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

2. Global malaria mortality between 1980 and 2010: a systematic analysis Murray et. al. 2012 Lancet vol 379, February 4 2012 Key findings: Mortality burden higher in adults than previously estimated. Significant decline in mortality in Africa.

6. 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.

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

8. 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

9. Plasmodium vivax

10. Plasmodium ovale

11. Plasmodium malariae

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

15. Malaria and pregnancy

16. 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

17. 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

18. 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

19. 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

20. First results of Phase 3 Trial of RTS,S/AS01 malaria vaccine in African children The RTS,S Clinical Trials Partnership New England Journal of Medicine, November 17, 2011 vol 365, no. 20 Current leading recombinant pre-erythrocytic malaria vaccine candidate: RTS,S/AS01or AS02 (circumsporozoite protein)