Malaria

A) Malaria B) 1) Sporozoites are approximately 10 micrometers long; they implant themselves within the mouth of //Anopheles// mosquitos so that they can easily infect the hosts during a feeding.

2) When the sporozoites enter the blood stream, the first part of their life cycle brings them to the liver. As they pass through the blood stream, they are subject to regulation by the human immune system. If they make it to the liver, then they divide within liver cells where they create thousands of haploid merozoite cells for each liver cell infected.

3) After they lyse within the liver cells, the merozoites are released into the circulatory system where they are free to travel about and infect any red blood cells that they come into contact with. They are subject to regulation here by white blood cells as well, but they have the ability to bypass this immune response by masking themselves within red blood cells. The body’s immune system has a difficult time differentiating between infected red blood cells and non-infected.

4) As they infect the red blood cells, they divide within them and some sexually distinctive forms are created at this point. All of the various malarial cells travel throughout the blood stream causing various medical implications based on where they infect.

5) When a female //Anopheles// mosquito bites a human, and draws the sexually distinctive forms of the merozoite. They help to continue the life cycle of the parasite as they will form zygotes, which forms ookinetes, which create cysts in the gut of //Anopheles// where sporozoites will be released that will live in the mouth of the mosquito. C) 1) The disease is transmitted through the bite of a female //Anopheles// mosquito into humans.

2) Various parts of the human body are affected including, but not limited to the spleen, liver, muscles, brain, lungs, and skin. Any part of the human body where blood infected by //Plasmodium falciparum// is present can be affected. The sporozoites are the first stage during infection; they enter through the mouth of the //Anopheles// mosquito where they head towards the liver, the primary organ infected.The sporozoites infect liver cells and they produce thousands of merozoite cells. The merozoites exit the liver and infect red blood cells; they reproduce within them, lyse them, and subsequently infect other red blood cells (CDC, 2014).

3) Common symptoms of malaria include, but are not limited to fever, spleen enlargement, dry cough, muscle fatigue, chills, sweating, nausea, and vomiting. As mentioned before, since the merozoites infect red blood cells that travel throughout the body, they can cause more symptoms dependent on where they end up (CDC, 2014).

4) Malaria has been around for approximately 4,000 years. Malaria was “discovered” in 1880 by Charles Louis Alphonse Laveran, a French Army Surgeon. Malaria has claimed the lives of many individuals indiscriminately, including George Gordon Byron, a famous poet. It has been found throughout various ancient literatures around the world, from China, Greece, and Italy. In China, Nei Ching was written by Emperor Huang Ti. During the 4th century of Greece, it became widely recognized. Hippocrates wrote many notes on some of the common symptoms associated with the disease, followed by Pericles. Malaria was responsible for many deaths in ancient times as there was not a treatment for it. It was not until the 2nd century in China, the Qinghao plant was one of the first treatments for the deadly pathogen. The active ingredient in the plant is artemisinin, a compound that is potent against malaria, and is still used to combat it to this day (CDC, 2014).

5) Malaria is a difficult disease to combat. One of the most common ways of preventing it includes using pesticides that kill //Anopheles// mosquitos, but this of course holds environmental consequences. Once infected, antimalarial drugs can be prescribed which help to stop the various parts of the life cycle of //Plasmodium falciparum//. As drugs are made, resistance is built up as the pathogen is exposed to it more. A common treatment which was created in 1930, cloroquine, is becoming less effective due to the evolution of the parasite (WHO, 2013). Other common treatments which have been used include pyrimethamine and sulfadoxine and they have been found to increase the concentration of hemoglobin, more than cloroquine. Cloroquine is still the most popular method of treatment in sub-Saharan Africa, one of the most prevalent locations of the disease (Bloland et. al, 1993).

6) Given the fact that //Plasmodium falciparum// has been evolving quickly due to exposure to many different antimalarial drugs (WHO, 2013), research is being done to determine how much it has become resistant. //In vitro// assays were conducted which assessed the sensitivity of the parasite to drugs, a vital tool to monitor how effective drugs still are to the evolving strains. //In vitro// assays in one study have actually helped to identify evolved strains faster than ever (Noedl et. al, 2003). Drugs that are being studied allow for the immune system to identify the parasite, leading to its removal. They also stop vital life processes. Drugs such as cloroquine, sulfadoxine, and pyrimethamine are at risk of being obsolete (Bloland et. al, 1993), the research done to determine drug resistance is crucial. Other drugs that are being used to help combat malaria include spiroindolones, a drug which is being researched that has been shown to be widely effective. Alternatives such as this may be effective in combating adaptive forms of //Plasmodium falciparum// that may have outwitted other medications (Rottmann et. al, 2010).

7) References: MALARIA, U. F. (2003). Assessment and monitoring of antimalarial drug efficacy for the treatment of uncomplicated falciparum malaria. <span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Bloland, P. B., Lackritz, E. M., Kazembe, P. N., Were, J. B., Steketee, R., & Campbell, C. C. (1993). Beyond chloroquine: implications of drug resistance for evaluating malaria therapy efficacy and treatment policy in Africa. //Journal of infectious diseases//, //167//(4), 932-937. <span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Noedl, H., Wongsrichanalai, C., & Wernsdorfer, W. H. (2003). Malaria drug-sensitivity testing: new assays, new perspectives. //Trends in parasitology//, //19//(4), 175-181. <span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Rottmann, M., McNamara, C., Yeung, B. K., Lee, M. C., Zou, B., Russell, B., ... & Diagana, T. T. (2010). Spiroindolones, a potent compound class for the treatment of malaria. //science//, //329//(5996), 1175-1180. <span style="font-family: 'Times New Roman',serif; font-size: 12pt;">CDC. (2014). //CDC and Malaria//. Atlanta, GA: Centers for Disease Control. Retrieved September 2, 2014, from [|http://][|www.cdc.gov/malaria/resources/pdf/fsp/cdc_malaria_program.pdf]

====<span style="font-family: 'Comic Sans MS',cursive; font-size: 130%;">Historical background: Dating back to2700 BC, malaria was known as “roman fever”. The word malaria originates from medieval Italian mala aria which means bad airs. It was formerly called ague or marsh fever because of its association with swamps. Malaria was the most important health hazard encountered by the US troops during World War II, with about 500,000 soldier infected. ==== ====<span style="font-family: 'Comic Sans MS',cursive; font-size: 130%;">Charles Louis Alphonse Laveran, a French doctor first discovered parasites inside the red blood cells of infected people in 1880. He thus proposed that it is caused by an organism. In 1894, Sir Ronald Ross proved the complete life cycle of the malaria parasite in mosquitoes thus proving that the mosquito is the vector fir malaria in humans. ====

====<span style="font-family: 'Comic Sans MS',cursive; font-size: 130%;">Common symptoms: fever, chills, headache, sweats, fatigue, convulsion, jaundice, nausea and vomiting, dry cough, confusion, muscle and/or back pain, enlarged spleen. In rare cases, malaria may lead to impaired brain and spinal cord functioning. ====

====<span style="font-family: 'Comic Sans MS',cursive; font-size: 130%;">Standard treatments: For uncomplicated malaria, artemisinin-combination therapy (ACT) is used which reduces the ability of the parasite to develop resistance to drug components. Severe malaria on the other hand requires parenteral administration of antimalarial drugs. The most common treatment of severe malaria was quinine up until 2000 because chloroquine-resistant infections have become common in certain regions. In such cases, the combination of quinidine plus doxycycline can be used, artesunate (which is most commonly used now), and atovaquone plus proguanil. ====

====<span style="font-family: 'Comic Sans MS',cursive; font-size: 130%;">Current research: Tran et al, as well as other like Rappuoli and Aderem are researching the possible malaria vaccinations. It has been discovered that humans can acquire immunity to Plasmodium falciparum through natural and experimental means. The tools of immunology are currently being looked into to determine how to go about creating these vaccines ====