Malaria Microscopy Quiz: Diagnosis and Classification

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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?

20mg of artemether and 120mg of lumefantrine Signup and view all the answers

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

$15-30mg/kg/day$ Signup and view all the answers

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

$7.5-15mg/kg/day$ Signup and view all the answers

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

Atovaquone+proguanil Signup and view all the answers

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

Doxycycline Signup and view all the answers

Which medication is sufficient for treating P. malariae infections?

Chloroquine Signup and view all the answers

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

Insecticide-treated bed nets (ITNs) 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?

Atovaquone-proguanil 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?

Chloroquine+proguanil Signup and view all the answers

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

To identify parasite-negative patients for further diagnosis Signup and view all the answers

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

It allows quantification of malaria parasites Signup and view all the answers

What is the basis for microscopic diagnosis of malaria?

Giemsa stained thick and thin blood smears Signup and view all the answers

What is severe malaria defined as?

Malaria with signs of severity and vital organ dysfunction Signup and view all the answers

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

To prevent unnecessary use of anti-malarials Signup and view all the answers

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

Romanowsky stain Signup and view all the answers

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

High insecticide costs Signup and view all the answers

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

Aedes aegypti 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?

RTS,S Signup and view all the answers

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

Plasmodium falciparum parasite Signup and view all the answers

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

Hawaii Signup and view all the answers

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

Mosquito bite Signup and view all the answers

Which region has the highest percentage of rabies deaths annually?

Asia Signup and view all the answers

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

Bites from infected dogs and cats Signup and view all the answers

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

Rabies Signup and view all the answers

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

Through axonal transport in neurons Signup and view all the answers

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

Dogs and cats Signup and view all the answers

What is the average incubation period for rabies once exposed?

1-3 months Signup and view all the answers

How should Category 2 rabies exposures be managed?

Wash wound with soap and water, start vaccine immediately Signup and view all the answers

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

Days 0, 3, 7, 28 with 0.1 ml per dose on each deltoid or thigh for ID vaccination Signup and view all the answers

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

Immediate initiation of preventive measures regardless of exposure-to-consultation interval Signup and view all the answers

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.

Malaria Diagnosis and Classification Quiz

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