Ppt Akun Malaria
Transcript of Ppt Akun Malaria
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Prepared by:
ALINGAN, MUAMIR A.
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WHAT IS MALARIA
A vector-borne infectious disease caused by protozoan
parasites.
The term MALARIA originates from MEDIEVAL ITALIAN:MALA
ARIA BAD AIR; and the disease was formerly called
ague or marsh fever due to its association with swamps.
It is widespread in tropical and subtropical regions,
including parts of the Americas, Asia, and Africa.
Historical records suggest malaria has infected humans
since the beginning of mankind.
It has been infected humans for over 50,000 years, and
may have been a human pathogen for the entire history of
our species.
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1880
A French army doctor
working in the military
hospital of Constantine
Algeria namedCharlesLouise Alphonse Laveran
observed parasites for
the first time, inside
the red blood cells of
people suffering from
malaria. He therefore
proposed that malaria wascaused by this protozoan,
the first time protozoa
were identified as
causing disease.
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1884
Ettore Marchiafava and
Angelo Celli, while
studying wet blood
smears from malariouspatients with the new
oil-immersion lens,
looked at unstained
blood and saw an active
amoeboid ring in the
red blood cells. Theythen published this
finding and named it
Plasmodium.
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A yearlater Carlos Finlay, a Cuban
doctor treating patients
with yellow fever in
Havana, first suggested
that mosquitoes weretransmitting disease to
and from humans.
1898
It was Britain's Sir
Ronald Ross working inIndia who finally proved
in 1898 that malaria is
transmitted by mosquitoes
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NORMAL ANATOMY AND
PHYSIOLOGY
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ETIOLOGY
Malaria is caused by protozoan parasites of the
genus Plasmodium (phylum apicomplexa).
There are several species of Plasmodium Parasitesbut only four of them are significant to the cause
of malaria diseases to humans. Some of these are
in to animals. Like birds,reptiles, monkeys,
chimpanzees, and rodents.
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PATHOPHYSIOLOGY
A female Anopheles mosquito bites, injecting saliva containing sporozoites,
the infective form of malaria parasite.
The sporozoites enter the liver and multiply
In the liver, the sporozoites change into merozoites,
another form of the parasite.
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Merozoites are released from the liver and
enter the bloodstream.
Merozoites attack Red Blood Cells.
Red Blood cells burst and release the merozoites
which invade other red blood cells
and cause recurring chills and fever.
(At this point the infected person becomes a reservoir of malaria that infects
any mosquito that feeds on him.)
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PLASMODIUM
VIVAX
PLASMODIUM
MALARIAE
PLASMODIUM
OVALE
PLASMODIUM
FALCIPARUM
P. Vivax is the most common
cause of infection, responsible
for about 80% of all malaria
cases.
However, P. Falciparum is the
most important cause of disease,
and responsible for about 15% ofinfections and 90% of deaths.
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The Parasites primary hosts andtransmission vectors are femalemosquitoes of the Anopheles genus.
The disease is transmitted to
humans when an infectedAnopheles
mosquito bites a person and injects
the malaria parasites (sporozoites)
into the blood.
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Mosquito injects the
infective plasmodial
sporozoites.
Sporozoites enter the liver
cells, and transform into
merozoites which penetrate
RBC.
Once in RBC,
merozoites reproduce
rapidly, producing
many more
merozoites, which
burst out of the RBC
& penetrate newcells.
Some of these
merozoites form male
& female
gametocytes, which
can be picked up by
another mosquito.
Inside the gut of
the mosquito,
gametocytes will
fertilize creating
zygote.
The zygote then develops into
an oocyst and ruptures to
release thousands of
sporozoites.
Ready for
another cycle.
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Only female mosquitoes feed onblood, thus males do nottransmit the disease. Thefemales of the Anopheles genusof mosquito prefer to feed atnight. They usually startsearching for a meal at dusk,and will continue throughoutthe night until taking a meal.
Malaria parasites can also betransmitted by bloodtransfusion, although this israre.
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SIGNS & SYMPTOMS
The symptoms characteristic of malaria includeflu-like illness with fever, chills, muscle aches,joint pain (athralgia), vomiting, anemia caused byhemolysis, hemoglobinuria, convulsions, and
headache. The classical symptom of malaria is cyclical
occurrence of sudden coldness followed by rigorand then fever and sweating lasting four to sixhours, occurring every two days in P. vivaxand P.ovale infections, while every three for P.malariae. P. falciparum can have recurrent feverevery 36-48 hours or a less pronounced and almostcontinuous fever.
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People with severe P.falciparum malaria can developbleedingproblems, shock,liver orkidney failure,central nervoussystemproblems, coma, and can die
from the infection or itscomplications.
Cerebral malaria (coma, oraltered mental status orseizures) can occur withsevere P. falciparuminfection. It is lethal if nottreated quickly; even withtreatment, about 15%-20% die.
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INCUBATION PERIOD
The period between the mosquito bite and the onset ofthe malarial illness is usually one to three weeks(seven to 21 days). This initial time period is highlyvariable as reports suggest that the range of incubationperiods may range from four days to one year.
The usual incubation period may be increased when aperson has taken an inadequate course of malariaprevention medications.
Certain types of malaria (P. vivaxand P. ovale)parasites can also take much longer, as long as eight to10 months, to cause symptoms. These parasites remaindormant (inactive or hibernating) in the liver cellsduring this time. Unfortunately, some of these dormantparasites can remain even after a patient recovers frommalaria, so the patient can get sick again. Thissituation is termed relapsingmalaria.
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TREATMENT
Malaria can be a severe, potentially fatal disease
(especially when caused by P. Falciparum) and treatment
should be initiated as soon as possible.
The Word Health Organization recommends that those in
endemic areas, treatment should be started within 24hours after the first symptoms appear. Treatment of
patients with uncomplicated malaria can be conducted on
an ambulatory basis (without hospitalization) but
patients with severe malaria should be hospitalized if
possible.
In areas where malaria is not endemic, all patients withmalaria (uncomplicated or severe) should be kept under
clinical observation if possible.
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Drug Treatment
The first effective treatment for malaria
was the bark of cinchonatree, which
contains QUININE. It was first used by the
inhabitants of Peru, where these trees
mainly grow.
Today, there are several antimalarial drugs
available for treatment:
Chloroquine
sulfadoxine-pyrimethamine (Fansidar)
mefloquine (Lariam)
atovaquone-proguanil (Malarone)
quinine
doxycycline artemisin derivatives
primaquine
But, drug treatment of malaria is not
always easy. You have to consider some
factors in treating different conditions of
patients having malaria.
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1. The infecting species of Plasmodium parasites. Different species of Plasmodium parasites may vary in
treating patients.
2. The clinical situation of the patient.
Mild malaria can be treated with oral medication.
Severe malaria (having one or more symptoms of either
coma, severe anemia, renal failure, shock, etc.)requires intravenous (IV) drug treatment and fluids.
Malaria may pose a serious threat to a pregnant women
and her pregnancy. Infection may be more severe than
those women who are not pregnant.
3. The drug susceptibility of the infecting parasites.
Determined by the geographic area where the infection
was acquired.
Different areas of the world have malaria types that
are resistant to certain medications.
Correct drug must be prescribed by the doctor who is
familiar with malaria treatment protocol.
Therearethreemain factorsin determiningtreatment
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PUBLIC HEALTH PREVENTION
& NURSING MANAGEMENTS
MALARIACONTROL
The goal of malaria control in
malaria-endemic countries is to reduce
as much as possible the health impact
of malaria on a population, using theresources available, and taking into
account other health priorities.
Malaria control does not aim to
eliminate malaria totally. Complete
elimination of the malaria parasite
(and thus the disease) wouldconstitute eradication. While
eradication is more desirable, it is
not currently a realistic goal for
most of the countries where malaria is
endemic.
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Malaria control is carried out through the following
interventions, which are often combined:
Case Management (diagnosis and treatment) of
patients suffering from malaria.
Persons who are sick should be treated promptly
and correctly. It eliminates an essential
component of the cycle (the parasite) and thus
interrupts the transmission cycle.
WHO recommends that anyone suspected of having
malaria should receive diagnosis and treatment
with an effective drug within 24 hours of the
onset of symptoms.
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Prevention of Infection through vector control.
Infection is prevented when malaria-carrying
Anopheles mosquitoes are prevented from biting
humans.
Vector control aims to reduce contacts between
mosquitoes and humans.
Some vector control measures like (destruction
of larvalbreedingsites,insecticidespraying
insidehouses) may require organized teams and
resources that are not always available.
Insecticide-treatedbed nets could also be analternative in vector control and personal
protection. It could be conducted by the
community themselves and become a major
intervention in malaria control.
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Prevention of Disease by administration ofantimalarial drugs to particularly vulnerablepopulation groups such as pregnant women andinfants.
Administration of antimalarial drugs tovulnerable population groups does not preventinfection, which happens through mosquitobites. But drugs can prevent disease byeliminating the parasites that are in theblood, which are the forms that causedisease.
Pregnant women are the vulnerable group most
frequently targeted. They may receive, forexample, "intermittent preventive treatment"(IPT) with antimalarial drugs given mostoften at antenatal consultations during thesecond and third trimesters of pregnancy.
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MALARIA IN THEPHILIPPINES
The Philippines is one of the Southeast Asian countries
plagued with malaria. Although the country doesnot
contribute significantly to the global mortality
attributed to malaria, the disease remains to be a major
cause of healthy days of life lost (HDLL) in theendemic areas of the country. Malaria affects the
socioeconomic well-being of the affected population, and
the different socioeconomic activities affect
transmission, prevention, and control of the disease.
Thus, this situation not only generates an enormous
economic, social and health burden to these people per
se, but also poses a huge and persistent challenge tothe health deliverers of the Malaria Control Program.
PHILIPPINE SCENARIO
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MALARIA AS A HEALTH PROBLEM
It is the eighth leading cause of morbidity in the
Philippines. (HIS 2000) According to DOH Secretary Reynaldo Duque, an
average of three Filipinos die daily due to malariadespite the governments intensified efforts tocontrol the occurrence of the ailment.
Malaria has become a health threat.
Although malaria endemicity is now generally moderate
to low, the disease continues to be a majorimpediment to human and economic development in areaswhere it persists
This disease is still endemic in 65 of the 79provinces in the country, and around 10 millionpeople who live in these areas are at risk of gettingthe disease.
Morbidity trend suggest that there might be a causeand effect relationship between the activities whichaim to eradicate malaria and its incidence
There is a decreasing number of deaths caused bymalaria
Chloroquine, the cheapest medicine against malaria islosing its effectiveness
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Malariaasa Health ServicesProblem
It poses challenges of access to health care for promptand effective treatment
There are shortages of antimalarial drug supplies,especially in peripheral health centers
The disease still costs the Philippine economy to spendover Php 100 million in order to sustain control efforts
Failures in treatment still occur despite thepreventability of malaria.
Causes of Malaria Treatment Failure in the Philippines
Drug resistance Non-compliance of patients in the treatment regimen
Deficient drug absorption
Self-medication
Resorting to herbal remedies
Seeking help when the disease is severe (Malaria isfatal only when it is seen in its later stages.)
Epidemiology of malariaiscomplex, dueto
Variety of ecological conditions observed in differentisland groups
Occurrence of more than one vector species
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MalariaControlProgram of the Department of Health
For 2007, The Department of Health has developed amalaria control program as a measure to help eradicatethe spread of the disease. Some of the programstrategies are:
1. Early diagnosis of the disease and prompt treatment.
This was achieved through:
diagnostic centers which serve as cites ofmicroscopy
manning by a RDT (Rapid Diagnostic Test) trainedpersonnel
promotion of the existence of diagnosticcenters
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2. Controlling the spread of mosquitoes
This was achieved through:
giving out insecticide-treated mosquito nets
indoor spraying which targets houses and not onlycommunities
3. Implementation of community-based malaria control
This was achieved through:
social mobilization education sessions
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JOURNALSMosquito Nose Transplants Help Fight Malari
Main Category: Tropical DiseasesAlso Included In: Biology / Biochemistry; Aid / DisastersArticle Date: 16 Feb 2010 - 9:00 PDTIn .
a new approach to combating malaria, a disease that affects half a billion peopleworlwide, US scientists successfully transplanted most of the "nose" of the disease-spreading Anopheles mosquito into frogs' eggs and fruit flies so they could analysethe insect's odorant receptors and find out how to lure it into traps and even prevent itbeing able to detect and thereby target humans.
You can read about the two studies by researchers from Yale University in NewHaven, Connecticut, and Vanderbilt University in Nashville, Tennessee, in a report inthe 3rd February online issue of the journal Nature and there is also a complementaryarticle in the Proceedings of the National Academy of Sciences, PNAS.
The mosquito Anopheles gambiae is the major route through which humans in sub-Saharan Africa become infected with malaria. While we know that the insect uses itssense of smell to find human hosts, we know little about the underlying molecularprocess.
A mosquito's "nose" is in its antennae which carry nerve cells covered with odorantreceptors that react to different chemical compounds in the insect's environment.These receptors are similar to those that give us our senses of smell and taste in ournose and on our taste buds.
Co-author Dr Laurence Zwiebel, professor of biological sciences at Vanderbilt, toldthe press that:"We've successfully expressed about 80 percent of the Anopheles
mosquito's odorant receptors in frog's eggs and in the fruit fly antennae."
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Zwiebel's lab at Vanderbilt is where they successfully transplanted thereceptors into frogs' eggs. The transplant into fruit-fly (Drosophila melanogaster) eggswas done at the laboratory of John Carlson, Eugene Higgins Professor ofMolecular,
Cellular and Developmental Biology at Yale and is written up as a complementarystudy in PNAS.
Scientists have previously used frogs' eggs to study olfactory receptors in moths,bees and fruit flies. For this study, the researchers injected DNA that codes for themosquito's olfactory receptors into a frog egg and waited for it to produce proteins.Eventually the surface of the egg became covered with mosquito odorant receptors.
They then tested the engineered egg's reaction to being exposed to various odorant
chemicals. They floated the egg in a buffer solution in a voltage clamp (so they couldmeasure changes in the egg's electrical properties) and dissolved the chemicals oneby one in the solution. They detected a measurable electrical response in the egg.
Guirong Wang, lead author of the PNASstudy, and a senior researcher in Zwiebel'slab, said:"The frog egg system is relatively rapid, highly sensitive and allows us to dovery precise measurements of odorant response."
Wang, who personally conducted several thousand measurements of egg responsesto changes in odorant, described this method as a "medium throughput system",because although they could set it up quite quickly, they had to make the odorantsolutions by hand, which took much longer.
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Antioxidants May Help Prevent Malaria Complications That Damage Brain
Using an experimental mouse model formalaria, an international group of scientists hasdiscovered that adding antioxidant therapy to traditional antimalarial treatment may prevent long-lastingcognitive impairment in cerebral malaria. Their findings were published online June 24, 2010, in the
journal PLoS Pathogens.
Malaria, an infection caused by parasites that invade liver and red blood cells, is transmitted to humansby the female Anopheles mosquito.Malaria is one of the leading infectious diseases worldwide, affectingmore than 400 million people and causing more than 2 million deaths each year, mainly among Africanchildren. Recently, the U.S. Centers for Disease Control and Prevention (CDC) issued a report on 11laboratory-confirmed cases of malaria among U.S. emergency responders and those traveling in theUnited States from Haiti.
Cerebral malaria is a severe, potentially fatal neurologic complication of infection by the most-fearedmalarial parasite, Plasmodium falciparum. Recent studies of children with cerebral malaria indicate thatcognitive deficits, which may impair memory, learning, language, and mathematical abilities, persist inmany survivors even after the infection itself is cured.
"Cerebral malaria and its molecular mechanisms are under intense study, but the cognitive dysfunctionthat can persist in survivors in the aftermath of successful treatment has gone unrecognized untilrecently," says Guy A. ZimmermanM.D., professor and associate chair for research in the University ofUtah School ofMedicine's Department of Internal Medicine and a contributor to the study. "Thiscomplication may impose an enormous social and economic burden because of the number of people atrisk for severe malaria worldwide. Our findings demonstrate that, by using experimental models ofcerebral malaria in mice, we can explore mechanisms of cognitive damage and also examine potentialtreatments for reducing or preventing neurologic and cognitive impairment."
Zimmerman and colleagues in Brazil studied the persistence of cognitive damage in mice withdocumented cerebral malaria after cure of the acute parasitic disease with chloroquine, an antimalarialtherapy. By administering a battery of behavioral tests to these mice, post-doctoral fellow Patricia Reis,Ph.D., determined that impairment in memory skills was still present 30 days after the initial malariainfection. Cognitive deficits that persist for years after the episode of cerebral malaria have also beenreported in 11 percent to 28 percent of children who survive the infection.
"Although we believe that long-term cognitive dysfunction after cerebral malaria is initiated by injury to thebrain during the initial period of untreated infection, it is possible that the mechanisms for persistentcognitive deficits are independent of those that cause neurological injury and death during acute cerebralmalaria," says Zimmerman. "Future research is aimed at clarifying this point. However, we have been
able to demonstrate that oxidative stress is present in the brains of mice infected with cerebral malaria."
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Malaria And Algae Linked To Common Ancestor By 'Little Brown Balls'
Unconspicuous "little brown balls" in the ocean have helped settle a long-standing debateabout the origin ofmalaria and the algae responsible for toxic red tides, according to a new studyby University of British Columbia researchers.
In an article published this week in the Proceedings of the National Academy of Sciences EarlyEdition, UBC Botany Prof. Patrick Keeling describes the genome of Chromera and its role indefinitively linking the evolutionary histories of malaria and dinoflalgellate algae.
"Under the microscope, Chromera looks like boring little brown balls," says Keeling. "In fact, theocean is full of little brown and green balls and they're often overlooked in favour of moreglamorous organisms, but this one has proved to be more interesting than its flashier cousins."
First described in the journal Nature in 2008, Chromera is found as a symbiont inside corals.
Although it has a compartment - called a plastid - that carries out photosynthesis like other algaeand plants, Chromera is closely related to apicomplexan parasites - including malaria. Thisdiscovery raised the possibility that Chromera may be a "missing link" between the two.
Now Keeling, along with PhD candidate Jan Janouskovec, postdoctoral fellow Ales Horak andcollaborators from the Czech Republic, has sequenced the plastid genome of Chromera andfound features that were passed down to both apicomplexan and dinoflagellate plastids, linkingthe two lineages.
"These tiny organisms have a huge impact on humanity in very different ways," says Keeling.
"The tool used by dinoflagellates and Chromera to do good - symbiosis with corals - at some pointbecame an infection mechanism for apicomplexans like malaria to infect healthy cells.
"Resolving their evolutionary origins not only settles a long-standing scientific debate but couldultimately provide crucial information for tackling diseases and environmental concerns."
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