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mmmmm. Infectious Diseases. CHP400 COMMUNITY HEALTH PROGRAM-II. Emerging and Re-emerging Infectious Diseases. Malaria Epidemiology & Control. mmmmm. mmmmm. Mohamed M. B. Alnoor. Malaria. mmmmm. mmmmm. Importance:. mmmmm. 1/2 world pop: live in malarious areas - PowerPoint PPT PresentationTRANSCRIPT
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Mohamed M. B. Alnoor
CHP400COMMUNITY HEALTH PROGRAM-II
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Malaria
Epidemiology
& Control
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Malaria
Importance:1/2 world pop: live in malarious areas219 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 childrenpregnancy :anaemia & low birth weight
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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
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Malaria
Agent: Plasmodium sp. P. falciparumP. vivaxP. ovaleP. malariae
Vector: AnophelineReservoir: Man
Mode of Transmission:
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Malaria
Mode of Transmission:
1-3 yrs : P. vivax 1 yr : P. falciparum
Mosquito
Man
Man
Mosquito
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Malaria
Mode of Transmission:
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Malaria
Mode of Transmission:Factors Influencing Transmission:
Host factors Parasite factors The vector The environment
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Malaria
Immunity:
Unstable malaria: Low endemicity spleen rate ≤ 50%
Stable malaria: High endemicity spleen rate ≥ 50%
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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.
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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
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Malaria
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Malaria
Control (and Prevention):
Vector Reduction Vector-host contact reduction Parasite reduction Research
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Malaria
Control (and Prevention):
Vector Reduction• Breeding sites• Destruction of larvae• Adult anophelines
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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?
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Malaria
Control (and Prevention):
Parasite reduction• Chemotherapy• Chemoprophylaxis• Antimerozoite vaccine?
• Antigamitocyte vaccine? Research
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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,
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Malaria
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Malaria
Resurgence
The problem is increasing Vector:
Breeding siteCost and resistanceChanging habits
Parasite: Resistance and cost
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Malaria
Resurgence
Chloroquine 16 years
1940 1950 1960 1970 1980 1990
Fansidar 6 years
Mefloquine 4 years
Atovaquone 6 months
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Malaria
Population: Movement. In-cooperation. Neighboring countries Inadequate Control: Political and economic. Technical.
Resurgence
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Malaria