Infant and Child Health - Malaria and Tuberculosis

Flashcards about Malaria and Tuberculosis, including symptoms, transmission, and treatment, based on lecture notes.

What is Malaria?

A life-threatening disease caused by parasites transmitted through the bites of infected female Anopheles mosquitoes.

In 2023 ____ was home to 94% of malaria cases and 95% of malaria deaths.

africa

Which age group accounts for about 76% of all malaria deaths in Africa?

children under five

During which season/time period throughout the year do most malaria cases occur? What impact does this have?

growing season; illness can cause long-term food insecurity

What impacts does malaria have on education, the economy, and health systems in Africa?

• significantly harms school attendance and academic achievement

• decreases workers’ productivity which negatively impacts society, the economy, and general development

• places a high burden on health systems as about 30% of outpatient visits in Africa are due to malaria

What are the symptoms of uncomplicated malaria? Severe malaria?

• Fever, chills, and malaise.

• cerebral malaria

What are the three ways that malaria kills children?

1. infection in pregnancy —> low birth weight/preterm

2. acute febrile illness (sudden fever/sickness with no clear cause)

3. chronic repeated infection—anemia

What other condition/diseases that with co-infection with malaria increases morbidity?

HIV

What are the four species of Protozoan Parasite: Plasmodium that cause parasitic infections? Which is the most serious?

1. Plasmodium falciparum (most serious)

   • 90% of cases in Africa

   • 50% of cases in Latin America and Asia

2. Plasmodium vivax

   • most dominant malaria parasite in most countries outside of sub-saharan Africa

3. Plasmodium ovale

4. Plasmodium malariae

How is human malaria transmitted?

The bite of females of the genus Anopheles.

The anopheles gambiae are the most effective vector of malaria. During what season does their abundance correlate? When do they typically feed on humans? What new evidence has emerged about their feeding preferences?

• seasonal abundance correlates with rainfall

• 90% of blood-meals taken from sleeping human hosts

• new evidence suggests that the mosquitos increasingly bite during the day

  • this has been supported by an increase in malaria cases in school-aged children

  • complicates malaria control ☹

Larval habitat

• refers to environments conducive to the breeding of mosquitoes, such as stagnant water, puddles, or marshes, which provide ideal conditions for larvae to develop

• rice fields and irrigated areas provide anopheles breeding sites in vietnam and gambia

• water storage pots breeding site in nigeria

• roof water breeding site in Maritius

What are some methods of malaria primary prevention?

Personal protection, vector control, malaria prophylaxis, new vaccines, and intermittent preventative treatment.

What is one of the most effective forms of primary malaria treatment for personal protection?

• insecticide treated bed nets (ITNs) and long-lasting insecticide treated bed nets (LLITNs)

• have been shown to reduce clinical cases by half

• very cost effective!

While access to bed nets has been steadily increasing, there are still some issues to solve. What are barriers to access to ITNs?

• production

• distribution

• human behavior

  • ex: improper usage

What is a form of vector control for malaria prevention?

indoor residual spraying

What is secondary prevention for malaria characterized by?

Prompt diagnosis and treatment.

How are all pediatric fever cases treated (with regard to malaria)?

it is assumed that any pediatric fever case could be malaria, so they are treated with antimalarials

What is the best treatment for malaria?

Artemisinin-based combination treatments (ACTs).

What arising issue is negatively impacting malaria control and prevention?

increasing drug resistance

What are the two currently WHO approved malaria vaccines? What is the status of vaccine roll-out in Africa?

1. RTS,S/AS01

2. R21/Matrix-M

vaccines are now being rolled out in routine childhood immunization programs across Africa

What is IPTp? When does WHO recommend the treatment to start?

• intermittent preventive treatment in pregnancy

• a full therapeutic course of antimalarial medicine given to pregnant women at routine antenatal care visits, regardless of whether the recipient is infected with malaria

• WHO recommends that IPTp be given to all pregnant women starting as early as possible in the second trimester

  • receive at least three doses at least one month apart

  • can be safely administered up until the time of delivery

What is Tuberculosis?

An infectious bacterial disease caused by Mycobacterium Tuberculosis that most commonly affects the lungs.

What are the symptoms of active TB of the lung? How is this different in healthy people?

• Coughing (sometimes with sputum or blood), chest pains, weakness, weight loss, fever, and night sweats.

• in healthy people, infection often causes no symptoms

How is Tuberculosis transmitted?

Via droplets from the throat and lungs of people with the active respiratory disease.

In which country is the burden of disease for TB highest?

India

How is TB disease generally treated?

6-month course of 4 antibiotics, including rifampicin and isoniazid.

What current issue poses a major threat to decreasing TB deaths?

multidrug-resistant TB (MDR-TB)

The leading cause of death among people with HIV is ______.

tuberculosis

Which age group is most at risk for developing active TB?

very young children under 5 (mainly pulmonary TB)

True or false: TB is harder to diagnose in children and adolescents.

true

• it is often overlooked by health care providers because…

  • clinical signs and symptoms are nonspecific

  • diagnostic specimens are hard to obtain from children

What vaccination can protect children from severe kinds of TB? What kind of TB infection is it not clearly effective in preventing?

• BCG vaccination

• not clearly effective in reducing risk of pulmonary infectious TB

What is the treatment for childhood TB? What issue complicates treatment?

• 6-8 months of directly observed therapy short course (DOTS)

  • similar to adults

• emergence of multidrug resistant strains

What is the purpose of IMCI (integrated management of childhood diseases)? What is the goal?

• most children suffer from several conditions, so child health programs need to go beyond single diseases and address overall health

• Goal: improvement of health practices in health facilities and at home.

What are the three components of the IMCI (Integrated Management of Childhood Illnesses)?

1. Improvement in case-management skills of health staff

2. improvements in health systems (primary care and referral)

3. improvement in family and community practices

What key conditions are addressed by the IMCI (Integrated Management of Childhood Illnesses)?

ARI, diarrhea, measles, malaria, and malnutrition

What are the systematic steps for IMCI (Integrated Management of Childhood Illnesses) for the sick child?

Examine for danger signs —→ assess main symptoms —→ classify (as urgent referral, treatable in clinic, or treat at home) —→ treat in clinic or at home —→ counsel caretaker—→ follow-up and monitor progress

What are challenges of IMCI?

• health system development —→ expanded capacity at service-delivery level

• training requires more than 10 days—→ maintaining the quality of trainings is difficult

• importance of good supervision of health workers

• community awareness and education

• inclusion of the perinatal period

• inclusion of trauma and surgical conditions

• adaptation of the program to local conditions, based on local epidemiology