Scientifik classification

Kingdom Phylum Class Order Family Genus Species :Protista :Apicomplexa :Aconoidasida :Haemosporida :Plasmodiidae :Plasmodium :P. malariae

Disease
Quartan malaria (malariae malaria)
fever chills flu-like symptoms muscle pain kidney failure

fever, quartan (every third day) anemia nephrotic syndrome

headache fatigue

Identification
Species identification is possible on the basis of the appearance of parasites of each of the four malaria species. Shape and size of asexual parasites and of macro- and microgametocytes, developmental stages in peripheral blood, modifications of infected erythrocytes, presence of dots or clefts on the red blood cells are the main differential characteristics

Morphology P.malariae
a.Trophozoites are usually small rings with a single dot of chromatin or have a compact, regular cytoplasm that seems to contain the nucleus. The pigment in late trophozoites is scattered. b. Trophozoites may assume a band form typical of the species. Red blood cells are not enlarged or rather smaller than normal. Multiple infection is rare. The parasitemia is usually low. No dots or clefts.

c. Schizonts are small and with a low number of merozoites (<12) arranged in regular forms (rosettes) with a thickened, often central, pigment. The complete erythrocytic cycle takes 72 hours and ends with the releasing of free merozoites (c). d. Micro- and macrogametocytes are round, small with chromatin defined; they must be differentiated from late trophozoites. During P.malariae infection all stages of development are present in peripheral blood.

Picture of P.malariae
(a) pm1-ic pm2-ic (b)

pm4-ic

P_malariae1

(c)

(d) pm6-ic

pm5-ic

pmthin-ic P_malariae2-ic (c) pmM-ic

Life cycle

Immunology
Spesific immune response have cellular immunity by T limfosit and humoral immunity by B limfosit . T Limfosit differences to T limfosit helper (CD4+) and cytotoxic (CD8+) From the product of cytokin made differences become subset Th-1 (output IFN- and TNF-) subset Th-2 (output IL-4, IL-5, IL-6, IL10)

Immunology
The cytokin characterized activated humoral immunity.CD4+ have function as regulator by helping production antibody and other phagocyt activity and CD8+ have function as the direct effector for parasit phagocytosis and blocking parasit growth with the IFN- product.

Diagnostic Factors

Blood smear Morphology in RBC

DNA probe

Immunoassay

DIAGNOSIS
P. Malariae diagnosis relies mainly on observation of parasites in Giemsa-stained thin or thick smears (G-TS). Alternative techniques for identification of malaria parasites are based on fluorochromes such as Acridine Orange (AO), DAPI-PI or BCP. With these dyes malaria parasites are easily recognized under UV light, reducing the time spent reading the slides. Another method, based on fluorochromes, the quantitative buffy coat (QBC) .(Becton-Dickinson) analysis wich uses AO staining of centrifuged parasites in a capillary tube containing a float, has been shown to be rapid and accurate.

Treatment and Prevention

mosquito control

mosquito repellants

chloroquine Intra-venous antibiotic therapy with ampicillin and cefotaxime.

Epidemiology
Congenitally acquired malaria is rare in the United States; <10 cases are reported each year (1). Congenital infection with Plasmodium malariae is particularly uncommon because distribution of this parasite is focal and sparse in areas where P. falciparum is endemic (2). The last case of congenital P. malariae infection in the United States was reported in 1992 (3). This report describes the investigation of a case of P. malariae in an infant with no travel history outside of the United States and suggests that health-care providers suspect malaria when treating a neonate or young infant with fever if the mother has traveled or lived in a malarious area.

Daftar pustaka
http://www.cdc.gov/mmwr/index.html http://en.wikipedia.org/wiki/Plasmodium_malariae http://medinfo.ufl.edu/year2/mmid/index.html http://www.kalbefarma.com.html http://www.ratsteachmicro.com http:// www.sanger.ac.uk http:// www.humanillnesses.com