Plasmodium is a protozoan parasite that causes malaria and is transmitted to humans by the bite of the female Anopheles mosquito. It is an intracellular parasite that infects liver cells and red blood cells (RBCs). The most important species affecting humans include Plasmodium falciparum (the most dangerous and severe form), Plasmodium vivax (the most common), Plasmodium malariae (associated with chronic infection), and Plasmodium ovale (rare).
In the life cycle of Plasmodium, humans act as the intermediate host, while the female Anopheles mosquito is the definitive host because sexual reproduction occurs inside the mosquito. The infective stage to humans is the sporozoite, which is injected during a mosquito bite. Sporozoites enter the bloodstream and quickly migrate to the liver, where they invade hepatocytes. This stage is known as the exo-erythrocytic schizogony or liver stage. Inside liver cells, the parasites multiply and form schizonts, which rupture to release merozoites into the bloodstream. Notably, P. vivax and P. ovale can form dormant hypnozoites in the liver, leading to relapse; however, P. falciparum does not form hypnozoites.
When a mosquito feeds on an infected person, it ingests the gametocytes. Inside the mosquitos gut, gametocytes develop into gametes, which fuse to form a zygote. The zygote transforms into an ookinete, which develops into an oocyst. The oocyst eventually releases sporozoites that migrate to the mosquitos salivary glands, completing the cycle. For examination purposes, the infective stage to humans is the sporozoite, the infective stage to the mosquito is the gametocyte, the diagnostic stage is the ring form or trophozoite seen in RBCs, and the blood stage is responsible for the clinical symptoms of malaria.
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