C3. Plasmodium and Malaria

Question 1

What is the most important tropical disease?

Answer 1

Malaria

Question 2

Who mainly dies from malaria?

Answer 2

Children under 5

Question 3

True or false?

Malaria is preventable and treatable if diagnosed earlier

Answer 3

True

Question 4

What is the meaning of an endemic area ?

Answer 4

Where malaria is commonly found

Question 5

Who should be assessed with malaria ?

Answer 5

Any body who has recently traveled to an endemic country or has been in an international airport, presenting with a fever

Question 6

Who is at risk of developing malaria ?

Answer 6

Anybody regardless of age, gender, ethnicity or country of brith

Question 7

How long after travel can malaria be made apparent ?

Answer 7

Up to one year

Question 8

Should malaria be reported to the local authorities ?

Answer 8

Yes

Question 9

What are the causative agents of malaria ?

Answer 9

Plasmodium falciparum
Plasmodium ovale
Plasmodium viva
Plasmodium Malariae

Plasmodium Knowlesi

Question 10

What causative agents of malaria is zoonotic ?

Answer 10

Plasmodium Knowlesi

Question 11

What genus of mosquito spreads plasmodium? (Vector)

Answer 11

anopheles

Question 12

Briefly describe the lifecycle of malaria ?

Answer 12

1. A single female mosquito lays 50-200 eggs.
2. Eggs lay onto still water and develop into aquatic larvae in 2-3 days
3. Over 8-10dyas the larvae go through 4 stages of development called instar
4. During the last larval instal. the larvae develop into pupae
5. After 1-2 days the adult mosquito emerges from the water

Question 13

What is the meaning of anthropophilic ?

Answer 13

Mosquitos that have the tendency to bite humans

Question 14

True or false ?

The saliva contains anti-coagulants that prevents blood clots

Answer 14

True

Question 15

Who are the two hosts that plasmodium lives in ?

Answer 15

Female mosquito and humans

Question 16

Briefly describe the lifecycle of a mosquito

Answer 16

1. Mosquito takes a blood meal and injects sporozoites
2. Sporozoites migrate to and infect our liver cells where they mature into schizonts . These liver cells can rupture and release merozoites
3. Merozites infect RBCs
4. Rig-form trophozoites mature into schizonts, which rupture and release merazoites
5. Some differentiate into gametocyte enables formation of male and female gametocytes which are taken up by mosquitos next meal and allows the propagation of the lifecycle

Question 17

What are the symptoms of malaria ?

Answer 17

No symptoms accosted with the liver stage

Symptoms occur when red blood cells rupture and release malaria toxins and pyrogens

Common symptoms are:

• Fever
• Anaemia
• Slenomegaly
• Jaundice
• Diarrhea
• Vomiting

Question 18

Are fever pattens regular ?

Answer 18

They are irregular in the first initial weeks and then turns into a regular patten called tertian, subtertiana and quartan

Question 19

What are the classical stages of fever

Answer 19

Cold stage
hot stage
sweating stage

Question 20

True or false?

There can be cases of severe malaria whiteout fever

Answer 20

true

Question 21

What species of malaria usually causes tertian fever curve?

Answer 21

P.vivax/p.ovale

Question 22

What species of malaria usually cause quartan fever curve ?

Answer 22

P.malariae

Question 23

What species of malaria usually causes subtertiana fever curve ?

Answer 23

P.falciparum

Question 24

What complications can arise with P. falciparum if left untreated ?

Answer 24

Altered consciousness and coma caused by hypoglycaemia, acidosis, seizures or very severe anaemia

Question 25

What is the main cause of malaria death?

Answer 25

Cerebral malaria | Large number of red blood cells containing mature parasites found in capillaries and venues of brain and other organs

Question 26

What is the underlining mechanism of hypoglycaemia and malaria ?

Answer 26

Caused by impairment of body to undergo gluconeogenosis that is triggered by cytokines in the body. The parasites are additionally taking up large amounts glucose. Also quinine therapy can induce insulin production resulting in low glucose.

Question 27

What is the underlining mechanism of amaemia and malaria ?

Answer 27

Direct distruction of RBC when shizonts rupture and immune mediated haemolysis occurs. in addition the cytokines produce affect RBC formation in the bone marrow

Question 28

What is the underlining mechanism of acidosis and malaria ?

Answer 28

Tissue anoxia (oxygen depletion in tissue)linked with severe anaemia leads to anaerobic metabolism and releases lactic acid. Low blood pressure can also cause anoxia therefore drop in blood pressure can occur

Question 29

What are the key facts associated with malaria and pregnant women ?

Answer 29

- Risk of abortion - Can cause anaemia and low birth weight - Parasitre not normalt transmitted From mother to new born baby in endemic areas - Not all drugs can be used in pregnant women

Question 30

What is the meaning of recrudescence ?

Answer 30

Malaria caused by a small number of parasites permitting in RBCs

Question 31

What is the meaning of reinfection?

Answer 31

Malaria attack caused by new inoculation of parasite from infected vector

Question 32

What is the meaning of relapse ?

Answer 32

When hypnozoites in liver are reactivated and initiate a new cycle of RBC infection been after elimination of all parasites from blood

Question 33

Why are some people immune to malaria ?

Answer 33

People who live in endemic area people have protection as they may have parasite-specific IgG. This means that frequent exposure to parasite must be made

Question 34

What is the link between HIV and malaria ?

Answer 34

T-cell count progressively decrease in HIV-infected individuals this means that people with HIV are more likely to have a high number of parasitaemia than immunocompetent people who are infected Malaria increases plasma viral load in GIV infected people Reinforce each other

Question 35

What os the link between climate change and malaria ?

Answer 35

Most affected by global warming. Temperatures will rise and plasmodium parasite will beagle to survive in other ears that they usually do not survive in