Several red cell inherited factors influence the
morality of Plasmodium falciparum malaria. P. falciparum does not grow well in red cells that contain
Haemoglobin F, C or especially S.
haemoglobin S. heterozygotes (As) are protected against the lethal
complications of malaria. B. thalasemia heterozygotes enjoy a selective advantage in malaria environment P. vivax cannot enter red
cells that lack a Duff blood group.
CLINICAL
FEATURES
Plasmodium falciparum
is most dangerous, the onset is insidious with malaise, headache, vomiting and
is often mistaken for influenza, cough and mild diahoarrdea, muscle aches,
shaking chills, tiredness, are also common fever which has no particular
pattern. Jaundice is haemolysis is very high or if there is hepatic dysfunction
and anaemia. Without treatment P. falciparum infection ordinarily will terminate
spontaneously in less than one year
unless it ends fatally.
P. vivax and P. ovale malaria infection
starts with a period of several days of continued fever before the development
of classical bouts of fever on alternate days. Fever starts with rigor. The
patient feels cold and the temperature rises up to 400C. After half
an hour, the hot flush phase begins, then perspiration and gradual temperature
decline. The cycle is repeated every 48 hours. Relapses are common in the first
two years of leaving the malarious area.
P. malariae infection is
similar to the above but fever repeats third day. P. malariae causes glomerulonephitis and nephritic syndrome in
children.
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