Plasmodium spp., including P. falciparum, P. malariae, P. ovale, and P. vivax (malaria)

Images: 
Plasmodium falciparum: 
http://www.k-state.edu/parasitology/625tutorials/Plasmodium01.html
Plasmodium lophurae exflagellation: 
http://www.k-state.edu/parasitology/625tutorials/Apicomplexa05.html
Plasmodium malariae: 
http://www.k-state.edu/parasitology/625tutorials/Plasmodium04.html
http://www.cbu.edu/~seisen/Malaria_files/frame.htm

Generalized Life cycle of Plasmodium spp.

MalariaLifeCycle03

World Malaria Report 2005:  http://rbm.who.int/wmr2005/html/exsummary_en.htm

Timeline, adapted from Maher, B.A.  (2005).  Fever Pitch.  The Scientist 18(10):25.

Year

Discovery

400 BC

Susruta, A Brahmin priest, describes malarial fever that he attributes to mosquito bites.

95 BC

Lucretius suggests that an organism rather than poisonous air or miasma might cause malaria, which means “bad air” in Italian.

450 AD

A widespread epidemic occurs in Lugnano, north of Rome, according to forensic DNA evidence.

1638

Juan del Vego uses a tincture from bark of a tree to treat the Countess of Chinchon in Peru; the remedy is later named quinine.

1716

Giovanni Maria Lancisi, physician to three popes, notes that draining swamps curbs malaria; he suggests an insect origin.

1880

French army surgeon Charles Louis Alfonse Laveran identifies malaria parasite; wins Nobel Prize in 1907.

1894

Patrick Manson hypothesizes that an external vector transmits malaria.

1897

Ronald Ross, military physician in India, observes malaria parasite in Anopheline mosquito guts, wins Nobel Prize in 1902.

1934

Chemist Hans Andersag at Bayer laboratories in Germany discovers chloroquine (resochin), but the compound is largely forgotten.  It won’t be recognized as a safe effective antimalarial drug until 1946.

1939

Paul Muller in Switzerland notes insecticidal properties of DDT, synthesized nearly a 100 years earlier by Othmar Zeidler, a German chemistry student.

1947-1951

National Malaria Eradication Program established by state and federal agencies essentially eradicates malaria in the United States.

1956

World Health Organization (WHO) launches Global Malaria Eradication Program.

1960’s

Widespread drug-resistant parasites and DDT-resistant mosquitoes are noted

1962

Rachel Carson publishes Silent Spring, about the environmental effects of DDT.

1967

WHO abandons malaria eradication in favor of control.

1972

The US Environmental Protection Agency bans the use of DDT

1979

Chinese researchers describe artemisinin, a wormword-derived treatment noted in ancient texts.

1983

First Plasmodium gene is cloned

1998

WHO initiates Roll Back Malaria program with the goal of halving the burden of malaria by 2010.

2000

UK researchers produce the first transgenic mosquitoes.

2002

International consortia publish the sequence of Plasmodium falciparum and a draft sequence of Anopheles gambiae.

Phylogeny:
Subphylum Apicomplexa

Preferred definitive host:
Technically, mosquitos are the definitive host since the parasite undergoes sexual reproduction in the mosquito. By convention, mosquitos are considered the "vectors" to humans.

Reservoir hosts:
None

Vector/intermediate host:
Mosquitos, particularly those of the genus Anopheles.

Geographical location:
Central and South America, Africa, Middle East, Asia, Pacific Islands

Organs affected:
Liver, blood, kidney

Symptoms and clinical signs:
Most symptoms are associated with its effects on erythrocytes. Symptoms commonly include chills, fever, and anemia. Other symptoms include muscle pain, headache, loss of appetite, nausea, vomiting, jaundice, and renal failure.

Treatment: Chloroquine, Primaquine, Sulfamethoxine, Pyrimethamine, Sulfadiazine, Quinine, Amodiaquine.

Some drugs used in the treatment of malaria are nasty, and have psychological effects. Here is the text of an e-mail distributed, requesting information regarding Lariam:

From: "Dan Olmsted" <DOlmsted@upi.com
To: <info@rpcv-wa.org>
Sent: Wednesday, June 05, 2002 1:14 PM
Subject: Lariam query from UPI

We would appreciate it if you could post this and/or send to volunteers. If you have any questions feel free to contact me at 202 302 3753 or via e-mail. Thanks, Dan Olmsted, Washington Bureau Chief, United Press International. United Press International is investigating the anti-malaria drug Lariam and is interested in hearing from Peace Corps volunteers about any problems they may have experienced.

If you experienced psychiatric or other reactions to the drug either during or after your Peace Corps years, we would like to hear from you. We also are interested in hearing about any reports of volunteers not taking the drug because of side effects; what kind of warnings you received; whether your complaints about side effects were taken seriously, and how Peace Corps medical officers dealt with the issue of side effects. We also would like to find former medical officers or Peace Corps officials who would talk to us. Also, we are interested in any information about suicidal thinking or behavior, or actual suicides or unexplained deaths, that might be connected with the drug. UPI published an article on side effects including suicide on May 21; you can read it by going to UPI.com and typing in Lariam, or going to Newsday.com and doing the same thing (that is a shorter version).

You can e-mail me at dolmsted@upi.com. Please include a phone number and indicate whether you would be willing to be quoted by name (we only use named sources in our reporting). Also, if you are attending the Peace Corps convention in Washington in June, please let us know.

We are taking the issue of side effects very seriously and are committed to full and accurate reporting about the situation.

Sincerely,

Dan Olmsted
Washington Bureau Chief
United Press International

New Study of Malaria Finds Many New Cases:  From a Reuters article released March 11, 2005

More than half a billion people, nearly double previous estimates, were affected by the deadliest form of malaria in 2002, according to a new estimate by scientists.

.

Most of the cases were in sub-Saharan Africa but nearly 25 percent of them occurred in Southeast Asia and the Western Pacific.

.

There are 515 million clinical attacks of Plasmodium falciparum malaria a year on the planet, said Robert Snow, professor of public health at the Kenyan Medical Research Institute in Nairobi and one of the authors of the study.

.

"We have taken a conservative approach to estimating how many attacks occur globally each year," Snow said, "but even so the problem is far bigger than we previously thought."

.

The figures, which were reported in a letter to the science journal Nature, published Thursday, are almost twice those of the World Health Organization, which estimated the global incidence at 273 million cases in 1998, with 90 percent of cases in Africa.

.

"It is quite substantially higher than the WHO estimate," Snow said. In the new study, it was estimated that there were 365 million cases of malaria in Africa alone in 2002.

.

Malaria is an infectious disease caused by parasites transmitted to humans by the bite of an infected mosquito. The disease occurs in more than 100 countries and kills more than one million people each year - mostly young children in sub-Saharan Africa.

.

The new research suggests that 2.2 billion people are at risk of malaria.

.

Although the scientists did not estimate deaths from the disease, the risk of severe life-threatening complications was estimated to be approximately 10 times higher in Africa than in Southeast Asia and the Western Pacific.

.

"Getting the numbers right is important," Snow said. "Not knowing the size of the problem limits our ability to articulate how much money we need to tackle the problem - not knowing where the problem is located means you can't spend wisely."

.

Groovy Web site(s):

Malaria Foundation International
http://www.malaria.org

 Note: A number of genetic conditions have evolved among human populations in response to malaria. The best known are sickle-cell anemia and favism, a deficiency of gluose-6-phosphate dehydrogenase.

From the Abstract of Aluoch, JR, 19997. Higher resistance to Plasmodium falciparum infection in patients with homozygous sickle cell disease in western Kenya. Trop. Med. Int. Health 1997 Jun;2(6):468-71.

"Sickle haemoglobin (HbS) is considered to be protective against malaria. Malaria is fatal in homozygous sickle cell (HbSS) disease. In a cross-sectional survey…of 766 residents of Western Kenya…, 20 were found to have HbSS disease, `120 sickle cell trait (HbAS) and 626 the normal genotype (HbAA). Blood slides for malarial parasites (MPs) were performed in 728 cases, i.e. 592 HbAAs, 116 HbASs and all 20 HbSSs. Malaria parasites were found in 261 (35.8%) HbAAs, 42 (5.8%) HbAss, and 20% (4 out of 20) in HbSSs. The relative risk of malarial infection was 0.33 in the HbSSs compared to both HbAAs and HbASs. It seems that the protection conferred by HbS against malaria is more marked in HbSS disease than in HbAS and is HbS-content related, and that the balanced polymorphism in the HbS-malaria relationship is maintained-by higher mortality risk due to malaria and high mortality risk of HbSSs caused by complications of HbSS."

 

 

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WHO Urges Free Distribution of Anti-Malaria Nets



Reuters Health Information 2007. © 2007 Reuters Ltd.
Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.

By Stephanie Nebehay

GENEVA (Reuters) Aug 16 - The World Health Organisation on Thursday recommended that malaria endemic countries widely distribute free insecticide-treated mosquito nets that give long-term protection against the disease which kills more than one million people a year.

The new guidance from the United Nations agency follows "impressive results" in Kenya, where mortality was reduced by 44 percent among children sleeping under long-lasting nets that cost $5.

"For the first time, WHO recommends that insecticidal nets be long-lasting and distributed either free or highly subsidised and used by all community members," it said in a statement.

Free mass distribution of the nets, which are efficient for at least three years and also kill the mosquitoes, is a "powerful way to quickly and dramatically increase coverage, particularly among the poorest people".

Malaria kills a child every 30 seconds, mainly African children under 5 years old, WHO says. Some 114 countries in Africa, Asia and Latin America are endemic.

The disease, which makes more than 500 million people a year severely ill, is caused by a parasite transmitted via bites from infected mosquitoes.

Conventional nets need to be re-treated regularly and many people fail to wash them properly or replace them when torn.

WHO director-general Margaret Chan said the new guidance provided "a road map for ensuring that life-saving long-lasting insecticidal nets are more widely available".

"Long-lasting insecticidal nets, with longer useful life, are cheaper to use, even if they are more expensive to buy," the WHO said in a paper sent to its 193 member states.

WHO's previous guidelines recommended providing insecticide-treated mosquito nets for use by children under five and pregnant women.

"However, recent studies have shown that by expanding the use of these nets to all people in targeted areas, increased coverage and enhanced protection of vulnerable groups can be achieved while protecting all community members," it said.

In Kenya, between 2004 and 2006, a near tenfold increase in the number of children sleeping under insecticide-treated nets resulted in 44 percent fewer deaths than among children not protected by nets, according to preliminary government data.

President Mwai Kibaki last year launched an effort to distribute 3.4 million long-lasting insecticidal nets free of charge to children in 45 of Kenya's 70 districts, the WHO said.

"Seven lives were saved for every 1,000 nets given out," Peter Olumese, a medical officer with WHO's Global Malaria Programme, told Reuters on Thursday.

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'Happy' Malaria Awareness Day

Today on campuses around the country students with the Student Campaign for Child Survival are demanding concrete US action to prevent the deadly impact of malaria.  On lawns, in their homes, in dining halls, around the dinner table and as a part of the "Malaria Bites, Bite Back" nation-wide house party students are coming together, preparing foods from malaria regions, learning about the devastating impact of the disease, and sending a bold message to their elected officials in DCs – WE ARE BITING BACK! 

·        Students from California to New York, from Wisconsin to Texas will be taking part. 

·        Stanford:  Students will be tabling on campus, hosting a speaker and screening a film – all on African malaria

·        Cornell:  Campaign members are hosting house parties and taking pictures of all the partygoers who are 'biting back.'

·        St. Scholastica:  Students participating in the Mayfest Fun Run will be sporting "I'm Biting Back" stickers.  Non-runners can pose for pictures in the student union or make a fee call to their elected officials in DC. 

·        Beloit College:  At this small school in Southern Wisconsin students are taking over their entire (and only) dining hall with a school-wide game of Malaria Trivia. 

·        Texas A&M:  Students are gathering for a more intimate roundtable discussion on the US response to the deadly disease.

·        And many more!

Photos of students participating in their events and holding signs that read "I'm biting back" will be compiled by students at SCCS's DC headquarters and presented to Representative Obey (D-WI) with our semester's primary request - fully fund the Global Fund and PMI. 

Our press release is attached, updates on how everything panned out will follow, and the house-party action kit, if you are curious, is still online here

Keep up the good work everyone,

Simon Stumpf  |  SCCS National Organizer
The  Student  Campaign  for  Child Survival
c: 320 420 0959  |  supportchildsurvival.org

          CHARACTERISTICS OF PLASMODIUM SPP.

 

 PARAMETER

            VIVAX

            FALCIPARUM

            OVALE

            MALARIAE

CIRCADIAN CYCLE OF FEVERS

 

          48 hours

 

          IRREGULAR -

          48 hours

 

          72 hours

 

          72 hours

OCCURRENCE

Temperate zone & North Africa & Vietnam

 

Tropical: Accounts For 50% of cases

 

Africa, S.E. Asia, New World

Tropics: Java & New Guinea

CELLULAR MARKINGS

Schuffner's Dots

          Maurer's

          Cleft

Schuffner's Dots

          Absent

EXOERYTH-

ROCYTIC GENERA-

TIONS

 

          Several

 

          Only 1

 

          ?

 

 

Relapses Possible

AGE OF SUSCEP-

TIBLE RBC'S

 

 

          Only young

 

 

          Any age

 

 

          Aging

Any age, but low incidence

# MEROZOITES

 

          16

 

          16

 

          8

 

          8

MULTIPLE INFECTIONS OF RBC'S?

 

          Rare

 

          Frequent

 

          No

 

          No

PROTECTION BY SICKLE CELL TRAIT

 

          No

 

          Yes

 

          No

 

          No

NECESSITY OF DUFFY FACTORS

 

          Yes

 

          No

 

          No

 

          No