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FACTS ABOUT MALARIA
Cynthia Dike, MPH student
Walden UniversityPUBH 6165-2
Instructor: Patrick Tschida 3rd Quarter, 2011
This presentation on malaria is created to increase the knowledge of visitors and foreign workers traveling to the Tropics and Subtropics region.
Outline
What is malaria?Epidemiology of the disease globallyBasic pathogenesis of the disease.Vulnerable population.The economic impactDiagnosing and advise on seeking
medical attention.Prevention of the Disease.
CONTENTS
1. What is malaria?Malaria is a vector borne disease.
2. Where is malaria found?Malaria is one of the most serious diseases to affect people in developing countries with tropical and subtropical climates. Malaria is prevalent in Africa, Central and South America.
Learning Outcome
3. The burden of malaria.Globally, 300–500 million episodes of malaria illness occur each year, resulting in over one million deaths. Socio-economic conditions and anti-malaria interventions have gradually reduced the areas of the world where malaria is endemic.
4. Types of malaria and the most fatal parasite.Species of malaria parasites are P. falciparum, P. vivax, P. malariae and P. ovale, P. falciparum is more likely to cause a severe and fatal disease
Learning Outcome (contd.)
5. The life cycle of malaria.Human malaria (Plasmodium parasite) is transmitted from an infected person to another person by Anopheles mosquitoes.
6. The symptoms and signs of malaria.The most important symptom of malaria is fever (or a history of fever within the last two to three days) after visiting a malaria infested area. An attack often begins with shivering (body shaking). This is followed by a period of fever, and finally there is profuse sweating. During an attack the patient often complains of headache and pains in the back, joints, and all over the body. Malaria can lie dormant for months after infection.
Learning Outcome(contd.)
7. The incubation period of malaria. Symptoms of malaria usually start to appear 7 to 21 days after the bite of an infected mosquito.
8. The danger signs of severe malaria. Confusion, seizures, weakness (unable to stand or sit), jaundice, dehydrated and anemia and kidney failure are some danger signs.
Learning Outcome (contd.)
9. How malaria is diagnosed?Microscopic diagnosis involves taking a small amount of blood from the patient, staining it and looking at it under a microscope to check for malaria parasites.
10. The treatment of malaria and list the different anti-malaria drugs. Drugs used in treatment are chloroquine, atovaquone-proguanil, artemether-lumefantrine, mefloquine, quinine, quinidine, doxycycline, primaquine and clindamycin. Some drugs may be resistant to the parasite.
Learning Outcome(contd.)
11. The prevention of malaria.Sleep in rooms with screened windows and doors. Use a mosquito net around the bed, impregnated with an insecticide such as pyrethrum or permethrin. Wear long-sleeved clothing and socks to protect against mosquitos’ bite. Mosquito repellent creams containing diethyl toluamide (DEET) and prophylaxis medications are also recommended.
Learning Outcome(contd.)
An infectious disease caused by a parasite.
Transmission is by the bite of an female anophele mosquito(WHO).
Reference:World Health Organizationhttp://www.who.int/topics/malaria/en/
WHAT IS MALARIA?
Plasmodium falciparumPlasmodium vivaxPlasmodium ovalePlasmodium malariae Reference:Davis C,. Malaria. Medicinenet.comhttp://www.medicinenet.com/malaria/article.htm
TYPES OF MALARIA
Predominantly in tropics and subtropics region.
Regions:- Asia, Africa, Central and South America
Malaria endemic in 109 countries worldwide
References:
1. World Health Organization
http://www.who.int/mediacentre/factsheets/fs094/en/index.html
2. Centers for Disease Control and Prevention
http://www.cdc.gov/malaria/about/distribution.html
WHERE IS MALARIA FOUND?
MALARIA GEOGRAPHICS
In 2006 - 3.3 billion people at risk worldwide (WHO). Approximately 247 million cases diagnosed (WHO).
In 2008 – 863,000 malaria deaths
In the U.S. approximately 1500 cases diagnosed annually (CDC).
Reference:
1. World Health Organization
http://www.who.int/mediacentre/factsheets/fs094/en/index.html
2. Centers for Disease Control and Prevention
http://www.cdc.gov/malaria/about/distribution.html
STATISTICS OF MALARIA
In the United States:- Travelers Immigrants
In endemic countries Children Pregnant women
Reference:
World Health Organization
http://www.who.int/mediacentre/factsheets/fs094/en/index.html
WHO IS AFFECTED?
Individuals who have a trait of sickle cell disease.
Parasite cannot live in abnormal red cells.
Protected from lethal complications of malaria
Reference:
Aidoo M., Terlouw D. J., Kolczak M.S., McElroyP.D., ter Kuile F. O., Kariuki S., Nahlen B. L., LalA. A., Udhayakumar V. Protective effects of the sickle cell gene against malaria morbidityand mortality .(2002) Lancet, 359: 1311–12
http://www.biomed.emory.edu/PROGRAM_SITES/PBEE/pdf/Udhayakumar6.pdf
WHO IS PROTECTED?
1. Anophele mosquito gets infected by infected human blood.
2. Mosquito transmit parasite to uninfected human through biting.
3. Parasite mature in human liver.
LIFE CYCLE OF PARASITE
4. Parasite leaves the liver and5. Invade red blood cells to multiple. In this process red cell are damaged and symptoms of disease are produced.
Reference:Malaria and the red cellhttp://sickle.bwh.harvard.edu/malaria_sickle.html
LIFE CYCLE OF PARASITE (contd.)
MALARIA LIFE CYCLE
Symptoms: Fever, rigors, sweating, malaise, headaches, vomiting,
jaundice.
History of recent visit to a malaria endemic location.
Laboratory work – blood drawn to observe the parasite microscopically.
Reference:
Centers for Disease Control and Prevention
http://www.cdc.gov/malaria/about/distribution.html
HOW MALARIA IS DIAGNOSED?
P. falciparum is the most dangerous species.
In pregnancy causes maternal death , abortions, still birth and low birth weight babies.
Reference:
World Health Organization
http://www.who.int/mediacentre/factsheets/fs094/en/index.html
THE DANGERS OF MALARIA
In Africa malaria accounts for 20% of childhood deaths.200,000 children die annually.maternal death rate is 10–50%. abortion rate - 60%.
Reference:
World Health Organization
http://www.who.int/mediacentre/factsheets/fs094/en/index.html
THE DANGERS OF MALARIA (contd.)
P. falciparum causes cerebral malaria, blackwater fever, acute renal failure, pulmonary edema, hypotensive shock and death.
P. vivax malaria can result in relapses after treatment.
Reference:
World Health Organization
http://www.who.int/mediacentre/factsheets/fs094/en/index.html
THE DANGERS OF MALARIA (contd.)
Significant economic losses
Decrease gross domestic product (GDP)
The health costs is a heavy-burden countries
Reference:
World Health Organization
http://www.who.int/mediacentre/factsheets/fs094/en/index.html
. Sachs J. and Malaney P. (2002). The economic and social burden of malaria. Nature, 415, 680-685.
http://www.rbm.who.int/cmc_upload/0/000/015/330/415680a_r.pdf
THE ECOMONIC IMPACT
Treatment depends on the type of parasite, drug susceptibility and patient clinical characteristics.
A rapid diagnosis is very important.
Contact a health care provider if develop fever after visiting a country in the tropics.
Reference:
Centers for Disease Control and Prevention
http://www.cdc.gov/malaria/about/distribution.html
ADVISE ON TREATMENT
Avoid skin exposure- wear long sleeves and trousers, hats and boots
Use insect repellants on exposed areas.
Sleep under Mosquito nets and coils.
Screen houses with mesh
Reference:
World Health Organization
http://www.who.int/topics/malaria/en/
PREVENTION OF MALARIA
Spray houses and surrounding area with insecticides.
The use of DDT insecticide is controversial.
Chemoprophylaxis- prescribed by relevant authorities.
Reference:
1. World Health Organization
http://www.who.int/topics/malaria/en/
2. United States Environmental Protection Agency
http://www.epa.gov/pbt/pubs/ddt.htm
PREVENTION OF MALARIA (cont.)
Avoid the outdoor in the evening and nights.
Remove pools of stagnated or standing water.
Reference:
World Health Organization
http://www.who.int/topics/malaria/en/
PREVENTION OF MALARIA (cont.)
Malaria is causes by a parasite, transmitted by the anophele mosquito is the vector.Endemic areas are tropics and subtropics. Protective measures is necessary when visiting these region.
SUMMARY
If complain of fever, headaches or feeling unwell during and after travel visit a doctor immediately to rule out malaria.
The key to a good outcome of treatment is early diagnosis.
SUMMARY (contd.)
1. Centers of Disease Control and Prevention.
2. World Health Organization.
3. United States Environmental Protection Agency.
3. Malaria and the red cell
http://sickle.bwh.harvard.edu/malaria_sickle.html
5. Davis C,. Malaria. Medicinenet.com
http://www.medicinenet.com/malaria/article.htm
REFERENCES
6. Aidoo M., Terlouw D. J., Kolczak M.S., McElroyP.D., ter Kuile F. O., Kariuki S., Nahlen B. L., LalA. A., Udhayakumar V. Protective effects of the sickle cell gene against malaria morbidityand mortality .(2002) Lancet, 359: 1311–12
http://www.biomed.emory.edu/PROGRAM_SITES/PBEE/pdf/Udhayakumar6.pdf
7. Sachs J. and Malaney P. (2002). The economic and social burden of malaria. Nature, 415, 680-685.
http://www.rbm.who.int/cmc_upload/0/000/015/330/415680a_r.pdf
8. Chedrese P. J. and Feyles F. (2001).The diverse mechanism of action of dichlorodiphenyldichloroethylene (DDE) and methoxychlor in ovarian cells in vitro. Reproductive toxicology, 15; 680-685. DOI: 10.1016/S0890-6238(01)00172-1
http://www.sciencedirect.com/science/article/pii/S0890623801001721
REFERENCES (contd.)
3. Denholm I., Devine G. J., Williamson M. S. (2002). Evolutionary genetics. Insecticide resistance on the move. Science 297 (5590): 2222–3. Doi: 10.1126/science.1077266
4. Rhouma K. B., Tebourbi O., Krichah R., Salkly M. (2001). Reproductive toxicity of DDT in adult in male rats. Human and Experimental Toxicology, 20; 8, 393-397.
5. Cohn, B., Wolff, M., Cirillo P., & Sholtz R. (2007). DDT and Breast Cancer in Young Women: New Data on the Significance of Age at Exposure. Environmental Health Perspectives, 115(10), 1406-1414.
EXTRA READING INFORMATION
6. Salazar-Garcia F., Gallardo-Diaz E., Cerón-Mireles, P., Loomis, D., & Borja-Aburto, V. (2004). Reproductive effects of occupational DDT exposure among male malaria control workers. Environmental Health Perspectives, 112(5), 542-547.
EXTRA READING INFORMATION