Workshop on Word Malaria Day

SUDIPTA DESR PHN

BAHADURPUR BPHCJAMURIA II

ASANSOL HEALTH DISTRICTBURDWAN

Introduction: Malaria in Brief

• Malaria is caused by a parasite that is passed from one human to another by the bite of infected Anopheles mosquitoes. After infection, the parasites travel through the bloodstream to the liver, where they mature and release another form, the merozoites. The parasites enter the bloodstream and infect red blood cells. The parasites multiply inside the red blood cells, which then break open within 48 to 72 hours, infecting more red blood cells.

• Malaria can be carried by mosquitoes in temperate climates, but the parasite disappears over the winter.

• The disease is a major health problem in much of the tropics and subtropics.

Introduction: What is Malaria?• Malaria is a potentially life threatening parasitic disease caused by parasites

known as Plasmodium viviax (P.vivax), Plasmodium falciparum (P.falciparum), Plasmodium malariae (P.malariae) and Plasmodium ovale (P.ovale)

• It is transmitted by the infective bite of Anopheles mosquito• Man develops disease after 10 to 14 days of being bitten by an infective

mosquito.• There are two types of parasites of human malaria, Plasmodium vivax, P.

falciparum,which are commonly reported from India.• Inside the human host, the parasite undergoes a series of changes as part of its

complex life cycle. (Plasmodium is a protozoan parasite)• (erythrocytic schizogony• Infection with P.falciparum is the most deadlyThe parasite completes life cycle

in liver cells (pre-erythrocytic schizogony) and red blood cells form of malaria.

History of Malaria

Malaria has been a major public health problem in India. Intermittent fever, with high incidence during the rainy season, coinciding with agriculture, sowing and harvesting, was first recognized by Romans and Greeks who associated it with swampy areas. They postulated that intermittent fevers were due to the 'bad odour' coming from the marshy areas and thus gave the name 'malaria' ('mal'=bad + 'air') to intermittent fevers. In spite of the fact that today the causative organism is known, the name has stuck to this disease. 

Symptoms of Malaria

Typically, malaria produces fever, headache, vomiting and other flu-like symptoms.

• The parasite infects and destroys red blood cells resulting in easy fatigue-ability due to anemia, fits/convulsions and loss of consciousness.

• Parasites are carried by blood to the brain (cerebral malaria) and to other vital organs.

• Malaria in pregnancy poses a substantial risk to the mother, the fetus and the newborn infant. Pregnant women are less capable of coping with and clearing malaria infections, adversely affecting the unborn fetus.

Symptoms of Severe Malaria• The priority requirement is the early recognition of signs and symptoms of

severe malaria that should lead to prompt emergency care of patient. The signs and symptoms that can be used are non-specific and may be due to any severe febrile disease, which may be severe malaria, other severe febrile disease or concomitant malaria and severe bacterial infection.

The symptoms are a history of high fever, plus at least one of the following:-

Prostration (inability to sit), altered consciousness lethargy or coma• Breathing difficulties• Severe anaemia• Generalized convulsions/fits• Inability to drink/vomiting• Dark and/or limited production of urine

Life Cycle of Malaria Parasite in Man & Mosquito

Vector of MalariaThere are many vectors of malaria

• Anopheles culicifacies is the main vector of malaria• It is a small to medium sized mosquito with Culex like sitting posture• 1. Feeding habits

It is a zoophilic species• When high densities build up relatively large numbers feed on men• 2. Resting habits

Rests during daytime in human dwellings and cattlesheds• 3. Breeding places

Breeds in rainwater pools and puddles, borrowpits, river bed pools, irrigation channels, seepages, rice fields, wells, pond margins, sluggish streams with sandy margins.

• Extensive breeding is generally encountered following monsoon rains.• 4. Biting time

Biting time of each vector species is determined by its generic character, but can be readily influenced by environmental conditions.

• Most of the vectors, including Anopheles culicifacies, start biting soon after dusk. Therefore, biting starts much earlier in winter than in summer but the peak time varies from species to species.

Malaria Control Strategies-I

1. Early case Detection and Prompt Treatment (EDPT) EDPT is the main strategy of malaria control - radical treatment is

necessary for all the cases of malaria to prevent transmission of malaria.

• Chloroquine is the main anti-malaria drug for uncomplicated malaria.

• Drug Distribution Centres (DDCs) and Fever Treatment Depots (FTDs) have been established in the rural areas for providing easy access to anti-malarial drugs to the community.

• Alternative drugs for chloroquine resistant malaria are recommended as per the drug policy of malaria.

Malaria Control Strategies-II• 2. Vector Control

(i) Chemical ControlUse of Indoor Residual Spray (IRS) with insecticides recommended under the programnme

• Use of chemical larvicides like Abate in potable water• Aerosol space spray during day time• Malathion fogging during outbreaks• (ii) Biological Control

Use of larvivorous fish in ornamental tanks, fountains etc.• Use of biocides.• (iii) Personal Prophylatic Measures that individuals/communities can take up

Use of mosquito repellent creams, liquids, coils, mats etc.• Screening of the houses with wire mesh• Use of bednets treated with insecticide• Wearing clothes that cover maximum surface area of the body

Malaria Control Strategies-III• 4. Community Participation

Sensitizing and involving the community for detection of Anopheles breeding places and their elimination

• NGO schemes involving them in programme strategies• 5. Environmental Management & Source Reduction Methods

Source reduction i.e. filling of the breeding places• Proper covering of stored water• Channelization of breeding source• 6. Monitoring and Evaluation of the programme

Monthly Computerized Management Information System(CMIS)• Field visits by state by State National Programme Officers• Field visits by Malaria Research Centres and other ICMR Institutes• Feedback to states on field observations for correction actions.

Name of the Insecticide Name of the Larvicide

DDT 50% WP MLO

Malathion 25% WP Temephos (Abate)

Deltamethrin 2.5 % WP Bacillus Thuringenisivar israelensis WP

Cyfluthrin 10% WP Bacillus Thuringenisivar israelensis 12 Aqueous Suspension (AS)

Lambadacyhalothrin 10% WP

Alphacypermethrin 5% WP

Bifenthrin 10 % WP Information from MH&FW INDIA

Massage on World Malaria Day

IEC on Malaria Eradication Programme

IEC on Malaria Eradication Programme

IEC on Malaria Eradication Programme

Thanks You