13/05/2020
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Malaria is caused by Plasmodium parasites that are spread to people through the bites of infected
Anopheles mosquito vectors. Of the 5 parasite species that cause malaria in humans,
Plasmodium falciparum is the most deadly.
Pregnant women are at high risk of dying from the complications of severe malaria. Malaria is also a cause of spontaneous abortion, premature
delivery, stillbirth and severe maternal anaemia,
and is responsible for about one third of
preventable low-birth-weight babies.
WHO recommends intermittent preventive
treatment for pregnant women living in areas of
high malaria transmission.
Clinical Manifestations :-
Pts initially develop nonspecific symptoms (e.g.,
headache, fatigue, myalgias) that are followed by
fever.
• Febrile paroxysms at regular intervals are
unusual and suggest infection with P. v ivax or P.
ovale.Splenomegaly, hepatomegaly, mild anemia, and
jaundice may develop.
• The diagnosis of severe falciparum malaria
requires ≥1 of the following: impaired
consciousness/coma, severe normocytic anemia,
renal failure, pulmonary edema, ARDS, circulatory
shock, DIC, spontaneous bleeding, acidosis,
hemoglobinuria, jaundice, repeated generalized
convulsions, and a parasitemia level of >5%.
– Cerebral malaria manifests as diffuse
symmetric encephalopathy, typically without focal
neurologic signs.
– Coma is an ominous sign associated with
mortality rates of ~20%.
• Pregnant women have unusually severe illness.
Premature labor, fetal distress, stillbirth, and
delivery of low-birth-weight infants are common. Tropical splenomegaly (hyperreactive malarial
splenomegaly) may result as a chronic
complication of malaria and is characterized by
massive splenomegaly, hepatomegaly, and an
abnormal immunologic response to infection.
Diagnosis:-
• Thick and thin smears should be examined;
thick smears and the less sensitive thin smears
detect parasitemia levels as low as 0.001% and
~0.05%, respectively.