There is introduced the analysis of molecular-genetic mechanisms of tropical malaria pathogenesis and P. falciparum virulence. It is shown, that pathogenesis of tropical malaria is associated with the properties of red blood cells membrane surface (RBCs or erythrocytes) that are infected by P. falciparum. There are «knobs structures» on membrane surface infected RBCs. Knobs structures contains a complex of P. falciparum proteins – PfEMP1 (Plasmodium falciparum erythrocyte membrane protein 1). PfEMP1 is associated with virulence of P. falciparum. Complex PfEMP1 has difficult polymorphous structure. Domains of PfEMP1 are able to associate with different cell receptors. Virulence`s individual components of the main factor are selectively sensitive to different tissues and organs. The severity of the clinical malaria infection course depends on the complex structure PfEMP1 of malaria parasites. Composition of polypeptide PfEMP1 is determined by var-complex. Nowadays there are 60 variants of var-complex. Regulation of gene expression, forming part of the var-complex, is carried out on a molecular-genetic level, cellular level, tissue level. Modern research in this area are aimed to explore genes polymorphism of the virulence`s main factor, to identify mechanism of its differential expression. Search of molecular – genetic markers is relevant to develop methods of gene diagnostic and malaria vaccine.
The experience of organizing a system of anti-epidemic measures in the Russian military medical group operating on the territory of the island of Sumatra during the humanitarian operation to eliminate the effects of the tsunami in 2005 is presented. A characteristic of the consequences of a natural disaster, a climatogeographic description of the region is presented. The natural-climatic and socio-economic conditions for the spread of malaria infection in the coverage area of the Russian military medical group are analyzed. Russian military physicians acted in an equatorial climate in a zone of tropical rainforest in a highly endemic area for tropical (P. falciparum) and three-day (P. vivax) malaria, as well as for vector-borne tropical infections such as dengue fever, vuhereriosis, and brugiosis. Among the carriers of malaria parasites and other tropical infections on the territory of about. Sumatra mosquitoes Anopheles sundaicus are of the greatest epidemic importance. In 2005, their mass breeding occurred in late January - early February (1,5-2 months earlier than usual). A system of anti-malarial protection of personnel is described, aimed at reducing the risk of infection of military personnel, preventing the development of the disease and its malignant course, early detection of patients and their effective treatment. There were no cases of malaria among the Russian military personnel during their entire stay in the endemic territory. At the same time, the incidence rate among Indonesian soldiers and local residents was constantly increasing. In hospitals, the number of patients with severe forms of tropical malaria increased. Thus, the effectiveness of the developed system of anti- malarial measures among the military personnel involved in peacekeeping and humanitarian operations in the territory with a continuous season of transmission of malaria infection has been confirmed.
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