Health Malaria. BackgroundBackground The name comes from the Italian mal (bad) and aria (air) – it was originally thought the disease was spread by the.

HealthHealthMalariaMalaria

BackgroundBackgroundBackgroundBackground

The name comes from the Italian mal (bad) and aria (air) – it was originally thought the disease was spread by the damp air from swamps.

The name comes from the Italian mal (bad) and aria (air) – it was originally thought the disease was spread by the damp air from swamps.

The link between the disease and the Anopheles Mosquito was first made by Ronald Ross, a Scottish army doctor, working in India.

The link between the disease and the Anopheles Mosquito was first made by Ronald Ross, a Scottish army doctor, working in India.

When the Anopheles Mosquito “bites”, it actually sinks a long, thin mouth part, the

proboscis, into the skin.

The mosquito then pumps saliva under the skin, to stop the blood clotting – so that it can drink

uninterrupted! In the saliva is the main culprit, the Plasmodium, a single-cell blood parasite.

Malaria is a disease which is endemic in many countries – this means it is always present.

Malaria is a disease which is endemic in many countries – this means it is always present.

It is predominantly a disease of the Tropics.

Global Distribution of Malaria

MALARIA TODAY…MALARIA TODAY…MALARIA TODAY…MALARIA TODAY…

Global population at risk: 2.3 billion people (about 40% Global population at risk: 2.3 billion people (about 40% of the world’s population)of the world’s population)

Number infected: 500-600 million people Number infected: 500-600 million people

Global mortality: between 4000 and 8000 deaths each Global mortality: between 4000 and 8000 deaths each dayday

In the time it takes to say the word In the time it takes to say the word malariamalaria, ten people , ten people (seven of them children) will have caught it.(seven of them children) will have caught it.

Every 30 seconds, a child dies of malaria.Every 30 seconds, a child dies of malaria.

TaskTask

In groups, collect one Higher Paper 2 past In groups, collect one Higher Paper 2 past paper from 2008, 2007, 2006 & 2005.paper from 2008, 2007, 2006 & 2005.

Development & Health is always Q6.Development & Health is always Q6.

Come up with a list of what you will need to Come up with a list of what you will need to know about Malaria for the exam (5 mins).know about Malaria for the exam (5 mins).

Summarise the list into Summarise the list into fivefive main ‘objectives’ for main ‘objectives’ for what you need to know about Malaria.what you need to know about Malaria.

Objectives – Please CopyObjectives – Please Copy

Human causes/risk factors of MalariaHuman causes/risk factors of Malaria

Physical (environmental) causes of MalariaPhysical (environmental) causes of Malaria

Methods/strategies of controlMethods/strategies of control

Effectiveness of strategiesEffectiveness of strategies

Benefits to a country of controlling MalariaBenefits to a country of controlling Malaria

TaskTask

Take detailed notes on Physical Causes and Take detailed notes on Physical Causes and Human causes.Human causes.

Use all the relevant textbooks/photocopies.Use all the relevant textbooks/photocopies.

Tip: remember to include numbers/figures Tip: remember to include numbers/figures where possible.where possible.

Human Causes of MalariaHuman Causes of Malaria

Human blood supply. Human blood supply.

Areas of stagnant water where mosquitoes Areas of stagnant water where mosquitoes can breed e.g. tank wells, irrigation channels can breed e.g. tank wells, irrigation channels etc. etc.

Mosquitoes will breed where you have poor Mosquitoes will breed where you have poor drainage, irrigation or poor sanitation. drainage, irrigation or poor sanitation.

Lack of health care facilities. Lack of health care facilities.

Migrants moving into malarial areas - clearing Migrants moving into malarial areas - clearing land, looking for work, refugees etc.land, looking for work, refugees etc.

Poor housing, like this shanty, offers little protection.

Physical Causes of MalariaPhysical Causes of Malaria

Moist hot climate (15°C - 40°C) Moist hot climate (15°C - 40°C)

Areas of shade where mosquitoes can digest Areas of shade where mosquitoes can digest meal. meal.

Presence of female anopheles mosquitoes.Presence of female anopheles mosquitoes.

Ideal breeding grounds for mosquitoes – still, shallow water.

Mosquitoes will breed in small puddles, even in animal hoof prints, empty cans and bomb craters.

A jar containing mosquito larvae.A jar containing mosquito larvae.

A high risk area – people, vegetation cover and stagnant water during the wet season.

Solutions & EffectivenessSolutions & Effectiveness

Make detailed notes on solutions AND their Make detailed notes on solutions AND their effectiveness under 2 categories:effectiveness under 2 categories:

PreventionPreventionTreating SufferersTreating Sufferers

Ways to prevent MalariaWays to prevent Malaria

Insecticides can be Insecticides can be sprayed in homes to kill sprayed in homes to kill mosquitoes e.g. mosquitoes e.g. Malathion.Malathion.

Effective but expensive Effective but expensive as it is petroleum based. as it is petroleum based. Also smells bad and Also smells bad and stains walls yellow.stains walls yellow.

Mustard Seeds are put Mustard Seeds are put on water surfaces as on water surfaces as they become sticky they become sticky when wet. They drag when wet. They drag mosquito eggs under mosquito eggs under water and drown them.water and drown them.

This is difficult to This is difficult to maintain & seems maintain & seems wasteful.wasteful.

Ways to prevent MalariaWays to prevent Malaria

Spraying Egg Whites also kills larvae on Spraying Egg Whites also kills larvae on stagnant water as it suffocates them by stagnant water as it suffocates them by clogging up their breathing tubes.clogging up their breathing tubes.

This also seems wasteful.This also seems wasteful.

Ways to prevent MalariaWays to prevent Malaria

Bti bacteria in coconuts is eaten by larvae and Bti bacteria in coconuts is eaten by larvae and destroys their stomach lining. Coconuts are left to destroys their stomach lining. Coconuts are left to ferment for a few days, broken open & thrown into ferment for a few days, broken open & thrown into ponds.ponds.

Effective Effective 1.1. 2/3 coconuts ‘control’ a pond for 45 days2/3 coconuts ‘control’ a pond for 45 days2.2. Cheap to produce & plentifulCheap to produce & plentiful3.3. Bacteria is not harmful to humans or animals Bacteria is not harmful to humans or animals

Ways to prevent MalariaWays to prevent Malaria

Larvae-eating fish introduced to paddy fields. Larvae-eating fish introduced to paddy fields.

These are effective PLUS a useful source of These are effective PLUS a useful source of protein to be added to peoples’ diet.protein to be added to peoples’ diet.

Ways to prevent MalariaWays to prevent Malaria

Drainage of swamps & irrigation channels.Drainage of swamps & irrigation channels.

This is effective but not always practical in This is effective but not always practical in tropical places as it rains a lot. Also very tropical places as it rains a lot. Also very expensive.expensive.

Ways to prevent MalariaWays to prevent Malaria

Release water from dams to drown larvae.Release water from dams to drown larvae.

This is successful but has to be done every This is successful but has to be done every 7-10 days to fit in with breeding cycle.7-10 days to fit in with breeding cycle.

Ways to prevent MalariaWays to prevent Malaria

Planting Eucalyptus trees to absorb excess water from the soil helps drain breeding sites.

Planting Eucalyptus trees to absorb excess water from the soil helps drain breeding sites.

Ways to prevent MalariaWays to prevent Malaria

Education “Prevention easier than Cure”Education “Prevention easier than Cure”

Use insect repellentUse insect repellent

Cover exposed skin at dusk (when mosquito Cover exposed skin at dusk (when mosquito most active)most active)

Sleep under a mosquito net sprayed with Sleep under a mosquito net sprayed with insecticideinsecticide

This is thought to be most effective treatment This is thought to be most effective treatment (30% of child deaths could be avoided) & (30% of child deaths could be avoided) & cheap to implementcheap to implement

We can also treat sufferers:We can also treat sufferers:

Chloroquine (drug)Chloroquine (drug)

Easy to use and cheap but Easy to use and cheap but mosquitoes are becoming mosquitoes are becoming resistant to it.resistant to it.

Larium (drug)Larium (drug)

Powerful and effective but can have harmful Powerful and effective but can have harmful side-effects.side-effects.

VaccinesVaccines

This would be the most effective treatment This would be the most effective treatment (easier to give out than a course of drugs and (easier to give out than a course of drugs and offers lasting protection)…offers lasting protection)…

However, a successful and widely available However, a successful and widely available one has not been invented yet. Trials still one has not been invented yet. Trials still going on in Gambia and Columbia.going on in Gambia and Columbia.

Quinghaosu (drug)Quinghaosu (drug)

Plant extract which has been used as a Plant extract which has been used as a traditional cure in China for many years.traditional cure in China for many years.

It can be put into pill form making it easy to It can be put into pill form making it easy to take and distribute.take and distribute.

This is a possible future solution, especially This is a possible future solution, especially considering China’s improved relationship considering China’s improved relationship with the West.with the West.

No ONE solution has been foundNo ONE solution has been found

A mix of strategies is most successful.A mix of strategies is most successful.

WHO “Roll Back Malaria” programme (global WHO “Roll Back Malaria” programme (global campaign aimed at halving number of Malaria campaign aimed at halving number of Malaria cases by 2010).cases by 2010).

Bill Gates Foundation donated £105 million to Bill Gates Foundation donated £105 million to help research a vaccine and new drugs to help research a vaccine and new drugs to fight this disease.fight this disease.

KEY REVISION POINTSKEY REVISION POINTSKEY REVISION POINTSKEY REVISION POINTS

Anopheles MosquitoAnopheles Mosquito

PlasmodiumPlasmodium

Humid climate: 16-40Humid climate: 16-40ºC, abundant rainfallºC, abundant rainfall

Vegetation for shadeVegetation for shade

Areas of still or stagnant waterAreas of still or stagnant water

Lost education through bouts of illnessLost education through bouts of illness

Lost productivity by adults, especially at planting and harvest time – less Lost productivity by adults, especially at planting and harvest time – less food, lower incomefood, lower income

Huge amount spent on trying to prevent or control malaria Huge amount spent on trying to prevent or control malaria

Negative impact on foreign investment and tourismNegative impact on foreign investment and tourism

Anopheles MosquitoAnopheles Mosquito

PlasmodiumPlasmodium

Humid climate: 16-40Humid climate: 16-40ºC, abundant rainfallºC, abundant rainfall

Vegetation for shadeVegetation for shade

Areas of still or stagnant waterAreas of still or stagnant water

Lost education through bouts of illnessLost education through bouts of illness

Lost productivity by adults, especially at planting and harvest time – less Lost productivity by adults, especially at planting and harvest time – less food, lower incomefood, lower income

Huge amount spent on trying to prevent or control malaria Huge amount spent on trying to prevent or control malaria

Negative impact on foreign investment and tourismNegative impact on foreign investment and tourism

KEY REVISION POINTSKEY REVISION POINTSKEY REVISION POINTSKEY REVISION POINTS

MalathionMalathion

Genetic engineering – sterile male mosquitoesGenetic engineering – sterile male mosquitoes

ITNs – Insecticide Treated Bed netsITNs – Insecticide Treated Bed nets

Draining and flushing breeding sitesDraining and flushing breeding sites

Oil, egg whites and mustard seedsOil, egg whites and mustard seeds

Bti, Fish (Bti, Fish (Muddy LoachMuddy Loach), Eucalyptus trees), Eucalyptus trees

Chloroquine, ArtemisiaChloroquine, Artemisia

NoNo effective vaccines yet - several on trial effective vaccines yet - several on trial

World Health Organisation campaign – World Health Organisation campaign – Roll Back Roll Back MalariaMalaria

MalathionMalathion

Genetic engineering – sterile male mosquitoesGenetic engineering – sterile male mosquitoes

ITNs – Insecticide Treated Bed netsITNs – Insecticide Treated Bed nets

Draining and flushing breeding sitesDraining and flushing breeding sites

Oil, egg whites and mustard seedsOil, egg whites and mustard seeds

Bti, Fish (Bti, Fish (Muddy LoachMuddy Loach), Eucalyptus trees), Eucalyptus trees

Chloroquine, ArtemisiaChloroquine, Artemisia

NoNo effective vaccines yet - several on trial effective vaccines yet - several on trial

World Health Organisation campaign – World Health Organisation campaign – Roll Back Roll Back MalariaMalaria

Benefits to ELDCs of eradicating MalariaBenefits to ELDCs of eradicating Malaria

Less money spent on medicine, drugs, insecticides, doctors, Less money spent on medicine, drugs, insecticides, doctors,

drainage etc.drainage etc.

Saved money available to be spent in other areas of the country’s Saved money available to be spent in other areas of the country’s

economy.economy.

There will be healthier workforce which will speed up development.There will be healthier workforce which will speed up development.

EMDCs more likely to invest in ELDCs that have eradicated malaria.EMDCs more likely to invest in ELDCs that have eradicated malaria.

Malaria-free countries can encourage tourism which will benefit the Malaria-free countries can encourage tourism which will benefit the

economy.economy.

Longer life expectancy.Longer life expectancy.

Reduction in national debt.Reduction in national debt.

Lower infant mortality means birth rate will fall & population growth Lower infant mortality means birth rate will fall & population growth

will slow down.will slow down.