SACHI BELLE SY CABACCANG, 2BSMT3 SHORT WRITING ASSIGNMENT 5

1. Identify the following: definitive or final host, intermediate host, asexual phase, sexual phase,
infective stage to: IH ang DH.
• Definitive stage or final host – the host in which the parasite reaches sexual maturity
and reproduces sexually. The definitive host is typically required for the completion of
the parasite’s life cycle.
• Intermediate host – the host in which the parasite undergoes reproduction,
devepment or maturation, before it can infect the definitive host. The intermediate host
is often necessary for the survival and transmission of the parasite.
• Asexual phase – the stage of the parasite’s life cycle in which it undergoes asexual
reproduction. This may involve processes such as binary fission or budding.
• Sexual phase – the stage of the parasite's life cycle in which it undergoes sexual
reproduction. This may involve processes such as mating or fusion of gametes.
• Infective stage to IH – the stage of the parasite's life cycle that is capable of infecting
the intermediate host. This may be a specific life cycle stage or form, such as a cyst or
larval stage.
• Infective stage to DH – the stage of the parasite's life cycle that is capable of infecting
the definitive host. This may be a specific life cycle stage or form, such as a mature or
reproductive form.

2. Define the following: hypnozoite, accole, schizont, merozoite and hemozoin.

• Hypnozoite (pl., hypnozoites) – dormant liver cells infected with Plasmodium vivax or
Plasmodium ovale. These cells may remain dormant for months to years and, when
reactivated, may cause relapsing malarial infections.
• Accole – refers to the location of parasites, specifically select species of Plasmodium,
that assume a crescent-shaped mass at the outer edge of a red blood cell; also known
as applique.
• Schizont (pl., schizonts) – morphologic form, most notably found in the Plasmodium
spp. Life cycle, responsible for the development and maturing of a merozoite, a
morphologic from critical to the survival and continued replication of the parasites in a
human host.
• Merozoite (pl., merozoite) – contents of the fully developed stage of the asexual
Sporozoa trophozoite (i.e, Plasmodium spp., the mature schizont) produced in both the
liver cells and RBCs and capable of initiating infection in previously healthy red blood
cells.
• Hemozoin – a remnant of the parasite feeding on RBS hemoglobin that is visible as a
brown pigment.

3. Differentiate relapse from recrudescence. In what malarial species do we observe this

phenomenon?
Relapse refers to the reemergence of symptoms after a period of recovery, frequently
as a result of the original infection becoming active again. Contrarily, recrudescence is the term
for the recurrence of symptoms during a continuous illness, typically as a result of the inability
of the treatment to completely eradicate the pathogenic parasite.
SACHI BELLE SY CABACCANG, 2BSMT3 SHORT WRITING ASSIGNMENT 5

In the malarial species Plasmodium vivax and Plasmodium ovale, relapse and
recrudescence have been documented. As part of their life cycle, these two species have a
special ability to generate hypnozoites, which are latent liver stages. Following the original
infection, these hypnozoites can stay in the liver for days, weeks, or even months before
reactivating to induce an infection recurrence. Due to insufficient parasite clearance during the
initial treatment, recrudescence can also happen in some species, which causes the symptoms
to return. Relapse and recrudescence are not commonly seen in the other malaria species,
such as Plasmodium falciparum and Plasmodium malariae, since they lack hypnozoites.

4. Enumerate therapeutic regimes that are used in the treatment of malaria. Give its use.
The choice of antimalarial drug and treatment regimen depends on several factors,
including the species of Plasmodium causing the infection, the severity of the disease, the age
and weight of the patient, and any comorbidities or contraindications. Here are some examples
of antimalarial drugs and their therapeutic regimens:

• Artemisinin-based combination therapy (ACT) – this is the recommended first-line

treatment for uncomplicated malaria caused by P. falciparum, the deadliest malaria
parasite. ACTs combine an artemisinin derivative with another antimalarial drug to
improve efficacy and reduce the risk of drug resistance. Examples of ACTs include
artemether-lumefantrine, artesunate-amodiaquine, and dihydroartemisinin-piperaquine.
• Chloroquine – this is a widely used antimalarial drug for treating uncomplicated
malaria caused by P. vivax, P. ovale, and some P. falciparum strains that are still
sensitive to chloroquine. Chloroquine is also used for prophylaxis in areas with
chloroquine-sensitive malaria. The recommended regimen for chloroquine varies
depending on the age and weight of the patient.
• Quinine – this is an antimalarial drug that is used to treat severe malaria caused by P.
falciparum or when other drugs are not effective. Quinine is administered intravenously
for severe malaria or orally for uncomplicated malaria. The recommended regimen for
quinine depends on the severity of the disease.
• Mefloquine – this is an antimalarial drug that is used for prophylaxis in areas with
multidrug-resistant P. falciparum. Mefloquine can also be used to treat uncomplicated
malaria caused by P. falciparum or other Plasmodium species, although resistance has
become more common. The recommended regimen for mefloquine depends on the
age and weight of the patient.
• Doxycycline – this is an antibiotic that has antimalarial properties and is used for
prophylaxis in areas with chloroquine-resistant malaria. Doxycycline can also be used
to treat uncomplicated malaria caused by P. falciparum or other Plasmodium species,
although it is not recommended for pregnant women or young children. The
recommended regimen for doxycycline varies depending on the age and weight of the
patient.

5. What is black water fever? How does it happen?

SACHI BELLE SY CABACCANG, 2BSMT3 SHORT WRITING ASSIGNMENT 5

Blackwater fever is a complication of malaria infection that causes hemoglobin to be

released into the urine, leading to a dark brown or black color of the urine. This condition is rare
but can be life-threatening.
The exact cause of blackwater fever is not fully understood, but it is believed to be
associated with the breakdown of red blood cells and the release of hemoglobin. This can
occur due to several factors, such as immune-mediated destruction of red blood cells, a
reaction to antimalarial medication, or a severe form of malaria infection.
Blackwater fever can cause anemia, kidney failure, and other serious complications.
Therefore, prompt treatment is necessary to manage the condition and prevent further
complications.

6. What is the best time to collect blood (thick and this smear) for malarial parasite diagnosis?
The best time to collect blood for malaria diagnosis through thick and thin smears is
during the febrile period or when the patient is experiencing symptoms of malaria.
Malaria parasites have a periodicity of 24 to 72 hours, depending on the species.
Therefore, the timing of blood collection is crucial in detecting the parasites in the blood. During
the febrile period, the number of parasites in the blood is usually highest, making it easier to
detect them on a blood smear.
In general, blood should be collected for thick and thin smears before antimalarial
medication is initiated. This is to ensure that the parasites are still present in the blood and can
be detected. The blood sample should also be collected before any transfusion to prevent
contamination with donor blood.

7. What is QCB? How is it performed?

QBC or Quantitative Buffy Coat is a laboratory test used to detect malarial parasites in
the blood. It is a simple and rapid method that is commonly used in areas where malaria is
endemic.
The QBC test involves mixing a small amount of blood with an acridine orange stain
and a buffer solution. The mixture is then centrifuged, causing the red blood cells and malarial
parasites to settle at the bottom of the tube.
A fluorescent microscope is then used to examine the sediment at the bottom of the
tube. The acridine orange stain binds to the nucleic acids in the parasites, causing them to
fluoresce under the microscope. This makes it easier to detect and count the parasites in the
blood.
One advantage of the QBC test is that it can differentiate between different species of
malaria parasites. It is also more sensitive than conventional blood smears, allowing for the
detection of low levels of parasitemia. However, it is not as widely available as other diagnostic
methods and may require specialized equipment and expertise.

8. Indicate the formula quantifying malarial parasite/ul of blood sample.

The formula for quantifying malarial parasites/µl (microliter) of blood sample is as follows:

(parasite count / number of fields counted) x (1 / volume of blood counted) x 8,000

SACHI BELLE SY CABACCANG, 2BSMT3 SHORT WRITING ASSIGNMENT 5

Parasite count: the number of parasites observed in the counted fields

Number of fields counted: the total number of fields counted under the microscope
Volume of blood counted: the volume of blood counted under the microscope (usually 0.5 µl)
8,000: the assumed number of red blood cells per microliter of blood
For example, if 100 fields are counted and 20 parasites are observed, and the volume of blood
counted is 0.5 µl, the calculation would be:

(20 / 100) x (1 / 0.5) x 8,000 = 320,000 parasites/µl

This means that there are approximately 320,000 parasites per microliter of blood in the
sample.