Malaria GTG

Question 1

Parasites causing malaria?

Answer 1

P. falciparum, P. vivax, P. ovale

Question 2

Physiology of malaria infestion

Answer 2

Develops in liver, invasion of erythrocyte consumes haemoglobin and alters red cell membrane.
Abnormal RBCs stick to inside of small blood vessels of organs.
In pregnancy, parasites sequestered in placenta

Question 3

Adverse effects of malaria infx in pregnancy?

Answer 3

maternal and fetal mortality, miscarriage, SB, premature birth
FGW, LBW, maternal and fetal anaemia, interaction with HIV, infant malaria

Question 4

Parasite which confers greater morbidity?

Answer 4

P. falciparum

Question 5

Symptoms of malaria in pregnancy?

Answer 5

Flu-like illness
Fever
Vomiting
Jaundice
Resp distress
Splenomegaly

Question 6

How to diagnose malaria in pregnancy?

Answer 6

Microscopic diagnosis
(Rapid detection may miss low parisitaemia)
In febrile patient, exclude with negative malaria smears 12-24 hours apart

Question 7

In uncomplicated malaria what is the fatality rate in pregnancy?

Answer 7

0.1%

Question 8

In severe malaria what is the fatality rate in pregnancy?

Answer 8

50%

Question 9

Treatment for severe falciparum malaria?

Answer 9

IV artesunate

Question 10

Treatment for uncomplicated falciparum malaria?

Answer 10

Quinine, clindamycin

Question 11

Treatment for other non-falciparum malarias?

Answer 11

Chloroquine

Question 12

Side effects quinine?

Answer 12

Cinchonism = tinnitus, headache, nausea, altered auditory acuity and blurred vision

Question 13

Issues with malaria treatment in pregnancy?

Answer 13

Lower efficacy
Risk of recurrence at 28-42 days

Question 14

Does a case of malaria in the UK need reporting?

Answer 14

Yes - report to public health authorities and health protection agency

Question 15

How to monitor the neonate when there has been maternal infection in pregnancy?

Answer 15

Screen for malaria with standard microscopy at birth
Weekly blood films for 28 days