Term
| what % of malaria deaths occur in sub saharan africa? |
|
Definition
93%
67% occur in children <5 |
|
|
Term
| which mosquito spreads malaria? |
|
Definition
| Female anopheles mosquito |
|
|
Term
| How many species of malaria affecting humans are there? |
|
Definition
5 species.
P falciparum
P vivax
P ovale
P malarie
P knowlesi |
|
|
Term
| which malria species have a liver hypnozoite stage? |
|
Definition
Vivax and Ovale
Treat with addition of primaquine. |
|
|
Term
p malarie asexual cycle lasts 72hours. This means fever presents every??
what is this known as? |
|
Definition
3rd day
Quartan fever.
asexual cycle is 72 hours |
|
|
Term
| Tertan fever includes which malaria species? |
|
Definition
Falciparum
Ovale
Vivax
Asexual cycle 48 hours |
|
|
Term
| How often do you get fever with P knowelsi? |
|
Definition
| Asexual cycle lasts 24 hours therefore capable of very rapid increases in parasitaemia. |
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|
Term
|
Definition
|
|
Term
ARDS
coma
seizures
hypoglycaemia
pulmonary oedema
are all manifestations of...... |
|
Definition
|
|
Term
| risks of having malaria during pregnancy? |
|
Definition
maternal aneamia
risk of severe malaria
foetal growth retardation
stillbirth |
|
|
Term
| duration of incubation period in liver for malaria? |
|
Definition
|
|
Term
| Gold standard for malaria diagnosis? |
|
Definition
Thick and thin blood smears.
in the absence of microscopy RDT can be used. |
|
|
Term
| Rx for P falciparum malaria? |
|
Definition
ACT artemisinin-combination therapy
e.g Artemether and Lumefantrine. |
|
|
Term
| prophylaxis options for malaria |
|
Definition
bed nets
Atovaquone-proguanil (Malarone)
Mefloquine (Lariam)
Doxycycline |
|
|
Term
| widespread resistance to ACT is reported. Which part of the combination does resistance rise to? |
|
Definition
| the artemisinin part. therefore the combo therapy is still useful. |
|
|
Term
| how can you get false negatives on RDT kits? |
|
Definition
| emergence of parasites who lack the protein HRP2. |
|
|
Term
| acquisition of malaria immunity leads to tolerance of infection.. what is this aka? |
|
Definition
|
|
Term
| define premunition in relation to malaria infecion |
|
Definition
| where acquisition of malaria immunity leads to tolerance of infection. |
|
|
Term
|
Definition
West africa
AO - lets go!
africa/ovale |
|
|
Term
|
Definition
worldwide but most commonly asia
AV node
Asia/vivax |
|
|
Term
| which malaria species mimics p malarie on microscopy? |
|
Definition
|
|
Term
| distribution of P malarie? |
|
Definition
Worldwide
10% occur > 1 year after infection |
|
|
Term
| out of thick and thin which is most sensitive? |
|
Definition
Thick film most sensitive
RBD are lysed
Requires expertise. |
|
|
Term
| In which malaria film would you find full blood cells? |
|
Definition
|
|
Term
| rx of malaria in pregnancy 1st trimester? |
|
Definition
| Quinine and clindamycine 7/7 |
|
|
Term
| rx of malaria 2nd and 3rd trimester? |
|
Definition
|
|
Term
| rx of severe disease malaria in pregnancy? |
|
Definition
|
|
Term
| why should you avoid artemisinines in 1st trimester? |
|
Definition
| teratogenic in rats and rabbits. |
|
|
Term
| how to reduced mortality and morbidity from malaria in high risk groups? |
|
Definition
Intermittent presumptive therapy (IPT)
This is a WHO policy in malaria endemic countries. |
|
|
Term
| malaria infected female anopheles injects ........ into human host |
|
Definition
sporozoites.
These infect liver cells and mature into schizonts. |
|
|
Term
| schizonts rupture and release.... |
|
Definition
merozoites.
Merozoites infect RBCs and differentiate into immature trophozoites that mature into merozoites again.
Others differntiate into gameteocytes. |
|
|
Term
| Describe malaria life cycle in host |
|
Definition
| Mosquito innoculates spherozoite into human > liver schizont > ruptures to merozoite > infectes RBCs > trophozoite to merozoite again or trophozoite to gameteocyte. |
|
|
Term
| Describe malaria life cycle in anopheles |
|
Definition
| Mosquito takes up micro and macro gameteocytes > micro penetrates macro and become zygote > ookinetes > oocysts > sporozoites > salivary glands |
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|
Term
| how to get a who certificate of malaria elimination? |
|
Definition
| No indigenous cases of malaria for 3 consecutive years. |
|
|
Term
| side effect of mefloquine? |
|
Definition
psychosis
depression
insomnia
seizures. |
|
|
Term
|
Definition
| prevalence of blood stage infections |
|
|
Term
|
Definition
| proportions of individuals with palpable spleen |
|
|
Term
| define entomological innoculation rate |
|
Definition
| number of infected bites per year. |
|
|
Term
| how does sickle cell trait prevent development of high parasitaemia? |
|
Definition
| parasitised cells sickle in circulation and are removed by spleen before they can develop into schizonts. |
|
|
Term
| pt lacking duffy blood group Ag are protected from which malaria? |
|
Definition
P vivax
The parasite is unable to penetrate rbc lacking Duffy blood group antigen. |
|
|
Term
| main adverse effect of cholorquine? |
|
Definition
|
|
Term
| what dots might you see in P falciparum blood film? |
|
Definition
|
|
Term
| What is the equivalent of maurer dots you may see in P vivax/ovale microscopy? |
|
Definition
|
|
Term
| Is leishmania an intra or extra cellular parasite? |
|
Definition
|
|
Term
| Visceral leishmaniasis AKA |
|
Definition
|
|
Term
| L braziliensis causes which types of leishmania? |
|
Definition
|
|
Term
| L donovania causes which type of leishmania? |
|
Definition
|
|
Term
| L infantum/chagasi causes which type of leishmania? |
|
Definition
|
|
Term
| which vector spreads leishmania? |
|
Definition
Female Lutzomyia sandfly new world
Old world: Phlebotomus sandfly |
|
|
Term
| when female sandfly takes a blood meal what form of Leishmania does she inject? |
|
Definition
Leishmania promastigotes.
These are phagocytosed by macrophages where they evolve and multiply in cells. |
|
|
Term
| Symptoms of visceral leishmaniais |
|
Definition
Fever, weight loss.
Splenomegaly > hepatomegaly
Epistaxis.
Lymphadenopathy. |
|
|
Term
| In Post Kala Azar Dermal Leish why are the lesions important resevoirs for infections? |
|
Definition
| They are loaded with amastigotes |
|
|
Term
|
Definition
some regions it can resolve w/o rx
treated same as VL
it is treated as part of elimination programme or for cosmetic reasons. |
|
|
Term
| Diffuse cutaneous leishmania is a complication of which leish species? |
|
Definition
|
|
Term
| Which leishmania is a rare form of disease seen in Syria/Iran/Iraq that causes recurrent facial lesions that can persist for decades? |
|
Definition
|
|
Term
| How is leishmaniasis diagnosed? |
|
Definition
Molecular PCR
Cutaneous skin smear
Needle biopsy of lesion
Biopsy from spleen/bone marrow/liver/lymph nodes
Serology methods for VL donovani rK39 rapid test |
|
|
Term
| Rx duration for cutaneous and mucocutaneous/visceral lesih? |
|
Definition
2 weeks cutaneous
4 weeks mucosal/visceral |
|
|
Term
| parenteral rx options for leishmaniasis |
|
Definition
Sodium stibogluconate or
meglumine antimonate |
|
|
Term
| Which forms of leishmania can be treated with Liposomal amphotericin B? |
|
Definition
All 3 types
Given typically for 1-2 weeks. |
|
|
Term
| which aminoglycoside is an option for VL? |
|
Definition
| Paromomycin given IM for 3/52 |
|
|
Term
| PO Rx options in leishmaniasis |
|
Definition
Miltefosine
Used for all 3 leishmania in non-pregnant population. |
|
|
Term
|
Definition
Vector control - IRS, ITN, PPE
Disease surveillance
Control resevoir hosts
L infantum in europe - dogs main resevoir
insect repellant dog collars
L donovani in india - early rx of PKDL controls human resevoirs. |
|
|
Term
| main method for control and rx of leishmania? |
|
Definition
|
|
Term
| sodium stiboglucunate used to rx |
|
Definition
leismania
given IV
up 28/7 course
S/E nausea abdominal pain |
|
|
Term
| meglumin antimoniate used to rx? |
|
Definition
|
|
Term
| list WHOs 5 pronged approach for leishmania control |
|
Definition
Facilitate early dx and prompt rx
Control sandfly populations via IRS and ITN
Health education and training
Detect and contain epidemics in early stages
Early dx and effective mx of leishmania/HIV co-infection |
|
|
Term
| l infantum and l chagasi. Are they the same species? |
|
Definition
Yes.
L infantum old world
L chagasi new world
they cause VL |
|
|
Term
| Can VL be cured spontaneously? |
|
Definition
No
It is fatal if left untreated. |
|
|
Term
| mucocutaneous leishmania caused by? |
|
Definition
|
|
Term
| diffuse cutaneous leishmania caused by? |
|
Definition
L mexicana or
L aethiopica |
|
|
Term
| where are metacyclic promastigotes found? |
|
Definition
| In the sandflies probiscus. This is the infective form. |
|
|
Term
| Out of the procyclic and metacyclic promastigote, which one has a bigger cell body and which one is infective? |
|
Definition
Procyclic promastigote has larger cell body and found in midgut. Not infectious.
Metacyclic promastigote has smaller cell body but more prominent flagellum. It is the infectious form and found in sandfly probiscus. |
|
|
Term
| Gold standard for diagnosis Leishmania? |
|
Definition
Observe parasites in biopsy material.
can be done via smear or needle biopsy. |
|
|
Term
| how are sandfly parasites not harmed by macrophages? |
|
Definition
| sandfly saliva inhibits L arginine dependant nitric oxide killing mechanism of macrophages. |
|
|
Term
| how many species of leishmania can cause human disease? |
|
Definition
|
|
Term
|
Definition
Sodium stiboglucunate or
liposomal amphotericin B |
|
|
Term
| What is anthroponotic transmission? |
|
Definition
|
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