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Malaria

IntroductionMalaria is a serious and sometimes fatal disease caused by a parasite that commonly infects a certain type of mosquito which feeds on humans as defined by the world health organization. It is considered the most important parasitic disease affecting man.This parasite-caused disease is the 9th leading cause of morbidity in the Philippines according to the department of health.

Usually, people get malaria by being bitten by an infective femaleAnophelesmosquito. Only Anophelesmosquitoes can transmit malaria and they must have been infected through a previous blood meal taken from an infected person. When a mosquito bites an infected person, a small amount of blood is taken in which contains microscopic malaria parasites.

Malaria is not contagious but it is infectious. Malaria is not spread from person to person like a cold or the flu, and it cannot be sexually transmitted. You cannot get malaria from casual contact with malaria-infected people, such as sitting next to someone who has malaria.

EpidemiologyWorldThe WHO estimates that in 2010 there were 219 million cases of malaria resulting in 660,000 deaths.Others have estimated the number of cases at between 350 and 550 million for falciparum malaria and deaths in 2010 at 1.24 million up from 1.0 million deaths in 1990.The majority of cases (65%) occur in children under 15 years old.About 125 million pregnant women are at risk of infection each year; inSub-Saharan Africa, maternal malaria is associated with up to 200,000 estimated infant deaths yearly.

Malaria is presently endemic in a broad band around the equator, in areas of the Americas, many parts of Asia, and much of Africa; in Sub-Saharan Africa, 8590% of malaria fatalities occur. An estimate for 2009 reported that countries with the highest death rate per 100,000 of population wereIvory Coast(86.15),Angola(56.93) andBurkina Faso(50.66).A 2010 estimate indicated the deadliest countries per population were Burkina Faso,MozambiqueandMali.

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Philippine settingAccording to Roll Back Malaria, dataaveraged over 10 years (1991-2000)show that malaria isendemic in 65 of the 79 provinces, i.e., 760 of the 1,600 municipalities and 9,345 of the 42,979 barangays nationwide.90% of the cases are found in 25 of the 65 endemic provinces, i.e., 348 of the 760 endemic municipalities (districts), and4, 407 of the 9,345barangays (villages).The remaining 40 provinces, which accounts for about 10% of reported malaria,are considered epidemic prone

Malaria in the Philippines has an Incidence: 0.48 per 1000 (2000) having Total number of deaths: 536 (2000). Provinces with high endemnicity: Palawan, Kalinga-Apayao, Ifugao and Agusan del Sur. Cases of MDR falciparum malaria: Davao del Norte, Compostela Valley and Palawan

Infectious Disease Process

AgentAccording to the Center of disease control and prevention Plasmodium falciparum, is found worldwide in tropical and subtropical areas. It is estimated that every year approximately 1 million people are killed by P. falciparum, especially in Africa where this species predominates. Plasmodium vivax

found mostly in Asia, Latin America, and in some parts of Africa. Because of the population densities especially in Asia it is probably the most prevalent human malaria parasite

Plasmodium ovale found mostly in Africa (especially West Africa) and the islands of the western Pacific. It is biologically and morphologically very similar to P. vivax. However, differently from P. vivax, it can infect individuals who are negative for the Duffy blood group, which is the case for many residents of sub-Saharan Africa. This explains the greater prevalence of P. ovale (rather than P. vivax ) in most of Africa.

Duffy blood groupAccording to the journal dated october 11 2006 by the Department of Hematology and Transfusion Medicine, Santa Casa Medical School, So Paulo, Brazil. The duffy blood group factor serves as a receptor for plasmodium vivax parasites. Individuals with the Duffy-negative phenotype are resistant to P. vivax invasion,

Plasmodium malariae,

found worldwide, is the only human malaria parasite species that has a quartan cycle (three-day cycle). can cause serious complications such as the nephrotic syndrome

Plasmodium knowlesi

found throughout Southeast Asia as a natural pathogen of long-tailed and pig-tailed macaques.

In the Philippines the most common would be the plasmodium falciparum specie accounts to > 70 % of the cases plasmodium vivax which has < 30 %Plasmodium malariae which is