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Paludism / Malaria : Two names , an ignored problem

Paludism / Malaria : Two names , an ignored problem. Oral presentation by Matthieu Ravelomanantsoa Yaniss Ouamri. Plan :. Introduction Parasites - Vector - Cycle Epidemiology Diagnosis & Prevention Conclusion. 1) Introduction. Paludism : from latin paludis «  marsh  »

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Paludism / Malaria : Two names , an ignored problem

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  1. Paludism / Malaria : Twonames,an ignoredproblem Oral presentation by Matthieu Ravelomanantsoa YanissOuamri

  2. Plan : Introduction Parasites - Vector - Cycle Epidemiology Diagnosis & Prevention Conclusion

  3. 1) Introduction Paludism : fromlatinpaludis « marsh » Malaria : fromitalianmal'aria « bad air » Infectiousdisease Hemolyticanemia Parasites : Plasmodiums Propagation : Anopheles (mosquitos) punctures World’smost important parasitosis

  4. Paludism & humanity, a long timeintrication : HumanPathogen for 50.000 years Sickle-cellanemia, G6PDH deficiency, thalassemia Toutankhamon DNA’sanalysis : diedof paludism. Hippocrates : describedpaludism’sdifferentfevers. Christopher Colombus : hadpaludismsymptoms. 1880 : Laveran discovers the cause in Algeria : plasmodiums in redbloodcells Nobel Prize in 1907.

  5. 2) Parasites / Cycle / Vector 5 kinds of plasmodiums affect humans : • Zoonosis : • Intermediate host : Man • Final host : anophele • Protozoa parasites : • 1 or 2 µm • Coloration MGG : • Blue cytoplasm • Red nucleus P. Falciparum+++ P. Vivax P. Ovale P. Malariae P. Knowlesi (simianorigin)

  6. One vector : Anopheles Latin : anôphelês « useless » Pools somespecies of mosquitos Final host of plasmodiums Bite only by night Only the females do bite : hematophagusspecie. Attracted by : CO2, lacticacid, sebum, heat, perspiration. Paludism’sprevalence : directlyrelated to its distribution.

  7. Anophele’s cycle : sexual Bite  Gametocytes♂+♀ fromhuman’sblood : fecundation  oocyste in anophele’sstomach. Each oocyste containsmanySporozoa Final location :Salivary glands. Next bite : transmission of sporozoa.

  8. Man’s cycle : asexual Cycle’sdurationdependson the plasmodium specie and isrelatated To the kind of fever (24h : quotidian, 48h : tertian , 72h : quartan) Bite  sporozoa in man’s blood  hepatocytes Hepatocytesburst : Merozoa release  2 future locations : Redcells : - for all plasmodium species - responsible for redcellsburst  Anemia Liver : - Only for P. Vivax / Ovale / Malariae -  Hypnozoa : quiescent parasites - Responsible for relapses of the disease.

  9. 3) Epidemiology Related to anophele’s distribution Alarmingstatistics, eachyear : 2 Billions : exposedpersons 100 Millions : personswithcinicalsigns of paludism 1 to 3 Millions : deathfrompaludism most of the death : childrenunder 5 yearsold. Each 30 seconds : 1 death.

  10. WHO : Divides world map in 4 categories Group 0 : No paludismGroup 2 : Paludism and resistance to treatment Group 1 : Paludism but no resistanceGroup 3 : Paludisme, and Multi-resistance

  11. Group O cases : Imported cases aftervisitingrisky countries Cases afterblood-transfusion Airportpaludismphenomenon

  12. 4) Diagnosis/Prevention • Symptoms : • Asthenia • Anorexia • Giddinesses • Cephalgias • Digestive disorders: • nauseas, vomiting, abdominal pain • Diarrhoea • Myalgias. • Signs : • Periodic Fever • Anemia • Thrombopenia • Intermittent tremors • Hemoglobinuria Icterus • Convulsions • Splenomegaly • Hepatomegaly

  13. Paludism is a medical emergency : Results of exams : 2 hours. Smear fromblood MGG Thick-Smear fromblood  MGG DetectingcirculatingAntigenes Aftertreatment : control.  research of hematozoa.

  14. Treatment : No vaccine available ACT(Artemisinin-basedcombinationtherapy)  The only one to bereally efficient. Problems : Veryexpensive False drugs

  15. Prevention : Prophylaxis Fightagainstanophele’sdevelopement ChemicalRepellents Mosquito nets For occidental tourists : Chloroquine Depending on the destination Treatmentbefore contamination France : bad observance  7000 Paludism cases a year.

  16. 4) Conclusion Mechanism and physiopathology are perfectlyknown Treatmentavailable Still a massive killer in the third world country

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