1. Class sporozoa Genus Plasmodium
P.vivax Benign tertian malaria
P.malariae--- Quartan malaria
P.falciparum---Malignant tertian
Subtertian malaria
P.ovale ovale tertian
Benign tertian malaria

2. P vivax Mature schizont

3. P vivax Trphozoites

4. P vivax trophozoite

5. P malariae

6. P malariae

7. P falciparum (rings & gametocyte)

8. P falciparum

9. P Ovale

12. Life cycle Vertebrate host---asexual cycle---schizogony
Invertebrate host---sexual cycle---sporogony

14. Prepatent period
Incubation period
Latent malaria
Relapse
Recrudescence

15. Pathology Anemia & tissue anoxia Anemia:
Destruction of RBC by the parasite
Haemolysis of non infected RBC(Autoimmune process)
Hypersplenism
Bone marrow depression
Increase RBC fragility

16. Tissue anoxia Congestion Reduced blood flow Stasis of blood Thrombi
Obstruction of small blood vessels
Petechial hemorhages
Anoxia of the affected organ

17. Complications Cerebral malaria Hyperpyrexia Gastrointestinal
Algid malaria
Black water fever
Renal complications
Tropical spleenomegaly

18. Cerebral malaria Hyperpyrexia Gastrointestinal complications Algid malaria
Parasitemia is high > 5%
Multiple infection in the RBC is common
Trophozoits &schizonts appear in the peripheral blood

19. Epidemiology
Prevalence:
Reservoir
Transmission
Endemicity study

20. Transmission Bite of female anophiline mosquito
Blood transfusion,Contaminated syringes
Across the placenta(placental defect)

21. Endemicity study Statistical data for morbidity &mortality
Splenic index
Parasite index
Mosquito density & infection rate
Environmental factors affect the transmission

22. Splenic index
Holo endemic
Hyper endemic
Mesoendemic
Hypoendemic

23. Environmental factors
Climate
Socio-economic state of the population

24. Immunity Innate resistance(natural immunity:
Black people immune to P vivax
Sickle Hb Trait immune to P falciparum
G6 PD deficiency of RBC limits parasitemia especially to P falciparum

25. Acquired immunity Stimulated by erythrocytic parasites
Immunity is specific for spices & strain

26. Premunition

27. Diagnosis History Clinical signs Blood films: Thick film Thin film
Sero-dignosis

28. Treatment
General measures
Chemotherapy

29. Drugs acting on asexual erythrocytic parasites (Schizontocides)
Quinine
4 aminoquinolene:
Chloroquine
Nivaquine
Amodiaquine
Mefloquine
Mepacrin
Proguanil
Pyrimethamine
Sulphonamide & sulphones(in combination with other drugs

30. Drugs acting on tissue forms
Proguanil & pyrimethamin
8 aminoquinolene( primaquine),has gametocidal activity

31. Treatment of all uncomplicated attacks except resistant P falciparum
Chloroquine phosphate orally:
day one : Gm
0.5 Gm after 6 hours
day two ; Gm
day three; Gm
In P falciparum If no response = Drug Resistance
In P vivax & Ovale: destroy hypnozoites in the liver
Primaquine phosphate(15 mg /orally /day for 14 day

32. Treatment of severe illness except resistant P falciparum
Chloroquine hydrochloride I.M until oral therapy is possible

33. Treatment of P falciparum resistant to Chloroquine
Combined therapy:
Quinine sulphate
Pyrimethamine
Sulfadiazine