Malaria Diagnosis and Classification Quiz
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Questions and Answers

What do Rapid Diagnostic Tests (RDTs) for malaria detect?

  • White blood cells
  • Malaria specific antigens (correct)
  • Platelets in the blood
  • Malaria antibodies

How is the presence of antigen indicated in Rapid Diagnostic Tests (RDTs)?

  • Result line along the strip (correct)
  • Result dot at the end
  • Result zigzag pattern
  • Result circle in the center

What is the therapeutic dose regimen for treating uncomplicated falciparum malaria with Artemether plus lumefantrine?

  • 6-dose regimen over 3 days (correct)
  • 4-dose regimen over 2 days
  • 1-dose regimen over 3 days
  • 3-dose regimen over 6 days

What are the components of the fixed-dose formulation of Artemether plus lumefantrine?

<p>20mg of artemether and 120mg of lumefantrine (C)</p> Signup and view all the answers

What is the therapeutic dose range for Artesunate in treating uncomplicated falciparum malaria?

<p>$15-30mg/kg/day$ (B)</p> Signup and view all the answers

In the combination therapy of Artesunate plus amodiaquine, what is the target dose for amodiaquine per day?

<p>$7.5-15mg/kg/day$ (D)</p> Signup and view all the answers

Which medication is recommended in areas where both P. vivax and P. falciparum malaria transmission co-exist?

<p>Atovaquone+proguanil (A)</p> Signup and view all the answers

What is a recommended prophylaxis against malaria in areas with varying resistance patterns?

<p>Doxycycline (D)</p> Signup and view all the answers

Which medication is sufficient for treating P. malariae infections?

<p>Chloroquine (B)</p> Signup and view all the answers

What method can be used as personal protection to reduce malaria illness and death in endemic regions?

<p>Insecticide-treated bed nets (ITNs) (D)</p> Signup and view all the answers

In areas with high risk of P. falciparum malaria and reported antimalarial drug resistance, what medication combination can be recommended?

<p>Atovaquone-proguanil (D)</p> Signup and view all the answers

Which medication regimen is suggested when malaria is due exclusively to P. vivax or fully chloroquine-sensitive P. falciparum?

<p>Chloroquine+proguanil (D)</p> Signup and view all the answers

What is the primary advantage of parasitological diagnosis in suspected malaria cases?

<p>To identify parasite-negative patients for further diagnosis (C)</p> Signup and view all the answers

Why is microscopy considered the 'gold standard' for diagnosing malaria?

<p>It allows quantification of malaria parasites (D)</p> Signup and view all the answers

What is the basis for microscopic diagnosis of malaria?

<p>Giemsa stained thick and thin blood smears (C)</p> Signup and view all the answers

What is severe malaria defined as?

<p>Malaria with signs of severity and vital organ dysfunction (D)</p> Signup and view all the answers

Why is it recommended to perform parasitological diagnosis in all suspected malaria cases?

<p>To prevent unnecessary use of anti-malarials (B)</p> Signup and view all the answers

What type of staining allows for a high degree of sensitivity and specificity in microscopy for malaria diagnosis?

<p>Romanowsky stain (B)</p> Signup and view all the answers

What is the main factor hindering the widespread use of ITNs in endemic countries?

<p>High insecticide costs (A)</p> Signup and view all the answers

Which mosquito species is the primary transmitter of dengue viruses in the Western Hemisphere?

<p>Aedes aegypti (A)</p> Signup and view all the answers

Which vaccine is mentioned as the first one to significantly reduce malaria in young children living in moderate-to-high transmission areas?

<p>RTS,S (D)</p> Signup and view all the answers

What is the main target of the RTS,S vaccine in combating malaria?

<p>Plasmodium falciparum parasite (D)</p> Signup and view all the answers

In what region did a 2001 outbreak of dengue occur due to transmission by Aedes albopictus?

<p>Hawaii (B)</p> Signup and view all the answers

What is the main mode of transmission for dengue to humans?

<p>Mosquito bite (D)</p> Signup and view all the answers

Which region has the highest percentage of rabies deaths annually?

<p>Asia (C)</p> Signup and view all the answers

What is a common mode of exposure to rabies from animals?

<p>Bites from infected dogs and cats (D)</p> Signup and view all the answers

What is the most acutely fatal infectious disease in the Philippines?

<p>Rabies (A)</p> Signup and view all the answers

How does rabies virus primarily spread within the Central Nervous System (CNS)?

<p>Through axonal transport in neurons (C)</p> Signup and view all the answers

Which of the following animals pose a risk for rabies infection through bites?

<p>Dogs and cats (D)</p> Signup and view all the answers

What is the average incubation period for rabies once exposed?

<p>1-3 months (A)</p> Signup and view all the answers

How should Category 2 rabies exposures be managed?

<p>Wash wound with soap and water, start vaccine immediately (A)</p> Signup and view all the answers

What is the recommended vaccination regimen for infants in the Philippines?

<p>Days 0, 3, 7, 28 with 0.1 ml per dose on each deltoid or thigh for ID vaccination (A)</p> Signup and view all the answers

What is crucial for individuals directly exposed to suspected rabid animals?

<p>Immediate initiation of preventive measures regardless of exposure-to-consultation interval (B)</p> Signup and view all the answers

Flashcards

What is Rabies?

A fatal viral disease primarily transmitted through animal bites, affecting the central nervous system.

Where is Rabies most prevalent?

Asia and Africa account for the vast majority of rabies deaths worldwide.

Rabies Symptoms

Fluctuations in consciousness, spasms, and autonomic instability are common symptoms.

Who is most at risk for Rabies?

Rabies disproportionately affects vulnerable and under-resourced populations.

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Rabies Reporting Issues

There is often a lack of accurate reporting, especially in rural areas.

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Main Rabies Transmission

Dog bites are the primary route of rabies transmission to humans.

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Other Rabies Carriers

Besides dogs, cats and bats can transmit rabies.

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Non-Bite Rabies Exposure

Scratches, open wounds, and mucous membranes exposed to saliva can transmit rabies.

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Animals Not Likely to Carry Rabies

Bites from these animals generally do NOT pose a rabies risk.

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Rabies Incubation Period

The period between exposure and symptom onset, usually 1-3 months.

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Factors Affecting Rabies Incubation

The amount of virus, severity, and location of the exposure.

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Initial Rabies Diagnosis

Clinical signs and exposure history.

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Hydrophobia Definition

Fear of water due to difficulty swallowing.

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Paralytic Rabies Challenges

Paralytic rabies may lack the classic hydrophobia symptom, making it harder to recognize.

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Lab Confirmation of Rabies

Testing fresh tissue samples in a lab.

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Importance of Rabies PEP

Post-exposure prophylaxis (PEP) is critical to prevent rabies after a potential exposure.

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Timing of Rabies PEP

Start PEP immediately, regardless of the time since exposure.

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Components of Rabies PEP

Vaccines and Rabies Immunoglobulin (RIG)

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Rabies Exposure Category I

Touching an animal or licking of intact skin.

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Rabies Exposure Category II

Nibbling, minor scratches without bleeding.

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Rabies Exposure Category III

All Category II exposures on the head and neck.

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Category I Management

Wash with soap and water; no vaccine/RIG needed.

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Category II Management

Wash and start vaccine immediately.

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Category III Management

Wash, start vaccine and RIG immediately.

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PEP in Special Cases

Pregnancy and infancy are NOT reasons to withhold PEP.

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Newborns of Rabid Mothers

Vaccination and RIG at birth.

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Delayed Exposure Evaluation

Treat as if recent, regardless of the delay.

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Philippines' Rabies Centers

Animal Bite Treatment Centers (ABTCs).

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Philippines' Vaccine regimine

Intradermal (ID) regimen is recommended

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Rabies Vaccine Quality

Ensuring high-quality, WHO-approved vaccines

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Study Notes

Rabies

  • Estimated 55,000 deaths annually worldwide, predominantly in Asia (56%) and Africa (43.6%)
  • Highly fatal, with symptoms including consciousness fluctuations, spasms, and autonomic instability
  • Neglected disease affecting poor and vulnerable populations
  • Limited reporting of deaths, particularly in remote rural communities
  • Lack of preventative measures in areas with dog-to-human transmission
  • Under-reporting hinders international resource mobilization for rabies elimination

Philippines Scenario

  • Rabies remains a public health problem in the Philippines
  • Most acutely fatal infectious disease, causing 200-250 deaths annually
  • One-third of deaths in children under 15 years
  • Two-thirds of cases are males

Modes of Transmission

  • Bites from infected animals, particularly dogs and cats, are the most common mode
  • Exposure can also come from other domestic and wild animals, including bats
  • Non-bite exposures are less common but may include scratches, open wounds, and mucous membranes licked by an infected animal
  • Bites from rats, rabbits, rodents, reptiles, and birds do not pose a risk for rabies infection

Pathogens

  • Incubation Period: 1-3 months, with 90-95% of cases having an incubation period of less than one year, but longer periods in 5-10% of cases
  • Factors influencing incubation: amount of virus, severity, and location of exposure
  • Rabies virus multiplies in muscle cells or may directly invade nerves

Diagnosis

  • Often based on clinical manifestations and exposure history
  • Hydrophobia and/or aerophobia pathognomonic; however, paralytic rabies may pose diagnostic challenges
  • Laboratory confirmation is necessary
  • Diagnosis performed on fresh tissue specimens stored at appropriate temperatures

Rabies Post-Exposure Prophylaxis

  • Crucial for individuals directly exposed to suspected rabid animals
  • Initiation should not be delayed, regardless of exposure-to-consultation interval
  • Delay increases the risk of rabies and is associated with treatment failure

Categories of Exposure

  • Category I: Feeding/touching an animal, licking of intact skin, exposure to patients with signs and symptoms of rabies, casual contact
  • Category II: Nibbling of uncovered skin, minor/superficial scratches/abrasions without bleeding, including those induced to blood
  • Category III: All Category II exposures on the head and neck area

Management of Exposure

  • Category I: Wash exposed skin immediately with soap and water, no vaccine or Rabies Immune Globulin (RIG) needed
  • Category II: Wash wound with soap and water, start vaccine immediately, complete regimen until Day 28
  • Category III: Wash wound with soap and water, start vaccine and RIG immediately, complete regimen until Day 28

Special Considerations

  • Pregnancy and infancy not contraindications to PEP
  • Babies born to rabid mothers should receive rabies vaccination and RIG upon birth
  • Exposed persons evaluated weeks or months after the bite should be managed as if the exposure occurred recently

Rabies Vaccination in the Philippines

  • Vaccine-preventable disease
  • Animal Bite Treatment Centers (ABTC) established for PEP
  • Intradermal (ID) regimen recommended for cost-effectiveness
  • WHO-approved vaccines for ID use required

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Description

Test your knowledge on the parasitological diagnosis required for confirming malaria cases and the classification of populations based on the intensity of transmission. Learn about the signs of severe malaria and the importance of physical examination in identifying vital organ dysfunction.

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