MALARIA

Sheena Rose Cogo

 Malaria is a potentially
serious disease caused by
parasites called
PLASMODIA. Plasmodia
parasites are transmitted
between humans by the bite
of an infected female
ANOPHELES mosquito,
which can carry the
parasites.
 Malaria is the most deadly VECTOR-BORNE disease
in the world.
At least 10 of the more than 200 parasitic protozoa
species of the genus Plasmodium:
Plasmodium ovale
Plasmodium vivax
Plasmodium malariae
Plasmodium falciparum
and Plasmodium knowlesi,
P. falciparum causes the most severe morbidity and
mortality.
 Malaria is primarily transmitted through the
bite of an infected female ANOPHELES species
mosquito. Malaria also can be transmitted via a
blood transfusion or congenitally between
mother and fetus, although these forms of
infection are rare.
 At risk for contraction of malaria are persons living in or
traveling to areas of
Central & South America
Hispaniola
sub-Saharan Africa
Indian subcontinent
Southeast Asia
Middle East
and Oceania.
Of these areas, sub-Saharan Africa has the highest occurrence of
P falciparum transmission to travelers from the United States.
 Sign and Symptoms
Mild Early Symptoms
• Cold Stage (1-2 hours)
– Fever, Shaking, Chills
• Hot stage (3-4 hours)
– High fever(41.70C), Headache, Nausea,
Vomiting, Dizziness, Pain Delirium
• Sweating Stage (2-4 hours)
– Sweating(diaphoresis), fall in temp.
 Sign and Symptoms
• Anemia • brain damage, coma
– Pallor, tiredness, (cerebral malaria)
shortness of • Hemoglobinuria
breath, fatigue (black water fever)
• Splenomegaly • hemolysis
• Hepatomegaly • jaundice
 Diagnostic Tests
• CBC – can detect anemia which usually occur a long
with Malaria
• Blood test – check for the plasmodian parasite that
caused Malaria
• Urine and Blood Cultures
• Rapid diagnostic tests (RDTs)- it has been found to
be as specific as microscopy studies
• Thick and thin blood smears
 Nursing Diagnosis
• Decreased C/O r/t destruction of RBC
secondary to invasion of merozoites in the
bloodstream
• Hyperthermia r/t infection in the blood
secondary to malaria
• Impaired tissue integrity r/t excess bilirubin in
the blood secondary to destruction of RBC by
merozoites
 Nursing Diagnosis
• Deficient knowledge about the disease
process of Malaria
• Ineffective breathing pattern r/t destruction of
RBC due to invasion of merozoites secondary
to Malaria
 Nursing Intervention
1. The patient must be closely monitored.
• Intake and output should be closely monitored to
prevent pulmonary edema.
• Daily monitoring of patient’s serum bilirubin, BUN
creatinine, and parasitic count
2. If the patient exhibits respiratory and renal symptoms,
determine the arterial blood gas and plasma electrolyte
3. During the febrile stage, tepid sponges, alcohol rubs,
and ice cap on the head will help bring the temperature
down.
 Nursing Intervention
4. Application of external heat and offering hot
drinks during chilling stage is helpful.
5. Provide comfort and psychological support.
6. Encourage the patient to take plenty of fluids.
7. As the temperature falls and sweating begins,
warm sponge bath maybe given.
8. The bed and clothing should be kept dry.
 Nursing Intervention
9. Watch for neurologic toxicity (from quinine
infusion) like muscular twitching, delirium,
confusion, convulsion, and coma.
10. Evaluate the degree of anemia.
11. Watch for any signs especially abnormal
bleeding.
12. Consider severe malaria as medical
emergency that requires close monitoring of
vital signs.
 Medical Management
• Antiprotozoal
Chloroquine phosphate remains the DOC if
the patient is infected with a nonresistant
strain of Plasmodium species. For chloroquine-
resistant strains, a form of quinine is the drug
next in line.
 Medical Management
• Antipyretics, such as acetaminophen or
• Nonsteroidal anti-inflammatory drugs (NSAIDs),
are indicated to reduce the level of discomfort
caused by the infection and to reduce fever.
 Prevention
• Avoid travelling to endemic regions
• Take the proper prophylactic drugs at proper
intervals if travelling to endemic regions.
• Use topical insect repellent (30-35%
diethyltoluamide [DEET]), especially from dusk
to dawn.
• Wear long-sleeved permethrin-coated
clothing if not allergic to permethrin; spray
under beds, chairs, tables, and along walls.
 Prevention
• Sleep under fine-nylon netting impregnated
with permethrin.
• Avoid wearing perfumes and colognes.
• Seek out medical attention immediately upon
contracting any tropical fever or flulike illness.
• Avoiding outdoor night activities (peak biting
hour 9pm-3am)
 Prognosis
• Most patients with uncomplicated malaria
exhibit marked improvement within 48 hours
after the initiation of treatment and are fever
free after 96 hours.
• P falciparum infection carries a poor prognosis
with a high mortality rate if untreated.
However, if diagnosed early and treated
appropriately, the prognosis is excellent.
 Gene Linked to Drug Resistance in Malaria
Pinpointed
ScienceDaily (Oct. 12, 2010) — Scientists have
shed light on how malaria is able to resist
treatment with a leading drug.
Researchers have identified a gene that
enables the parasite that causes the infection to
resist treatment with the plant-based remedy
artemisinin.
 Journal
TITLE: Development of an attenuated sporozoite
vaccine to prevent and eliminate Plasmodium
falciparum malaria (20 October 2010)

The first-generation vaccine is a metabolically

active, non-replicating Plasmodium falciparum
sporozoite (PfSPZ) vaccine that is attenuated by
irradiation.
The End