Download - World health day 2014
Md. Kabiul Akhter AliVBD Consultant, PH Wing
World Health Day is celebrated
on 7 April every year to mark the
anniversary of the founding of
WHO in 1948 We are all one on
“WORLD HEALTH DA Y”
Each year a theme is selected that
highlights a priority area of public
health.
MD. K. A. ALI
Vector-borne disease (VBD): an illness caused by aninfectious microorganism (pathogen) that is transmitted topeople by a vector, usually arthropods
Arthropod: an invertebrate animal having an exoskeleton(e.g. insects or arachnids)
Definitions
MD. K. A. ALI
Common Vector Borne Diseases (VBD-s)
Dengue
Chikungunya
Yellow fever
Malaria
Japanese encephalitis
Kala-azar
Lymphatic filariasis
Scrub typhus
Plague
MD. K. A. ALI
Impact of Vector Borne Diseases
Causes High Burden….
Illness
Death
Worsening of poverty
Negative impact on economy
High health cost
Overloading of Health System
MD. K. A. ALI
VBD problem : global magnitude
50% population is at risk from Vector Borne Disease.
17% of infectious diseases due to VBDs.
40% population is at risk from Dengue.
1.3 Million new cases of Kala azar every year
Kill one million people every year out of which 660,000 die due to Malaria.
Dengue has increased 30 folds during last 50 years
MD. K. A. ALI
Types of VBD transmission
Vector VectorVector Vector
Humans
HumansAnimals
HumansAnimals
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Vectors spread diseases
Mosquitoes, flies, ticks, bugsand freshwater snails canspread diseases that causeserious illness and death
50% of world population
is at risk
Increased travel, trade andmigration make even morepeople vulnerable
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VBD & climate change
A.Temperature
B. Precipitation
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TemperatureExample– Summer: more days with higher temperature
effects
•
•
•
LongerLonger
Longer
lifespanreproduction period
activity period
– Winter: less days with low
temperature• Benefits overwintering
• Shorter overwinteringDr.T.V.Rao MD
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Temperature effectsPathogen
Decreased extrinsic incubation period of pathogen in vector at higher temperature
Changes in the transmission season
Changes in geographical distribution
Decreased viral replication
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Precipitation effectsVector•Survival: increased rain may increase larval habitat
•Excess rain can eliminate habitat by flooding
•Low rainfall can create habitat as rivers dry into pools (dry season mosquitoes)
•Decreased rain can increase container-breeding mosquitoes by forcing increased water storage
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Precipitation effectsVector
Heavy rainfall events can synchronize vector host-seeking and virus transmission
Increased humidity increases vector survival and vice-versa
PathogenFew direct effects but some data on humidity effects on parasite development
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Summary effects climate change
Climate change has the potential to
•Increase range or abundance of animal reservoirs and/or arthropod vectors
•Enhance transmission
•Increase importation of vectors or pathogens
•Every Human at Risk
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Diseases are Preventable
Malaria, dengue,leishmaniasis, JE andfilariasis arepreventable, yet theyhave the biggestimpact on some of theworld’s poorest people.
MD. K. A. ALI
Treatment of VBD-sMalaria :
• The current protocol is to
- treat vivax cases with chloroquine for 3 days, and
primaquine for 14 days to prevent relapse;
- treat all falciparum cases with artemisinin combination
therapy (ACT) and primaquine single dose for gametocyte
clearance.
Kala-azar :
• First line regimen is miltefosine orally x 4 weeks (for VL) and x
12 weeks (for PKDL).
• Shorter regimen with miltefosine & inj paromomycin or inj
lyposomal amphotericin-B in pilot districts.
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Limitation of treatment
• No specific drug so far available for cure of
Dengue, JE or Chikungunya.
- Supportive care is the mainstay of treatment.
- In Dengue, there is risk of haemorrhage/shock,
particularly if a new serotype takes entry.
• Specific drug available for Malaria & Kala-azar,
but evolution of drug resistance is common.
- Even resistance to artemisinin has started.
• No effective vaccine as yet against Malaria or
Dengue.
So the vector issues should be
further highlighted.
The importance of vector control and reduction of man-
vector contact need to be impressed upon the public.
MD. K. A. ALI
Changes in the vector ecology
• With worldwide changes in the climate and environment of villages & cities, vector breeding is on the rise.
• Deforestation tilts the man-vector balance.
• Because of mutations, certain mosquito species are becoming more efficient as vectors.
• Mosquitoes are adapting their behaviour. - As example, we found aedes
breeding in spots well exposed to sunlight.
• Vectors developing resistance to insecticides.
The threat is big !
MD. K. A. ALI
Protect yourself
You can protect yourself
and your family by taking
simple measures that
include sleeping under a
bed net, wearing a long-
sleeved shirt and trousers
and using insect repellent.
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Keep the Environment Clean
and Save many Lives
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SAVE THE PLANET
SAVE FROM VECTOR BORN DISEASES
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Challenges in prevention & control –(1/2)
Though there is no dearth of technical knowledge, some of the
challenges are :
• Reaching health service to 100% population, both rural and urban.
• Making services affordable to the population.
• Quality assurance of health care, both in public and private systems – for
diagnostics as well as treatment.
• Adequate surveillance of disease, vectors and the determinants for
diseases.
• Involving people in vector control and bringing about behavioural change
to make this possible.
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Important components of Health system
to meet the challenge (1)• Finance
o Adequate budgetary allocation
o Control over drug & diagnostic kit pricing
o Health insurance
o Provision of reimbursement to private sector
• Health manpower (both public and private)
o Adequate in number
o Adequate skill through initial and periodic training
• Health facilities
o Geographical distribution
o PPP model for hard to reach areas
o Adequately equipped facilities
• Standardised diagnostic and treatment protocol
o Binding for both public and private settings
MD. K. A. ALI
Challenges in prevention & control –(2/2)
• Sustaining & managing the human resource of the programme.
• Problems with vector control :
- Non-availability of effective measures e.g. in JE.
- Difficulty of access in disturbed/ hard to reach areas.
• Changing social and environmental determinants to effectiveness of
standard intervention in some high risk population.
• Lack of inter-sectoral coordination and convergence of action.
• Rehabilitation of survivors following JE.
MD. K. A. ALI
More informationwww.climatetrap.eu
www.ecdc.eu
www.who.int/globalchange/en/
MD. K. A. ALI
Thank You
MD. K. A. ALI