labaratory diagnosis of malaria
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LABORATORY
DIAGNOSIS OF
MALARIA
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Common infectious disease in indonesia
Parasite called Plasmodium
name "mal aria" meaning "bad air" in Italian
INTRO
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250 million cases of fever and approximately one milliondeaths annually
children under 5 years old Pregnant women
endemic in a broad band around the equator
sub-Saharan Africa where 8590% of malaria fatalities occur
common in rural areas than in cities contrast to dengue fever where urban areas present the greater
risk
EPIDEMIOLOGY
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protozoan of the genus Plasmodium
sporozoites, merozoites, and gametocytes
Sporozoites are the form that is injected by the mosquito intohumans
parasite travels into the bloodstream and eventually makes itsway to the liver
develop into merozoites
merozoites leave the liver and enter red blood cells toreproduce
Infect red blood cells
CAUSE OF MALARIA
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reproducing Plasmodia will create a form known as agametocyte in the human bloodstream
mosquito takes a blood meal when gametocytes are present,the parasite begins to reproduce in the insect and create
sporozite forms that are infectious to people five species of Plasmodium
P. vivax
P. ovale
P. malariae
P. falciparum
P. knowlesi
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cyclical occurrence of sudden coldness followed by rigor andthen fever and sweating lasting four to six hours
Different for different parasites
children with malaria frequently exhibit abnormal posturing, a
sign indicating severe brain damage
cognitive impairments
neurologic damage results from cerebral malaria
Severe malaria 6
14 days after infection coma and death
Splenomegaly (enlarged spleen), severe headache, cerebralischemia, hepatomegaly (enlarged liver), hypoglycemia, and
hemoglobinuria with renal failure
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Imaging
Chest radiography may be helpful if respiratory symptoms are
present a computed tomography (CT) scan of the head may be
obtained to evaluate evidence of cerebral edema orhemorrhage
DIAGNOSIS
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Polymerase chain reaction assay
very specific and sensitive
are not available in most clinical situations
effective at detecting
10 parasites/mL of blood
Lumbar puncture
mental-status changes, and even if the peripheral smeardemonstrates P falciparum, a lumbar puncture should beperformed to rule out bacterial meningitis
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Blood Smears
Rapid diagnostic tests (RDT)
Immunochromatographic tests based on antibody to histidine-
rich protein-2 (PfHRP2), parasite LDH (pLDH), orPlasmodium aldolase
very sensitive and specific.
But less effective when parasite levels are below 100parasites/mL of blood,
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treated at home with oral medications and fluids
Hydration will not treat or cure malaria, but it will reduce side
effects associated with Chloroquine
quinine
Mefloquine
Doxycycline Clindamycin
TREATMENT
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When traveling to endemic areas
use mosquito precautions
medications to reduce the risk of disease NO VACCINE
wearing light, protective clothing
window screens and bed nets
Insect repellants containing DEET
PREVENTION
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infectious disease caused by a parasite called Plasmodium
in Asia and African Nations
high fatality rate where treatment not available
SUMMARY
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