malaria in zambia a refresher 2012. scope of presentation background on malaria overview of...
TRANSCRIPT
Scope of Presentation
Background on Malaria Overview of malaria in Zambia
Interventions Impact
Active Case Detection Case Management
Clinical features Treatment Prevention
Background
• Malaria is a disease caused by a tiny parasite• Transmitted through an infected bite of a
female anopheles mosquito• The malaria parasites enter and leave the
body through mosquito bites• An adult mosquito will only have parasites if it
has bitten a person infected with malaria• The parasites have a life cycle in humans as
well as in a mosquito
Overview of Malaria in Zambia
• Malaria is common throughout Zambia
• Seasonal and geographical differences
• A leading cause of death and sickness in children
• <5 years and pregnant women most at risk
• In 2010– 4.2 million cases – 4384 deaths reported
A new malaria map, calls for
new approaches
Type 1 –very low
Type 2 –low
Type 3 –mod/high
3 transmission zones
Percentage malaria parasite prevalence by province among children under age five years (Zambia 2006–2010)
Key Interventions
• Insecticide Treated Nets (ITNs), namely LLINs • Indoor Residual Spraying (IRS), 72 districts
(2011)• Intermittent Preventive Treatment of Pregnant
women (IPTp)• Case management
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Impact • 50% reduction in malaria mortality.• Need to sustain control over time• Reversal in Luapula, Northern and Eastern
Provinces• Specific interventions based on zoning to
sustain gains
Target: 5 malaria free zones in Zambia by 2015
Objectives
• Work with districts and local communities • Train community health workers to – Test for malaria– Treat positive cases
• Implement systematic campaign strategies at the rural health centre level
Reduce the parasite reservoir
• Actively look for people who transmit malaria but may have no symptoms
• Test in the community• Treat all confirmed cases• Enhanced surveillance
Clinical features
• Incubation period is 10 – 14 days• Characterized by fever which may be
continuous, periodic or irregular• Malaria may manifest as – an acute uncomplicated disease– a severe complicated disease
• Check blood to confirm the infection– Rapid Diagnostic test (RDT) – Parasite slide (microscopy)
Uncomplicated Malaria
• Early symptoms are usually non-specific • Fever is the most common symptom, but could be
from another infection• Headache, aching joints, back pain, nausea and
vomiting and general discomfort usually accompany fever.
• Patient may not have a fever but may have a history of fever
Severe Malaria
Examples of life threatening conditions are: Cerebral malaria General convulsions Unconsciousness Severe vomiting Excessive bleeding Extreme weakness• Fever >temperature of more than 38°C
Treatment
• For uncomplicated malaria:– Artemether –Lumefantrine combination
(Coartem)– Control fever: fanning, sponging or paracetemol– Take entire course of medicine– If drug is spat out within 30 min, repeat dose.– If persistent vomiting : REFER TO HEALTH CENTRE
• For severe malaria:– REFER TO HEALTH CENTRE
Prevention
• Malaria is a preventable disease:– Insecticide treated nets (ITNs)– Indoor residual spraying (IRS)– Intermittent Presumptive Treatment in pregnancy
(IPTp)– Proper treatment of malaria– Personal protection e.g. protective clothing– Environmental management• Clear stagnant waters, fill in pools and ponds, clear
vegetation