15-Malaria Year 4 Internal Medicine Notes OmpathStudy

15-Malaria Year 4 · Internal Medicine Collection: 4TH YEAR ALL NOTES / IMED / I MED BEAUTIFUL NOTES / INFECTIOUS -- Malaria ● Objectives: 1- Understand the epidemiology and global burden of malaria 2- Understand the cycle of infection of malaria 3- Define modes of transmission, clinical features, risk factors, community diagnosis and treatment for malaria (Outline how to take history of Malaria patient, and how to give preventive advise) OSCE 4- Enlist the factors responsible for antimalarial drug resistance 5- Understand the role and measures taken by WHO to combat the burden of Malaria globally 6- Enlist the global measures of prevention and elimination for Malaria 7- Understand the epidemiology and risk factors related to Malaria in KSA \n● Resources: [Colors index: Important Notes Slides Extra \nDr notes]\nSlides.\nDoctor’s notes. [ Editing file Share note ] \nDone by: laila alsabbagh - ghada algarni - mohammed\nhakeem\nTeam’s leader: Aljouhara Alibrahim\nReviewed by: Yazeed Al-Dossare \n\n Malaria Malaria is a life-threatening disease caused by Plasmodium parasites that are transmitted\nto people through the bites of infected mosquitoes. Malaria is responsible for approximately 1-3 million deaths per year. Fatal if not treated\n\n Epidemiology: ● In 2016, there were 216 million cases and 445,000 deaths\ncaused by malaria worldwide. ● Between 2000 and 2015, malaria incidence fell by 37%\nglobally. ● During the same period, malaria mortality rates decreased\nworldwide by 60% among all age groups, and by 65%\namong children under 5. ● In 2014, 13 countries reported zero cases of the disease and\n6 countries reported fewer than 10 cases.\n\n Analytical Epidemiology Triad:\nPrimary host: mosquito.\nHost Secondary host: human\n\n Agent Environment\nPlasmodium parasites Rainy areas\n(P. Falciparum) In KSA \n\n Malaria Malaria in Saudi Arabia: ● Areas at the southern region are at risk of malaria\ntransmission, specifically Asir and Jizan. The dominant\nMalaria parasite in Saudi Arabia is P. Falciparum. ● Saudi Arabia achieved a decrease in malaria cases and case\nincidence rates of ≥65%. ● Malaria outbreak in 1998, Since then, only a few cases were\nreported. ● In 2012, only 82 cases of malaria were reported. ● The proportion of imported malaria has increased from\n23% to 99% of total detected cases.\n\n Information for you to know how\nis the distribution in malaria\n\n Saudi Arabia-World Health Organization\n\nImported malaria: via asymptomatic travelers from malaria endemic areas, sustains a threat for possible resurgence of local transmission: \nWorkers Immigrants Pilgrims \n\n Plasmodium Parasites\n● Five species cause malaria in humans:\n○ Plasmodium falciparum\n○ P. vivax\n○ P. ovale\n○ P. malariae\n○ P. knowlesi \n● P. falciparum and P. vivax pose the greatest threat. \n● Transmitted through the bites of infected female Anopheles mosquitoes (vector). \n● Other modes of transmission:\n○ From mother to unborn child\n○ Blood transfusion It is in the blood Plasmodium Parasites transmission and lifecycle:\n\n The malaria parasite life cycle involves two hosts. During a blood meal, a malaria-infected female Anopheles mosquito inoculates\nsporozoites into the human host. Sporozoites infect liver cells and mature into schizonts, which rupture and release merozoites. (Of\nnote, in P. vivax and P. ovale a dormant stage [hypnozoites] can persist in the liver (if untreated) and cause relapses by invading the\nbloodstream weeks, or even years later.) After this initial replication in the liver (exo-erythrocytic schizogony ), the parasites undergo\nasexual multiplication in the erythrocytes (erythrocytic schizogony ). Merozoites infect red blood cells. The ring stage trophozoites\nmature into schizonts, which rupture releasing merozoites. Some parasites differentiate into sexual erythrocytic stages (gametocytes) . Blood stage parasites are responsible for the clinical manifestations of the disease. The gametocytes, male (microgametocytes) and\nfemale (macrogametocytes), are ingested by an Anopheles mosquito during a blood meal. The parasites’ multiplication in the\nmosquito is known as the sporogonic cycle. While in the mosquito’s stomach, the microgametes penetrate the macrogametes\ngenerating zygotes. The zygotes in turn become motile and elongated (ookinetes) which invade the midgut wall of the mosquito\nwhere they develop into oocysts. The oocysts grow, rupture, and release sporozoites, which make their way to the mosquito’s\nsalivary glands. Inoculation of the sporozoites into a new human host perpetuates the malaria life cycle. \n\n Clinical features Symptoms\nEarly Symptoms Severe illness\nIf not treated\nearly might Severe anemia\nFever\nprogress to\nRespiratory distress\nHeadache\nCerebral malaria\nChills Multiorgan failure Paroxysmal fever It has a pattern\n\n In OSCE ask about:\n1- History of Mosquito\nbites\n● Cold stage: lassitude, headache, nausea, chills. (¼ -1 h) skin cold then hot 2- Symptoms\n3- F