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© 2012 Right Doctor MALARIA MALARIA Prepared By Department of Community Medicine Shaheed Monsur Ali Medical College 2014

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Dhaka, Bangladesh

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  • 1. 2012 Right Doctor MALARIAMALARI Prepared By Department of Community Medicine Shaheed Monsur Ali Medical College 2014
  • 2. 2012 Right Doctor Malaria Malariaisaprotozoaldiseasecausedby infectionwithparasitesofthegenus Plasmodiumandtransmittedtomanby certainspeciesofinfectedfemale Anophelinemosquito. Malaria Malariaisaprotozoaldiseasecausedby infectionwithparasitesofthegenus Plasmodiumandtransmittedtomanby certainspeciesofinfectedfemale Anophelinemosquito.
  • 3. 2012 Right Doctor Bangladesh situation: In Bangladesh 1 crore 13 lakh population are at risk of malaria in 13 districts. 80% of the infections occur at Rangamati, Bandarban and Khagrachhari districts of Chittagong Hill tracts. Affected population was 26,851 and total number of deaths due to malaria was 15 at 2013. Bangladesh situation: In Bangladesh 1 crore 13 lakh population are at risk of malaria in 13 districts. 80% of the infections occur at Rangamati, Bandarban and Khagrachhari districts of Chittagong Hill tracts. Affected population was 26,851 and total number of deaths due to malaria was 15 at 2013.
  • 4. 2012 Right Doctor Epidemiology of malaria:Epidemiology of malaria: As regards malaria problem, Bangladesh can be broadly divided into three distinct epidemiological zones/areas: 1.High risk area: this includes forested hilly areas, forest fringe areas and foothill areas and covers C.H. Districts (Rangamati, Khagrachhari, Bandarban and Chittagong), Coxs Bazar district, greater Sylhet (parts), and frontier areas of greater Mymensingh district. This area is characterized by presence of stable malaria and high immune status among indigenous population. As regards malaria problem, Bangladesh can be broadly divided into three distinct epidemiological zones/areas: 1.High risk area: this includes forested hilly areas, forest fringe areas and foothill areas and covers C.H. Districts (Rangamati, Khagrachhari, Bandarban and Chittagong), Coxs Bazar district, greater Sylhet (parts), and frontier areas of greater Mymensingh district. This area is characterized by presence of stable malaria and high immune status among indigenous population.
  • 5. 2012 Right Doctor 2. Epidemic prone area: This area includes 20 upazilas and 43 unions under 9 districts namely Sylhet, Sunamgonj, Habigonj, Moulvibazar, Netrokona, Mymensingh, Sherpur, Jamalpur and Kurigram. 3. Low risk areas: These comprise vast plain cultivable areas. 2. Epidemic prone area: This area includes 20 upazilas and 43 unions under 9 districts namely Sylhet, Sunamgonj, Habigonj, Moulvibazar, Netrokona, Mymensingh, Sherpur, Jamalpur and Kurigram. 3. Low risk areas: These comprise vast plain cultivable areas.
  • 6. 2012 Right Doctor Agent: Humanmalariaiscaused byoneofthefourspecies ofPlasmodium-P.vivax, P.ovale,P.falciparumand P.malariae;thecausative agentsofvivax(benign tertian)malaria,ovale (ovaletertian)malaria, falciparum(malignant tertian)malariaand malariae(quartan) malariarespectively. Agent: Humanmalariaiscaused byoneofthefourspecies ofPlasmodium-P.vivax, P.ovale,P.falciparumand P.malariae;thecausative agentsofvivax(benign tertian)malaria,ovale (ovaletertian)malaria, falciparum(malignant tertian)malariaand malariae(quartan) malariarespectively.
  • 7. 2012 Right Doctor Exo- erythrocytic (hepatic) cycle Sporozoites Mosquito Salivary Gland Malaria Life Cycle Life Cycle Gametocytes Oocyst Erythrocytic Cycle Zygote Schizogony Sporogony Hypnozoites (for P. vivax and P. ovale)
  • 8. 2012 Right Doctor
  • 9. 2012 Right Doctor Life cycle of malaria parasite:Life cycle of malaria parasite: The life cycle of malaria parasite is completed in two hosts- the vector mosquitoes (the definitive host) in which the sexual cycle takes place and the human host (the intermediate host) in which asexual cycle occurs. The life cycle of malaria parasite is completed in two hosts- the vector mosquitoes (the definitive host) in which the sexual cycle takes place and the human host (the intermediate host) in which asexual cycle occurs. When the female mosquito takes an infective blood meal it ingests both asexual and sexual forms of the parasite. Asexual forms are digested in the mosquitos stomach but the mature sexual forms gametocytes survive. The male and female gametocytes undergo further development and form micro (male) and female (macro) gametes. A male gamet fertilizes a female gamet and the resultant structure (zygote, which later on develops into ookinete) penetrates the stomach wall. When the female mosquito takes an infective blood meal it ingests both asexual and sexual forms of the parasite. Asexual forms are digested in the mosquitos stomach but the mature sexual forms gametocytes survive. The male and female gametocytes undergo further development and form micro (male) and female (macro) gametes. A male gamet fertilizes a female gamet and the resultant structure (zygote, which later on develops into ookinete) penetrates the stomach wall.
  • 10. 2012 Right Doctor Ookinete Oocyst in 7-14 days Sporozoites (the infective form) Ookinete Oocyst in 7-14 days Sporozoites (the infective form)
  • 11. 2012 Right Doctor The oocyst rupture and the sporozoites are released into the body cavity of the mosquito and eventually appear in its salivary gland. When it bites a human, sporozoites are injected together with saliva and circulate in the blood stream for less than an hour, by which time some of them invade liver cells in which develop pre-erythrocytic forms. The oocyst rupture and the sporozoites are released into the body cavity of the mosquito and eventually appear in its salivary gland. When it bites a human, sporozoites are injected together with saliva and circulate in the blood stream for less than an hour, by which time some of them invade liver cells in which develop pre-erythrocytic forms. After 6-15 days these rupture and release thousands of merozoites. Some of these are phagocytosed, others enter erythrocytes, and the erythrocytic phase begins. They pass through the stages of trophozoite and schizont. It ends by liberation of merozoites, which infect fresh red blood cells. Some erythrocytic forms do not divide but become male and female gametocytes. These are the sexual forms and infective to mosquito. After 6-15 days these rupture and release thousands of merozoites. Some of these are phagocytosed, others enter erythrocytes, and the erythrocytic phase begins. They pass through the stages of trophozoite and schizont. It ends by liberation of merozoites, which infect fresh red blood cells. Some erythrocytic forms do not divide but become male and female gametocytes. These are the sexual forms and infective to mosquito.
  • 12. 2012 Right Doctor Host factors: Human is the intermediate host Mosquito is the definitive host. Human host: Immunity in malaria are of two types- natural or innate immunity and acquired immunity. Host factors: Human is the intermediate host Mosquito is the definitive host. Human host: Immunity in malaria are of two types- natural or innate immunity and acquired immunity.
  • 13. 2012 Right Doctor Vector mosquito: In Bangladesh following species are important vectors of malaria: Vector mosquito: In Bangladesh following species are important vectors of malaria: A. philippinensis A. dirus A. sundaicus A. aconitus A. maculatus A. philippinensis A. dirus A. sundaicus A. aconitus A. maculatus Other species causing malaria in SEARO countries are- A.culcifacies, A. stephensi, A.aconitus, A. fluviatilis. Other species causing malaria in SEARO countries are- A.culcifacies, A. stephensi, A.aconitus, A. fluviatilis.
  • 14. 2012 Right Doctor Environmental factors: The best conditions for the development of Plasmodia in the Anopheles and the transmission of the infection are when the mean temperature is within a range of 20-30C, while the mean relative humidity is at least 60%. Environmental factors: The best conditions for the development of Plasmodia in the Anopheles and the transmission of the infection are when the mean temperature is within a range of 20-30C, while the mean relative humidity is at least 60%.
  • 15. 2012 Right Doctor Diagnosis of malaria: The diagnosis of malaria is based on a) Clinical features and b) laboratory investigations. Diagnosis of malaria: The diagnosis of malaria is based on a) Clinical features and b) laboratory investigations.
  • 16. 2012 Right Doctor Clinical features: The natural H/O malaria is characterized by incubation period, prepatent period, primary attack (composed of paroxysms), latent period (parasitic latency) and recurrences (long term relapses) Clinical features: The natural H/O malaria is characterized by incubation period, prepatent period, primary attack (composed of paroxysms), latent period (parasitic latency) and recurrences (long term relapses) The typical attack has 3 distinct stages: 1.cold stage ( 1 hour or so), 2. hot stage (