Identification of Patients with Malaria
Session 15: Identification of Patients with Malaria
Total Session Time: 120 minutes + 2 hours Assignment
Prerequisites
Learning Tasks
By the end of this session studentsare expected to be able to:
Resources Needed
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
Causative Agents of Malaria
There are 4 different species of Malaria parasite which infect human
beings:
STEP 3: Mode of Transmission of Malaria (30 minutes)
human blood for the development of eggs.
o Anopheles Gambiae -Most important vector in Africa.
[pic]
Figure 15.1 Spread of malaria
Life cycle of malaria parasite
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)
via the proboscis of the mosquito
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
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
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
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)
and then fuse in the stomach of mosquito to form a zygote
the stomach to form an oocyst
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
Signs and symptoms of Severe Malaria
state of confusion)
STEP 5: Treatment of Malaria (30 minutes)
Treatment of Uncomplicated Malaria with First Line Drugs
o The first dose should be given as Direct Observation Treatment (DOT)
o The second dose should strictly be given after 8 hours
o Subsequent doses could be given twice daily (morning-evening) until
completion of 6 doses
[pic]Refer to Handout 15.2: Treatment Schedule of uncomplicated Malaria
using ALU
Contra-indications of ALU
Side Effects of ALU
Other Artimesinin Combined Therapy (ACT) options Treatment of Uncomplicated
Malaria
those with minimum 3-day course which include:
o Dihydroartemesinin-Piperaquine (DPQ) –Oral
o Artesunate-Amodiaquine-oral
o Artesunate-Mefloquine-oral
Treatment of Severe Malaria
Artesunate
as allergy, medicine interaction, non-response or when it is not
available.
Artesunate Injection
can tolerate oral medication earlier before 24 hours, and thereafter,
complete treatment by giving a complete course of Artemether-Lumefantrine
injection.
The recommended formulation for public sector is 60mg
Injectable Quinine
Formulated as Injection 600mg in 2mls
o Acceptable alternative choice for treatment of severe Malaria
o Medicine of choice for treatment of severe Malaria in first trimester
of pregnancy
o Hypersensitivity to quinine
o Optic neuritis
o Myasthenia gravis
o Cinconism (Tinnitus, Vertigo and Dizziness)
o Hypotension
o Hypoglycaemia
o Injection site abscess
infusion Where
saline
STEP 6: Prevention and Control of Malaria (20 minutes)
|Activity: Buzzing (10 minutes) |
| |
|ASK students to pair up and buzz on the following question for 2 |
|minutes |
| |
|What are the methods for preventing and controlling Malaria? |
| |
|ALLOW few pairs to respond and let other pairs to add on points not |
|mentioned |
| |
|WRITE their response on the flip chart/board |
| |
|CLARIFY and SUMMARIZE by using the content below |
o This is done by prompt diagnosis and appropriate treatment of infected
individuals
o Controlling the vector population by:
and Doxycycline
STEP 6: Key Points (5 minutes)
characterized by fever, joint pains headache and resulting in anaemia
because of haemolysis
Anopheles mosquito
Malaria.
Malaria
STEP 7: Evaluation (5 minutes)
STEP 8: Assignment (5 minutes)
|Activity: Take Home Assignment (5 minutes) |
| |
|DIVIDE students in groups or individuals |
| |
|ASK the students to work on the following Assignment |
|Prepare a presentation to be delivered to the class indicating |
|prevention and control methods of Malaria you use in your house hold |
| |
|ALLOCATE time for students to do the assignments and submit |
| |
|REFER students to recommended reference |
References
Cook, G. & Zumla, A. (2003). Manson’s Tropical Diseases. (21st ed.).
London: Saunders Ltd
Denyer, S. P., Hodges, N. A., & Gorman, S. P (2011) (Ed).Hugo & Russell’s
Pharmaceutical Microbiology (8thed). Oxford: Willey-Blackwell publishing
Eshuis, J.& Manschot, P. (1992).Communicable diseases,(1st ed). Nairobi:
AMREF
GoT (2004): National Infection Prevention and Control (IPC) Guidelines for
Healthcare Workers. Dar es Salaam: MOHSW
GoT (2013) National Guidelines for Diagnosis and Treatment of Malaria. Dar
es salaam: MOHSW
GoT (2013) Standard Treatment Guidelines & National Essential Medicines
List (4thed).
Dar es Salaam: MOHSW
Nordberg, E. (1999): Communicable Diseases, A Manual for Health Workers in
Sub-Saharan Africa, Nairobi: AMREF
Nordberg, E., Kingondu, T., & Mugambi, E., et al. (2008) Communicable
Diseases. (4thed.). Nairobi: AMREF
Handout 15.1 Life Cycle of Malaria Parasite
[pic]
[pic]Handout 15.2 Dosage Schedule for Artemether-Lumefantrine
| |
|Kg | |Day 1 |Day 2 |Day 3 |
| |
Source: National Guidelines for Malaria Diagnosis and Treatment, 2013
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