MALARIADr . Krithiga SPG Community Medicine

FrameworkIntroductionProblem statementEpidemiological triadLifecyclePrevention

The term malaria originates from Italian: mala

aria — "bad air“ in 18th century.

Formerly called ague or marsh fever due to its

association with swamps and marshland

In 1897, Ronald Ross established the life cycle

of plasmodium and identified that infection was

transmitted by Anopheles.

Problem statement

216 million cases of malaria in 2011 and an

estimated 660 000 deaths

Fallen by more than 25% globally since 2000

Africa account for over 40% of the estimated total of

malaria deaths globally.

Cause specific malarial mortality rate – 19.8 per lac

population.

7% of under 5 mortality (cerebral malaria &

anaemia).

India

95 % malaria prone area

Unevenly distributed

1.5 - 2.million cases annually / yr

27% - high transmission areas.

(High transmission >1 case/ 1000 popln)

92% of cases & 97% of death – north-eastern states.

API has declined from 3.29 (1995) to 1.10 (2011)

Malaria trend in India

Epidemiological determinants

Agent

Host Environment

Vectors:

LIFE SPAN: 10- 12 days

CHOICE OF HOST : anthrophilic species

RESTING HABITS : endophily, exophily

BREEDING HABITS: moving water, wells, fountain,

garden pools (clean water)

TIME OF BITING : night time

An. culicifacies- rural , periurban An. fluviatilis- forest, hilly areaAn. stephensi – urban, industrialAn. minimus – foot hillsAn. philippinensisAn. sundaicus

Asexual cycle

Sexual cycle in mosquito

PreventionStratification of the problem

◦Case detection◦Early diagnosis and treatment◦Sentinel surveillance

Integrated vector controlNational vector borne disease

control programme

Main activities of NVBDCP

Formulating policies & guidelines Technical guidance Planning ,Monitoring & evaluation Coordination of activities with national organization Collaboration with international organisation Training Facilitating research Coordinating control activities

Malarial Indices ABER = No. of blood smears examined during the year x 100

Population covered under surveillance

API = Confirmed cases of malaria during one year x 1000 Population covered under surveillance

SPR= No of blood smears found positive for malaria parasite x 100 No. of blood smear examined

Millennium development Goals (MDG)

MDG 6 : Combat HIV/AIDS, malaria and other diseases Indicators Target 6a: Halt and begin to reverse the spread of HIV/AIDS Target 6b: Achieve, by 2010, universal access to treatment for HIV/AIDS for all those who need it

Target 6c: Halt and begin to reverse the incidence of malaria and other major diseases

6.6 Incidence and death rates associated with

malaria

6.7 Proportion of children under 5 sleeping under

insecticide-treated bed nets

6.8 Proportion of children under 5 with fever who

are treated with appropriate anti-malarial drugs

6.9 Incidence, prevalence and death rates associated

with tuberculosis

6.10 Proportion of tuberculosis cases detected and

cured under directly observed treatment short

course

Roll Back malaria

• RBM is a global partnership founded in 1998

by (WHO), (UNDP), (UNICEF) and the World

Bank with the goal of halving the world's

malaria burden by 2010.

• It forges consensus among key actors in

malaria control, harmonises action and

mobilises resources to fight malaria in endemic

countries and to improve and support capacity

to scale up action against malaria.

RBM's four pillars of action

ROLL BACK MALARIA is promoting four main strategies

to pursue its goal of halving the world's burden of

malaria by 2010. The strategies are evidence-based

Prompt access to treatment

Insecticide-treated mosquito nets (ITNs)

Prevention and control of malaria in pregnant women

Malaria epidemic and emergency response