MALARIA INTRODUCTION.

Infectious Diseases: A World in Transition

AIDS Avian Influenza Ebola Marburg Cholera Rift Valley Fever Typhoid Tuberculosis Leptospirosis Malaria Chikungunya Dengue JE Antimicrobial resistance

UP
DOWN

Guinea worm Smallpox

Yaws Poliomyelitis

Measles
Leprosy Neonatal tetanus

Reasons for emergence of diseases:

Environmental degradation. Unhygienic condition. Natural disaster. Alternations in microorganisms Insecticidal resistance. Un controlled urbanization. Migration of population. International trade ,tourism. Resistance to antimicrobials. 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.

THE RICH AND THE FAMOUS WHO DIED OF MALARIA:

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

MALARIA.
250 million cases, 650,000 deaths 90% of deaths are in Africa

One child every 60 seconds

Half the world is at risk

$12 billion in lost productivity

Poverty is a factor

Attacks the most vulnerable

GLOBAL MALARIA BURDEN

Endemic in 109 countries

Over 40% of world population live in malaria endemic countries 247 million cases and nearly one million deaths in 2008
(WHO report 2010)

Lancet 2010; 376: 156678

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

Malaria --endemic areas

MALARIA BURDEN IN AFRICA

Africas share:

60% of global malaria cases 91% of global malaria death

30-50% of hospital admissions 50% of outpatient visits in areas of high transmission 10% of the overall disease burden in Africa

Responsible for

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

MALARIA CASES (2008)

SEARO, 8.50% EMRO, 3.30% AMRO, 1.10% WPRO, 0.90% AFRO, 86.20%

MALARIA DEATHS ( 2008)

SEARO, 4.10% EMRO, 4.30% AMRO, 0.30% WPRO, 0.50%

AFRO: African region. AMRO: Regions of America. SEARO: South-East region. EMRO: Eastern mediterren.
AFRO, 90.80%

WPRO: western pacific region.

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

MALARIA CASES IN INDIA (2008)

59%
60%

50%

% of cases

40%

30%

14%

20%

8%

5%

4%

10%

4%

3%

3%

0%

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

BURDEN OF MALARIA:
At risk of malaria: 2400 Million of worlds Cases: 300-500 million cases world wide. population

1.5- 3.0 million deaths/ year.

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

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

Map showing Malaria Endemic Areas in India

API

MAP SHOWING HIGH RISK TOWNS FOR MALARIA IN INDIA

Haryana

Gujarat
Madhya Pradesh

Maharashtra

A.P

Karnataka

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

India

ECONOMIC CONCERN

Labor loss due to malaria: 1328.75 million mandays/ 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

Leading causes of death in children under five in the world

Deaths of children under five Pneumonia Preterm birth complications Diarrhoea 18% 14% 11%

Birth asphyxia

9%

Malaria
Other causes

7%
41%

Incidence of Malaria in India

Year 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012( Prov.) Total Malaria Cases (million) 2.93 3.04 2.66 2.22 2.28 2.03 2.09 1.84 1.87 1.92 1.82 1.79 1.51 1.53 1.56 1.60 1.31 Deaths due to malaria 1151 1010 879 664 1048 932 1005 973 1006 949 963 1707 1311 1055 1144 1018 754

1.06

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

Anti malaria month

Month of June

World Malaria day

25th April of every year.

Millennium development goal 6.

WHOs T3,

Test. Treat. Track initiative

The global campaign theme for 2013 and the coming years : Invest in the future , defeat malaria

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

MALARIA HAS BEEN SIGNIFICANT ENOUGH TO MAKE THE WORLD DIFFERENT!

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