Evolution of Malaria

by

QUESTION

how did malaria evolve?

ANSWER

Malaria in humans probably evolved independently several times, and both times likely due to a cross-over event from a closely related primate malaria. For example, Plasmodium vivax is evolutionarily closely related to several species of malaria found in macaque monkeys in south-east Asia, and so a cross-over of one of those species into human, with subsequent adaptation and speciation, is one hypothesis as to the origin of P. vivax. Conversely, some people argue that P. vivax emerged in Africa, due to the high prevalence of certain genetic traits in African populations (such as the Duffy negative antigen), which protect against P. vivax.

In contrast, P. falciparum is agreed to have emerged in sub-Saharan Africa, and likely in the Congo basin, though the exact source of its origin has been under recent scientific dispute. Until 2010, it was thought that P. falciparum had crossed over to humans from chimpanzees, as chimps are known to be infected with P. reichenowi, a species very closely related to P. falciparum. However, a paper was published in 2010 which had sampled Plasmodium parasites of gorillas and revealed new species of Plasmodium which are even more closely related to P. falciparum, suggesting that the cross-over occurred from gorillas to humans.

As you can see, humans are not the only primates to get malaria; many species of monkey and ape are also susceptible to Plasmodium species, and even lemurs have their own suite of Plasmodium parasites. Among the mammals, rodents also can get malaria, and bats are infected with Hepatocystis, a malaria-like parasite which also infects hippos, primates and rodents. However, no other species of mammal appears to be susceptible to Plasmodium/Hepatocystis, and the reasons for this are not entirely clear.

Plasmodium probably crossed over to mammals from birds or lizards, both of which are infected with a vast number of species of Plasmodium. It is unclear in which of these groups Plasmodium first emerged, though it likely evolved originally from another type of blood-borne parasite called Leucocytozoon, which infects birds and uses blackflies (genus Simulium) as vectors.

A sister group to Plasmodium, called Haemoproteus, also evolved from Leucocytozoon but utilises a variety of different vectors, including mosquitoes, biting midges (Culicoides), louse flies (Hippoboscidae) and tabanids (Tabanidae). Plasmodium, by contrast, exclusively uses mosquitoes as its vectors (apart from one species of lizard Plasmodium, P. mexicanum, which uses sandflies), but while mammalian Plasmodium is only transmitted by Anopheles mosquitoes, bird and lizard Plasmodium can be transmitted by Culex, Aedes, Culiseta, Anopheles, Mansonia and Psorophora. As such, understanding the patterns of vector and host switches within Plasmodium and related taxa can actually provide interesting insights into the genus’ evolutionary history.

Dangerous

by

QUESTION

Why malaria so dangerous?

ANSWER

Malaria can be dangerous for a number of different reasons, some of which relate to each other. First of all, there are five different types of malaria that infect humans, and each varies in terms of its severity and potential for severe consequences. Even within these types, the severity of the disease caused (termed “virulence” by scientists and doctors), can even vary by strain or geography. Generally, the most dangerous form of malaria is caused by Plasmodium falciparum. One reason why this species of malaria is so dangerous is that is replicates very quickly in the blood. This means that infection levels can build up very quickly; if a person infected with P. falciparum does not get diagnosed and treated within a few days of feeling sick, the infection can progress to a point where the disease becomes very severe. This rapid accumulation of infection is also observed with P. knowlesi, a much rarer form of malaria found in south-east Asia. The parasites of P. knowlesi have a 24-hour reproductive cycle in the blood, the quickest for any type of malaria that infects humans. However, P. falciparum also has other characteristics which make it even more dangerous, and which do not occur with P. knowlesi. For example, when P. falciparum infects red blood cells, it causes their shape to change, and makes them “sticky”. This stickiness causes the red blood cells to become lodged in the blood vessels leading in to major organs, in a process known as sequestration. Sequestration creates blockages of these blood vessels, reducing blood flow and resulting in oxygen deprivation. When this process occurs in the blood vessels in the brain, the outcome is known as cerebral malaria, characterised by impaired consciousness, coma and even death. It is this pathology which is associated with most cases of severe malaria, and causes the most number of deaths.

However, if treated promptly with the correct drugs, even P. falciparum malaria is usually easily controlled. Therefore, one of the additional reasons why malaria is so dangerous is that in many places, and particularly sub-Saharan Africa, people do not have access to medication, or not the right types of medication. Many strains of P. falciparum have become resistant to chloroquine, once the first line treatment for malaria, and so this drugs is now ineffective in many cases. Instead, the World Health Organisation recommends now that artemisinin-based combination therapies (ACTs, such as Coartem) should be given as first-line treatment against all uncomplicated malaria, to prevent additional resistance from developing.

Thalassaemia and Malaria

by

QUESTION

How can Thalassaemia effect Malaria infection?

ANSWER

Thalassaemia is the name given to a group of inherited genetic blood disorders, which result in reduced or no synthesis of one of the globin protein chains that combine to make haemaglobin. Haemaglobin is used to carry oxygen throughout the body and to its organs.

Thalassaemia can result in anaemia; in some cases, this is severe enough to require periodic blood transfusions. There has long been a hypothesis that thalassaemia might have persisted due to conveying protection against malaria infection; this was suggested due to the geographical distributions of populations with high prevalence of the alleles (gene types) that cause thalassaemia and areas with high levels of malaria transmission. However, scientifically confirming this association has proved challenging.

A recent study from Kenya demonstrated that children with either one copy of the thalassaemia allele or two copies appeared to have a reduced incidence of severe malaria, fewer deaths from malaria and were hospitalized less frequently for malaria. However, they were just as likely as non-thalassaemic children to have mild or sub-clinical malaria, and the same levels of parasitaemia (numbers of parasites in the blood).

A contrasting study from Vanuatu observed higher incidences of severe malaria in children with thalassaemia, though one potential confounding factor in comparing these studies is that the Vanuatu study looked at both P. falciparum and P. vivax, whereas the Kenya study only looked at P. falciparum malaria.

The difference is significant: one of the proposed mechanisms by which thalassaemia protects against malaria is by preventing modification of the surface of red blood cells, which causes the red blood cells to become “sticky” and sequester within the blood vessels that feed major organs, eventually restricting blood flow and causing major complications. This sequestration is only observed to occur during infection with P. falciparum, and so thalassaemia might not be as protective against other forms of malaria. More empirical research from the field is needed to understand the mechanisms relating malaria infection with thalassaemia more fully.

Malaria Parasite Picture

by

QUESTION

Please show parasites pictures.

ANSWER

The first plate below shows various stages of the life cycle of Plasmodium falciparum, the most deadly form of malaria, and the most commonly found type in sub-Saharan Africa. Below that, a similar plate shows a series of images of Plasmodium vivax, the most widespread type of malaria.

A: The stages of P. falciparum. 1: Normal red cell; Figs. 2-18: Trophozoites (among these, Figs. 2-10 correspond to ring-stage trophozoites); Figs. 19-26: Schizonts (Fig. 26 is a ruptured schizont); Figs. 27, 28: Mature macrogametocytes (female); Figs. 29, 30: Mature microgametocytes (male). Illustrations from: Coatney GR, Collins WE, Warren M, Contacos PG. “The Primate Malarias”. Bethesda: U.S. Department of Health, Education and Welfare; 1971. Reproduced here courtesy of the CDC (www.cdc.gov)

 

 

Frequent Urination and Malaria

by

QUESTION

Can malaria result in frequent urination, especially during night?

ANSWER

Malaria can affect the kidneys, especially malaria caused by P. falciparum. This could result in changes to urination patterns. However, at this stage in the infection, the patient would also be experiencing severe fever, chills and other symptoms associated with malaria. The fever would also likely be causing dehydration if the patient was not taking on sufficient fluids, which would result in less frequent urination.

Malaria Recovery Time

by

QUESTION

How long does it take to recover from malaria?

ANSWER

A number of different factors affect recovery time from malaria. These include the type of malaria, how quickly treatment is administered and the immune status of the patient. For example, children and pregnant women tend to get much more severe cases of malaria, due to their reduced natural immunity. 

The type of malaria will impact on the severity and length of the infection as well—P. falciparum is the most severe kind, and can result quickly in death if not treated promptly, whereas less rapidly progressing forms of malaria, such as P. malariae, may persist for longer but not cause severe disease. For most cases of uncomplicated malaria, once the appropriate form of treatment is started, the patient will start to recover within a couple of days.

Malaria in the Brain

by

QUESTION

I would like to know how dangerous is malaria in the brain?

ANSWER

Only a certain kind of malaria, Plasmodium falciparum, is usually associated with causing problems in the brain. The P. falciparum parasite infects red blood cells and changes their surface structure, causing them to become “sticky”. These sticky red blood cells become lodged in the small blood vessels that flow through organs, causing blockages and reducing oxygen flow.

When this process occurs in the brain, the result is called “cerebral malaria”, and can result in impaired consciousness, coma and even death. As such, once malaria-infected blood passes into the brain, it can be very dangerous. Luckily, however, if people are diagnosed promptly and given treatment, it is usually possible to stop the progression of P. falciparum malaria before it enters the brain, allowing for a swift and uncomplicated recovery.

Blood Transfusion and Malaria

by

QUESTION

Do people need to receive blood if they get malaria?

ANSWER

Usually not. Most cases of malaria are uncomplicated and are treated using oral antibiotics. However, if the disease progresses sufficiently and the patient is not promptly treated, it can become more severe. This is particularly true for infection with Plasmodium falciparum malaria, which can lead to impaired consciousness, coma and even death. In these severe cases, maintaining the patient’s balance of fluids, electrolytes and blood pressure is crucial, and so administration of plasma or blood might be required.

Symptoms and Causes of Malaria

by

QUESTION

What are the symptoms and causes of malaria?

ANSWER

Malaria is caused by a parasite called Plasmodium, which is transmitted via the bites of infected mosquitoes. In the human body, the parasites multiply in the liver, and then infect red blood cells. Usually, people get malaria by being bitten by an infective female Anopheles mosquito. Only Anopheles mosquitoes can transmit malaria and they must have been infected through a previous blood meal taken on an infected person. When a mosquito bites an infected person, a small amount of blood is taken in which contains microscopic malaria parasites. About 1 week later, when the mosquito takes its next blood meal, these parasites mix with the mosquito’s saliva and are injected into the person being bitten.

Because the malaria parasite is found in red blood cells of an infected person, malaria can also be transmitted through blood transfusion, organ transplant, or the shared use of needles or syringes contaminated with blood. Malaria may also be transmitted from a mother to her unborn infant before or during delivery (“congenital” malaria).

There are five kinds of malaria known to infect humans: Plasmodium falciparum, P. vivax, P. ovale, P. malariae and P. knowlesi. The symptoms of malaria differ depending on the type of malaria; P. falciparum  is the most deadly and severe form of the disease. General symptoms of malaria include  include fever and flu-like illness, including shaking chills, headache, muscle aches, and tiredness. Nausea, vomiting, and diarrhea may also occur. Malaria may cause anemia and jaundice (yellow coloring of the skin and eyes) because of the loss of red blood cells.

Symptoms usually appear between 10 and 15 days after the mosquito bite. If not treated, malaria can quickly become life-threatening by disrupting the blood supply to vital organs.

What are the causes of malaria?

by

QUESTION

What are the causes of malaria?

ANSWER

Malaria is caused by a parasite called Plasmodium, which is transmitted via the bites of infected mosquitoes. In the human body, the parasites multiply in the liver, and then infect red blood cells. Usually, people get malaria by being bitten by an infective female Anopheles mosquito. Only Anopheles mosquitoes can transmit malaria and they must have been infected through a previous blood meal taken on an infected person. When a mosquito bites an infected person, a small amount of blood is taken in which contains microscopic malaria parasites. About 1 week later, when the mosquito takes its next blood meal, these parasites mix with the mosquito’s saliva and are injected into the person being bitten.

Because the malaria parasite is found in red blood cells of an infected person, malaria can also be transmitted through blood transfusion, organ transplant, or the shared use of needles or syringes contaminated with blood. Malaria may also be transmitted from a mother to her unborn infant before or during delivery (“congenital” malaria).

There are five kinds of malaria known to infect humans: Plasmodium falciparum, P. vivax, P. ovale, P. malariae and P. knowlesi.