PAPER

RECOGNIZING MALARIA DISEASE

By:
IDAWATI
NIM 2018012164

SPECIAL PROGRAM
NURSING SCIENCE
STIKES MUHAMMADIYAH SIDRAP
 TABLE OF CONTENTS
Page
TABLE OF CONTENTS ……………………………………………………………………2
CHAPTER I INTRODUCTION
A. Background ……...………………………………………………………..3
B. Formulation of the problem….…………………………………………..3
C. Purpose of the Paper…..…………………………………………………4
D. Uses of Paper ………………………………………………………..4
E. Writing method ………………………………………………………..4
CHAPTER II LITERATURE REVIEW …………………………………………………...5

CHAPTER III DISCUSSION

A. Definition of Malaria Disease ………………………………………….6
B. Types of Parasites Causing Malaria Disease …………………………….6
C. Anopheles Mosquito Life Cycle ………………………………………….8
D. Transmission Mechanism………………………………………………...9
E. Symptoms That Arise Due To Malaria …………………………………10
F. Prevention and Treatment Methods……………………………………..12

CHAPTER IV CONCLUSIONS AND SUGGESTIONS

A. Conclusion………………………………………………………………14

B. Suggestions……………………………………………………………...14
 CHAPTER I
INTRODUCTION

A. Background

Malaria comes from the African continent. Malaria is a disease caused by air
or bad seasons. In 1880 the cause of Malaria was discovered by Laveran. The
cause is a parasite that lives in human blood cells. Then Ross discovered that the
parasite was transmitted by Anopheles mosquitoes. Anopheles mosquitoes live in
coastal areas, forests, plantations, swamps and rice fields, they also like dirty
water.

Malaria is spread all over the world, especially in hot climates where the
Plasmodium parasite can thrive. Southern Sahara regions in Africa and Papua New
Guinea in Oceania are the places with the highest malaria incidence rates.

  Malaria can cause death especially in high risk groups, namely infants,
children under five, pregnant women. besides malaria directly causes anemia and
can reduce work productivity.

  Today, efforts to eradicate malaria are carried out through eradicating

malaria-causing vectors (Anopheles mosquitoes) and continuing with treatment for
those suspected of suffering from malaria. In terms of eradicating malaria in
addition to direct treatment is also often done by spraying the house and the
environment around the house with insect poison to kill adult mosquitoes, other
efforts are also made to eradicate mosquito larvae.

B. Formulation of the problem

Based on what was stated in the background, the writer is interested in
studying further on:
 a. What is the meaning of Malaria?
b. What are the types of parasites that cause malaria?
c. What is the life cycle of anopheles mosquitoes?
d. How is the transmission mechanism?
e. What is the prevention and treatment method?
C. Purpose of the Paper
a. Know the understanding of Malaria.
b. Knowing the types of parasites that cause malaria.
c. Knowing the life cycle of anopheles mosquitoes.
d. Knowing the mechanism of transmission.
e. Knowing how to prevent and treat it.
D. Use of Papers
1. Theoretical benefits
As a source of information that can be used for further research.
2. Practical benefits
Providing information to the public about the importance of maintaining
environmental cleanliness and knowing various types of parasites that cause
Malaria.

E. Writing Method
1. The writing method in this paper the writer uses leterature studies sourced from
the internet
 CHAPTER II
LITERATURE REVIEW
Malaria has been known for 3000 years. A scientist Hippocrates (400-377
BC) Already distinguish types of malaria. Alphonse Laveran (1880) found
plasmodium as a cause of malaria, and Ross (1897) found that intermediaries for
malaria were anopheles mosquitoes.
Malaria is a disease caused by plasmodium falsifarum, plasmodium vivax,
plasmodium malariae, plasmodium ovale and which mixes or interferes with
transmission through the bite of female anopheles mosquitoes (Kemenkes, 2011).
According to Hiswani (2004) Malaria is one of the diseases transmitted
through the bite of female anopheles mosquitoes. Based on the SPP work unit
survey (insect transmitted diseases), it has been found in Indonesia that there are
46 species of anopheles mosquitoes spread throughout Indonesia.
The recurrence of malaria is caused by the reactivation of the latent phases
of P vivax and P ovale hypnozoites (Wilson, 2001).
  In Indonesia, malaria sufferers reach 1-2 million people per year, with a
mortality rate of 100,000. The highest case of malaria is in Papua, but around 107
million Indonesians live in malaria endemic areas spread from Aceh to Papua,
including in densely populated Java (Adiputro, 2008).
 CHAPTER III
DISCUSSION
A. Definition of Malaria Disease
Malaria is an acute and chronic parasitic infection, attacks erythrocytes and
is characterized by the discovery of asexual forms in the blood. Eukaryotic
plasmodium protists transmitted by mosquitoes are a major cause of malaria. In the
human body the disease is hiding and multiplying in the liver (liver). Infect red
blood cells causing symptoms such as fever, chills, anemia, headaches and
enlarged spleen. which in severe cases will lead to coma (unconsciousness) and
death. Malaria infection can progress without complications or experience
systemic complications known as severe malaria.
This disease is caused by malaria parasites which are a group of
Plasmodium. The protozoan parasite that causes malaria is transmitted through the
bite of a female Anopheles mosquito. This type of parasitic protozoa is widespread
in tropical and subtropical regions, especially in forested and wet climates, such as
in America, Asia and Africa.

B. Types of parasites that cause malaria

  The cause of malaria is the genus plasmodia family plasmodiidae and
ordcoccidiidae. Until now in Indonesia, there are 4 types of malaria parasites,
namely:

a. Plasmodium vivax causes contracted malaria.

The incubation period is 12-17 days, sometimes 12-20 days longer, usually
without symptoms. Symptomatic It is preceded by symptoms of headache, low
back pain, nausea and vomiting, lethargy, drowsiness due to oxygen disturbances
in the brain, fever (at first irregular fever then fever starts regularly every 48 hours,
arising every third day. Fever arise during the day or evening and body
temperature can reach 41 ° C). the palpation of the spleen can begin to swell,
clinical manifestations In vivax malaria can be severe but less dangerous.
The greatest malaria in Indonesia is spread almost throughout the island. This is
the most common type of malaria found in malaria-infected areas.

b. Plasmodium malaria causes quartana malariae.

Malaria is often found in Africa, Latin America, but rarely found in
Indonesia. The distribution is not as extensive as P. vivax and P. falciparum. The
incubation period is 18-40 days. Clinical manifestations such as in vivax malaria
are only mild. Usually without symptoms, often found incidentally during blood
tests and in red blood cells found malaria parasites. Regular fever every fourth day
(72 hours), this disease can interfere with the kidneys and lasts for years. The
longer the damage, the more severe the kidneys, so that the cells and kidney tissue
are damaged and die, the symptoms of kidney disorders are more severe than in
other diseases. The spleen is very large.
Prognosis is generally good, but the disease can recur ten years later. People
who have had this disease when they are young, have a fever at one time. Like the
symptoms of malaria, it is necessary to have a blood test to find the malarial
parasite.
c. Plasmodium ovale
Is the mildest form of all types of malaria and can heal by itself and rarely
recur.
  The incubation period is 11-16 days. If there is a mixed infection with other
plasmodium, then P.ovale will not appear in the peripheral blood but other
plasmodium will be found. Clinical symptoms are similar to vivax malaria.
d. Plasmodium Falciparum causes tropical malaria which often causes severe
malaria.
This type of malaria is widespread in all islands in Indonesia. The incubation
period is 9-14 days. Tropical malaria is the most severe form (malignant),
characterized by headaches, aching rheumatic pain and lumbago, cold arms and
legs, nausea and vomiting, sometimes accompanied by diarrhea, mild fever, spleen
and swollen liver, kidney disorders.
If not treated, this disease will continue and get worse. And when it has invaded
the brain will appear seizures and paralysis, and decreased consciousness even
under certain conditions sufferers can die. But this disease can still be cured by
adding doses and medication, such as the addition of antibiotics or various anti-
malaria mixtures.

C. Anopheles Mosquito Life Cycle

All insects, including mosquitoes, in their life cycle have stages that
sometimes between one level and the next it looks very different. Based on the
place of life there are two levels of life, namely:
a. Depth in water.
b. Depth beyond water (land / air).
For mosquito survival, water is needed. If there is no water, the life cycle of
the mosquito will be interrupted. The levels of life in water are: eggs, larvae and
cocoons. After one or two days the eggs are in the water, the eggs will hatch and
larvae come out. The larva that just came out of the egg is still very smooth like a
needle. In its growth the larvae of anopheles undergo skin release four times.
The time needed for larval growth between 8-10 days depends on the
temperature, the state of food and species of mosquitoes. From larvae will grow
into a cocoon (pupa) which is a level or stage of resting and not eating. At the
cocoon level it takes one to two days. After enough time, from the cocoon will
come out adult mosquitoes that have sex can be distinguished.
After the mosquitoes come into contact with the air, soon the mosquitoes
have been able to fly, which means leaving the watery environment to continue his
life on land or air. In continuing his descendants. Female mosquitoes mostly mate
once during their lives. Usually marriages occur after 24 -48 hours from the time of
departure from the cocoon.

D. Transmission Mechanisme
Most anopheles mosquitoes will bite at dusk, or at night. In some types of
mosquitoes peak bite is midnight until dawn. Plasmodium will experience two
cycles, the asexual cycle (schizogony) occurs in the human body. While the sexual
cycle (sporogony) occurs in mosquitoes.
Parasites reproduce asexually in the human body, starting with the union of
male and female gametes to form ookinet in the stomach of a mosquito. Ookinet
will penetrate the stomach wall to form a cyst in the outer membrane of the
mosquito's stomach.
The time needed to reach this process is 8-35 days, depending on the
environmental situation and the type of parasite. In this place the cyst will form
thousands of sporozoites are released and then spread to all mosquito organs
including the mosquito salivary glands.
In this gland, sporozoites mature and are ready to be transmitted. Anopheles
mosquitoes which contain human bite parasites. Sporozoites enter the blood
through these bites. Humans who are bitten by an infective mosquito will
experience symptoms according to the amount of sporozoites, plasmodium quality
and endurance. Sporozoites will begin the echoerythrociter stage by entering liver
cells. In the liver the sporozoites ripen into schizons that will break and release
tissue merozoites. Merozoites will enter the bloodstream and infect blood flow to
start the erythrocyte cycle. Merozoites in erythrocytes will undergo morphological
changes, namely: merozoite ring shape trophozoite merozoite this change process
takes 2-3 days. Among these merozoites there will develop to form gametocytes to
re-start the sexual cycle into microgameth (male) and microgameth (female).
Infected erythrocytes usually rupture which manifests in clinical symptoms. If
there are mosquitoes that bite this infected human, then the gametocytes present in
human blood will be sucked by mosquitoes.
Transmission of malaria can occur naturally through the bite of anopheles
mosquitoes or congenital malaria that occurs in newborns because their mother has
malaria, transmission occurs through the umbilical cord or placenta.
Mechanical transmission occurs through blood transfusions or syringes that
are no longer sterile. This method of transmission has been reported to occur in one
hospital in Bandung in 1981, in patients who were treated and received intravenous
injections using syringes used to inject several patients, where the syringe should
be disposed of once (disposeble).
E. Symptoms That Arise Due To Malaria
clinical symptoms with the main symptoms of periodic chills and headaches
sometimes with other clinical symptoms as follows:
a. The body feels weak and pale due to lack of blood and sweating.
b. Decreased appetite.
c. Nausea is sometimes followed by vomiting.
d. Severe, persistent headaches, especially in infections with plasmodium
Falciparum.
e. In chronic conditions (chronic) symptoms above, accompanied by
enlarged spleen.
 f. Severe malaria, such as the above symptoms accompanied by seizures and
decrease.
g. In children, the younger the more unclear the clinical symptoms but the
prominent ones are diarrhea and pale, due to anemia and originating from
malaria areas.
The classic symptoms of malaria, usually consisting of 3 sequential stages,
namely:
1) Cold stage
chills and a very cold feeling. Tooth rattling and sufferers usually cover the
body with all kinds of clothes and blankets available, the pulse is fast but weak.
Pale lips and fingers bluish, dry skin. Sufferers may vomit and seizures often occur
in children. This stadium lasts between 15 minutes to 1 hour.

2) Fever stage (Hot stage)

After feeling cold, at this stage the patient feels hot. Red face, dry skin and
very hot like burning, headache and vomiting, the pulse becomes strong again.
body temperature can increase to 41 ° C or more. This stadium lasts between 2 to 4
hours. Fever is caused by rupture of a ripe blood vessel and the insertion of blood
merozoites into the bloodstream.
In plasmodium vivax and P. ovale, the cycles of each generation mature
every 48 hours so that fever occurs every three days from the previous fever attack.
The name malaria tertiana comes from this phenomenon. In plasmodium malaria,
the phenomenon is 72 hours so it is called P. vivax / P malaria. ovale, only the
fever interval is not clear. Fever attacks are followed by a latent period that
depends on the process of parasitic growth and the level of immunity that then
arises in patients.
 3) Stadium sweating (sweating stage).
At this stage, sufferers sweat so much that the bed is wet. Body temperature
rises rapidly, sometimes to below normal temperatures. Patients usually can sleep
soundly. When you wake up from sleep feeling weak but there are no other
symptoms, this stage lasts between 2 to 4 hours. The symptoms mentioned above
are not always the same in every patient, depending on the parasitic species and
age of the patient, severe clinical symptoms usually occur in tropical malaria
caused by plasmodium falciparum.

F. Ways of Prevention and Treatment

    Ways of prevention, understanding of the habits and behavior of female
Anopheles mosquitoes are very useful in disease prevention. Swampy places and
quiet microenvironment can support the breeding of Anopheles mosquitoes.
Avoiding places filled with mosquitoes and cleaning breeding sites can reduce the
chance of mosquito bites.
Preventive measures to avoid mosquito bites by sleeping with a mosquito
net, installing mosquito netting in house vents, skin covered with mosquito
repellent, maintaining mosquito larvae, etc.
Treatment of malaria aims to prevent the transfer of parasites (breaking the
chain of transmission). how treatment can be done by giving anti-malaria drugs (by
prescription), providing additional drugs such as analgesics and antipyretics. If a
malfunctioning liver, kidney, brain function occurs, the patient needs hospital
treatment.
   In malaria treatment antiplasmodium therapy and supportive care are very
important to reduce morbidity and mortality. Chloroquine is an effective anti-
malaria drug against P. falciparum which is sensitive to chloroquine. The benefits
do not cause hypoglycemia and do not interfere with pregnancy. However, with
widespread resistance to chloroquine, this drug has rarely been used for the
treatment of severe malaria. Kona is an anti-malaria drug that is very effective for
all types of plasmodium and was chosen as the main drug to treat severe malaria
because it still has a strong effect on P. falciparum which is resistant to
chloroquine. Although kona can be used during pregnancy, it can cause uterine
contractions and contribute to hypoglycemia (Wilson, 2001).
 CHAPTER IV
CONCLUSIONS AND RECOMMENDATIONS
A. Conclusion
Based on the results of the description of CHAPTER I - CHAPTER III, the
following conclusions can be drawn:
Malaria is an acute and chronic parasitic infection and attacks erythrocytes.
caused by malaria parasites which are a group of Plasmodium. The protozoan
parasite that causes malaria is transmitted through the bite of a female Anopheles
mosquito.
Based on the place of life, there are two stages of life, namely in water and
in the ground / air. Transmission of malaria can occur naturally through the bite of
anopheles mosquitoes or congenital malaria, mechanically transmission occurs
through blood transfusions or through needles that are no longer sterile. clinical
symptoms with the main symptoms of fever chills regularly and headaches
sometimes with other clinical symptoms such as body feels weak, decreased
appetite, sweating and pale due to lack of blood.
to avoid mosquito bites by sleeping with a mosquito net, skin covered with
mosquito repellent, maintaining mosquito larvae, etc. how treatment can be done
by giving anti-malaria drugs (by prescription), providing additional drugs such as
analgesics and antipyretics.
B. Suggestions
It is hoped that the government will pay more attention and handle this
disease. Such as conducting intensive counseling to provide understanding to the
community about how to prevent and cope with malaria, namely by installing
mosquito netting in house ventilation, using mosquito nets and using mosquito
repellent when sleeping. Carry out comprehensive malaria surveillance activities,
both monitoring parasites and vector species as well as malaria vector density.