Malaria is a parasitic disease that is transmitted from human to human by the bite of infected Anopheles mosquitoes. In humans, the parasites (called sporozoites) migrate to the liver where they mature and become merozoites, which enter the bloodstream and infect red blood cells.

The parasites multiply within red corpuscles, after 48 to 72 hours, break and infect more red blood cells. The first symptoms usually occur 10 days to 4 weeks after infection, although they may appear as early as 8 days or up to 1 year thereafter. Then, symptoms of the disease occur in cycles of 48 to 72 hours.

Most symptoms are caused by the massive release of merozoites into the bloodstream, the anemia resulting from destruction of red blood cells and the problems caused by large amounts of free hemoglobin released into the circulation after the breakdown of red blood cells .

Malaria can also be transmitted from mother to fetus (whether congenital) and by blood transfusions. The mosquitoes in temperate climates can carry malaria, but the parasite disappears in winter.

The disease is a major health problem in much of tropical and subtropical countries. The CDC (Center for Disease Control in the U.S.) estimates that each year there are 300 to 500 million malaria cases and more than one million people die. It is the major disease hazard for travelers to warm climates.

In some regions of the world, mosquitoes that carry malaria have developed resistance to insecticides. In addition, parasites have developed resistance to some antibiotics. This has led to difficulty in controlling both the rate of infection and spread of the disease.

The Plasmodium falciparum, one of four different types of malaria, affects a larger proportion of red cells compared to other types and is much more serious. It can be fatal after a few hours of onset of first symptoms.

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The primary liver cancer is cancer that occurs in the liver spontaneously and develops depends directly on liver cells (liver cells).

Causes and risk factors

The primary liver cancer:

* Is increasing for several years;
* Is more common in some regions: Africa (tropical) and South-Eastern Asia;
* Occurs around age 60 in Europe and North America and to 35 years in Africa and Asia;
* Is mainly observed in humans;
* Is most often linked to the evolution of a pre-existing cirrhosis. In France, the cancerous cirrhosis due to alcohol varies between 10 and 30%. In the tropics, the carcinogenesis is linked to cirrhosis of viral origin (hepatitis B). When liver cancer develops on a liver showing no lesions of cirrhosis, the role of dietary factors has been advanced, and especially that of certain toxins (aflatoxin contaminant of peanut flour in Africa).

The signs of the disease

The patient may experience pain in relation to the liver, fever, impaired general condition (weight loss, loss of appetite, fatigue) or jaundice (yellowing of the skin).

Consultation
Careful examination of the abdomen found an increased volume of liver (hepatomegaly), hard with irregular surface, sometimes sensitive or painful.

Reviews and analyzes
The laboratory tests found evidence of non-specific anemia (low hemoglobin in the blood), increased number of white cells in the blood, changes in blood levels of enzymes produced by the liver (increased gamma-GT, alkaline phosphatase …).

The determination of alpha-fetoprotein (AFP) is useful for diagnosis of primary liver cancer. This protein is present at the 8th week of embryonic life and then decreases in adults. In the context of primary liver cancer, AFP increased significantly 9 times out of 10. However, AFP was found increased in other diseases (viral hepatitis, certain digestive cancers, pregnancy). However, it is interesting to note that in a patient with chronic liver disease, increased AFP must suspect the occurrence of cancer.

Other biological parameters directly associated with cancer are sometimes found: hypercalcemia (increased calcium in the blood), hypoglycemia.

The radiological find items for the diagnosis of cancer. The liver ultrasound found a mass or more evocative.

Evolution of the disease
The development of liver cancer is often poor because the liver produces many substances necessary for many body functions.

The risk of patient death is usually related to bleeding or infectious complications.

Treatment
The treatment of primary tumors involves surgery if it is feasible (general condition, location and size of the tumor) in the form of a partial removal of the liver reached. Surveillance of AFP after the operation to detect at best a cancer recurrence. When surgery is not feasible, treatment involves the chemotherapy intravenously.

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