Communicable disease - Malaria

What is malaria?

A tropical vector-borne disease.

Caused by protozoan parasites and is transmitted to humans through the bite of a female Anopheles mosquito.

How is a parasite transmitted?

If the female Anopheles mosquito bites someone, the parasite can get into a person’s bloodstream, attacking the liver and affecting red blood cells.

What are symptoms of malaria?

Fever, headache, vomiting and appear 10-15 days after being bitten.

If not treated it can become life threatening as it weakens the immune system.

Where has the highest incidence of malaria?

Sub-Saharan Africa, with 90% of malaria deaths.

Also prevalent in Zambia, Tanzania and Mozambique.

What was incidence of malaria like just a few generations ago?

Malaria was common in many more places around the world than today.

Many parts of the USA and Europe have eliminated the disease.

What did the WHO say about malaria in 2018?

• 3.6 billon people in 91 countries lived in areas at risk of malaria transmission.

• Estimated 288 million cases occurred, killing around 405,000 people.

How many children die every minute due to malaria?

1 child every minute dies from malaria.

70% of deaths occur within the 5 and under age bracket.

What do child infections account for?

It accounts for 50% of the absence rates in school in African countries.

What does the disease cause in children?

Anaemia - blood condition with less red blood cells.

What are symptoms of malaria in advanced stages?

May cause destruction of red blood cells, kidney failure, fluid on the lungs, convulsions, coma and ultimately death.

How does malaria impact economic well-being?

• Prolongs the vicious cycle of poverty.

• Economic costs to families to purchase medication and travel to hospitals for treatment.

• Costs to governments in drugs, education and medical staff.

What is risk of malaria strongly linked to?

The natural environment.

Mosquitoes breed in stagnant water and transmission is greatest in areas during and just after the rainy season.

Where do malaria transmissions fall?

• At altitudes above 1500m.

• Rainfall is below 1000mm.

What conditions do parasites require?

Temperatures between 16’c and 32’c to develop inside the mosquito and this is one reason why the disease is largely concentrated in the tropics and sub-tropics.

What is the relationship between floods and malaria transmission?

• Areas receiving more flood events may show higher incidents of transmission over a longer period.

• Regions prone to drought may have shorter transmission seasons.

When is transmission of malaria greatest?

Just after the rainy season.

Where is malaria very prevalent?

Coastal areas at low altitude, small seasonal variation in temperature and relatively high humidity raise prevalence. (at high temperatures).

How can poor housing quality increase risk of malaria?

Homes with earth/sand floors using materials such as mud, bamboo cane or wooden trunks for walls.

How can high density occupancy increase risk of malaria?

Densely clustered built-up areas and overcrowded rooms (for sleeping) is an important factor.

High malaria incidence is associated with high infant mortality and subsequent high fertility rates.

How can unsanitary conditions increase risk of malaria?

Studies of malaria ‘hotspots’ in Chennai identified that although individual houses were clean, surrounding areas were dirty and polluted by rubbish and waste outflows.

What can be said about agricultural workers?

Agricultural workers, especially those working near irrigation stores, are more prone to malaria.

Why do poorer households have a higher risk?

They have less money to spend on prevention, e.g. insecticide treated nets.

What is higher incidence of malaria related to?

Related to a lack of education on the causes and risks of malaria infection, including poor hygiene and sanitation.

Why is risk higher in remote communities?

Remote communities without access to outlets selling prevention methods, and with a greater distance to travel to clinics and hospitals to treat malaria, are more at risk.

What is important with malaria?

Prompt and effective treatment.

What is widespread used to manage malaria?

• Use of insecticide-treated nets by people at risk - this can reduce transmission by 90%.

• Indoor spraying to control the vector mosquitoes.

• Burning mosquito coils.

What does the WHO have a target to do?

A target to reduce malaria incidence and mortality by 90% and to eliminate the disease from 35 countries by 2030.

What were the Post 2015 Sustainable Development Goal?

To ensure healthy lives and promote well-being for all at all ages.

What did Sri Lanka prioritize from the 1960s?

Prioritised malaria funding.

Mosquitoes were targeted - population provided with bed nets and medicines against the parasite.

Strong surveillance systems set up to monitor outbreaks.

What happened when Sri Lanka experience a resurgence of insecticide resistant mosquitoes and drug resistance malaria?

It adopted a change in strategy, stressing the need to eliminate both parasite and vector.

Government improved disease surveillance and efforts to interrupt transmission, in addition to spraying structures and distributing bed nets.

What was set up in Sri Lanka to combat malaria?

Mobile malaria clinic set up to diagnose and treat people early alongside community engagement and education programmes.

What happened in Sri Lanka despite their civil war?

Both parties recognised malaria ads a common enemy and agreed to stop fighting when anti-malaria work was being carried out.

A peace accord was even signed to facilitate the containment of war-induced malaria in affected areas.

What did Sri Lanka manage to recognise?

Elimination cannot happen in a vacuum.

Requires governments, NGOs, businesses and grant makers to work together.