Pathogenesis

1. The parasite enters the mosquito’s stomach through the infected

human blood obtained by biting or during blood meal.

2. Within the stomach of the female mosquito, the female

gametocyte matures into female gamete and the male
gametocyte produces several gametes. They undergo sexual
conjugation and form a zygote.

3. The zygote matures into motile form called ookinete.

4. After a number of days, young parasites (sporozoites) are

released which work their way into the salivary gland of the
mosquito. Life cycle that occurs in the mosquito takes 8-35 days,
depending on the species.

5. The organisms are carried in the saliva into the victim when the
mosquito bites again.
6. The female alone plays the role of a vector and
definitive host in conveying the disease from
man to man.

7. In humans, the organisms invade the RBC

where they grow and undergo asexual
schizogony.

8. Erythrocytic merozoites are produced leading

to the rupture of RBC upon the release of the
tiny organisms.

9. Young merozoites invade a new batch of RBC,

to start another schizonic cycle.
 Anopheles Mosquito
Gets parasites in the blood of an infected person
Parasites multiply in the mosquito

Parasites invade the salivary gland of the mosquito

Mosquito bites a person and thus, injects the parasites

The parasite invade the RBC and undergo asexual propagation
RBC ruptures and burst releasing merozoites
Merozoites invade new batch of RBC to start another schizonic cycle
Indefinite malaise and slowly rising fever occur for several days
Chills, rapidly rising temperature, and profuse sweating

Coagulation defect Anemia

Liver and renal failure Pulmonary and cerebral edema Shock

Coma

Death
 Diagnostic Procedure
• Malaria Smear

• Rapid Diagnostic Test (RDT)

– A blood test for malaria that can be conducted
outside the laboratory and in the field
– Gives a result within 10-15 minutes
 Medical Management
• Anti-malarial drug
• Chloroquine (all species except P. malariae)
• Quinine
• Sulfadoxine (for the resistant P. falciparum)
• Primaquine (for relapse of P. vivax and ovale)
• Erythrocyte exchange transfusion
– for rapid production of high levels of parasites
in the blood
 Nursing Management
• The patient must be closely monitored

• Monitor intake and output to prevent pulmonary edema

• During febrile stage, lower the fever (i.e. TSB, alcohol rubs, ice cap
on the head)

• Application of external heat and offering hot drinks during chilling

stage.

• Provide comfort and psychological support

• Encourage the patient to take plenty of fluids

• As the temperature falls and sweating begins, warm
sponge baths may be given

• The bed and clothing should be kept dry

• Watch for neurologic toxicity (like muscular twitching,

delirium, confusion, convulsion, and coma)

• Evaluate the degree of anemia

• Watch for abnormal signs

• Close monitoring of vital signs