malaria presentation world malaria day

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MedicineNet.com We bring Doctors’ Knowledge to You

Malaria• Is an infectious disease caused by a parasite,

Plasmodium which infects red blood cells.• It is characterized by cycles of chills, fever,

pain and sweating.• It is caused and spread by a female

anopheles mosquito


HISTORICAL BRIEFHas infected humans since beginning of

mankind.The name “mal aria” (meaning “bad air” in

Italian)First used in English in 1740 by H. WalpoleThe term was shortened to “malaria” in the

20th century. C. Laveran in 1880 was the first to identify the parasite in human blood

In 1889, R. Ross discovered that mosquitoes transmitted malaria


Four common species - ParasitesPlasmodium vivaxPlasmodium malariaePlasmodium ovalePlasmodium falciparum – the most serious

type. It can be life-threatening.However, another relatively new species,

Plasmodium knowlesi, is also a dangerous species that is typically found only in long-tailed and pigtail macaque monkeysLike P. Falciparum, P. Knowlesi may be deadly to

anyone infectedMedicineNet.comWe bring Doctors’ Knowledge to You

Symptoms and Signs?•Characterized by flulike illness with:

• Fever• Chills• Muscle aches• Headaches• Nausea/vomiting• Cough• diarrhea


How is malaria transmitted?


Where is malaria a particular problem?Is a particular problem and a major one in

areas of Asia, Africa, and Central and South America.

Anyone living in or traveling to a country where malaria is present can get the disease

Occurs in about 100 countries; approximately 40% of the world population is at risk for contracting malaria

(http://www.cdc.gov/malaria/travelers/country_table/a.html)


Incubation period for malaria?Period between the mosquito bite and the onset of the

malarial illness is usually one to three weeks (7 – 21 days)Initial time period is highly variable as reports suggest that

the range of incubation periods may range from 4 days to 1 year

Certain types of malaria (P. Vivax and P. Ovale) parasites can also take much longer, as long as 8 – 10 months to cause symptoms

These parasites remain dormant (inactive or hibernating)in the liver cells during this time

Some of these dormant parasites can remain even after a patient recovers from malaria, so the patient can get sick again. This situation is termed relapsing malaria


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Malaria DiagnosisClinical symptoms associated with travel to

areas that have malaria risk (travel history is essential)

Many diseases can mimic symptoms of malaria (e.g. yellow fever, dengue fever, typhoid fever, cholera, filariasis and even measles and tuberculosis )

Blood smear on microscope slide that is stained (Giemsa stain) to show parasites inside red blood cells


MALARIA DIGNOSIS - PMGH

Malaria Laboratory PMGH 2011

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec0

50

100

150

200

250

300

350

400

450

500

0 - 4 yrs15 + yrs

No. of slides examined - MALE 0 - 4 yrs

5 - 14 yrs

MALARIA DIGNOSIS - PMGH

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec0

50

100

150

200

250

300

350

No. of slides examined - FEMALE0 - 4 YRS5 - 14 YRS15 + Yrs

Malaria LaboratoryPMGH 2011

Malaria Admissions – Emergency Department (PMGH 2011)

10; 12%4; 5%

8; 10%8; 10%

18; 22%5; 6%

2; 2%

13; 16%

5; 6%3; 4% 5; 6%1; 1%

JanFebMarAprMayJunJulAugSepOctNovDec

Emergency Daily Attendance 2011

Diagnosis at Emergency - 2011Common diseases seen in Emergency

Head Injury CVA/Stroke Pneumonia PTBExtra PTB Cancer Resp. Diseases HIV/AIDSDiabetes Hypertension AMI Heart diseasesMalaria Burns Fractures ApendicitisMeningitis Liver Diseases Asthma GBSBowel Obstruction Kidney Problems Chest injuries Gastro-EnteritisAnaemia General Surgical Spinal Injuries Other Medical prob-

lemsO&G Cases Psychiatric cases SnakeBites

Emergency Daily Attendance 2011

Malaria Admissions – Medical Ward - 2010

Ward 4A Ward 4B0

10

20

30

40

5045

12

39

7

6 5

No: of Malaria cases - 2010

AdmissionsDischargesDeaths

Medical Ward Data Reports - 2010

Malaria Admissions – Medical Ward - 2011

Ward 4A

Ward 4B

0

10

20

3021

9

18

7

3

2

Admissions Discharges DeathsMedical Ward Data Reports - 2010

Treatment for MalariaThree main factors determine treatments:

The infecting species of plasmodium parasite,

The clinical situation of the patient (e.g. adult, child, pregnant female with either mild or severe malaria)

The drug susceptibility of the infecting parasites – drug susceptibility is determine by the geographic area where the infection was acquired.MedicineNet.com

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Cont’ treatmentDrug treatment of malaria is not always easy.Chloroquine phosphate (Aralen)is the drug of

choice for all malaria parasites except for chloroquine-resistant plasmodium strain

Unfortunately, resistance is usually noted by drug-treatment failure in the individual patient.

However, multiple drug-treatment protocols for treatment of drug-resistant plasmodium strains (quinine sulfate + doxycycline), Sulphadoxine with Pyrimethamine (Fansidar) or tetracycline (Achromycin), or clindamycin (Cleocin), or atovaquone-proguani (Malarone)


Con’t treatmentThe WHO’s treatment policy recently established

in 2006, is to treat all cases of uncomplicated P. falciparum malaria with artemisinin derived combination therapy (ACTs).

ACTs are drug combinations artesunate-amodiaquine, artesunate-mefloquine, artesunate-pyronaridine,

etc used to treat drug-resistant P. falciparum.) • One promising drug class under investigation is

the spiroindolones, which have been effective in stopping P. falciparum experimental infections.


Is malaria a particular problem during pregnancy

Infants, children and pregnant women, along with immuno-depressed patients are at higher risk for worse outcomes when infected with malaria parasites


How do people avoid getting malariaTo reduce chance of getting malaria,

people should avoid malaria-endemic areas of the world,

use mosquito repellents, cover exposed skin, and used treated mosquito netting covered areas

when sleeping Regular health checks to know your status Prophylaxis


PNG reports on successesHealth and HIV/AIDS Minister Jamie Maxton-

Graham said the country had the highest case of malaria in the Western Pacific region

About 1.7 million malaria cases and 600 deaths caused by malaria were recorded annually in health facilities

Mr. Maxton-Graham emphasized the importance of prevention saying malaria would not be an issue in this country if we all practiced prevention

(By Shirlyn Belden, April 25th 2012 - The National)MedicineNet.com We

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What is the prognosis (outcome) for people with malaria

Majority of people do well and the fevers abate after 96 hours (4 days)

Malaria caused by P. falciparum or P. knowlesi, even when treated have outcomes ranging from fair to poor, depending on how the parasites react to treatment

Untreated people die from infectionIn general – infants, children under 5yrs,

depressed immune system (AIDS or cancer patient) have a more guarded prognosis


Researchers cite drop in malaria casesThe PNGMRI has reported a significant reduction in the

prevalence of malaria infections in the country in the past three years

This was due to efforts by the national government and international partners to conduct awareness, distribute treated nets and effective malaria treatments in hospitals under malaria programmes and other supportive initiatives.

Studies & Surveys conducted by MRI revealed that malaria prevalence had dramatically dropped from 12% in 2009 to below 8% in 2011

50% of PNGean are now sleeping under treated mosquito nets and are seeking treatment when sick

Over 160 villages and 5,000 households had been reached by awareness and distribution of treated nets since 2004 (DR. Manuel Hetzel, MRI’s population & demography unit)

Insecticides-treated bed nets have distributed widely in communities since 2004 by RAM PNG and NDOH with 80% of household across PNG now owning at least one treated net, up from about 10% before the widespread distributions began

(by Shirlyn Belden, The National April 2012)

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Where can people get more information about malaria

CDC – Center for disease control and prevention

PNG – Health Department Hospitals Health centers Local Health post Health workers And NGOs & partners



THANK YOU ALL…TENKIU TRU…

WUROH!..

ANY QUESTIONS?SAMPLA ASKIM?

References D’Acremont, V., C. Lengeler, and B. GENTON.

“Reduction in the Proportion of fevers Associated with Plasmodium falciparum Parasitaemia in Africa: A systemic Review.” Malaria journal 9.240 Aug. 22, 2010 doi: 10.1186/1475-2875-9-240.

Rottmann, M., C. McNamara, B. Yeung, et al. “Spiroindolones, a Potent compound Class for the treatment of Malaria.” Science 329 (2010): 1175-1180.

The National, April 2012 (World Malaria day) MedicineNet.comWe bring Doctors’ Knowledge to You

malaria presentation world malaria day

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