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MMI 445 > Lecture 19- Malaria > Flashcards

Lecture 19- Malaria Flashcards

1
Q

Nearly every minute a child under ____ dies of malaria

A

Child under 5

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2
Q

Malaria stands for?

A

Bad air

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3
Q

How long has P. falciparum been in existence for?

A

50,000 to 100,000 years

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4
Q

Malaria is ____ and ____ parasitic infection in history

A
  • Serious
  • Fatal
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5
Q

Who observed parasite inside RBC in 1880?

A

Charles Louis Alphonse Laveran

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6
Q

Malaria is a ____ born disease

A

Mosquito borne disease

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7
Q

Malaria is transmitted by what species?

A

Female anopheles group

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8
Q

What is the genus of malaria?

A

Plasmodium

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9
Q

What are the 5 human infection species of plasmodium?

A
  1. P. falciparum
  2. P. malariae
  3. P. ovale
  4. P. vivax
  5. P. knowlesi
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10
Q

What is the most severe form of malaria?

A

P. falciparum

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11
Q

P. knowlesi is restricted to ____ and is a ____ disease

A
  • Southeast Asia
  • Zoonotic disease (found in primates)
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12
Q

What were two 19th century drugs used to treat malaria?

A
  1. Quinine (fever tree bark)
  2. Artemisinins (extract from qinghao)
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13
Q

Was there malaria in the Rideau Canal/Eastern Seaboard and why?

A
  • Yes
  • Because the vector anopheles existed
  • There was also long cycle (the ones that survived harsh winter in humans) and the short cycle (spread by mosquitoes)
  • P. vivax so people were able to overcome infection
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14
Q

What species of malaria has been in the US?

A
  • P. vivax
  • P. falciparum
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15
Q

Has malaria come back into the US?

A
  • Yes
  • Seen cases that arent releated to travel
  • Locally aquired cases in Texas and Florida
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16
Q

How many individuals are at risk of malaria in 90 endemic countries?

A

2 billion (125 million is travelers)

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17
Q

Huge amounts of cases is restricted to ____ with high amounts of deaths

A

Africa

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18
Q

What is the top infection in travelers with fever in Canada?

A

Malaria

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19
Q

What are the two most common strains of malaria seen?

A
  • P. falciparum
  • P. vivax
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20
Q

Where do you find P. falciparum?

A
  • Sub Saharan Africa
  • New guinea
  • Central and South America
  • Southeast Asia
  • Tropics and subtropics
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21
Q

Where do you find P. vivax?

A
  • Central and South America
  • India
  • Southeast Asia
  • Eastern Africa
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22
Q

Describe the lifecycle of malaria

A
  • Mosquito will take a blood draw, mosquito contains all these sporozoites
  • It releases these sporozoites and has now entered the blood stream
  • Once in the blood, they will locate themselves to the liver
  • Once they infect a hepatocyte, the sporozoites will develop and mature into Schizonts
  • It’ll enter the blood
  • Then it’ll develop into the adult stages (trophozoite to mature trophozoite)
  • Then to gametocyte that is picked up by the mosquito and turned back into sporozoites
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23
Q

What is a Schizont?

A

Its a large cell that contains thousands and thousands of daughter cells (merozoites)

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24
Q

What is a merozoite?

A

Young parasite that will eventually enter the blood stream

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25
Q

What are the two main stages of an infection?

A
  1. Liver stage
  2. Erythrocytic stage
26
Q

It only causes infection when its in?

A

The blood (fever means its circulating in the blood)

27
Q

What are the different stages in malaria life cycle?

A
  • Sporozoite
  • Schizont which contains merozoites
  • Merozoites develop into trophozoites
  • Can differentiate into schizont or gametocytes
  • Gametocytes differentiates into a sporozoite in the mosquito
28
Q

What are some general symptoms of malaria?

A

Fever, diarrhea, headache, sweats or chills, nausea or vomiting, muscle and stomach pain

29
Q

What are some severe manifestations of malaria?

A
  • Cerebral malaria
  • Severe anemia
  • Coma and death
30
Q

Severe manifestations are most common in?

A

Children under the age of 5

31
Q

Why do you need to differentiate the difference between severe (complicated) and non-severe (uncomplicated) malaria?

A

Do this because there are different treatment regiments based on what kind of malaria an individual has

32
Q

What is non severe/uncomplicated malaria?

A

Symptomatic malaria without evidence of severe disease or vital organ dysfunction (general symptoms)

33
Q

What is severe/complicated malaria?

A
  • General symptoms plus severe manifestations
  • Symptomatic malaria with this complications:
34
Q

What is the most morbid complication of malaria?

A

Cerebral malaria

35
Q

If cerebral malaria is untreated, the mortality rate is?

A

15-20% of cases

36
Q

What are some symptoms of cerebral malaria?

A
  • Confusion
  • Disorientation
  • Delirium
  • Agitation
  • Seizure activity -> coma > 30 min
37
Q

How does cerebral malaria happen?

A
38
Q

What happens to the brain in cerebral malaria?

A

Cortical thickening

39
Q

What is considered the gold standard for malaria diagnostics?

A

Microscopy

40
Q

What is the use of microscopy in the diagnosis of malaria?

A

Looking for the parasites in the blood and looking for the stage of the lifecycle

41
Q

Why is microscopy limited in Canada?

A
  • Limited accessibility because you need trained staff that can identify the different stages and differentiate the type of species and it takes a long time to develop this skill
  • Not many cases in Canada, so harder to maintain this level of expertise
42
Q

What is the difference between a thick and thin blood smear?

A
  • Thick = allows you to look at the entire area to see if you can see anything abnormal
  • Thin = to speciate and identify the stage in lifecycle
43
Q

Why is microscopy considered a gold standard?

A
  • Doesn’t take lots of money or resources
  • People in endemic areas have lots of expertise for identifying different species
44
Q

If you see a banana shaped gametocyte, then what species is it?

A

P. falciparum

45
Q

The shape, size and number of ____ can differ between species

A

Merozoites and schizonts

46
Q

What other parasite presents similarly to malaria under the microscope?

A

Babesia

47
Q

What is an example of a Rapid Antigen Test (RAT) for malaria?

A

Immunochromatographic test = BinaxNOW malaria

48
Q

What is T1 and T2 targets for RATs?

A
  • T1 = targets histidine rich protein 2 (HRP2) specific for P. falciparum
  • T2 = targets pan-malarial antigen common to all other malaria species (pan-aldolase)
49
Q

What happens if you have a T1 band present on a RAT?

A

Most likely infection with P. falciparum

50
Q

What is the main issue to RATs?

A
  • Has undergone mutation to HRP2 (T1 target) to cause it to not show up as positive
  • Can miss malaria all together without microscopy
51
Q

Why can you not rely solely on one test?

A

You could miss the HRP2/3 mutant

52
Q

Can you speciate using PCR?

A

Yes

53
Q

Describe LAMP

A
  • Loop-mediated isothermal amplification (LAMP)
  • Uses 4-6 primers targeting 6-8 regions of DNA for highly specific amplification at a constant temperature
  • Strand displacing DNA polymerase allows primers to bind to create loop structures that facilitate subsequent rounds of amplification of the loops and additional annealing of primers
  • Product visualization by eye
  • Compatible with real time fluorescence, lateral flow or agarose gel
54
Q

____ is fast but no speciation available

A

LAMP

55
Q

Which test is best when it comes to sensitivity?

A

Molecular assay

56
Q

Which species are considered the relapsing species of malaria?

A
  • P. vivax
  • P. ovale
  • Lays dormant in the liver
57
Q

You need drugs to treat both what?

A
  • Targets the parasites in the liver
  • Targets parasites in the blood
58
Q

What is the greatest threat to malaria control?

A

Drug resistance

59
Q

What species have confirmed resistance?

A
  • P. vivax
  • P. falciparum
60
Q

What are the two types of control initiatives?

A
  1. Fungus to kill anopholes mosquitoes
  2. Vaccine
61
Q

What is malaria elimination?

A

Interruption of local transmission of a specified malaria parasite in a defined geographical area as a result of deliberate activities

MMI 445 (26 decks)

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