MedicalMicrobiology&Parasitology

Metric No: MAAUN/22/MLS/0115 Name:Salaha Musa

Nuhu
Assignment
Discuss malaria based on the following.
● Causative agent
● Classification
● Morphological characteristics
● Life cycle
● Pathogenesis
● Clinical manifestation
● Diagnosis
● Treatment, prevention and control.

Dr kabiru yakubu

Answer
Causative Agent
Malaria is a life-threatening disease caused by parasites of the genus
Plasmodium. There are several species of Plasmodium that can infect humans,
with the most common ones being Plasmodium falciparum, P. vivax, P. malariae,
and P. ovale. These parasites are transmitted to humans through the bites of
infected female Anopheles mosquitoes.
1. **Plasmodium falciparum**: This species is the most deadly and is
responsible for the majority of malaria-related deaths globally. P. falciparum-
infected red blood cells often adhere to the walls of blood vessels, leading to
complications such as cerebral malaria, severe anemia, and organ failure.
2. **Plasmodium vivax**: P. vivax is the most widespread species and is
responsible for a significant proportion of malaria cases outside of Africa. It can
cause relapsing malaria due to the formation of dormant liver stages called
hypnozoites. P. vivax infection can also lead to severe complications, although it
is

generally less severe than P. falciparum.

3. **Plasmodium malariae**: P. malariae causes a chronic, low-grade form of
malaria and can persist in the human host for many years. It is less common
than P. falciparum and P. vivax but can still cause severe complications,
including nephrotic syndrome and renal failure.
Understanding the different species of Plasmodium is crucial for effective
diagnosis, treatment, and control of malaria. Different species may exhibit
variations in their geographic distribution, drug susceptibility, and clinical
manifestations. Therefore, accurate identification of the causative agent is
essential for providing appropriate management and preventing complications
associated with malaria infection.

Classification
Malaria is a vector-borne infectious disease caused by parasites of the genus
Plasmodium. It is classified based on several factors, including the species of
the infecting parasite, the geographical distribution, the severity of the disease,
and the characteristics of the host immune response. Here's a discussion on
the classification of malaria:

1. **Species of Plasmodium**: The classification of malaria begins with the

identification of the species of Plasmodium responsible for the infection. The
most common species that infect humans include:
- Plasmodium falciparum: This species is the most deadly and accounts for the
majority of malaria-related deaths worldwide.
- Plasmodium vivax: P. vivax is the most widespread species and can cause
relapsing malaria due to the formation of dormant liver stages.
- Plasmodium malariae: P. malariae causes a chronic form of malaria and can
persist in the human host for many years.
- Plasmodium ovale: P. ovale is less common and mainly found in West Africa. It
can also produce dormant liver stages, leading to relapses.
- Plasmodium knowlesi: This species primarily infects macaques but can
occasionally infect humans, causing severe malaria.
2. **Geographical Distribution**: Malaria is classified based on its geographical
distribution, which varies depending on factors such as climate, mosquito
vectors, and human behavior. Endemic regions for malaria include sub-Saharan
Africa, Southeast Asia, the Indian subcontinent, parts of South America, and
Oceania.
3. **Severity and Clinical Presentation**: Malaria can be classified based on the
severity of the disease and its clinical presentation:
- Uncomplicated Malaria: This refers to malaria infections that do not involve
severe complications and are typically characterized by fever, chills, headache,
and muscle aches.
- Severe Malaria: Severe malaria encompasses a spectrum of complications,
including cerebral malaria, severe anemia, acute respiratory distress syndrome
(ARDS), renal failure, and metabolic acidosis.

Morphological Characteristics
Malaria is caused by parasites of the genus Plasmodium, which exhibit distinct
morphological characteristics throughout their life cycle. Understanding these
characteristics is crucial for accurate diagnosis and treatment of the disease.
Here's a discussion on the morphological characteristics of Plasmodium
parasites:
1. **Sporozoites**: Sporozoites are the infectious form of the parasite that are
transmitted to humans through the bite of an infected Anopheles mosquito.
These elongated, spindle-shaped organisms are motile and have a single
nucleus. They are released from the salivary glands of the mosquito and enter
the human bloodstream, eventually reaching the liver.
2. **Merozoites**: Once inside the liver, sporozoites undergo replication to form
merozoites. Merozoites are small, pear-shaped organisms with a single nucleus.
They are released from the liver cells (hepatocytes) and invade red blood cells,
where they continue their replication cycle.
3. **Trophozoites**: Inside the red blood cells, merozoites develop into
trophozoites, which are larger, amoeboid-shaped organisms. Trophozoites feed
on hemoglobin and undergo a series of morphological changes as they digest
hemoglobin and replicate their own organelles.
4. **Schizonts**: As trophozoites mature, they develop into schizonts, which
are multinucleated structures containing multiple merozoites. Schizonts
eventually rupture the red blood cell membrane, releasing merozoites into the
bloodstream to infect new red blood cells and continue the cycle of replication.
5. **Gametocytes**: Some merozoites differentiate into sexual forms called
gametocytes. Gametocytes are non-motile, crescent-shaped or round cells with
a single nucleus. They circulate in the bloodstream and are ingested by
mosquitoes during a blood meal, where they undergo sexual reproduction to
produce new sporozoites.

Maleria based on the Life cycle Lifecycle

The natural history of malaria involves cyclical infection of humans and female
Anopheles mosquitoes. In humans, the parasites grow and multiply first in the
liver cells and then in the red cells of the blood. In the blood, successive broods
of parasites grow inside the red cells and destroy them, releasing daughter
parasites (“merozoites”) that continue the cycle by invading other red cells.
The blood stage parasites are those that cause the symptoms of malaria. When
certain forms of blood stage parasites (gametocytes, which occur in male and
female forms) are ingested during blood feeding by a female Anopheles
mosquito, they mate in the gut of the mosquito and begin a cycle of growth and
multiplication in the mosquito. After 10-18 days, a form of the parasite called a
sporozoite migrates to the mosquito’s salivary glands. When the Anopheles
mosquito takes a blood meal on another human, anticoagulant saliva is injected
together with the sporozoites, which migrate to the liver, thereby beginning a
new cycle.
Thus the infected mosquito carries the disease from one human to another
(acting as a “vector”), while infected humans transmit the parasite to the
mosquito, In contrast to the human host, the mosquito vector does not suffer
from the presence of the parasites.
The parasites’ multiplication in the mosquito is known as the sporogonic cycle
. While in the mosquito’s stomach, the microgametes penetrate the
macrogametes generating zygotes. The zygotes in turn become motile and
elongated (ookinetes)which invade the midgut wall of the mosquito where they
develop into oocysts . The oocysts grow, rupture, and release sporozoite, which
make their way to the mosquito’s salivary glands. Inoculation of the sporozoites
into a new human host perpetuates the malaria life cycle.
More on: Anopheles Mosquitoes More on: Malaria Parasites
Human Factors And Malaria
Biologic characteristics and behavioral traits can influence an individual’s risk of
developing malaria and, on a larger scale, the intensity of transmission in a
population.

Pathogenesis
The pathogenesis of malaria involves a complex interplay between the
Plasmodium parasite, the human host, and the mosquito vector. Understanding
the pathogenesis is crucial for elucidating the mechanisms underlying the
clinical manifestations and complications of the disease. Here's a discussion on
the pathogenesis of malaria:
1. **Infection**: Malaria transmission occurs when an infected female
Anopheles mosquito bites a human host, injecting sporozoites into the
bloodstream. Sporozoites then travel to the liver, where they infect hepatocytes
and undergo replication.

2. **Liver Stage**: During the liver stage of infection, sporozoites replicate and
mature into merozoites. This stage is asymptomatic and can last from several
days to weeks, depending on the species of Plasmodium.
3. **Blood Stage**: After exiting the liver, merozoites invade red blood cells
(RBCs) and begin the blood stage of infection. Inside the RBCs, merozoites
undergo asexual reproduction, resulting in the formation of new merozoites.
This process leads to the destruction of RBCs and the release of merozoites
into the bloodstream, causing the characteristic symptoms of malaria, such as
fever and chills.

In summary, the pathogenesis of malaria involves multiple stages, including liver

and blood stages of infection, activation of the host immune response,
sequestration of infected RBCs, and the development of complications. A better
understanding of these mechanisms is essential for the development of
effective treatments and preventive strategies against malaria.

Clinical Manifestation
Malaria presents with a wide range of clinical manifestations that can vary in
severity depending on factors such as the species of Plasmodium involved, the
host's immune status, and access to prompt diagnosis and treatment. The
clinical manifestations of malaria typically manifest in paroxysms, with
symptoms recurring in cycles corresponding to the periodic release of
merozoites from infected red blood cells. Here's a discussion on the clinical
manifestations of malaria:
1. **Fever**: Fever is the hallmark symptom of malaria and is often the first sign
of infection. Fever in malaria typically follows a cyclic pattern, with episodes of
high fever occurring at regular intervals corresponding to the release of
merozoites from infected red blood cells. The fever may be accompanied by
chills, sweats, and rigors.
2. **Headache**: Headache is a common symptom of malaria and is often
described as throbbing or pounding in nature. It can be severe and debilitating,
leading to decreased productivity and impaired daily activities.
3. **Muscle Aches**: Muscle aches, also known as myalgia, are frequently
reported by individuals with malaria. These aches and pains can affect various
muscle groups throughout the body and may contribute to feelings of fatigue
and malais

Diagnosis
Diagnosing malaria accurately is crucial for prompt treatment and prevention of
complications. Diagnosis typically involves a combination of clinical
assessment, laboratory tests, and, in some cases, imaging studies. Here's a
discussion on the various methods used for diagnosing malaria:
1. **Clinical Assessment**: Malaria diagnosis often begins with a thorough
clinical assessment, including a review of symptoms and a detailed medical
history. Healthcare providers inquire about recent travel to malaria-endemic
areas, exposure to mosquito bites, and any previous episodes of malaria.
Common symptoms suggestive of malaria include fever, chills, headache,
muscle aches, nausea, vomiting, and fatigue. However, clinical symptoms alone
are not sufficient for a definitive diagnosis of malaria, as they can overlap with
other febrile illnesses.
2. **Microscopic Examination of Blood Smears**: Microscopic examination of
thick and thin blood smears remains the gold standard for diagnosing malaria.
Blood samples obtained via finger prick or venipuncture are smeared onto glass
slides, stained with Giemsa or Wright stain, and examined under a microscope
for the presence of Plasmodium parasites. Thick smears are used to detect the
presence of parasites, while thin smears allow for species identification and
quantification of parasitemia (parasite density). This method enables healthcare
providers to differentiate between the various species of Plasmodium and
assess the severity of infection.
3. **Rapid Diagnostic Tests (RDTs)**: Rapid diagnostic tests are simple, point-
of- care tests that detect specific antigens produced by Plasmodium parasites.
RDTs are particularly useful in resource-limited settings where microscopy may
not be
readily available. They provide rapid results within 15-20 minutes and do not
require specialized laboratory equipment or skilled personnel. However, RDTs
may have lower sensitivity compared to microscopy, especially at low levels of
parasitemia, and their performance can vary depending on factors such as the
species of Plasmodium and the quality of the test

Treatment, prevention and control

Treatment, prevention, and control strategies for malaria involve a multifaceted
approach aimed at reducing transmission, preventing infection, and treating
individuals affected by the disease. Here's a discussion on each aspect:
1. **Treatment**:
- **Antimalarial Medications**: The choice of antimalarial medication depends
on
factors such as the species of Plasmodium involved, the severity of the
infection,

and the individual's age, weight, and pregnancy status. Commonly used
antimalarial drugs include:
- Artemisinin-based combination therapies (ACTs), such as artemether-
lumefantrine, artesunate-amodiaquine, and dihydroartemisinin-piperaquine, are
recommended as first-line treatments for uncomplicated malaria caused by
Plasmodium falciparum.
- Chloroquine is effective against malaria caused by chloroquine-sensitive
strains of Plasmodium vivax and Plasmodium malariae but is no longer
recommended for P. falciparum due to widespread resistance.
- Primaquine is used to eliminate hypnozoites in patients with Plasmodium vivax
or Plasmodium ovale infections to prevent relapses.
2. **Prevention**:
- **Vector Control**: Vector control measures aim to reduce mosquito
populations and prevent mosquito bites. Strategies include:
- Insecticide-treated bed nets (ITNs) provide physical barriers against mosquito
bites and are treated with insecticides to kill or repel mosquitoes.
- Indoor residual spraying (IRS) involves the application of insecticides to the
interior walls of houses and other structures where mosquitoes rest.
- **Chemoprophylaxis**: Travelers to malaria-endemic areas may be prescribed
chemoprophylactic medications to prevent malaria infection. Commonly used
drugs include chloroquine, atovaquone-proguanil, doxycycline, and mefloquine.
- **Environmental Management**: Environmental modifications, such as
draining stagnant water and removing mosquito breeding sites, can reduce
mosquito populations and limit malaria transmission.

3. **Control**:
- **Case Management**: Prompt diagnosis and treatment of malaria cases are
essential for preventing transmission and reducing morbidity and mortality.
Healthcare providers should follow national guidelines for malaria diagnosis and
treatment and ensure access to quality-assured antimalarial medications.
- **Surveillance and Monitoring**: Surveillance systems monitor malaria
transmission, track trends in disease incidence, and identify areas of high
transmission or emerging drug resistance. Surveillance data guide control
efforts and inform resource allocation.

ffective malaria control requires a coordinated effort involving governments,

public health agencies, healthcare providers, researchers, and communities.
Implementing comprehensive strategies tailored to local epidemiological
contexts and addressing socioeconomic determinants of malaria transmission
are essential for achieving malaria elimination and eventual eradicatio