3a- Communicable diseases have causes and impacts with mitigation and response strategies (malaria)

Question 1

environmental causes of Malaria in Ethiopia

Answer 1

warm humid climate- stagnant water provides ideal breeding grounds for mosquitoes

malaria is endemic in the western lowlands where temps and humidity are high through out the year but in the highlands there is an absence of malaria as its cooler in the higher altitudes which slows the development of mosquitoes

Question 2

human causes of malaria in Ethiopia

Answer 2

every year at harvest and planting leads to seasonal population movements from the malaria-free highlands to the agricultural lowlands. This seasonal migration also coincides with the rainy season, when malarial transmissions peak. After sunset harvesting often continues and this is when mosquitoes are most active so transmission increases, farmers also sleep in the fields

irrigation projects in the Awash Valley with the construction of canals, dams and pods and rice cultivation has expanded mosquitoes’ breeding habitats. Breeding grounds were also created by urbanisation as this led to garbage dumps and discarded containers

Malarial parasites are becoming increasingly drug-resistant

Question 3

prevalence and Patterns of malaria in Ethiopia

Answer 3

malaria is endemic in 75% of Ethiopia- 2/3 of the pop live in areas that are at risk from Malaria. The highlands (1/4 of the country) are malaria-free

higher risk in the western lowlands. Transmission peaks after the rainy season between June and November. In the midlands, transmission is seasonal with occasional epidemics

in the Amhara province which is badly affected prevalence of malaria has fallen from 4.6% of the population to 0.8% infected in 2011 due to strategies used

Question 4

socio-economic impacts of malaria in Ethiopia

Answer 4

badly built dwellings have poor barriers to mosquitoes so poor people are often hit the hardest

5million episodes of malaria a year which kill 70,000 people

malaria - cant work- slows economic growth and reinforces cycle of poverty- PFL. In wealthy highlands they can invest in bed nets so less disease risk so can continue working

Malaria absorbs 40% of national health expenditure and 10% of hospital admissions, dealing with malaria can overwhelm health services and damage tourism

the lowlands are resource rich which would help raise food production but malaria holds back development and has a knock-on effect in the highlands as its malaria-free and so supports an unusually high population density, farming resources are overexploited so widespread land degradation and famines in the 80s

Question 5

direct strategies used by governments to mitigate against malaria and respond to outbreaks

Answer 5

since 2005, Presidents Malaria initiative has helped scale up malaria prevention and treatment.

in 2011 Ethiopian government implemented a 5 year plan for malaria prevention and control it has direct and indirect strategies, its direct ones are - measures to eradicate mosquitoes like periodic spraying of dwellings with insecticides and managing the environment to help destroy breeding sites for mosquitoes

Question 6

direct strategies used by global agencies to mitigate against malaria and respond to outbreaks

Answer 6

Global health initiative helped scale up malaria prevention and treatment throughout Sub-Saharan Africa, between 2008 and 2013 Ethiopia received grants of $20-43 mil a year for malaria control

5 year plan operates in partnership with UNICEF, WHO and the world bank as well as NGOs

Question 7

indirect strategies used by governments to mitigate against malaria and respond to outbreaks

Answer 7

5 year plan- mass publicity campaigns to minimise potential mosquito breeding sites, early diagnosis and treatment of malaria within 24hrs of onset of fever

Question 8

indirect strategies used by international agencies to mitigate against malaria and respond to outbreaks

Answer 8

Bill and Melinda gates foundation helped distribute insecticide treated bed nets to all households in infected areas

Question 9

how succesful have the mitigation strategies been

Answer 9

rates have dropped significantly- between 2000 and 2010 death rates have halved and since 2003 there have been no malaria epidemics in Ethiopia

In the Amhara province which is badly affected by malaria, the prevalence of the disease has fallen from 4.6% of pop in 2006 to 0.8% in 2011

effectively educated the population and received funding to deal with the disease, planned for the future (5 year plan)