1. Depertment of Public Health
North South University

2.  Malaria is a mosquito-borne infectious disease.
 Four species of protozoan parasite of the genus
Plasmodium that are relevant for human
infection:
1. P. falciparum
2. P. vivax
3. P. ovale
4. P. malariae
 P. vivax is the most widespread malaria infection
in the world.P. falciparum causes the most
severe malaria disease in the world and is
responsible for the most deaths and morbidity.

4.  The parasite undergoes several transformations with both the human host
(intermediate) and mosquito host (definitive)
 Transmitted to humans as sporozoites from the saliva of an infected female
mosquito
 Sporozoites enter the venous blood system from the subcutaneous tissues by
way of the capillary bed and can invade liver cells within minutes if they
successfully evade the reticuloendothelial defenses
 Over the next 5 to 15 days, each sporozoite nucleus replicates thousands of
times within the liver cells to form a hepatic schizont within the liver cells
 When released from the swollen liver cells, each schizont splits into tens of
thousands of daughter parasites called merozoites
 Merozoites attach to specific erythrocyte receptors and enter the erythrocyte
 Each intraerythrocytic meroziote differentiates into a trophozoite that ingests
hemoglobin, enlarges, and then divides into 6 to 24 intraerythrocytic merozoites
forming a schizont
 The red cell swells and bursts, which releases the next batch of approximately
20 merozoites
 Theses new merozoites then attach and penetrate new erythrocytes to begin the
cycle again

5.  1. The release of merozoites into the
bloodstream
 2. Anemia resulting from the destruction of the
red blood cells
 3. Large amounts of free hemoglobin being
released into circulation after red blood cells
break open

6.  African countries south of the Sahara desert
 The Indian subcontinent
 Solomon islands, Papua New Guinea and Haiti
 People at increased risk of serious disease
include:
 Young children and infants
 Travelers coming from areas with no malaria
 Pregnant women and their unborn children

7.  Anemia
 Bloody stools
 Chills
 Coma
 Convulsion
 Fever
 Headache
 Jaundice
 Muscle pain
 Nausea
 Sweating
 Vomiting

8.  In order to make a malaria diagnosis, the healthcare provider may ask a number of
questions concerning:
1.Current symptoms
2.Medical conditions
3.Family medical history
4.Current medications
5.Recent travel history.
 A malaria diagnosis can be difficult to make, especially in areas where malaria is not
very common. A number of other conditions share similar symptoms with malaria.
Some of these conditions the healthcare provider will consider before diagnosing
malaria include:
The flu (influenza)
Common cold
Meningitis
Typhoid fever
Dengue fever
Acute schistosomiasis (disease caused by worms)
Bacteremia/septicemia (infection in blood)
Hepatitis
Viral gastroenteritis (stomach flu)
Yellow fever(disease typically transmitted by mosquitoes).

9.  The doctor may suspect malaria based on the patient's
symptoms, and the physical findings at examination;
however, to make a definitive diagnosis of malaria, laboratory
tests must demonstrate the malaria parasites, or their
components.
 The best test available to diagnose malaria is called a blood
smear. In this test, malaria parasites can be identified by
examining a drop of the patient's blood under the
microscope, spread out as a "blood smear" on a microscope
slide. Prior to examination, the specimen (blood) is stained to
give to the parasites a distinctive appearance.

10. Malaria can be fatal, particularly the variety that's common in tropical
parts of Africa. The Centers for Disease Control and Prevention estimate
that 90 percent of all malaria deaths occur in Africa — most commonly in
children under the age of 5.
In most cases, malaria deaths are related to one or more of these serious
complications:
 Cerebral malaria. If parasite-filled blood cells block small blood vessels
to your brain (cerebral malaria), swelling of your brain or brain damage
may occur.
 Breathing problems. Accumulated fluid in your lungs (pulmonary edema)
can make it difficult to breathe.
 Organ failure. Malaria can cause your kidneys or liver to fail, or your
spleen to rupture. Any of these conditions can be life-threatening.
 Severe anemia. Malaria damages red blood cells, which can result in
severe anemia.
 Low blood sugar. Severe forms of malaria itself can cause low blood
sugar, as can quinine — one of the most common medications used to
combat malaria. Very low blood sugar can result in coma or death.
 Recurrence may occur
Some varieties of the malaria parasite, which typically cause milder
forms of the disease, can persist for years and cause relapses.

11.  Malaria has been a major public health
problem in Bangladesh.
 Approximately 33.6% of the total population
are at risk of malaria Majority of malaria
cases are reported from 13 out of the total
64 districts in the country.
 About 4 million populations living in 34
upazillas of eight of the thirteen districts live
in the epidemic-prone border areas
 Focal outbreaks occur every year, and the
response to control the epidemic is
inadequate.

12.  Inadequate access to treatment and diagnostic
facilities especially in the remote areas
 Inadequate programme management capacity at
various level and management of severe malaria
in hospitals
 Poor coverage of prevention and control methods
(IRS, ITN/LLIN coverage still low) in the
community
 Referral system is weak and pre-referral
treatment provisions are limited;
 Optimum treatment of cases of severe malaria in
different categories of hospitals are inadequate
 Cross-border malaria at the Bangladesh India and
Ban- Myanmar border

13.  WHO
 World Bank
 Global fund
 BRAC and 14 member
NGO Consortium
 4 Local NGOs in
Chittagong Hill Tract(CHT)

14. Preventing malaria - four steps
There is an ABCD for prevention of malaria.
This is:
 Awareness of risk of malaria.
 Bite prevention.
 Chemoprophylaxis (taking antimalarial
medication exactly as prescribed).
 Prompt Diagnosis and treatment.

15. The types of drugs and the length of treatment
will vary, depending on:
 Which type of malaria parasite you have
 The severity of your symptoms
 Your age
 Whether you're pregnant

16.  Pregnant women are at particular risk of
severe malaria and should, ideally, not go to
malaria-risk areas.
 Non-pregnant women taking mefloquine
should avoid becoming pregnant.
 If you have epilepsy, kidney failure, some
forms of mental illness, and some other
uncommon illnesses, you may have a
restricted choice of antimalarial medication.
 Travellers going to remote places far from
medical facilities sometimes take emergency
medication with them.

17. THANK YOU