24

chloroquine usually but if resistant then artemisinin combo therapy

Question 25

with vivax infection…what must be given in addition to the chloroquine and why?

Answer 25

primaquine to treat the hypnozoites that are chillin in the liver

Question 26

Why should artemisinin be given with another drug and what is the common drug added?

Answer 26

artemisinin is a fast and short acting drug, so want to combine with a longer acting drug like mefloquine