3a Malaria Flashcards
Vector of malaria
Anopheles mosquito
Number of global cases in 2019
229 million
Number of malaria deaths in 2019
409,000
Percentage of malaria deaths in 2019 that were children under 5
67%
Percentage of malaria cases and deaths in the WHO African Region
94%
Total funding for malaria mitigation in 2019
Contributions of governments from endemic countries
US$3 billion
31%
Malaria is endemic in what % of Ethiopia’s land area
75%
Deaths of malaria in Ethiopia 2013
584,000
Areas most at risk in Ethiopia
Western lowlands below 1500m in Tigray, Amhara and Gambella provinces
Peak transmission rates
After rainy season (peak from Sept-Dec)
Tranmission in midlands
Seasonal - occasional epidemics
Central highlands prevalence
Malaria free
Eastern lowlands malaria patterns
Afar and Somali provinces
Arid climate confines malaria to river valleys
2 environmental factors influencing disease
Climate
Altitude/relief
How does climate influence disease?
Warm, humid climates
Stagnant water - ideal breeding habitats for mosquitos
How does altitude/relief influence disease?
Endemic in western lowlands - high temp and humidity, water collects in lakes and ponds
Absent in highlands
7 human factors influencing disease
Population movements
Irrigation schemes
Urbanisation
Misuse of malarial drugs
Misuse of mosquito nets
Poverty
Healthcare
How do population movements influence disease?
Harvest time - population movements between highlands and agricultural lowlands
Coincides with rainy season and peak malaria transmission period
Harvesting continues after sunset when mosquitos are most active and migrant workers sleep in the fields overnight
How do irrigation schemes influence disease?
In Awash Valley and Gambella Province
Construction of micro-dams, and ponds - expanded breeding habitats for mosquitoes
How does urbanisation influence disease?
Floods, garbage dumps, discarded containers - breeding sites
How do misuse of malarial drugs influence disease?
More drug resistant
How do misuse of nets influence disease?
Holes
How does lack of healthcare influence disease?
40% of Ethiopians have no access to basic healthcare
How does poverty influence disease?
Hunger and lack of maize
Undernutrition and malnutrition - susceptibility to disease
Socio economic impacts of malaria in Ethiopia
- 70,000 deaths per year
- Children hit the hardest
- Absenteeism from work, slowing economic growth and reinforcing the cycle of poverty
- US$12 billion lost production in sub-Saharan Africa per year
- 40% of national health expenditure, 10% of hospital admissions, 12% of health clinic visits
- Damage tourism and investment
3 Strategies/management plans to control malaria
- Presidents Malaria Initiative and Global Health Initiative
- 2008-2013, grants of US$20-43 million a year for malaria control
- 2011, Ethiopian government - 5 year plan (partnership with UNICEF, WHO, World Bank, NGOs and OECD donor countries)
Direct strategies of the 5 year plan
Eradicate mosquitos:
- Periodic spraying with insecticides
- Destroying breeding sites
- Indoor Residual Spraying How do population movements influence disease
Indirect strategies of the 5 year plan
Publicity campaigns to minimise potential breeding sites
Early diagnosis and treatment of malaria
Insecticide-treated bed nets
Positives of strategies
Death rates halved 2000-2010
No major malaria epidemics (used to be every 5 years)
Amhra - prevalence fell 4.6% to 0.8% from 2006 to 2011
Negatives of strategies
Not enough nets and education on use
DDT sprayed poisonous
Resistance to draining of swamps = drinking water for cattle
ACT drug expensive and high demand
Epidemics need to be identified earlier
45 million still remain at risk of 68 million
Drug resistance
Shortage of trained manpower, drugs spray pumps and funds
