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Vector ControlModule 1A

Malaria

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Worldwide Malaria Incidence

Key cause of morbidity and death in Afghanistan, Pakistan, Yemen, Timor, Key cause of morbidity and death in Afghanistan, Pakistan, Yemen, Timor, Aceh Indonesia, all Sub Saharan humanitarian crises plus othersAceh Indonesia, all Sub Saharan humanitarian crises plus others

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Malaria’s toll

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• Many types of Many types of mosquitoes, but 3 mosquitoes, but 3 main Anopheline main Anopheline species transmit species transmit malaria in Africamalaria in Africa

• Up to 500 million people infected each year

• 1.6-2.5 million deaths annually

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Behaviour of mosquitoes

Genus Breeding site Disease and distribution

Anopeline mosquito

Anopheles gambiae

arabiensis

funestus

Biting period : NIGHT

Non polluted water: Edges of rivers, swamps, tanks,

rice fields, saltwater without wave action,

Malaria : Tropical and sub-tropical

Filariasis : Asia and Africa

Aedes mosquito

Biting period : DAY

Small water containers:

Cans, jars, gutters

Yellow fever : Africa and Americas

Dengue : Africa and Americas, Asia

Filariasis : Pacific

Culex mosquito

Biting period : NIGHT

Any dirty water: Waste water ditches, latrines, septic pits,

Filariasis : Most tropical areas

Encephalitis virus: worldwide

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NATURAL DISASTERS

• African anopheles species are very efficient vectors, well adapted to breeding in clean flood waters

I.E. NE Kenya Flooding 1997, 2006, 2008

Aceh, Indonesia – Tsunami Dec 2004

Some Asian anopheles species breed efficiently in brackish water (Aceh & Burma)

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What causes malaria?• Mosquitoes transmit

malaria parasites to humans when they bite them and feed off people’s blood.

• There are four types of malaria but only one type that kills. This is the most common type in Africa.

Falciparum

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Locating the hostWhile many mosquitoes may bite in the day, ones carrying malaria bite only after dusk and before dawn.

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WHAT ARE THE SIGNS AND SYMPTOMS OF MALARIA

UNCOMPLICATED• Fever• Headache• Vomiting• Diarrhoea• Cough• Chills, Muscle pains

COMPLICATED• Confusion or

drowsiness with extreme weakness

• May develop: coma, convulsions, jaundice, high fever, shock, abnormal bleeding

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Children can die within 8 hours from onset of clinical symptoms so rapid and effective treatment seeking is vital.

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Effective malaria case management

Rapid malaria tests

Artemisinin based combination therapy (ACT) for uncomplicated malaria

IM artemether treatments for severe cases

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Disease burden of malaria is increasingbecause….

• War and conflicts• Disasters• No effective vaccine• Drug resistance: parasite and vector• Population growth in endemic areas• Population migrations

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StableStable

WarWar

Refugees/Refugees/IDPsIDPs

>90% of falciparum cases occur in sub Saharan Africa>90% of falciparum cases occur in sub Saharan Africa>90% of all malaria deaths occur in sub Saharan Africa>90% of all malaria deaths occur in sub Saharan Africa

EpidemicEpidemic

2002

1997/981999

2000/012001

2006/7

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Malaria Prevention Tools / Strategies in Complex Emergencies

• Personal protection from vectors

• Vector control• Chemophylaxis (anti-

malarials only)• Intermittent

Preventive Treatment (malaria only)

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Anopheles: clear ground water

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Issue for Control

• Most insects have short flight ranges but Anopheles can fly 2 km to find host:

All Breeding sites within that zone must be eliminated for this strategy to be effective

Slashing grass and maize has no impact on mosquito biting

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Environmental Control• Generally this means the elimination of

mosquito breeding sites. • This is not usually feasible because of

human resources needed, the extent of the breeding sites and operational cost.

• Some breeding sites may also be the only available water for the population.

• Breeding sites for malaria mosquitoes are extensive a they can breed in the water left in a footprint!

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Other vector control modules

• Information education and communication

• Net distribution

• Insecticide treated material