Identification of Patients with Malaria – PST04102 Disease Control and Prevention
NTA Level 4 • Semester 1 • PST04102 Identification of Patients with Malaria Disease Control and Prevention • Source Session/Topic 15 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 15: Identification of Patients with Malaria Total Session Time: 120 minutes + 2 hours Assignment Prerequisites • None Learning Tasks By the end of this session studentsare expected to be able to: • Describe Causes of Malaria, • Describe Mode of Transmission of Malaria • Describe Major Signs and Symptoms of Malaria • Explain Treatment of Malaria • Explain Prevention and Control of Malaria Resources Needed • Flip charts, marker pens, and masking tape • Black/white board, chalk and whiteboard markers • Computer and LCD projector • Handout 15.1; Life cycle of malaria parasite • Handout 15.2; Treatment of uncomplicated malaria SESSION OVERVIEW |Step |Time |Activity/ |Content | | | |Method | | |1 |5 minutes |Presentation |Introduction, Learning Tasks | |2 |5 minutes |Presentation |Cause(s) of Malaria | |3 |30 minutes |Presentation |Mode of Transmission of Malaria | |4 |15 minutes |Presentation |Major Signs and Symptoms of Malaria | | | |Brainstorming | | |5 |30 minutes |Presentation |Treatment of Malaria | |6 |20 minutes |Presentation |Prevention and Control of Malaria | | | |Buzzing | | |7 |5 minutes |Presentation |Key Points | |8 |5 minutes |Presentation |Evaluation | |9 |5 minutes |Presentation |Assignment | SESSION CONTENTS STEP 1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing STEP 2: Causes of Malaria (5 minutes) Malaria • An acute infection of the blood caused by protozoa of genus Plasmodium • Malaria is the most common disease in the tropical Africa Causative Agents of Malaria There are 4 different species of Malaria parasite which infect human beings: • Plasmodium falciparum (commonest cause of Malaria in Tanzania) • Plasmodium Malariae • Plasmodium vivax • Plasmodium ovale STEP 3: Mode of Transmission of Malaria (30 minutes) • Malaria is transmitted by the female Anopheles mosquito which requires human blood for the development of eggs. • The male mosquito does not suck human blood. • Major Anopheles species of importance in Africa include: o Anopheles Gambiae -Most important vector in Africa. o Anopheles Funestus – Breeds in permanent vegetation e.g. swamps. [pic] Figure 15.1 Spread of malaria Life cycle of malaria parasite • Divided into two phases o Asexual cycle occurring in human o Sexual or sporogony cycle occurring in female Anopheles (mosquito) Life Cycle of Malaria Parasites in Man (Asexual Cycle) • Sporozoites in the mosquito salivary glands are injected into the host via the proboscis of the mosquito • They quickly migrate to the liver • The hepatic (Liver) stage o The Sporozoites is taken up by the Kupffer cells of the liver and then passes through into the hepatocytes or liver cells o There, it develops into hepatic Schizont, releasing thousands of Merozoites into the general circulation • Hypnozoites o This stage of the parasites only occurs in Plasmodium Ovale and Plasmodium Vivax o The Hypnozoites mature unpredictably and releases new Merozoites responsible for recurrent infections up to 18 months after primary infection, even though earlier blood stages may have been cured o Without treatment (specific) using primaquine, it is thought that this stage may remain in the liver for life • Erythrocytic or Blood Stage o The merozoites released from the liver invade individual red blood cells (RBCs) and then develop within the RBCs from “rings” into blood schizonts o The schizonts then rupture the RBCs releasing numerous merozoites which invade new RBCs o It is this part of the cycle that causes clinical illness, and then Length of time for each RBC cycle gives the periodicity of the symptoms • Gametocytes o At unknown stage or time in the RBCs cycle, ‘sexual’ forms develop and are in turn responsible for the survival and transmission of the parasite o Male and female gametocytes circulate for a few weeks and are taken up by the feeding mosquito Life Cycle of Malaria Parasites in Mosquito (Sexual Cycle of Malaria Parasites) • Sexual reproduction, the male and female gametocytes develop into gametes and then fuse in the stomach of mosquito to form a zygote • This develops into a mobile ookinete which immigrates through the wall of the stomach to form an oocyst • Oocyst matures and releases sprorozoites • Sporozoites migrate to the salivary glands ready for delivery with the mosquito’s next meal [pic]Refer to handout 15.1: Life Cycle of Malaria Parasite STEP 4: Major Signs and Symptoms of Malaria (15 minutes) |Activity: Brainstorming (5 minutes) | | | |ASK students to brainstorm on the following question | | | |What are the major signs and symptoms of Malaria? | | | |ALLOW few students to respond | | | |WRITE their responses on the flip chart/ board | | | |CLARIFY and SUMMARISE by using the content below | Signs and symptoms of Malaria The signs and symptoms of Malaria are non–specific and can mimic symptoms of systemic viral illnesses or other disease condition. The occurrence of Malaria signs and symptoms may differ in children and adults Signs and symptoms of uncomplicated Malaria • Fever • Headache • Malaise • Joint pains • Vomiting /diarrhoea • Body ache • Poor appetite • Body weakness • Pallor • Enlarged spleen Signs and symptoms of Severe Malaria • Extreme weakness • Impaired consciousness • Change of behaviour ( hallucinations, delusions, agitation, and acute state of confusion) • Respiratory distress • Bleeding tendency • Jaundice • Circulatory collapse/ shock • Vomiting everything • Inability to drink or breastfeed STEP 5: Treatment of Malaria (30 minutes) Treatment of Uncomplicated Malaria with First Line Drugs • Artemether/ Lumefantrine (ALU) an oral fixed combination tablet of 20 mg Artemether (a derivative of artemisinin) and 120