What Is Malaria?

The word malaria comes from 18th century Italian mala meaning "bad" and aria meaning "air". Most likely, the term was first used by Dr. Francisco Torti, Italy, when people thought the disease was caused by foul air in marshy areas. It was not until 1880 that scientists discovered that malaria was a parasitic disease which is transmitted by theanopheles mosquito. The mosquito infects the host with a one-cell parasite called plasmodium. Not long after they found out that Malaria is transmitted from human-to-human through the bite of the female mosquito, which needs blood for her eggs.

According to Medilexicon's medical dictionary, Malaria is "A disease caused by the presence of the sporozoan Plasmodium in human or other vertebrate erythrocytes, usually transmitted to humans by the bite of an infected female mosquito of the genus Anopheles that previously sucked blood from a person with malaria" . Malaria is also known as Jungle fever, Marsh fever, Paludal fever Approximately 40% of the total global population is at risk of Malaria infection. During the 20th century the disease was effectively eliminated in the majority of non-tropical countries. Today Malaria causes over 350 million human acute illnesses, as well as at least one million deaths annually. The anopheles mosquito exists in most tropical and many sub-tropical countries of Latin America and the Caribbean, Africa, Oceania, and Asia.

According to WHO (World Health Organization), the majority of Malaria deaths occur among children in sub-Saharan Africa, killing an African child every 30 seconds. Not only is Malaria associated with poverty, it is also a cause of poverty and an important obstacle to economic development.

There are five types of Malaria:

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Plasmodium vivax (P. vivax) - milder form of the disease, generally not fatal. However, infected people still need treatment because their untreated progress can also cause a host of health problems. This type has the widest geographic distribution globally. About 60% of infections in India are due to P. vivax. This parasite has a liver stage and can remain in the body for years without causing sickness. If the patient is not treated, the liver stage may re-activate and cause relapses - malaria attacks - after months, or even years without symptoms.

Plasmodium malariae (P. malariae) - milder form of the disease, generally not fatal. However, the infected human still needs treatment because no treatment can also lead to a host of health problems. This type of parasite has been known to stay in the blood of some people for several decades.

Plasmodium ovale (P. ovale) - milder form of the disease, generally not fatal. However, the infected human still needs to be treated because it may progress and cause a host of health problems. This parasite has a liver stage and can remain in the body for years without causing sickness. If the patient is not treated, the liver stage may re-activate and cause relapses malaria attacks - after months, or even years without symptoms. Plasmodium falciparum (P. faliparum) - the most serious form of the disease. It is most common in Africa, especially sub-Saharan Africa. Current data indicates that cases are now being reported in areas of the world where this type was thought to have been eradicated. Plasmodium knowlesi (P. knowlesi) - causes malaria in macaques but can also infect humans. How does a human become infected with Malaria? The female Anopheles mosquito transmits the parasite to a human when it takes a blood meal - it bites the human in order to feed on blood. Only the female Anopheles mosquito can transmit malaria, and it must have been infected through a previous blood meal taken from an infected human. When the mosquito bites an infected person a minute quantity of the malaria (plasmodium) parasite in the blood is taken. Approximately one week later that same infected mosquito takes its next blood meal. The plasmodium parasites mix with the mosquito's saliva and are injected into the host (human being). Human-to-human transmission of Malaria As the parasite exists in human red blood cells, malaria can be passed on from one person to the next through organ transplant, shared use of needles/syringes, and blood transfusion. An infected

mother may also pass malaria on to her baby during delivery (birth) - this is called 'congenital malaria'. What are the symptoms of Malaria? In areas where Malaria is endemic people may have immunity or semi-immunity, and therefore have either no symptoms or few symptoms. The severity of the Malaria depends on three things: 1. The type of parasite. 2. Your immunity. 3. Whether you still have your spleen.

Early stage symptoms of Malaria

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A high temperature (fever) Chills Headache Sweats Tiredness (fatigue) Nausea Vomiting Symptoms may occur in cycles, each time they come they might do so at different levels of severity. How long symptoms last may also vary, depending on each cycle. However, at the beginning of the illness, symptoms may not follow this typical pattern.

Other common symptoms may include:

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Dry cough Back pain Muscle ache Enlarged spleen Very rare symptoms may include:

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Impairment of brain function Impairment of spinal cord function Seizures (fits) Loss of consciousness People who are infected with the P. falciparum parasite and become ill generally have much more serious symptoms, which may become fatal.

What is the incubation period of Malaria? Incubation period refers to how long it takes from initial infection to the appearance of symptoms. This generally depends on the type of parasite:
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P. falciparum - 9 to 14 days P. vivax - 12 to 18 days

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P. ovale - 12 to 18 days P. malariae - 18 to 40 days However, incubation periods can vary from as little as 7 days, to several months for P. vivax andP. ovale. If you are taking medication to prevent infection (chemoprophylaxis) the incubation period is usually longer.

It is important that a doctor eliminates other possible diseases or conditions which may have similar symptoms to Malaria. These include:
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Cold, flu, and some other viral infections Rickettsia (tick bite diseases) Gastroenteritis Hepatitis Typhoid fever Meningitis, and other bacterial infections Non-malarial parasitic infections What are the treatments for Malaria? According to WHO, in endemic areas treatment should start within 24 hours after the first symptoms appear. A person with uncomplicated malaria can be treated as an outpatient, while those with severe malaria need to be hospitalized. In non-endemic areas WHO recommends that

patients with uncomplicated or severe malaria should be kept under clinical observation if possible. A person who is infected with P. falciparum and has severe symptoms, but cannot take oral medications, should be given treatment intravenously. In some parts of the world anti-malarial drugs may be presented as suppositories (not USA). Some drugs used for treating malaria are available as continuous intravenous infusions.

According to the CDC (Centers for Disease Control and Prevention), the following drugs are commonly used for treating malaria:
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artemisin derivatives (not licensed in the USA, common elsewhere) atovaquone-proguanil (Malarone) chloroquine doxycycline mefloquine (Lariam) quinine sulfadoxine-pyrimethamine (Fansidar)

Also, primaquine is effective against hypnozoites (the dormant parasite liver forms) and prevents recurrences (relapses). Primaquine should not be given to expectant mothers, or patients who are deficient in glucose-6-phosphate dehydrogenase G6PD. A screening test excludes G6PD deficiency. Preventing malaria The two main ways of preventing malaria are:
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Avoiding mosquito bites - this can be achieved in various ways:

Vector control - this means trying to reduce contacts between people and vectors of disease. A vector is an organism, such as a mosquito, or tick that carries disease-causing microorganisms from one host to another. Controlling mosquitoes can significantly reduce malaria incidence, as well as other mosquito-borne diseases. Getting rid of malaria in a region does not necessarily mean eliminating all theAnopheles mosquitoes that might transmit the disease. Anopheles mosquitoes still exist in North America and Europe - however, the parasite is not longer there. Improvements in people's standard of living, such as the installation of screened windows, air conditioning, together with strategies to reduce vector populations are very effective, and have led to the total elimination of malaria without completely getting rid of the mosquito.

ITNs(Insecticide-Treated Bed Nets) ITNs can reduce the incidence of malarial infection, and also mortality, in an endemic area considerably. Untreated nets are significantly less effective because the mosquito can bite the host through the net if the person is standing next to it. Also, even tiny holes in the netting are usually enough for the mosquito to find a way in. Nets that have been treated with insecticide are much more protective. Not only does the insecticide kill the mosquito and other insects, it is also a repellent - fewer mosquitoes are likely to enter the room(s). If ITNs are widely used in an endemic area the mosquito population may drop dramatically, as will their lifespans. This further protects those in that area who have no ITNs. Preventing disease - using anti-malarial medications. These drugs do not prevent the parasite from entering your bloodstream, but they stop it from developing in the blood. This type of prevention is also known as 'suppression'.

ADVANCE BIOLOGY MALARIA, DIARRHEA AND FILARIASIS

PIA SAMANTHA T. DASECO III-CAMIA SUBMITTED TO: MS. FINEZA

What is Filariasis ?

Filariasis is a tropical disease spread through filarial worms. It is most commonly seen in the tropical areas of Africa, Asia, and Central and South America. It is believed that cases of filariasis have been around for approximately 4000 years. There are even artifacts from the ancient Egyptians depicting the disease. Filariasis is a serious condition that is usually not noticed until the adult worms die. Although the disease is usually not deadly, it can cause permanent damage to the lymphatic system, kidneys, or any other body part that has been affected by the condition. The cause of filariasis is filarial nematode worms. There are eight varieties of filarial worms that cause filariasis, divided into three types based on which areas of the body they affect, either the tissues and skin, the lymphatic system, or the stomach, lungs, and heart. Filarial worms have a complicated lifespan, being first born in a human host, and then removed from the human through a mosquito or other blood-sucking bug. Finally, the mature larvae are inserted into a new host when the insect feeds again.

Lymphatic filariasis is the most common strain of this disease. It usually affects the lower half of the body, resulting in thick, swollen limbs and, in men, mutated genitalia. Called elephantitis, this condition, if left untreated, can drastically deform the infected individuals until their lower halves

are unrecognizable as human. Other forms of filariasis can result in blindness, rashes, abdominal pain, or arthritis-like symptoms. Filariasis can be difficult to diagnose. Because the worms are nocturnal, they only show up in blood drawn at night. After a blood test has confirmed the presence of filarial worms, medications can be used to get rid of the worms. Albendazole and Ivermectin are two of the most common medications used as treatment. Antibiotics, such as doxycycline, can be used to kill the bacteria that live inside the worms, which will also kill the worms. There are ongoing efforts to eradicate filarial worms permanently, preventing millions of infestations every year. The Global Program to Eliminate LF is an organization focused on developing ways to treat and prevent additional cases of filariasis, and has already prevented millions of infections, mostly in children. Because the disease is commonly found in poverty stricken areas that are usually lacking adequate health care, developing a vaccination that can be cheaply and easily distributed may be the best chance to stop the further spread of filariasis.

What is Diarrhea ? Diarrhea is loose, watery stools. Having diarrhea means passing loose stools three or more times a day. Acute diarrhea is a common problem that usually lasts 1 or 2 days and goes away on its own. Diarrhea lasting more than 2 days may be a sign of a more serious problem. Chronic diarrhea diarrhea that lasts at least 4 weeksmay be a symptom of a chronic disease. Chronic diarrhea symptoms may be continual or they may come and go. Diarrhea of any duration may cause dehydration, which means the body lacks enough fluid and electrolyteschemicals in salts, including sodium, potassium, and chlorideto function properly. Loose stools contain more fluid and electrolytes and weigh more than solid stools. People of all ages can get diarrhea. In the United States, adults average one bout of acute diarrhea each year,1 and young children have an average of two episodes of acute diarrhea each year.

What causes diarrhea? Acute diarrhea is usually caused by a bacterial, viral, or parasitic infection. Chronic diarrhea is usually related to a functional disorder such as irritable bowel syndrome or an intestinal disease such as Crohns disease.

The most common causes of diarrhea include the following: y Bacterial infections. Several types of bacteria consumed through contaminated food or water can cause diarrhea. Common culprits includeCampylobacter, Salmonella, Shigella, and Escherichia coli (E. coli). y Viral infections. Many viruses cause diarrhea, including rotavirus, norovirus, cytomegalovirus, herpes simplex virus, and viral hepatitis. Infection with the rotavirus is the most common cause of acute diarrhea in children. Rotavirus diarrhea usually resolves in 3 to 7 days but can cause problems digesting lactose for up to a month or longer. y Parasites. Parasites can enter the body through food or water and settle in the digestive system. Parasites that cause diarrhea include Giardia lamblia, Entamoeba histolytica, and Cryptosporidium. y Functional bowel disorders. Diarrhea can be a symptom of irritable bowel syndrome. y Intestinal diseases. Inflammatory bowel disease, ulcerative colitis, Crohns disease, and celiac disease often lead to diarrhea. y Food intolerances and sensitivities. Some people have difficulty digesting certain ingredients, such as lactose, the sugar found in milk and milk products. Some people may have diarrhea if they eat certain types of sugar substitutes in excessive quantities. y Reaction to medicines. Antibiotics, cancer drugs, and antacids containing magnesium can all cause diarrhea.

What other symptoms accompany diarrhea? Diarrhea may be accompanied by cramping, abdominal pain, nausea, an urgent need to use the bathroom, or loss of bowel control. Some infections that cause diarrhea can also cause a fever and chills or bloody stools. Dehydration Diarrhea can cause dehydration. Loss of electrolytes through dehydration affects the amount of water in the body, muscle activity, and other important functions. Dehydration is particularly dangerous in children, older adults, and people with weakened immune systems. Dehydration must be treated promptly to avoid serious health problems, such as organ damage, shock, or comaa sleeplike state in which a person is not conscious. Signs of dehydration in adults include
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thirst less frequent urination than usual dark-colored urine

dry skin fatigue dizziness light-headedness

Signs of dehydration in infants and young children include

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dry mouth and tongue no tears when crying no wet diapers for 3 hours or more sunken eyes, cheeks, or soft spot in the skull high fever listlessness or irritability

How is the cause of diarrhea diagnosed? If acute diarrhea lasts 2 days or less, diagnostic tests are usually not necessary. If diarrhea lasts longer or is accompanied by symptoms such as fever or bloody stools, a doctor may perform tests to determine the cause. Diagnostic tests to find the cause of diarrhea may include the following: y Medical history and physical examination. The doctor will ask about eating habits and medication use and will perform a physical examination to look for signs of illness. y Stool culture. A sample of stool is analyzed in a laboratory to check for bacteria, parasites, or other signs of disease and infection. y Blood tests. Blood tests can be helpful in ruling out certain diseases. y Fasting tests. To find out if a food intolerance or allergy is causing the diarrhea, the doctor may ask a person to avoid foods with lactose, carbohydrates, wheat, or other ingredients to see whether the diarrhea responds to a change in diet. y Sigmoidoscopy or colonoscopy. These tests may be used to look for signs of intestinal diseases that cause chronic diarrhea. For sigmoidoscopy, the doctor uses a thin, flexible, lighted tube with a lens on the end to look at the inside of the rectum and lower part of the colon. Colonoscopy is similar to sigmoidoscopy, but it allows the doctor to view the entire colon.

How is diarrhea treated? In most cases of diarrhea, the only treatment necessary is replacing lost fluids and electrolytes to prevent dehydration. Over-the-counter medicines such as loperamide (Imodium) and bismuth subsalicylate (Pepto-Bismol and Kaopectate) may help stop diarrhea in adults. However, people with bloody diarrheaa sign of bacterial or parasitic infectionshould not use these medicines. If diarrhea is caused by bacteria or parasites, over-the-counter medicines may prolong the problem, so doctors usually prescribe antibiotics instead. Medications to treat diarrhea in adults can be dangerous for infants and children and should only be given with a doctors guidance. Eating, Diet, and Nutrition Until diarrhea subsides, avoiding caffeine and foods that are greasy, high in fiber, or sweet may lessen symptoms. These foods can aggravate diarrhea. Some people also have problems digesting lactose during or after a bout of diarrhea. Yogurt, which has less lactose than milk, is often better tolerated. Yogurt with active, live bacterial cultures may even help people recover from diarrhea more quickly. As symptoms improve, soft, bland foods can be added to the diet, including bananas, plain rice, boiled potatoes, toast, crackers, cooked carrots, and baked chicken without the skin or fat. For children, the health care provider may also recommend a bland diet. Once the diarrhea stops, the health care provider will likely encourage children to return to a normal and healthy diet if it can be tolerated. Infants with diarrhea should be given breast milk or full-strength formula as usual,

along with oral rehydration solutions. Some children recovering from viral diarrheas have problems digesting lactose for up to a month or more. Can diarrhea be prevented? Two types of diarrhea can be preventedrotavirus diarrhea and travelers diarrhea. Rotavirus Diarrhea Two oral vaccines have been approved by the U.S. Food and Drug Administration to protect children from rotavirus infections: rotavirus vaccine, live, oral, pentavalent (RotaTeq); and rotavirus vaccine, live, oral (Rotarix). RotaTeq is given to infants in three doses at 2, 4, and 6 months of age. Rotarix is given in two doses. The first dose is given when infants are 6 weeks old, and the second is given at least 4 weeks later but before infants are 24 weeks old.

Travelers Diarrhea To prevent travelers diarrhea, people traveling from the United States to developing countries should avoid
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drinking tap water, using tap water to brush their teeth, or using ice made from tap water drinking unpasteurized milk or milk products eating raw fruits and vegetables, including lettuce and fruit salads, unless they peel the fruits or vegetables themselves

eating raw or rare meat and fish eating meat or shellfish that is not hot when served

eating food from street vendors Travelers can drink bottled water, soft drinks, and hot drinks such as coffee or tea. People concerned about travelers diarrhea should talk with a health care provider before traveling. The health care provider may recommend that travelers bring medicine with them in case they develop diarrhea during their trip. Health care providers may advise some people especially people with weakened immune systemsto take antibiotics before and during a trip to help prevent travelers diarrhea. Early treatment with antibiotics can shorten a bout of travelers diarrhea.
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