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Introduction to Micro > Plasmodium - Malaria > Flashcards

Plasmodium - Malaria Flashcards

1
Q

Types of Plasmodium

A
  1. falciparum (Most Cases)
  2. malariae
  3. vivax
  4. ovule
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2
Q

Incidence/Prevalence

A

150 million current cases
1-1.5 million deaths per year
Endemic 91 countries
40% pop lives in areas - Endemic
1683 ‘traveller’ cases in UK
52 Scotland
5 deaths

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3
Q

Symptoms

A
  1. Early Infection
    - Fever
    - Headache
    - Chills
  2. Late disease
    - Anaemia
    - Respiratory distress
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4
Q

Life Cycle (two parts)

A
  1. Vector
    - Female Anopheles mosquito
    - Sexual Development
  2. Mammalian Host
    - Humans only
    - Asexual development
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5
Q

Asexual development

A
  1. Infected mosquito eats blood - injects anti-coagulant and sporozoites stage parasites.
  2. Sporozoites infect liver cells (30min)
  3. Develop into schizonts
  4. Rupture and release merozoites
  5. Merozoites infect RBC. (pass through blood cell stage).
  6. Some mature into gametocytes and are ingested by another Anopheles mosqutio.
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6
Q

Diagnosis - Smear

A

Microscopy is the gold standard
1. Thick smear
- Detects the presence of parasites
2. Thin smear
- Species-level identification

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7
Q

Advantages (smear)

A

Cheap & low-technology

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8
Q

Disadvantages (smear)

A

Requires well-trained competent microscopists and rigorous quality control & drug treatment may be difficult to identify species

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9
Q

Blood stage paracites

A
  • Ring
  • Trophozoite (identified in blood smears) (rings initially delicate, become compact as trophozoite develops)
  • Schizont (asexual replication, nuclear division without cytoplasmic division) (Large multi-nucleated form)
  • Gametocyte
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10
Q

Rapid Diagnostic Test (rDT)

A
  1. Complements blood tests
  2. Detects specific P. falciparum antigens
  3. Detects and antigens specific to all 4 human malarial species in blood.
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11
Q

rDT Disadvantages

A

May not detect low-level parasitaemia & not quantitive

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12
Q

Antimalarial Treatment Depends on?

A
  1. Plasmodium species
  2. The part of the world where the infection originated (resistance)
  3. Severity of symptoms
  4. Pregnancy
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13
Q

Antimalarial Drugs

A
  1. Chloroquine
    - Target blood-stage parasites
  2. Quinine
    - Target blood-stage parasites
  3. Primaquine
    - Targets dormant liver forms
  4. Doxycycline Clindamycin
    - Used in combo with quinine
  5. Artemisinin
    - ACT is a combination-based therapy
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14
Q

Artemisinin

A

Used in Malaria-ridden parts of the world. reduce mortality by 20% overall and by over 30% in children. In Africa alone, more than 100,000 lives are saved each year.

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15
Q

Problems with Treatment

A
  • No drug is effective against all stages
  • Resistance is a problem
  • Unpleasant side effects
  • Prevention is better than cure
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16
Q

Chemoprophylaxis

A
  1. Antimalarial tablets are recommended for visits to an area where there is a malaria risk.
  2. Reduce the risk of malaria by about 90%.
17
Q

Antimalarias

A
  1. Mefloquine (aka Lariam)
  2. Doxycycline (aka Vibramycin-D)
18
Q

Prevention/Eradication
1. Vector control with insecticides

A
  1. Insecticides
    - Successful in Italy
    -Unsuccessful in developing countries
    -Mosquito nets treated with insecticides have a remarkable impact
  2. Larvicides
    - destroy mosquito larvae
19
Q
  1. Vector control without insecticides
A

Sterile insect technology (SIT) project
Theory
1. Female Anopheles mate only once
2. If the males are sterile the females will lay infertile eggs
- SIT project released sterile UV irradiated mates (tend to be less fit and die)

20
Q

Transgenic Mosquito(TM)

A

Sterile Males
- Developed in joint project between WHO & Indian MRC
- Oxitec in London develop sterile mosquito

21
Q

Transgenic Mosquito with reduced parasite developement

A
  • TM expressing bee venom phospholipase in their gut
  • Ability to transmit parasite greatly decreased
22
Q

Vaccine & Molecular techniques

A
  • Best solution for individuals resident in endemic areas
  • Preferred for travellers entering endemic areas
23
Q

Three Vaccine Targets

A
  1. Pre-erythrocytic (RTS, S Vaccine)
  2. Blood Stage Vaccines
  3. Transmission blocking Vaccines
24
Q

Pre-erythrocytic (RTS, S Vaccine)

A
  1. The vaccine contains parts of two proteins found on the sporozoite surface
  2. Prevents the parasite from emerging from the liver and progressing to the erythrocytic stage
25
Q

Blood stage vaccines

A
  1. Prevent the development of the asexual stage infected erythrocyte and the merozoite
  2. Approaches
    - Attenuated whole malaria parasites
    - Merozoite (blood stage) surface antigens
26
Q

Transmission blocking vaccines

A
  1. Prevent the eventual development of oocysts and sporozoites in the mosquito.
  2. Approach
    - Anti-gamete antibodies bind to the surface of gametocytes and prevent parasite development in the mosquito midgut.

Introduction to Micro (9 decks)

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