Life Cycle of Malaria

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QUESTION

Why does the malaria parasite first enter the liver?

ANSWER

The malaria parasite enters the liver in order to transform from a sporozoite (which can infect liver cells) to a merozoite, which is capable of infecting red blood cells. Both stages also include a proliferation step, but in the blood, the merozoites are also able to differentiate into gametocytes, which are then taken back up by a mosquito during a blood meal, allowing the malaria parasite to continue its life cycle. If the red blood cell stage were first, followed by the liver, then it would be much harder for the gametocytes to be able to reach a new mosquito host, unless they were to enter the blood a third time.

The blood is also a difficult place for a parasite to survive, since it is the highway of the immune system, whereas the parasite is less easily destroyed when it is hiding out in the hepatocyte cells in the liver. It is also important to note that Plasmodium has a long evolutionary history, and may in some parts of its life cycle be constrained by physiological or life history characteristics of its evolutionary forebears, which may also contribute to our perception of the life cycle as being very complex!

Malaria Symptoms Flash Back

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QUESTION

I got cerebral malaria in Uganda in 1988. Upon returning to the US I was part of an on-going study through the CDC for a couple years. During that time I had recurrence of what appeared to be an 8-10 hour relapse of the severe body aches, disorientation, fever, chills etc. The tropical doctor that was following me informed me that with something as severe as cerebral malaria the brain can record the experience and periodically and randomly play it back kind of like an LSD flashback. I was tested on multiple occasions and the parasite was dead. This has happened to me every several years since 1988.

I had a recurrence of these malaria-like symptoms last night and this morning and by 10 am I felt fine. I looked online but could not find anything relating to this information of the brain replaying the symptoms. Can you let me know if this is common or true?

Thank you in advance.

ANSWER

Hi, that is a very interesting story! I personally have not heard of other cases where a patient experienced regular “flashbacks” and I have consluted one of our medical advisers, and he has not personally heard of other cases of malaria “flashbacks” either.

It might be worth checking up directly with the CDC to see if any other patients they followed experienced similar after effects.

Malaria Parasite

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QUESTION

1.classificaton
2.structure and size
3.life cycle
4.host range
5.effect on host
6.diagnosis of diseases(symptoms)
7.prevalence(statistics)of malaria cases in limpopo as from 2008-2011.
8.treatment and prevention (tradutional and modern methods) of the duseases
9.what socio-economic and environmental conditions contribute to the disease?

ANSWER

I have answered all of the above questions separately via your other recent posts to this forum – please search, either through scrolling through recent responses or using the search bar at the top of the page. Some of the questions, such as queries regarding diagnosis and symptoms, can be found under “Malaria Overview.”

Malaria Explained

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QUESTION

What is malaria?

ANSWER

Malaria is a serious and sometimes fatal disease caused by a parasite, of the genus Plasmodium, that commonly infects a certain type of mosquito (of the genus Anopheles) which feeds on humans. People who get malaria are typically very sick with high fevers, shaking chills, and flu-like illness. Four kinds of malaria parasites can infect humans: Plasmodium falciparum, P. vivax, P. ovale, and P. malariae. Infection with P. falciparum, if not promptly treated, may lead to death. Although malaria can be a deadly disease, illness and death from malaria can usually be prevented.

Malaria Mosquito Eggs

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QUESTION

Where do Anopheles mosquito lay their eggs?

ANSWER

Female Anopheles mosquitoes lay their eggs in standing, often stagnant, pools of fresh water. These larvae can be identified in ponds and puddles because unlike other mosquito larvae, they position themselves parallel with the surface of the water, allowing them to breathe air despite not having a respiratory siphon (instead, they have spiracles on their body).

Different species of Anopheles can tolerate very different larval habitats, including very brackish water (high salt content) in mangrove swamps and estuaries to pristine freshwater and also varying degrees of sun exposure and vegetative cover. Many different fish and aquatic invertebrates can predate on mosquito larvae, many of which have been used in attempts to control mosquito populations throughout the world.

Am I more susceptible to malaria?

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QUESTION

I contracted common malaria, vivax?, when i was 20 yrs old from long visit to Papua NewGuinea, 1970. Returned to USA and was treated with chloro, primaquine drugs and really no problems since treatment.

Now going to Thailand for week, Chiang Mai and region. If bitten by local malarial mosq. am i more likely to recur? And should I certainly choose prophylaxis? thnx

ANSWER

If you were treated successfully with chloroquine and primaquine then there is no reason for your malaria to reoccur. Since it has been a long time since you had malaria, you probably also don’t have any antibodies against the parasite in your system anymore; this just means you don’t have any extra immunity against P. vivax (which you might have done if you had returned to a malaria area, and particularly one with the same strain of P. vivax as that which infected you, within a few months or years of being infected the first time), but it doesn’t mean you will be any more susceptible than someone who never had malaria.

In terms of where you are going, the city of Chiang Mai itself is not considered to have malaria transmission, but the areas surrounding it are, particularly as you get closer to the Burmese border. As such, if you will be travelling in rural and/or forested areas, you might want to consider taking prophylactic medication (and other preventative measures, like sleeping under a long-lasting insecticide treated bednet).

Thailand unfortunately has seen the emergence of resistance to a couple widely used prophylactic measures, namely chloroquine and mefloquine (sold as Lariam), so these are not appropriate preventative medicine in this region. Instead, you should consider taking doxycycline or atovaquone-proguanil (sold as Malarone).

Malaria or Not?

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QUESTION

I went to Luanda, Angola and Port Hartcourt, Nigeria, Onne, Nigeria and Warri, Nigeria a few times. I suffer with voice problems, muscle control on my right side and some joint pains that have not been explained by my doctors.

I have been to doctors in Houston, Tx., New Orleans, La., New Iberia, La. and Franklin, La. and they all say the same thing. They don’t know what’s wrong with me. It maybe malaria that has laid dormant for nearly three years. I need to find out who can diagnose this for me and get me some help. My symptoms go back to 2009 with the balance being the first problem I noticed. The loss of my voice came later. I took off work for 5 months. Help me find someone close that might be able to help.

ANSWER

Although joint pains are associated sometimes with malaria infection, the most common symptoms are high fevers and chills—it would be unusual to suffer problems of with balance, the voice or muscle spasms.

A blood test is the only way to test for malaria for sure—this may be possible at a local travel clinic or any hospital which has a tropical medicine specialist.

I am not sure of any such exact clinics/hospitals in your area. However, I believe the CDC website has a list of local resources for tropical medicine. Otherwise, the CDC itself is located in Atlanta, GA, and they are certainly able to perform malaria testing, as well as give you advice as to whether you might be suffering from some other disease acquired internationally.

New Treatment for Malaria

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QUESTION

New treatment for malaria?

ANSWER

The most recently developed type of treatment for malaria actually has very ancient origins. The herb wormwood (Artemisia annua) has been used in ancient Chinese medicine for hundreds, even thousands, of years to cure certain fevers.

In the 1970s, a Chinese research program intensively sought new medications against malaria, as part of their Vietnam war effort. They re-discovered wormwood, and from it isolated the compound artemisinin, which is highly effective against malaria parasites in the blood, and kills them very quickly. Due to its quick action against malaria, there was concern that use of artemisinin alone would lead to resistance developing rapidly in the malaria parasite, as was seen with chloroquine in many parts of the world. As such, the World Health Organisation recommended that artemisinin should only be used in combination with another anti-malarial drug with a longer lasting action, to prevent resistance.

A number of such compounds, containing artemisinin derivatives and a second anti-malarial, have now been developed. These are collectively called “artemisinin-based combination therapies,” or ACTs. Some of the main artemisinin compounds used in these drugs are artemether, artesunate and dihydroartemisinin, and the brand names of the drugs as they are marketed (in combination with other compounds, such as lumefantrine, piperaquine and pyronaridine) include Coartem, Pyramax and Duo-Cotecxin.

How Many Affected by Malaria

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QUESTION

About how many people in the world are affected, die and survive malaria?

ANSWER

It has been estimated that about 3.3 billion people, or close to half the world’s population, is at risk of malaria infection at least at some point during the year. However, preventative measures mean that many fewer actually contract malaria in a given year—still, there are an estimated 216 million cases of malaria every year; of these, about 655,000 patients die. Most of these in children under the age of five, and most in sub-Saharan Africa.