1. Parasitic protozoa of human importance : Disease : Malaria Agent : Plasmodium 4 species Differential pathogenicity Vector-borne Apicomplexan inhabiting liver & blood

5. Malaria Plasmodium vivax : Most predominant and only species which extends to temperate regions. Benign tertian. Relapses. Plasmodium ovale : Tropical Africa, occasionally S. America and Asia. Ovale tertian. Relapses Plasmodium malariae : Primarily subtropical. Less frequent. Quartan.

6. Malaria Plasmodium falciparum : Most pathogenic species. Entirely confined to tropics and subtropics. Clinically sharply differentiated from the other three species. Malignant tertian.

7. Malaria : diagnosis Microscopy : Blood smears : thin versus thick smears Differentiation from P. falciparum (medical emergency in non-immune) Rapid diagnostic antigen test Serology Gene amplification methods

8. Plasmodium vivax

9. Plasmodium ovale

10. Plasmodium malariae

13. Complications Cerebral malaria Anemia Renal disease Blackwater fever Dysenteric malaria Algid malaria Hyper-reactive malarial splenomegaly (HMS)

14. Malaria and pregnancy

15. Pathogenesis Sequestration + cytoadherence : stage & strain- specific parasite- derived ligands Host secreted proteins : cytokines : TNF and interleukins Differential ability to infect RBCs RBC recognition and invasion Paroxysm

16. Epidemiology Transmission : characteristics of the vector Other forms of transmission (blood transfusion, shared needles, congenital) Innate resistance : red blood cell defects Immunity Control : eradication versus containment

17. Treatment : malaria Management of severe falciparum malaria Chloroquine-resistant P. falciparum Chloroquine-sensitive P. falciparum or P. vivax, P. ovale and P. malariae Severe falciparum chemotherapy Chemotherapy for P. vivax and P. ovale Chemotherapy for P. malariae

18. Prevention and Control Malaria control strategy Early diagnosis & treatment Selective & sustainable prevention against parasite & vector To detect & contain epidemics To reassess regularly a country’s malaria situation Roll back malaria campaign/WHO strategy –Note : impregnated bednets

19. A vaccine against malaria: a substantial step forward V. Moorthy et al. Lancet vol. 373 April 25, 2009 Comment Current leading recombinant pre- erythrocytic malaria vaccine candidate: RTS,S/AS02D (sporozoite antigen, CSP)