MALARIA

It is an infection caused by protozoa parasites known as plasmodium. They are tiny single-celled
organisms that are similar to animal cells. They are four species of plasmodium that affect human
beings:

plasmodium falcparum (most virulent)

plasmodium malariae

plasmodium vivax

plasmodium ovale

The vulnerable groups in a society are children below the age of five, pregnant women, persons with
HIV and the elderly.

Prevalence of malaria
Around two hundred and fifty million people contract malaria yearly resulting in about one million
deaths. Every thirty seconds, a child dies from malaria.

Transmission
Plasmodium parasites are transmitted by the female anopheles mosquito. The mosquitoes thrive in hot
and humid regions. Female mosquitoes are key to transmission due to their need for essential nutrients
that are found in blood for egg production. They take in plasmodium through their feeding process and
inject this to another host in the next feeding time.

Malaria life cycle

1. Exo-erythrocytic shizogony (Liver)
sporozoites schizonts merozoites
2. Erythrocytic shizogony (RBCs)
trophozoites schizonts merozoites gametocytes
3. Sporogony (In the mosquito)
gametocytes zygote sporozoites

They are several forms that the plasmodium parasite takes during its development:

Sporozoite ( elongate form)

Merozoite (rounded form)

Trophozoite (real form)

Gametocytes (banana shaped)

1. During a blood meal, a malaria infected anopheles inoculates sporozoites into the human host.
2. The sporozoites infect liver cells and mature into schizonts which rapture and release merozoites
(Exo-erythrocytic shizogony)
3. Merozoites infect red blood cells and destroy haemoglobin.
4. Tropozoites mature into schizoites which rapture releasing more merozoites into the blood stream.
This release triggers fever and other symptoms of the disease. (Erythrocytic schizogony)
5. Some merozoites differentiate into gametocytes.
6. The gametocytes are ingested by an anopheles mosquito during a blood meal
7. In the mosquito's stomach, male and female gametes fuse to form a zygote. (Sporogony)
8. Lastly, the zytgote developes into sporozoites which make their way into the mosquito's salivary
glands awaiting inoculation into a new human host.

Symptoms of malaria

Fever It is caused by the release of toxins and merozoites into the blood stream.

The person feels weak and exhausted

Severe headache

Back and joint and muscle pains

Vomitting and diarrhoea

Loss of appetite

Dizziness and fainting

Complications of malaria

Anaemia Since the red blood cells are raptured, the patient feels weak and dizzy due to less
oxygen in the body

Jaundice It is the yellowing of the eyes and the skin due to the release of the malaria pigment

Cerebral malaria Infected cells travel through blood circulation and reach the capillaries in the
brain where they attach themselves and block them. It cause severe headaches, mental

disorientation and it can lead to coma.

Splenomegaly It's an enlarged spleen. The spleen is the organ that filters blood. When
someone is infected with malaria, the spleen swells due to the high population of plasmodium
and raptured red blood cells being filtered.

Threatened pregnancies Malaria can lead to miscarriages, premature labour, low birth weight
or still birth

Diagnosis
The presence of plasmodium parasites is confirmed in the lab through identifying malaria parasites
microscopically in blood films.

Treatment
Uncomplicated is treated using artemisin compounds that are derived from a plant known as artemisia
annua. The most common drug is artemether-lumefantrine(coartem). This combination ensures that
parasites are killed. Severe cases of malaria are treated using quinine injection.

Drug resistance
Greatest resistance has been recorded against chloroquine and fansidar which are some of the cheapest
anti-malaria drugs. Resistance should be controlled by avoiding Over the Counter(OTC) drugs and
going for laboratory tests before taking medication in oder to lower the abuse of anti-malaria drugs.

Control
1. Use of insecticide treated nets. They are of two types
I. Insecticide Treated Nets (ITNs) Have to be treated after purchase and the insecticide
strength may last for about six months
II. Long Lasting Insecticide Treated Nets (LLINs) These are treated at the point of
manufacture and are effective for up to five years
2. Indoor Residual Spray A liquid insecticide is sprayed on the walls of the houses in endemic
regions. It crystalizes and remains on the walls. When mosquitoes rest on it, it destroys them
and brings about death.
3. Health promotion/education It is educating communities that prevention and treatment of
malaria is necessary. The people learn how to use the insecticide treated nets. When to retreat
and how to retreat.
4. Use of prophylactic drugs These are given before one is infected with malaria to prevent
severe manifestations.. It can be given to expectant women and people visiting endemic regions.
5. Use of repellents They are eithe in petroleum jelly or they can be fixed to the socket where
they continually release insecticide throught the night.

6. Altering the environment to prevent breeding of mosquitoes It involves trimming bushes and
long grass to decrease the breeding of mosquitoes.
7. Draining surface or stagnant water Unused pots
8. Sanitation of the environment Burying empty tins and covering water in water holding vessels
9. Selecting healthy sites for constructing houses and building with screening windows which
have mosquito netting.