MALARIA

By Marinel M. Caylo
I. Infectious Agents
Malaria
- is a disease caused by infection with single-celled
parasites of the genus Plasmodium. The bite of the
Anopheles mosquito transmits these parasites from one
person to another.

For plasmodia produce malaria in humans:

1. Plasmodium falciparum
2. P. vivax
3. P. ovale
4. P. malariae
 Plasmodium
falciparum
Plasmodium
vivax

Plasmodium Plasmodium
ovale malariae
The severity and characteristic manifestation
of the disease are governed by:

 infection species
 magnitude of the parasitemia
 metabolic effects of the parasite
 cytokines released as a result of the
infection
Life Cycle of the Malaria
Parasite
(A) Mosquito infected with the
malaria parasite bites human,
passing cells called sporozoites
into the human’s bloodstream.
(B) Sporozoites travel to the liver. Each
sporozoite undergoes asexual
reproduction, in which its nucleus
splits to form two new cells, called
merozoites.
(C) Merozoites enter the
bloodstream and infect red
blood cells.
D) In red blood cells, merozoites grow and divide
to produce more merozoites, eventually
causing the red blood cells to rupture. Some of
the newly released merozoites go on to infect
other red blood cells.
(E) Some merozoites develop into sex cells
known as male and female gametocytes.
(F) Another mosquito bites the infected
human, ingesting the gametocytes.
(G) In the mosquito’s stomach, the gametocytes
mature. Male and female gametocytes
undergo sexual reproduction, uniting to form
a zygote. The zygote multiplies to form
sporozoites, which travel to the mosquito’s
salivary glands.
(H) If this mosquito bites another
human, the cycle begins again.
 II. Signs and Symptoms

Fever Profuse sweating Anemia

Recurrent chills

Hepatomegaly Spleenomegaly
Malaise
Early Diagnosis and Prompt Treatment:

 Early Diagnosis
1.Clinical Method is based on the signs and
symptoms of the patient and the history of
he/she having visited a malaria-endemic area.
2. Microscopic Method is based on the
examination of the blood smear of the patient
through a microscope.
 Chemoprophylaxis

 Only chloroquine drug should given.

 It must be taken at weekly intervals, starting
from 1-2 weeks before entering the endemic
area.
 In pregnant women, it is given throughout the
duration of pregnancy.
Sustainable Preventive and Vector
Control Measures
Sustainable Preventive and Vector Control
Measures

-refer to the adoption

of measures for the
prevention and control
against the malaria
parasite and the mosquito
vector.
 Sustainable Preventive and Vector Control Measures

A. Insecticide- Treatment of Mosquito Net

 This involves the soaking of the mosquito net in an insecticide
solution and allowed to dry.

B. House Spraying

C. On Stream Seeding

 This involves the construction of bio-ponds for fish

propagation which shall be the responsibility of the LGUs and
their corresponding communities.

D. On Stream Clearing
 Recommended Anti-Malaria Drugs

Blood Schizonticides
-drugs acting on sexual blood stages of the parasites
which are responsible for clinical manifestations.

 Chloroquine phosphate 250 mg 150mg base/tablet

 Sulfadoxine or sulfalene 50 mg-pyrimethamine 25 mg/tablet
 Quinine hydrochloride 300 mg/ml,2 ml ampule
 Tetracycline hydrochloride 250 mg/capsule
 Quinidine sulfate 200 mg/durules
 Quinidine glucolate 80 mg 50 mg base ml, 1 ml vial
 Other Preventive Measures:
 Wearing of clothing that covers arms and legs in the evening

 Avoiding outdoor night activities, particularly during the vector’s peak

biting hours from 9PM to 3AM.
 Using mosquito repellents such as mosquito coils, soap lotion or other
personal protection measures advocated by the OH/ MCS- Malaria Control
Service.

 Planting of Neem tree or other herbal plants which are potential mosquito
repellent as advocated by the DOH /MCS- Malaria Control Service.
 Zoo prophylaxis- the typing of domestic animals like the
carabao, cow, etc., near human dwellings to deviate mosquito
bites from man to these animals.
Early Recognition Prevention
and Control of Malaria
Epidemics
 Early Recognition Prevention and Control of
Malaria Epidemics
-refer to the establishment of a system that will immediately
recognize an impending malaria epidemic.

 Malaria Epidemic
-is a situation where there is an incidence of new malaria
cases in excess of the expected.
Small epidemics are usually called outbreaks.

 Epidemic Potential
-is a situation where in an area is vulnerable to malaria
case upsurge due to causal factors such as climatic changes,
ecological changes or socio economic changes.
 Prevention of the Epidemic
1. The following should be done in the event that an imminent epidemic occurs:
 Mass Blood Smear MBS collection
 Immediate confirmation and follow –up of cases
 Insecticide-treatment of mosquito nets
 Focal Spraying
 Stream Clearing
 Intensive IEC Campaign

2. All case should be given drug treatment and followed-up until clinically
and/or microscopically found negative.

3. Continuous surveillance measures should be implemented for three years.

4. The Local Government Units in collaboration with the Nongovernmental

Organization and with the technical assistance from the provincial Malaria
Coordinator should contribute in terms of IEC campaign and logistics
support.
Public Health Nursing Responsibilities
 Public Health Nursing Responsibilities
1. Participates in the implementation of the
following:
 Treatment policies
 Provision of drugs
 Laboratory confirmation of diagnosis
 Training of Barangay Health Workers and volunteers on the
diagnosis and treatment of malaria
 Supervision of malaria control activities of all health
personnel in the area
 Collection, analysis and submission of required reports
2. Recognition of early signs and symptoms for
management and further referrals
3. Educate the individual/families/community of
the importance of the following:
 Taking of chemoprophylaxis
 Wearing of long-sleeved clothing and trousers when going
out at night.
 Application of insect repellant to skin
 Use of mosquito nets
 Use of screen in doors and windows. If no screen, close
windows and doors during night time.
 Use of insecticide aerosols and pyrethroid mosquito coils
 Clearing of hanging branches of trees along the stream
4. Availability of anti-malaria drugs and
chemoprophylaxis drugs
 The End

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