8/19/2019 Malaria: Old infections, Changing Epidemiology

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Malaria: Old infections, Changing Epidemiology

8/19/2019 Malaria: Old infections, Changing Epidemiology

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Presented by:

  Muhammad Waqas

(Bscn!"!#$%

Presented to:

Ms& 'obina ouser 

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Ob)ecti*es:+t the end of this presentation learner ill be able to:

-dentify a topic of research article related to public

health&

.efine the selected topic

.iscuss the distribution and pre*alence of problem&

.iscuss the ma)or determinant factors of problem&

.iscuss the morbidity and mortality associated ith

 problem&

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Cont&0&.escribe the problem ith the use of a model of the

natural history

.escribe the problem ith the use of rele*antliterature&

.iscuss the pre*enti*e measures for problem&

E/plains role of nurse in the pre*ention and

management of disease

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Malaria: old infections, changing

epidemiologyD.J. Bradley

 Department of Epidemiology and Population

Sciences, London School of Hygiene and Tropical Medicine, London, UK 

'esearch Conducted in +frica

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-ntroduction of 1opicMalaria has been around since ancient times& -t is old

-nfection that has affected the orld and its people

since the beginning of recorded human history,malaria remains an entrenched global health

challenge&

1he epidemiological pattern is changing& -n spite of

this long2term host2parasite relationship, there ha*e been ma)or epidemiological changes in human malaria

o*er the last fifty years and they are ta3ing place at an

accelerating rate&

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Cont&0&-n the +frica, ater2resource de*elopments and

En*ironmental 4actors tend to lengthen the

transmission season, though less than might bee/pected&

1he spread of multiple drug resistance of the parasites

is ma3ing case management harder and deaths rises&

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.istribution and Pre*alence5lobal geography of malaria is increasingly

disproportionate& 1he *ast ma)ority of malaria cases

and malaria2related deaths occur in sub26aharan+frica&

+bout 78 of all malaria deaths in the orld today

occur in +frica south of the 6ahara&

1his is because the ma)ority of infections in +fricaare caused by Plasmodium falciparum&

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Cont&0&Malaria is endemic in some of the offshore islands to

the est of mainland +frica 9 6ao 1ome and Principe

and 6o 1iago -sland of Cape ;erde& -n the east, malaria is endemic in Madagascar, in the

Comoro islands (both the -slamic 4ederal 'epublic of

the Comoros and the 4rench 1erritorial Collecti*ity of

Mayotte% and on Pemba and <an=ibar&-n Mauritius, malaria has been ell controlled since

the "7>s, but occasional outbrea3s of *i*a/ malaria

occur&

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Prevalence1he course of malaria as a orld problem has one of

massi*e incidence and pre*alence rate ith great

mortalityPrevalence of Malaria in Africa

E/posed !,?# million

-nfected !? million

-ll "" million.ied " million

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Ma)or determinants factors of

Malaria+lthough there are *arious factors that contribute to

Malaria disease, in hich the first factor is its agents&

Plasmodium falciparum – mainly found in +frica, itis the most common type of malaria parasite and is

responsible for most malaria deaths orldide&

 Environment is an other important determinant,

changes in the en*ironment may also contribute in thedisease occurrence, i&e Malarial Parasite Can@t 6ur*i*e

in Cold Climate& +nd Malarial Cases increased armer

climate&

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Cont0

-n the +frica, ater2resource de*elopments and

En*ironmental 4actors tend to lengthen thetransmission season, though less than might be

e/pected&

6ocio2economic conditions and the public health

infrastructure also contribute in the diseasedistribution

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Morbidity and Mortality#2> million clinical cases of malaria that occur

globally each year, 7 percent of them are in +frica&

+n estimated one million people in +frica die frommalaria each year and most of these are children under >

years old&

Malaria causes at least !8 of all deaths in children

under > years of age in +fricaA> 8 of all malaria deaths in +frica occur in young

children&

-n e*ery " Min , a child dies of malaria of +frica

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 'esearch .esign.escripti*e Obser*ational 6tudy

On the bases of

Case report Case series

6ur*ey

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Model of the natural history

+gents+gents of malaria are the four species of

 plasmodium, P&*i*a/, P&falciparum, P&o*ale ,P& 

malariae&

Ma)ority of infections in +frica are caused by

 Plasmodium falciparum, the most dangerous of the

four human malaria parasites and the most difficult

to control

osts

+nopheles0*ector a 3ind of female mosquito

umans 1he agents transmit into human through

mosquito bite

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Cont&0&En*ironment

En*ironment play an important role in the disease

occurrence& En*ironment suitable for mosquitos can

enhance the disease

+gent, host, and en*ironmental factors interrelate in a

*ariety of comple/ ays to produce disease in humans&

By eradicating one of the factor(+gent, host anden*ironment%, the hole disease process may be eradicated

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Diterature 6upport inety2fi*e million of Pa3istan@s "$" million people,

roughly $8 of Pa3istanFs population, li*e in malaria

endemic regions& (hata3 etal& !"#%+fter eradication efforts in the "7$s, malaria surged

 bac3 to an epidemic le*el in the "7?s&

(hata3 etal& !"#%

-n recent years, an uptic3 in malaria can be partially

attributed to floods that affected appro/imately !

million people in o*er $ districts&

(1arar etal&!"#%

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Cont&0&.espite a ell2established malaria control

 programmed, >, malaria infections and >,

malaria2attributable deaths occur each year inPa3istan, ith appro/imately #?8 of cases estimated

to occur in regions along the borders ith +fghanistan

and -ran& (Gasin=ai,!"#%

Caused By Plasmodium *i*a/(responsible forappro/imately $H8 of infections% and Plasmodium

falciparum(causing #$8 of infections%&

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Cont&0&Malaria is primarily found in the pro*inces of hyber

Pa3htun3ha, Balochistan, 6indh and the 4ederally

+dministered 1ribal +reas& (Gasin=ai,!"#%

Malaria transmission is considered to be unstable, ith

ma)or P& *i*a/ transmission pea3ing from Iune to

6eptember and again in +pril to Iune, hen relapses of

infections acquired the pre*ious season are obser*ed&1he ma)or transmission period for P& falciparum in

Pa3istan is beteen +ugust and .ecember& (1arar

etal&!"#%

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Pre*enti*e measures:Malaria can often be a*oided using the +BC. approach to

 pre*ention hich stands for:

Awareness of risk 9 find out hether you are at ris3 of

getting malaria&

Bite prevention 9 a*oid mosquito bites by using insect

repellent, co*ering your arms and legs and using a mosquito

net&

Check whether you need to take malaria prevention

talets 9 if you do, ma3e sure you ta3e the right antimalarial

tablets at the right dose, and finish the course&

Dia!nosis 9 see3 immediate medical ad*ice if you

ha*e malaria symptoms,

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Cont06tay inside hen it is dar3 outside, preferably in a

screened or air2conditioned room

Wear protecti*e clothing (long pants and long2slee*edshirts%&

Jse insect repellent ith .EE1 (,

diethylmetatoluamide%& 1he repellent is a*ailable in

*arying strengths up to "8& -n young children, usea preparation containing less than !H8 strength,

 because too much of the chemical can be absorbed

through the s3in&

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Cont0Jse bed nets (mosquito netting% sprayed ith or soa3ed

in an insecticide such as permethrin or deltamethrin& But

ma3e sure that these insecticides still or3 against the

mosquitoes here you are& -n some areas, mosquitoes

ha*e become resistant to permethrin and deltamethrin& 6o

the bed nets do not offer much protection&

Jse flying2insect spray indoors around sleeping areas&+*oid areas here malaria and mosquitoes are present

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Cont0+s a result of the scale2up of use of insecticide2

treated nets, -ndoor residual spraying, intermittent

 pre*enti*e treatment during pregnancy and+rtemisinin2based combination therapy, " countries

in the WO +frican region ha*e reduced malaria

cases&

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'ole of urse:

+t community the nurse can educate people by

organi=ing seminars and also teach them about further

complications of the disease& urses could conduct a medical camp ith the

cooperation of the go*ernment at different endemic

regions mostly rural areas&

By distributing pamphlets and displaying banners at public places&

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'eferencesBradley,.&)& (!>% Malaria: old infections, changing

epidemiology : Department of Epidemiology and

 Population Sciences, London

hatta3, +&,;en3atesan,M&,adeem,4,M&, Gaqoob,+&, K

6trauss, & (!"#%& Pre*alence and distribution of

human Plasmodium infection in Pa3istan&  Malaria

 Journal of Paistan! Retrieved fromhttp://www.malariajournal.com/content/12/1

/   297

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Gasin=ai,& M& - K a3arsuleman3hel,& I& & (!"#%& Pre*alence

of human malaria infection in Pa3istani areas bordering

ith -ran& Journal of Paistan Medical association& 'etrie*ed

fromhttp:LL&)pma&org&p3Lfullarticlete/t&phpNarti

cleidH>"

1arar, +& 6 K +yub, 6& M& (!"#%& Malaria& .irectorate of

Malaria Control of Pa3istan& 'etrie*ed 4romhttp:LL&dmc&go*&p3Linde/&phpNoptioncomcont

entK*iearticleKid>>K-temid?A

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