Pathology of Malaria.PPT

Pathology of Malaria David P. Humber School of Biosciences University of East London Learning Outcomes Know the parasites, vector epidemiology Understand of the life cycle Know the principal clinical features and pathology and the basis of diagnosis Appreciate the difficulties of control The Problem At Risk More than 40% of the world population Deaths More than 2 million per year Chemotherapy Limited Drugs drug resistance Vector control Vaccination The Parasite - Taxonomy Phylum - Apicomplexa (Sporozoa) Class - Haemosporidea (Sporozoea) Order - Haemosporidia Genus - Plasmodium Species Infecting Humans Plasmodium falciparum Malignant tertian (Cerebral) Plasmodium vivax Tertian Plasmodium ovale Tertian Plasmodium malariae Quartan Common Severe Rare Mild Species Infecting Humans Plasmodium falciparum Tropical Africa, Asia, Latin America Plasmodium vivax Worldwide Plasmodium ovale Tropical West Africa Plasmodium malariae Worldwide but very patchy Relapses Fevers No 24-48 Yes 48 Yes 48 No 72 Rare Mild Epidemiology 400 million cases annually 3 million deaths majority 2-5 years 103 endemic countries most in Africa most due to P.falicparum Need 15oCfor 4 weeks 300m 64oN to 32oS Distribution of Malaria Life Cycle Infected Liver CellHepatocyte Erythrocytic forms (signet) Gametocytes Exflagellation Clinical Features Pre-patent Period Time taken from infection to symptoms P. falciparum 6-12 days P. vivax 10-17days P ovale 14 days P. malariae 28-30 days Clinical Features of Malaria Prepatent period Flu-like initially Intermittent fever Recurrence Coma/death Chronic infection Relapses Cold stage ???hr Headache/shiver/rapid weak pulse Hot stage 6hrs Intense headache/nausea/thirst/distress Sweating stage 4hrs Profuse sweating Sleep! Tertian Malaria - P. vivax P. ovale Rarely fatal- relapses common Prodrome myalgia, headache, chilliness, low grade irregular fever (no sync m