Malaria
• Protozoal disease caused by malarial parasite (plasmodium).
• Malaria caused by 4 species of plasmodium e.g.
•Plasmodium falciparum (P. falciparum)
•Plasmodium malariae (P. malariae)
•Plasmodium vivax (P. vivax)
•Plasmodium ovale (P. ovale)
• P. Falciparum/cerebral malarial (also called blackwater fever because of bloody urine, responsible for 25-30% cases).
• Plasmodium Vivax (most common type of malaria)
Transmission: Infected female anopheline mosquito.
Incubation period:
• 14 days (8-17 days) for P. Vivax 12 days (9-14 days) for P Falciparum
• 28 days (18-40 days) for P. Malariae (quartan malaria) 17 days (16-18day) for P. Ovale.
C/M :
• Cold Stage: Headache, nausea & chilly sensation, Temp. 39 to 41 °C (1/4 – 11/2 hrs.)
• Hot Stage: Burning hot, intense headache (2-4 hr).
• Sweating Stage: Profuse sweating (2-4 hrs).
Complication:
• Complication of P. Falciparum malaria: Cerebral malaria, blackwater fever, ARF, anemia and collapse.
• Complications of other malaria: Hepatosplenomegaly, anemia, herpes and renal complication.
Diagnosis:
• Thin film: For detection of species
• Rapid diagnosis test (RDT) : It detects antigen of circulating parasites.
Prevention ;
• National Malarial Control Program (NMCP). : Launched on April 1953
• Modified Plan of Operation (MPO) : Launched on 1st April 1977
• NMCP change two National Malaria Eradication Program (NMEP) into 1958.
• Rename it as National anti-malaria Programme (NAMP) into 1999.
• NAMP again rename as National Vector Borne Disease Control Programme ( NVBDCP ) Into 2002.
• The National Framework for Malaria Elimination in India 2016-2030 was launched into Feb. 2016.
• National Strategic Plan for Malaria Elimination in India 2017-2022 launched into 2017.
• The Global Technical strategy for Malaria (2016-2030) adopted by WHO in May 2015.
Management:
• Treatment for positive P. vivax : Chloroquine (CQ) 25 mg/kg, which divide for 3 days+primaquine (PQ) mg artesunate+500 mg sulfodoxine+25 mg pyrimethamine) for 3 days+PQ single tablet on second days.
• Mixed infection treated as a positive P. falciparum.
• Quinine is in 1st trimester of pregnancy and primaquine is contraindicated during pregnancy.
Severe & complicated malaria:
• Choice of anti-malaria is quinine sulfate injection (derived from back of the cinchona plant) IV drip in 5% dextrose saline to be run over 4 hrs (give 8 hourly)
• Quinine sulfate may cause hypoglycemia.
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Writer: (Vandita Singh Lucknow)