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Human Malaria

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Title: Human Malaria


1
Human Malaria
2
  • Human Malaria
  • Suborder Haemosporina
  • ????????????????? Heteroxenous ??? ?? Asexual
    cycle ??? Sexual cycle ???????????
  • Asexual cycle ????????? RBC ??? Vertebrate
  • Sexual cycle ?????? Invertebrate
  • ?????????????????????????????? ??????
    ????????????? ????????

3
Family Plasmodiidae Genus Plasmodium
( Human , Animal Malaria) Mal
aria Bad air
4
Human Malaria - ?? 4 species ??? Plasmodium
falciparum (Welch,1897)Plasmodium vivax (Grassi
and Felett, 1890) Plasmodium malariae (Laveran,
1881) Plasmodium ovale (Stephens, 1922)
5
  • Genus Plasmodium ??????????? 9 subgenera
  • ????? 2 subgenera ???????????????? Malaria
    ???????????? ??????
  • 1. Subgenus Plasmodium
  • 2. Subgenus Laverania

6
  • Subgenus Plasmodium
  • ???? Exoerythrocytic schizonts ????? generation
    (?????? Parenchyma liver cells)
  • Gametocytes ????????????
  • Host insect ??? ??? Genus Anopheles
  • ?????? Plasmodium vivax
  • Plasmodium ovale
  • Plasmodium malariae

7
  • Subgenus Laverania
  • ???? Exoerythrocytic schizonts ???????????????
  • Gametocytes ????????? crescent
  • Host insect ??? ??? Genus Anopheles
  • ?????? Plasmodium falciparum

8
??????????????????????????? ?.?. 2390
(1847) Meckel ?? Pigment ??????? ?.?. 2392
(1849) ?????????????????? Virchow ?.?. 2398
(1855) ?????????????????? Chacot ?.?. 2423
Laveran ?????????????????????? ?.?.
2428 Marchiafava and Celli ???????????
??? Laveran??????????? Genus
Plasmodium
9
?.?. 2434 Romanosky ???????????????????????? ?.?.
2441 Ross ????? Life cycle ??????????? ?.?.
2442 Bignami ?????? ?????????????
?????????????????? ???????????
???????????
10
  • ????????????? (Distribution)
  • ??????????? (Tropical Zone)
  • ????? Plasmodium malariae ????????????
  • Subtropical zone
  • Temperate Zone ?? Plasmodium vivax
  • Plasmodium ovale ????????????? East
  • Africa , West Africa , Nigeria ??? Philippines

11
????????? (Mode of Infection) 1.
??????????? ?????????????? (Anopheles spp.)
?????????????? ?????? Sporozoites 2.
??????????????????????? ??????????????
Trophozoites ?????????????? 3. ???????????????????
???????? ?????????????????????????????????
???? ?????? Trophozoites ??????
12
  • ??????? (Life cycle)
  • 1. Sporogony cycle (Exogenous sexual phase)
  • ???????????????????? ?????????????????
  • ???? cycle ????????????? Invertebrate Host
    (Mosquito cycle)

13
2. Schizogony cycle (Endogenous sexual phase) -
??????????????????????? ???????? - ???? cycle
????????????? Vertebrate Host (Human cycle) -
?????????????? 3 ???
14
1. Exo-erythrocytic schizogony (Tissue stage) -
???????????????????????????? 2. Erythrocytic
schizogony (Blood stage) - ????????????????????
?????????????? 3. Gametogony -
??????????????????????
15
  • Sporogony cycle (Mosquito cycle)
  • ??????????????????????????????? ???????? ???
    ??? Gametocyte ???????????????
  • Mature Gametocytes ?????????????????????????????
    ?

16
Gametocyte Microgamete Macro
gamete Zygote Ookinete (Fusiform
body) Oocyst Sporozoites
17
  • Oocyst ?????????? Hemocelomic cavity ??????
  • Mature Oocyst ???????? Sporozoite ???????
    Hemocele Hemolymph Salivary
    gland

18
(No Transcript)
19
  • Schizogony cycle (Human cycle)
  • Sporozoites ???? Infective stage
  • ?????????????????? ????? sporozoites
  • ??????????????

20
Sporozoites Parenchymal cell ???
??? Schizogony Merozoite RBC
21
(No Transcript)
22
Pre-erythrocytic schizogony - ???????
?????????????????????????????? Schizogony
?????????????????? ?????????????? Merozoite
????????????????? (Erythrocytic cycle) - ???????
Pre-erythrocytic schizogony ??? 1 generation
??????????????????????????????????????????? ???
23
Piasmodium vivax ??????? 8 ??? Piasmodium
falciparum ??????? 6 ??? Plasmodium ovale
??????? 9 ??? Plasmodium malariae ??????? 15
???
24
Post-erythrocytic schizogony - Merozoites
???????????????? Infect cell ?????? ????
schizogony ???????????? Exoerythrocytic -
????? Merozoites ???????????? Hypnozoites -
??????? Post-erythrocytic ??????????????
??????????????????? ( Relapsing Fever)
25
Erythrocytic schizogony - ??????? Blood phase -
??????????????? Merozoites ?????
???????????? (RBC) - ?? 2 ??? ??? 1. Asexual
cycle ???? Schizogonic cycle 2. Gametogonic
cycle ???? Gametocytogenesis
26
Asexual cycle (Schizogonic cycle) - ????????
Merozoite ????????? ????????????????????? -
???????????????? (???? Erythrocytes ???
Reticulocytes ) - ?????????????????????????????
????????????????????? ??????????????
Plasmodium vivax ??? Plasmodium ovale
??????? Reticulocytes Plasmodium malariae
??????? Old Erythrocytes Plasmodium
falciparum ????????????????? RBC
27
  • ???????? RBC ????????????????????????????
    Merozoites
  • ??????? - merozoite ?????????? (Oval)
  • - ????? vacuole ?? cytoplasm
  • - ????? pigment (????? Malarial
    pigment)
  • - ??? cytoplasm ??????????????????????
    ??
  • - ??????????????????????? ?????????????
  • (Ring form)

28
????????cytoplasm??? RBC ?????????
????????????????????????????? ?????????????
Hematin ???????? Haemogobin , Hematin
??????????????? ???? Malarial Pigment
29
???? Ring Form - ??????????????? cytoplasm
???????????????????????????????? ????????????
Amoeboid Form - Malarial pigment ?????????
(pigment ????????????????????????????????????)
30
???? Amoeboid Form - ??????????????? Mitosis -
Activity ???? - Malarial pigment ??????? -
?????????????? nucleus ????? Immature Schizont
( Early Schizont) - ????????????????????????????
?????????????? ??????? activity ????? Mature
Schizont (Late Schizont)
31
???? Mature Schizont - cytoplasm
???????????????????? nucleus - ???????? pigment
?????? cell - ????? cell ???????? Malarial
pigment ??? vacuole ??? Merozoite
32
???? Merozoite - ?? infect RBC ?????
??????????????????????????????? - ????
Schizogony ????? - ???????????? Relapsing
Malaria ????? Merozoite ??????????????????
??????? Post erythrocytic cycle
33
(No Transcript)
34
  • Gametocytes ????????????? ??? ?? 1 nucleus
    ???????????????????????????????? gametocyte ?????
    ????????????????????
  • Gametocyte ?????????????????????
    ????????????????
  • ????????? gametocyte ???????????????????????????
    ? ??????????????? ?????? ???????????????????
    (crescents shape)

35
(No Transcript)
36
???????????????????????? - ?????????????????
Plasmodium ?????????????????????????????
??????????????????????????????????????????????????
??????????????????? - ??????????????????????????
???????????? ?????????????????????????????????????
??????????? ?????????????????????????????????????
?????????????? ???????????????????????????????????
? ????????????????????? ????????????????????????
???????? dot ?????
37
??????????????????????????????????? ??????????????
???????????????????????????? 1.Plasmodium
falciparum RBC - ???????? -
???? Maurers dot (???? dot ????????
??????????????????????? ????????????????
??????????????????? ??????????????????
????????????????? parasitophorous
vacuole) - ?? Multiple infection
38
2. Plasmodium vivax RBC -
???????????????? - ????
Schuffners dot (???????????? ?????
???????? ????????????????? ???????????
???????????????????????? ??????????
???????? caveola-vesicular
complex) - ????????? Mutiple
infection - Pigment ????????????????????
39
3. Plasmodium malariae RBC - ????????
???????????????? - ???? Ziemanns dots
(??????????????????) - ????? Mutiple
infection - Pigment ????????? ???????????
?????
40
4. Plasmodium ovale RBC - ??????
???????????? ???????????
??????????? - ???? Schuffners dot
?????? P. vivax -
Pigment ????????
41
???????????? Plasmodium ???????????? Human
Malaria Plasmodium falciparum ????????
Malignant tertian Subtertian
Estivo autumnal Falciparum
malaria ?????????????????????????????????????????
????? ?????? ????????????????????? ????
????????????????
42
Plasmodium vivax ????????
Benign tertian Simple
tertian Vivax
malaria ????????????????????????????????
????? ??????????????????????????????????
???? ?
43
Plasmodium malariae ????????
Quartan malaria
Malariae malaria ??????????????
??????????????????????????
(??????? ???? ?????????? ???????? ??????????
????????) ?????????????????????????????????
44
Plasmodium ovale ???????? Ovale
malaria ????????????????????????????? ??????
????????????? ??????????? ?????????????????????
????????
45
??????????????????? ?? 4 ???? 1.
?????????????????? ( Pre-patent Period )
- ??????? sporozoites ???????????? ?????
?????? Asexual stage
???????????? - ?????????????????
46
2. ?????????????????? ( Incubation Period )
- sporozoites ????????????????? ??????????
??????????? - ??????????
(???????????????????? ?????????) -
P.f. ?????? 12 ??? - P.o. ??? P.v.
?????? 13-17 ??? - P.m. ?????? 28-30 ???
47
3. ???????????? ( Premonitory Period ) -
???????????????? ?????????????????
????????????????? ??????????????????? -
?????????? ???????????? ????????
???????????? ?????? ??????????
48
4. ??????????????? ( Malaria Paroxysm ) -
????????????????? ??????????? 3 ???? ???
4.1 ???????? ( Cold stage ) ????????????
??????? ???????????????
???????????????? 15-60 ???? 4.2 ???????? ( Hot
stage ) ??????????????? ??????????????
1-3 ??????? (?????? 6 ???????)
49
4.3 ????????????? ( Sweating stage )
?????? 2-4 ??????? ??????????????
?????????? ??????????? (apyrexia)
????????????????????? ?????????
??????????
50
  • Vivax malaria ??? Ovale malaria
  • ??????????????
  • ?? Hypnozoite ??????????????
  • Pre-patent period 11-13 ???
  • Incubation period 13-17 ???
  • ??????? ??????? ???????? ?????????? ????????
    ??????? (????? ????)

51
  • ???????? ?????? 3 ????
  • ?????? ?????? (????????????? ?????)
  • ??????????????????????? 6-12 ???????
  • ???????????? ????????? ???????(Relapse)
  • ????? 2-3 ??

52
  • Malariae malaria
  • Pre-patent period 15-16 ???
  • Incubation period 28-30 ???
  • ??????? ??????????????? ???? ????????????????
  • ????????? 3 ???
  • ????????????? Nephrotic syndrome (??????
  • ??? ?????????)
  • ???????????? Recrudescence ?????????? 20 ??

53
Falciparum malaria - Pre-patent period 9-10
??? - Incubation period 12-17 ??? -
??????????? ?????????????????? - ???????
????? vivax ????????????? - ?????????????????????
? ????????? ??????? ??????????????????
54
- ??????????? 2-3 ??? ???????????????? ??? 36
??????? - ?????????????? 3 ???? - ??????????????
Recrudescence - ????????????? ???????????????
???? - ?????????????????? ????? ????????????
(???????????) - ?????????????? ??????
55
?????????? ??????????????????????????????????
???????????????????????????????
?????????????????????????????? 1.
????????????????????? 1.1 ???????????? ???
???????????????? (????????) ???
??? Hemolysis (????????) ???
Macrophage ????? ?????????
56
1.2 ???????????? Monocyte ???????????
(?????? 15) 1.3 ??????????????????????
?????????? Plasmodium falciparum
?????????????????? ?????? ???????????
(??????????????????????????)
57
2. ??????????????????? - ?????
?????????????? ?? ???????? ???????
- ??????????????????????????? 3.
?????????????????? - ??????????????????????
??????????? ???? (Merozoite, Pigment,
????????????)
58
4. ???????????????? - ????????????????
???? ??????????? ??? ???????? 3-4
?????????????????? 5. ??????????????? -
????????????????????????? Plasmodium vivax
??? Plasmodium malariae ??????
Plasmodium falciparum ???????? ???
(????????)
59
6. ???????????????? - ?????????
Plasmodium falciparum ???
????????????????????????????????? 7.
??????????????????????? - ?????????????
??????? ??????????? ????? ?????????
60
????????????? ???????????????? Plasmodium
falciparum 1. ???????????????? (Cerebral
malaria) ???????????????????????????
???? RBC ????? ????????????????????
??? ?????????????? ???????????
??????????? ???? ??? ??? ?????????
61
2. ???????????? (Black water fever) ????????? RBC
??????????????? ?????????? Hemoglobin ?????????
????? ?????? ???????? ?????????? ????????????
????????? 3. ????????????????? (Pulmonary
edema) ???????????????????????????????????????
Permeability ??????????????????????????????
????? ?????????? ???
62
4. ????????????????????? (Gastrointestinal
malaria) ?????????????????????????????????????
?????? O2 ????? ???????????????????????????
??????? ???????? ???????????? 5. ??????????
(Renal failure) ??????????????? ???????????????
??????????? ???????????????????????????? ????????
???? ?????????????????????????
63
??????????????? 1. ??????????????
- ???????????????????????????? ????????????
????????????? -
???????????????????????????????????
- ??????????????????????
64
2. ????? ????????????????????????????????????
(???????? P. falciparum) ??????????????????
??????????? ?????????
???????????????????
65
3. ?????????????? ????????????????????????
??????????????????????? ????????? ?????????
????????? ??????????? ?????????????? ????
????????? ?????????
4. ???????????? ?????????????????????????????????
??? Thin film ??? Thick film
66
???????? (Treatment) ??????????????????
(Antimalarial drug) ?????????????????????????????
??????????????????????????????????????????????????
? 1. Tissue schizontocides (????????????????????)
P. falciparum Pyrimethamin ,
Proquanil P. vivax , P. ovale , P. malariae
Primaquine ,
Pamaquine
67
2. Blood schizontocides (???????????? Asexual ??
RBC) 2.1 Quinoline derivative (????????
?????????????) - Quinine -
Chloroquine - Mefloquine 2.2 PABA
antagonists (????????????????????????????)
- Sulfonamide
68
2.3 Dihydrofolate reductase inhibitors -
Pyrimethamin - Proguanil 2.4 Antibiotic
(????????? ???????????? ???????)
- Tetracycline
69
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70
4. Sporontocides (??????????????????
Gametocyte ????????????) ?????? -
Pyrimethamin - Proguanil - Primaquine
- Pamaquine
71

Tissue schizontocides Sporozoites
Exo-erythrocytic schizogony Sporonto
cides Gametocytocides Blood
schizontocides Gametocytes Gametogony
Erythrocytic schizogony
72
?????????????? 1. ????????????? (Redical
treatment) - ????????????????????????????????
??????? - ??????????????????????????????
73
- P. falciparum ????? MSP (Fansimef)
Primaquine M Mefloquine S
Sulfadoxine P Pyrimethamine
???????????????????? ?????????????????
?????????? sulfa ?????????????????? 6 ?????
74
- P. vivax ??? P. malariae ?????
Chloroquin Primaquine ??? Asexual
???????????? Gametocytes
75
2. ?????????????? (Presumptive treatment) -
???????????? ??????????????????? -
???????????????????????????? -
?????????????????????????????????
???????? ???????? - Fansidar (SP)
Primaguine S Sulfadoxin P
Pyrimethamine
76
??????????????????? (Prevention and Control) 1.
??????????????????????????????? (Individual
Protection) - Bed nets - Screening -
Repellents - Antimosquito fumigants -
Pyrethrum house spray - Protective clothing
77
2. ???????????????? (Vectors Control) -
Residual insecticide spraying (D.D.T. ) -
Insecticide space spraying (Malathion) -
Biological control (Larvivorous fish ,
Bacillus thuringiensis ) - Chemical larvicide
(Abate) - Environmental modification (Clearing
of vegestation , Drainage)
78
3. ?????????????????????????? (Eliminate
parasite in human host) - Case detection
Active case detection Passive case
detection - Treatment Presumtive
treatment Radical treatment -
Vaccination againts malaria
79
????? Individual Protection
Eliminate parasite in Human host
?? ???
vector control
80
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