Embed Size (px)
Citation preview
mm
mm
m
mmmmm
Mohamed M. B. Alnoor
CHP400COMMUNITY HEALTH PROGRAM-II
mm
mm
m
Malaria
Epidemiology
& Control
mm
mm
m
mmmmm
mm
mm
m
mm
mm
mmmmmm
Malaria
Importance of malaria Mode of Transmission Factors Influencing Transmission Stable and unstable malaria Control and prevention of malaria
mm
mm
m
mmmmm
mm
mm
m
mm
mm
mmmmmm
Malaria
Importance:1/2 world pop: live in malarious areas
219 million infections(154 – 289 million),
Kills a child every minute
660,00 deaths( mostly African children)
90% deaths in Africa(1/6 childhood deaths)
Untreated P. falicparum < 25%
Anaemia among children
pregnancy :anaemia & low birth weight
mm
mm
m
mmmmm
mm
mm
m
mm
mm
mmmmmm
Malaria
Importance: Serious economic impacts in Africa. A disease of poverty — the poor in
malaria-prone rural areas live in poorly-constructed dwellings offering no barriers against mosquitoes.
Malaria is both preventable and treatable,
Resistance of parasite to drugs Resistance of mosquito to insecticdes
mm
mm
m
mmmmm
mm
mm
m
mm
mm
mmmmmm
Malaria
Agent: Plasmodium sp. P. falciparumP. vivaxP. ovaleP. malariae
Vector: AnophelineReservoir: Man
Mode of Transmission:
mm
mm
m
mmmmm
mm
mm
m
mm
mm
mmmmmm
Malaria
Mode of Transmission:
1-3 yrs : P. vivax 1 yr : P. falciparum
Mosquito
Man
Man
Mosquito
mm
mm
m
mmmmm
mm
mm
m
mm
mm
mmmmmm
Malaria
Mode of Transmission:
mm
mm
m
mmmmm
mm
mm
m
mm
mm
mmmmmm
Malaria
Mode of Transmission:Factors Influencing Transmission:
Host factors
Parasite factors
The vector
The environment
mm
mm
m
mmmmm
mm
mm
m
mm
mm
mmmmmm
Malaria
Immunity:
Unstable malaria: Low endemicity spleen rate ≤ 50%
Stable malaria: High endemicity spleen rate ≥ 50%
mm
mm
m
mmmmm
mm
mm
m
mm
mm
mmmmmm
Malaria
Immunity:
Unstable malaria: All population groupsStable malaria: Newborn:3-6/12(immune mothers): childhood: Clinical malaria
• Intermittent absence of parasitaemia.• Lower parasite density.• Premunition.• Splenomegaly.
mm
mm
m
mmmmm
mm
mm
m
mm
mm
mmmmmm
Malaria
Immunity:
Stable malaria:Adolescents and adults: Parasitaemia: sometimes Clinical symptoms: occasional
Pregnant: especially primigravidae Immunity
Use of prophylaxis:Delays the process of immunitySerious disease on re-exposure
mm
mm
m
mmmmm
mm
mm
m
mm
mm
mmmmmm
Malaria
mm
mm
m
mmmmm
mm
mm
m
mm
mm
mmmmmm
Malaria
Control (and Prevention):
Vector Reduction
Vector-host contact reduction
Parasite reduction
Research
mm
mm
m
mmmmm
mm
mm
m
mm
mm
mmmmmm
Malaria
Control (and Prevention):
Vector Reduction
• Breeding sites
• Destruction of larvae
• Adult anophelines
mm
mm
m
mmmmm
mm
mm
m
mm
mm
mmmmmm
Malaria
Control (and Prevention):
Vector-host contact reduction• Well screened areas.
• Mosquito nets (ITN).
• Cover most of the body.
• Use repellent on exposed skin.
• Insecticide spray.
• Antisporozoite vaccine?
mm
mm
m
mmmmm
mm
mm
m
mm
mm
mmmmmm
Malaria
Control (and Prevention):
Parasite reduction
• Chemotherapy
• Chemoprophylaxis
• Antimerozoite vaccine?
• Antigamitocyte vaccine? Research
mm
mm
m
mmmmm
mm
mm
m
mm
mm
mmmmmm
Malaria
- ITN- Treatment- Anemia- IPT:
IPTi: 3,6&9- 59%IPTcIPTsc: anemiaIPTp: twice
(RBM)Roll Back Malaria
Control (and Prevention):
WHO, UNICEF, UNDP and the World Bank,
mm
mm
m
mmmmm
mm
mm
m
mm
mm
mmmmmm
Malaria
mm
mm
m
mmmmm
mm
mm
m
mm
mm
mmmmmm
Malaria
Resurgence
The problem is increasing Vector:
Breeding site
Cost and resistance
Changing habits
Parasite:
Resistance and cost
mm
mm
m
mmmmm
mm
mm
m
mm
mm
mmmmmm
Malaria
Resurgence
Chloroquine 16 years
1940 1950 1960 1970 1980 1990
Fansidar 6 years
Mefloquine 4 years
Atovaquone 6 months
mm
mm
m
mmmmm
mm
mm
m
mm
mm
mmmmmm
Malaria
Population:
Movement.
In-cooperation.
Neighboring countries
Inadequate Control:
Political and economic.
Technical.
Resurgence
mm
mm
m
mmmmm
mm
mm
m
mm
mm
mmmmmm
Malaria
