P&E CS - communicable and non-communicable diseases

MALARIA and ASTHMA

What is malaria and it’s symptoms?

Water borne disease caused the bite of an insect carrying a parasite eg mosquito

• sickness

• high fever and shaking chills

• headaches and confusion

• yellow skin/whites of eyes

The early symptoms of malaria are similar to many other conditions, so people often don't realise they are infected until the disease is more advanced

How does malaria spread?

female anopheles mosquito

when an infected mosquito (carrying parasite) bite someone the infection is passed into the human bloodstream

in turn mosquitos can bite infected humans and get the parasite going on to infect more people

positive feedback loop

What is the prevalence of malaria worldwide?

• in 2020 241 million cases predicted worldwide

• approximately 600,000 deaths per year

• WHO African region is home to a large number of the cases 85-95%

• mainly in the tropics

What 4 physical factors cause malaria?

• high altitudes

• high humidity 60%+

• areas of stagnant water (for mosquitoes to breed) eg padi fields

• temp above 14ºC and below 40ºC

What 4 human factors cause malaria?

• houses creating areas of shade for mosqiotos to rest

• global air travel contributes to spread

• settlements frove populations for mosquitos to feed (blood)

• poor sanitation, unclean water etc in areas of pverty

what are the consequences of malaria for populations?

• large number of children dying

• adults that are infected are too weak to work reducing productivity for their family worsening poverty

• lack of food due to poverty makes people malnourished and more vulnerable

• decreases in tourism

all impacts the rate of a country’s development

What are the two main categories of method for controlling malaria?

• treating the host (human)

• treating the vector (mosquito)

What 3 methods of treatment for the host are there for malaria control?

• preventing bites = Insect repellent containing DEET, educating people (covering arms and legs after dusk), insecticide treated mosquito nets

• drugs such as chloroquine and quinine sulphate

• Government efforts - MDGs

How can drugs be used to combat malaria?

mosquitoes can build resistance meaning the need for new drugs is urgent

• once person starts to show signs of malaria anti-malarial drugs are needed as soon as possible to fight off the disease

• not all people in countries like malawi have accessibility to drugs as people live rurally and travel long distances to healthcare

• WHO has aimed to help this issue

what are millennium development goals?

adopted by governments in 2000 to reduce malaria by 2015

use a number of strategies to prevent malaria in developing countries such as malawi.

effective method used has been insecticide treated bed nets (ITNs) that are cost effective at only £3 per net, however not affordable in certain developing countries.

to combat this health charities such as Nothing But Nets have distributes ITNs

MDG have been extremely effective in decreasing the prevalence of malaria since 2000

• death rates 2000-15 decreased by 60%

• sick children being treated with appropriate drugs more increased by 100%+

What 4 methods of treatment for the vector are there for malaria control?

• drain breeding grounds of stagnant water

• larvae eating fish eg guppies

• genetic engineering to sterilise male mosquitos

• insecticides sprayed where they are likely to come into contact with humans however a level of resistance has been built up so are not less effective

How is the WHO working to prevent malaria?

launched campaigns to eradicate malaria using inseditices and drugs

research into finding ways to cure and prevent malaria

WHO are currently running the malaria vaccine implementation programme in some sub saharan african countries as part of a pilot program.

How is the red cross working against malaria?

• provide emergency medical care (short-term aid)

• help provide training and education in primary healthcare in malarial regions (long-term aid)

what is asthma?

WHO defines it as a chronic disease characterized by recurrent attacks of breathlessness and wheezing, varying in severity from person to person.

asthma attacks are associated with narrowing of the bronchial tubes that allow air to pass in and out of the lungs

what is the mortality rate of asthma?

less than 1% of all deaths are linked to asthma worldwide but this varies between countries (most deaths occurring in low and lower middle income countries.)

It can’t be cured so is a long-term illness but for most sufferers can be treated and controlled by self medication via an inhaler

What is the global prevalence and distribution of asthma?

300 million people worldwide have asthma, but further research is needed into the impacts of disease due to increase in recent prevalence

historically mainly affected HDEs but not mostly impacts people in low and middle income countries and prevalence in these locations is increasing the fastest

burden of asthma is most prevalent in elderly aged 75-79 and young people 10-14

What are the two categories of triggers of asthma?

environmental factors

family history

What environmental factors can trigger asthma?

most likely to be the cause after the age of 12

• exposure to different allergens that trigger or worsen asthma symptoms, at home or in the workplace

• wide range of workers identified as high risk for asthma, bakers, carpenters, hairdresser etc

• positive correlation between increased affluence in society and incidence of asthma due to cleaner homers and less exposure to parasite and pathogens

• hygiene hypothesis states we need this exposure to fully develop our immune system

How can family history cause asthma?

a family history of asthma is a high risk factor for developing the disease, particularly before the age of 12

up to 80% heritable but varies

what is the impact of asthma on people’s lives?

change in lifestyle to manage the impacts

• severe asthma attacks causing paranoia

• regular use of medication

• issues with cold damp weather so taking specific precautions

• aiming to avoid getting colds/flus that may impact symptoms worse

takes effect much earlier in life than other chronic illnesses so had a burden for the majority of a person’s life as well as families around them.

How can the burden of asthma be measured?

Daily adjusted life year (DALY) is a measure of overall disease burden

• expresses number years lost due to ill-health, disability and death

• higher the DALY the higher the number of healthy years lost

• asthma sufferers may die young, or have their education career disrupted

How does the DALY for asthma vary across the world?

• the UK ranks at the middle of the scale with 475-524 days lost per 100,000

• the worse burdened area is papua new guinea

• least burdened areas are asia

What 3 ways can asthma be managed?

once prescribed appropriate medication and given support asthma can be managed by …

1. avoiding trigger factors

2. taking preventative medication such as inhaled steroids that continuously prevent narrowing of a patient’s airways.

3. using different set of prescription drugs to reduce effects of the disease

however if incorrectly diagnosed and triggers not understood can lead to attacks, which can therefor have implications for the economy/individuals (hospital overnight stays etc)

What are some international agencies and NGOs involved in management and mitigation of asthma?

• Global initiative for asthma

• world allergy organisation

• WHO

• Asthma UK (charity)

What 5 roles do international agencies and NGOs play in management and mitigation strategies of asthma?

• raise awareness of asthma and the severity of the number of people affected by it

• educate medical staff in diagnosis and long/short term care

• educate policy makers for better investments in treatment

• educate sufferers on the preventive action they can take

• promote further research

How has fast food been linked to asthma?

The international study of asthma and allergies in childhood conducted a large scale study of the impacts of certain diets on the condition.

found that 3 or more servings of fast food a week put people as a significantly higher risk of asthma as well as worsening existing symptoms.

in contrast 3 or more portions of fruit a week reduced severity of symptoms by 14%