Mndp malaria control

Control of

A Presentation by Mandeep Poonia

The word “Malaria” originates from Italian words “mala” and “aria” means “bad air”. The Greek and Roman people found that in a season there is foul order or bad air coming from marshy areas and there is a series of fever in that season, hence they termed it as malaria disease(also known as marsh fever)

Malaria is caused by a parasite called “Plasmodium”, which is transmitted via the bitesof infected mosquitoes.

In the human body, the parasites multiply in the liver , and then infect red blood cells

Usually people get malaria by being bitten by an infective female Anopheles mosquito

Only female anopheles can transmit malaria and they must have been infected through aprevious blood meal taken on an infected person

When an mosquito bites an infected person, a small amount of blood is taken, which contains microscopic malaria parasites. About one week later, when the mosquito takes its next blood meal, these parasites mix with the mosquito’s saliva and are injected into the person being bitten.

Malaria can also be transmitted through blood transfusion, organ transplant, or the shared use of the needles or syringes contaminated with blood

Malaria is not infectious, it can only be passed on by parasites. When the mosquito bitesyou it will take some blood. If the mosquito has the plasmodium parasite in it, the bloodfrom its last meal will get infected. The next person it bites will receive the infected blood and infect them with malaria.

Malaria is spread by vectors. A vector is a carrier. In malaria a mosquito serves as the vector That carries and transfers the infectious agent(plasmodium), injecting it with a bite.

Humans develop malaria when infected with one of the four protozoan from plasmodium.A protozoan is a single celled organism. Plasmodium is a scientific name for a parasite.

Four species of plasmodium parasite causing malaria : Plasmodium Falciparum Plasmodium Vivax Plasmodium Malariae Plasmodium OvaleThe most dangerous of the four is P. falciparum

Malaria Life Cycle

Malaria Regions : It commonly occurs in Africa, Asia, South America, Central America, Southern Mexico, Carribbean Islands, Europe and North America. Most commonly found in Sub- Saharan Africa (P. Falciparum- most dangerous)

Transmission of Malaria do not occur <160 C and > 330C and also > 2000m Altitude

Diagnosis of malaria is usually confirmed by the microscopic examination of blood films or by antigen-based Rapid Diagnosis Test(RDT).Microscopy is the most commonly used method to detect the malarial parasite.

Malaria is treated with a class of drugs called Anti malarial Drugs.Anti-malarial drugs are designed to attack the parasites that causeMalaria, preventing them from spreading and killing them so that they cannot continue causing infection e.g. Quinine etc

PROBLEM STATEMENT WORLDWIDE

• 198 million cases (2013) led to 5,84000 deaths.• Roughly half the world’s population(3.3 billion) is at risk of malaria.

About 90% of deaths from malaria occur in Africa.• Thirty five countries (30 in Sub-Saharan Africa and 5 in Asia) account

for 98% of global malaria death.• In Africa, malaria is the 2nd leading cause of death after HIV/AIDS.

Malaria in India• 1.5-2 million cases annually.• Malaria cases in India accounts 58% of cases in South-East Asia Region of

WHO.• In 2014, there were 1.07 million cases of malaria , 0.70 million of

Plasmodium Falciparum and 535 deaths due to malaria.• 21.98%- High transmission areas(>= 1 case per 1000)• It occurs mainly in North-Eastern States, Chattisgarh, Jharkhand, M.P.,

Gujarat, Orissa, Andhra Pradesh, West Bengal and Karnatka.• Three species prevalent in India-I. P. Vivax is the predominant(50-55%)II. P. Falciparum (40-45%)III. P. Malariae(<1%)

History Events on Malaria• 1880 : Charles Louis Alphonse Lavern discovered malarial parasite in

wet mount.• 1883 : Methylene Blue Stain- Marchafava• 1891 : polychrome Stain- Romanowsky.• 1898 : Ronald Ross- Life cycle of Parasite transmission, wins Nobel

Prize in 1902.• 1948 : Site of Parasite development by Shortt and Garnham.• 1955 : WHO starts worldwide Malaria Eradication Programme using

DDT.• 1970 : Mosquitoes develop resistant to DDT(Programme Fails)

Nobel Prizes on Malaria

• 1902 : British Scientist Ronald Ross get Nobel Prize for his discovery of parasite in mosquito.

• 1907 : Alphonse Lavern receive Nobel Prize for his findings that the parasite was present in human blood.

Methods of Control

• Removing or poisoning the breeding grounds of the mosquitoes and their larva stages(fill or applying oil to places with standing water).

• Use of Bednets( mosquito bite at night)• Control of mosquitoes by spraying chemicals.• Early diagnosis and treatment.• Vector Control- insecticide treated mosquito net, indoor residual spraying.• Early management and surveillance.• Monitoring and Evaluation- drug and insecticide resistance monitoring.• Anti-malarial Drugs.• Awareness among people to take proper nutrition and about vector controls

scheme.

Malaria Control in India

• Prior to 1940 : no organised National Malaria Control Programme.• 1945 : insecticide prop. of DDT identified.• Prior to 1953 : 75 million malaria cases and deaths estimated 1 million.• 1953 : Launching of National Malaria Control Programme.• 1958 : Launching of National Malaria Eradication Programme.• Early 70’s : Resurgence of malaria• 1976 : 6.46 million cases (highest in post DDT era). It is due to vectors become

resistance to insecticide.• 1977 : Modified plan of operations implemented• 1997 : World Bank Assisted Enhanced Malaria Control Project(EMCP).• 1999 : renaming of programme to National Anti-Malaria Programme(NAMP)• 2002 :renaming of NAMP to National Vector Borne Disease Control Programme.• 2005 : NVBDCP became an integral part of National Rural Health Mission(NRHM),

Intensified Malaria Control Project(IMCP) launched.• 2008 : NMCP regulated

Strategic Action Plan of Malaria Control in India(2007-2012) Surveillance and Case Management- it includes case detection(passive or active) ,early diagnosis and treatment, surveillance. Integrated Vector Management (IVM)- it includes Indoor Residual Spray(IRS), Insecticide Treated Bed nets(ITNs)/Long Lasting Insecticide Treated Bed Nets(LLINs) Epidemic Preparedness and Early Response. Supportive Interventions- it includes capacity building, Behaviour Change Communication(BCC), Intersectoral Collaboration, Monitoring and Evaluation (M&E) operational and applied field research.

There are other side by side many programmes i.e. Urban Malaria Scheme(UMS)And presently it continues under NVBDCP

World Malaria Report, 2014 : 22% of India’s Population live in high transmission(>1 cases per 1000) 67% live in low transmission (0-1 cases per 1000) 11% live in malaria free area. there are 0.7-1.6 million cases and 400-1000 deaths annually.

World Malaria Report, 2015(Dec 1,2015) : 214 million cases globally. 4,38000 deaths annually. 90% of deaths occur in Sub-Saharan Africa. 78% deaths are children under five. About 3.2 billion people –almost half of the world’s population are at risk of malaria

Efforts at Global Level : At Global level , WHO take initiatives to control Malaria worldwide through Malaria Eradication Programmes WHO also releases World Malaria Report year by year. Last report launched on DEC 1, 2015”The World Malaria Report-2015” Every year 25th of April is celebrated as World Malaria Day(Start from May 2007)

World Malaria Day is one of the Eight official Global Public Health Compaigns currently marked by WHO World Tuberculosis Day- March 24 World Health Day- April 7 World Malaria Day- April 25 World Immunization Week- Last Week of April World No Tobacco Day- May 31 World Blood Donor Day- June 14 World Hepatitis Day- July 28 World AIDS Day- Dec 1

Each World Malaria Day Focuses on a Specific theme : Recent and past themes includes the following : World Malaria Day 2013-2014-2015 “Invest in the Future : Defeat Malaria” World Malaria Day 2012 “Sustain Gains, Save lives : Invest in Malaria World Malaria Day 2011 “Achieving Progress and Impact” World Malaria Day 2009-2010 “Counting Malaria Out” World Malaria Day 2008 “Malaria : A Disease Without Borders”