Malaria introduction

Dr.Sunil Pal Singh.C

MALARIA – INTRODUCTION.

?AIDS Avian InfluenzaEbolaMarburg CholeraRift Valley FeverTyphoidTuberculosisLeptospirosisMalaria Chikungunya DengueJEAntimicrobial resistance

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Infectious Diseases: A World in Transition

Reasons for emergence of diseases:

Environmental degradation. Un controlled urbanization.

Unhygienic condition. Migration of population. Natural disaster. International trade ,tourism. Alternations in microorganisms Resistance to antimicrobials. Insecticidal resistance. Weak public health system.

Malaria, the 'King of Diseases', continues to haunt and taunt mankind.

One of the oldest scripts, written several thousand years ago attributes malaria to Nergal, the Babylonian god of destruction and pestilence, pictured as a double-winged, mosquito-like insect.

The chinese Nei Ching (4,700 years ago) apparently refers to repeated paroxysmal fevers associated with enlarged spleens and a tendency to epidemic occurrence, suggesting P. vivax and P. malariae infections.

Malaria appeared in the writings of the Greeks from around 500 BC. Hippocrates, "The Father of Medicine" and probably the the first malariologist, described the various malaria fevers of man by 400BC

The recurrence of malaria is a phenomenon that was known to the ancients and first recorded by Roman Poet Horace (December 8, 65 BC - November 27, 8 BC) in his third satire.

Emperor Titus Caesar Vespasianus Augustus, Alexander the Great, Alaric, King of the Goths, St. Augustine, Otto II, King of the Germans and Emperor of Rome, Pope Gregory V

Pope Damasus II, Friedrich IV, Herzog von Schwaben, German King and Holy Roman

Genghis Khan, Richard, Earl of Cornwall, Henry of Luxemburg, Dante, Italian poet

Byzantine Emperor Andronicus III Palaeologus, Sultan Muhammed bin Tughluk, King Edward IV died

THE RICH AND THE FAMOUS WHO DIED OF MALARIA:

90% of deaths are in Africa

Half the world is at risk

250 million cases, 650,000 deaths

One child every 60 seconds

Attacks the most vulnerabl

ePoverty is a

factor

$12 billion in

lost productivi

ty

MALARIA.

GLOBAL MALARIA BURDEN

Lancet 2010; 376: 1566–78

Over 40% of world population live in malaria endemic countries247 million cases and nearly one million deaths in 2008 (WHO report 2010)

Endemic in 109 countries

–Like HIV and TB, malaria is –unequally distributed, even in the tropics

Malaria --endemic areas

MALARIA BURDEN IN AFRICA

Africa’s share: • 60% of global malaria

cases• 91% of global malaria

death

Responsible for • 30-50% of hospital

admissions• 50% of outpatient visits in

areas of high transmission• 10% of the overall

disease burden in Africa

Leading causes of death in Sub-Saharan Africa, South Asia, and Southeast Asia for persons age 0-44 (World Health Organization)

AS YOU KNOW IN THE DEVELOPING WORLD TREATABLE INFECTIOUS DISEASES REMAIN BIG KILLERS

SEARO; 8.50%

EMRO; 3.30%

AMRO; 1.10%

WPRO; 0.90%

AFRO; 86.20%

MALARIA CASES (2008)

SEARO; 4.10% EMRO; 4.30%AMRO; 0.30%

WPRO; 0.50%

AFRO; 90.80%

MALARIA DEATHS ( 2008)

Source: Subbarao sarla K, et al.ICMR Bulletin 1999; 29:76-80

AFRO: African region.

AMRO: Regions of America.

SEARO: South-East region.

EMRO: Eastern mediterren.

WPRO: western pacific region.

MALARIA CASES IN INDIA (2008)

ORIS

SA

JHARKHAND

OTH

ER S

TATE

S

CHHATTIS

GARHM

.P

ASSAMU.P

WES

T BEN

GAL0%

10%

20%

30%

40%

50%

60%

59%

14%8% 5% 4% 4% 3% 3%%

of

case

s

source :Subbarao sarla K, et al.ICMR Bulletin 1999; 29:76-80

BURDEN OF MALARIA:

Cases: 300-500 million cases world wide.

1.5- 3.0 million deaths/ year.

At risk of malaria: 2400 Million of world’s population

3000 deaths/ day world wide.

10 deaths/ second in African region.J.Kishore’. National Health programs of India.10th edition.century publications, New Delhi.

BURDEN OF MALARIA (IN 2010)

216 million cases of malaria world wide.

91% were P.falciparum

81% were in African

13% in SEAR.

5% in East mediterrean region

Park’s text book of Preventive and social medicine.22nd edition(2013).Bhanot publication, Jabalpur.India.

API

Map showing Malaria Endemic Areas in India

Haryana

GujaratMadhya Pradesh

Maharashtra

A.P

Karnataka

MAP SHOWING HIGH RISK TOWNS FOR MALARIA IN INDIA

ESTIMATED MORTALITY RATE:

19.8/lakh population world wide.

84.3/lakh in African region

3/lakh in SEAR.

Under 5 mortality rate due to malaria :7%.

27% of population lives in malaria high transmission area.

97% deaths due to malaria is reported from North eastern states,

India

Park’s text book of Preventive and social medicine.22nd edition(2013). Bhanot publication, Jabalpur.India.

ECONOMIC CONCERN

Labor loss due to malaria: 1328.75 million man-days/

year.

Expenditure incurred on Malaria :Rs. 7.18

per capita per annum.

Annual income loss : 10,270 millions ( if

Rs.10 /capita annual expenditure is taken

into account).

J.Kishore’. National Health programs of India.10th edition.century publications, New Delhi.

Leading causes of death in children under five in the world

Deaths of children under five

Pneumonia 18%

Preterm birth complications 14%

Diarrhoea 11%

Birth asphyxia 9%

Malaria 7%

Other causes 41%

Year Total Malaria Cases (million) Deaths due to malaria

1995 2.93 11511996 3.04 10101997 2.66 8791998 2.22 6641999 2.28 10482000 2.03 9322001 2.09 10052002 1.84 9732003 1.87 10062004 1.92 9492005 1.82 9632006 1.79 17072007 1.51 13112008 1.53 10552009 1.56 11442010 1.60 10182011 1.31 7542012(Prov.) 1.06 519

Incidence of Malaria in India

[http://nvbdcp.gov.in/malaria-new.html

Month of June

25th April of every year.

WHO’s T3,Millennium

development goal 6.

The global campaign theme for

2013 and the coming years : Invest in the future , defeat

malaria

World Malaria day

Anti malaria month

Test. Treat. Track initiative

MALARIA HAS BEEN SIGNIFICANT ENOUGH TO MAKE THE WORLD DIFFERENT!

Being sent to Gambia, Serra Leon, etc. was considered a death sentence because of the probability of contracting malaria!

THANK YOU

World health day theme -2014 :vector-borne diseases.