Malaria

Introduction To Malaria
Malaria is a vector-borne infectious disease caused by protozoan parasites. It is widespread in tropical and subtropical regions, including parts of the America, Asia, and Africa. Each year, there are approximately 515 million cases of malaria, killing between one and three million people, the majority of whom are young children in Sub-Saharan Africa.Ninety percent of malaria-related deaths occur in Sub-Saharan Africa. Malaria is commonly associated with poverty, but is also a cause of poverty and a major hindrance to economic development.

Cause Of Malaria
The causative agent (the organism which causes the disease) of malaria is the protozoan parasite Plasmodium. There are four types of plasmodium parasite which can infect humans. The most serious forms of diseases are caused by Plasmodium falciparum and Plasmodium vivax. The other two are types are Plasmodium ovale and malariae. This group of human-pathogenic. Plasmodium species is usually referred to as malaria parasites.

P. falciparum culture A Plasmodium sporozoite

Transmission Of Malaria
Malaria is transmitted by female mosqiutos of the genus Anopheles.This mosquito is itself a parasite, the females visiting humans for occasional meals of blood.They can only transmit malaria and have been infected through a previous blood meal taken on an infected person. When a mosquito bites an infected person, a small amount of blood is taken, which contains microscopic malaria parasites. About one week later, when the mosquito takes its next blood meal, these parasites mix with the mosquito's saliva and are injected into the person being bitten. Only female mosquitoes feed on blood, thus males do not transmit the disease. The females of the genus Anopheles prefer to feed at night and usually start searching for a meal at dusk, and will continue throughout the night until taking a meal. Malaria parasites can also be transmitted by blood transfusions, although this is rare.

Plasmodium

Anopheles Mosquito

Passage Of Plasmodium
An immature form of Plasmodium(the sporozoite) is injecteed into the blood of humans by the mosquito.This form disappears form the bloodstream as it enters various cells of the body,particularly the liver.Here it multiplies to produce large numbers of a form(the merozoite) which can infect other liver cells. Finally it leaves the liver and enters the red blood cells. Each parasite cell in a red blood cell undergoes further division. The red blood cells burst and the released parasite cells can enter other cells. As a result of the extensive division,millions of parasites can be present in the blood.Some of the parasites transform into male and female forms of the parasite (gametocytes)

Signs & Symptoms

Symptoms of malaria include fever, shivering, arthralgia (joint pain), vomiting, anemia, retinal damage,and convulsions. The classic symptom of malaria is cyclical occurrence of sudden coldness followed by rigor and then fever and sweating lasting 4 to 6 hours, occurring every 2 days in P. vivax and P. ovale infections, while every 3 for P. malariae. P. falciparum can have recurrent fever every 3648 hours or a less pronounced and almost continuous fever. Children with malaria frequently exhibit abnormal posturing.It causes widespread anemia during a period of rapid brain development and also direct brain damage. This neurologic damage results from cerebral malaria to which children are more vulnerable. Severe malaria is almost exclusively caused by P. falciparum infection and usually arises 614 days after infection.Consequences of severe malaria include coma and death if untreatedyoung children and pregnant women are especially vulnerable. Splenomegaly (enlarged spleen), severe headache, cerebral ischemia, hepatomegaly (enlarged liver), hypoglycemia, and haemoglobinuria with renal failure may occur. Renal failure may cause blackwater fever, where haemoglobin from lysed red blood cells leaks into the urine. Over the longer term, developmental impairments have been documented in children who have suffered episodes of severe malaria.

Life Cycle of Mosquito

Prevention & Treatment

Although some are under development, no vaccine is currently available for malaria; preventive drugs must be taken continuously to reduce the risk of infection. Most adults from endemic areas have a degree of long-term infection, which tends to recur, and also possess partial immunity (resistance); the resistance reduces with time, and such adults may become susceptible to severe malaria if they have spent a significant amount of time in non-endemic areas (Endemic: describes a disease which is always present at a low level in a given population or region). Prophyhlaxis, that is the use of medicines (drugs) to prevent disease, can be used by people entering areas endemic for malaria. The usually accepted prevention is chloroquine or mefloquine which is taken weekly before and during a visit to endemic areas. The dose must also be taken for 6 months after leaving the area. Other synthetic drugs are proguanil hydrochloride and pyrimethamine. However, the effectiveness of these drugs are decreasing as the parasite is becoming resistant to these drugs. A drug called Fansidar and another called Lariam (mefloquine) are effective against chloroquine-resistant Plasmodium. Malaria transmission can be reduced by preventing mosquito bites by wearing long sleeves and trousers and sleeping under a mosquito net.

Cinchona tree, this tree contains quinine

Eradication Of Malaria
Drainage Of Stagnant Water: Larval stages of the malaria live in stagnant water, so drainage removes breeding sites. This has done some success. However the process is expensive and incomplete because rural populations must ensure that ponds, ditches and even container holding water are not allowed to provide breeding places for mosquitoes. Destruction Of the breeding stages of the mosquito: The larvae and the pupae of the mosquitoes obtain their oxygen by the means of small tubes which are pushed through the water surface film. Thus any method of blocking these tubes will result in the death if the intermediate life stages of the mosquito. The simplest method is a thin layer of oil spread over the water surface to block the breathing tubes. Petroleum oil sprayed from back packs is used. This method was used in Brazil in 1938 and eliminated the Anopheles gambiae by 1940. Destruction Of the adult mosquitoes: This is aimed at killing the mosquitoes that enter the houses.; Thus the indoor surfaces are sprayed with a persistent insecticide. If the dwellings are sprayed for three years the cycle of the manmosquito-man can be disrupted because P.vivax and P.falciparum eventually die out in infected patients.

Protection Against Malaria due to Sickle Cell

The most-studied influence of the malaria parasite upon the human genome is a hereditary blood disease, sickle-cell disease. The sickle-cell trait causes disease, but even those only partially affected by sickle-cell have substantial protection against malaria. In the merozoite stage of its life cycle, the malaria parasite lives inside red blood cells, and its metabolism changes the internal chemistry of the red blood cell. Infected cells normally survive until the parasite reproduces, but, if the red cell contains a mixture of sickle and normal haemoglobin, it is likely to become deformed and be destroyed before the daughter parasites emerge. Thus, individuals heterozygous for the mutated allele, known as sickle-cell trait, may have a low and usually-unimportant level of anaemia, but also have a greatly reduced chance of serious malaria infection. This is a classic example of heterozygote advantage. Individuals homozygous for the mutation have full sickle-cell disease and in traditional societies rarely live beyond adolescence. However, in populations where malaria is endemic, the frequency of sickle-cell genes is around 10%. The existence of four haplotypes of sickle-type haemoglobin suggests that this mutation has emerged independently at least four times in malaria-endemic areas, further demonstrating its evolutionary advantage in such affected regions.