facts about malaria cynthia dike, mph student walden university pubh 6165-2 instructor: patrick...

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.


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.


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?

http://www.who.int/topics/malaria/en/


Plasmodium falciparumPlasmodium vivaxPlasmodium ovalePlasmodium malariae Reference:Davis C,. Malaria. Medicinenet.comhttp://www.medicinenet.com/malaria/article.htm

TYPES OF MALARIA

http://www.medicinenet.com/malaria/article.htm


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:



2. Centers for Disease Control and Prevention


STATISTICS OF MALARIA





In the United States:- Travelers Immigrants

In endemic countries Children Pregnant women

Reference:

World Health Organization


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.)

http://sickle.bwh.harvard.edu/malaria_sickle.html



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


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:



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:



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:



THE DANGERS OF MALARIA (contd.)


Significant economic losses

Decrease gross domestic product (GDP)

The health costs is a heavy-burden countries

Reference:



. 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


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:



PREVENTION OF MALARIA


Spray houses and surrounding area with insecticides.

The use of DDT insecticide is controversial.

Chemoprophylaxis- prescribed by relevant authorities.

Reference:



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:



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


5. Davis C,. Malaria. Medicinenet.com


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


7. Sachs J. and Malaney P. (2002). The economic and social burden of malaria. Nature, 415, 680-685.


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

http://en.wikipedia.org/wiki/Digital_object_identifier

http://dx.doi.org/10.1126/science.1077266

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

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