MALARIA
Malaria is a mosquito-borne disease caused by a
parasite. People with malaria often experience
fever, chills, and flu-like illness. Left untreated,
they may develop severe complications and
results in death
Pathophysiology
• The natural history of malaria involves cyclical infection of humans
and female Anopheles mosquitoes.
• In humans, the parasites grow and multiply first in the liver cells
and then in the red cells of the blood.
• In the blood, successive broods of parasites grow inside the red
cells and destroy them, releasing daughter parasites (“merozoites”)
that continue the cycle by invading other red cells.
• The blood-stage parasites are those that cause the symptoms of
malaria; when certain forms of blood stage parasites (gametocytes,
which occur in male and female forms) are ingested during
blood feeding by a female Anopheles mosquito, they mate in the
gut of the mosquito and begin a cycle of growth and multiplication
in the mosquito.
Pathophysiology
• After 10-18 days, a form of the parasite called
a sporozoite migrates to the
mosquito’s salivary glands.
• When the Anopheles mosquito takes a blood
meal on another human, anticoagulant saliva
is injected together with the sporozoites,
which migrate to the liver, thereby beginning a
new cycle.
Pathophysiology
• Thus the infected mosquito carries the disease
from one human to another (acting as a
“vector”), while infected humans transmit the
parasite to the mosquito.
• In contrast to the human host, the mosquito
vector does not suffer from the presence of
the parasites.
Clinical manifestation of malaria
• High fever
• Shaking chills that can range from moderate to
severe
• Profuse sweating
• Headache
• Abdominal pain
• Muscle pain
• Nausea
• Vomiting
• Diarrhea
Clinical manifestation of malaria
• Anemia
• Deep breathing and respiratory distress
• Clinical jaundice and evidence of vital organ
dysfunction
• Impaired consciousness
• Bloody stools
• Convulsions
• Coma
Diagnostic investigation
• History and physical examination
• Blood film for malaria parasite
• Rapid diagnostic test
Nursing Interventions
• Nursing interventions for a patient with malaria include the
following:
• Improve body temperature. Warm water compress on
forehead and both axilla (not more than 15 minutes each
time); maintain warm environment by using warm blankets,
adequate clothing); patient may sweat excessively, make
sure to avoid exposing patient to wet clothes and linens;
administration of antipyretic drugs as ordered.
• Improve tissue perfusion. Patient may need supplemental
oxygen if condition is severe; maintain a well-ventilated
room; head of the bed at 30º.; lessen activities that require
moderate to high exertion.
Nursing Interventions
• Improve fluid volume. Expect loss of fluid through sweat;
provide information about fluid balance and guideline for
fluid replacement; encourage increase in oral fluid intake;
administer parenteral fluids as ordered.
• Educate the patient and family. Review the disease process
and therapy, focusing on patient’s concerns; discuss
importance of adhering to therapy; go over medication,
purpose, frequency, dosage, and side effects; have a family
member or trusted individual listen to and understand
guideline of treatment as the patient chooses.
• Administer Prescribe medication
• Monitor patient response to treatment
• Monitor patient for complication
Medical management
• Artemisinin based combination therapy (ACT)
• Artesunate Amodiaquine
• Dihydroartemisinin piperaquine
Complication of malaria
• Anemia
• Cerebral malaria
• Acute encephalitis
• Hypoglycemia
• Renal failure
• Spleenomegaly
• Coma and death
Prevention 0f malaria
• Vector control
• Early recognition, diagnosis and treatment of
cases
• Wearing of long sleeves shirt and trousers at
night
• Sleeping under an insecticide treated bed net