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Epidemiology of Malaria

Epidemiology of Malaria



Epidemiology of Malaria by Dr Nikhil Bansal

Epidemiology of Malaria by Dr Nikhil Bansal



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    Epidemiology of Malaria Epidemiology of Malaria Presentation Transcript

    • Epidemiology of Malaria Dr Nikhil Bansal J.N.M.C.,W ardha
    • Malaria Vector borne infectious disease Caused by protozoan parasite Very common infectious disease Transmitted by female anopheles mosquito No vaccines available Can be treated easily with derivatives of quinine and artemisinin (drug resistance common)
    • History First record of “periodic fevers” from China in 2700 BC Term “malaria” derived from Italian for “bad air” – mala aria Also known as “ague” or “marsh fever”
    •  First effective treatment was the bark of the cinchona tree (contains quinine) Grows in the Peruvian Andes Used by the locals to control malaria Jesuits introduced it to Europe in 1640s Active ingredients (quinine) isolated from the bark Named by French chemist Pierre Pelletier and Jean Caventou
    •  The blood stage of malaria life cycle was recognized in 19th and early 20th century The latent form of the disease (in the liver) was only recognized in 1980s Explained why apparently “cured” people could have recurrent episodes years later in the absence of new exposure
    • Estimation of mortality and DALYs lostdue to malaria world wide (2002)Region Mortality DALYs (000) lost(000)Africa 1136 40855Americas 1 111East Medi- 59 1196terraneanEurope 0 21SEAR 65 2777Western Pacific 11 371Total 1272 46481
    • Epidemiology Precise statistics unknown - most cases are rural 400-900 million cases of fever per year Affects about 515 million people per year Kills between 1 – 3 million per year Most deaths occur in children less then 5 years in Sub Saharan Africa (pregnant women also vulnerable) One death every 30 seconds
    • State-wise distribution of malaria in India in 2005 and 2006 2005 2006State Malaria P.F. deaths Malaria P.F. deaths cases cases cases casesJharkha 192334 51484 21 33288 8707 1ndHaryana 33262 238 0 7558 7 0Punjab 1883 28 0 58 2 0Assam 67885 45453 113 85070 60885 271Orissa 391261 337934 249 63690 55365 49Uttar 105303 3149 0 14590 219 0Pradesh
    • Malaria parasite Malaria is caused by protozoan parasite of the genus plasmodium In humans the causes include  P. Falciparum  P. malariae  P. ovale  P. vivax
    •  P. vivax is the most common infection (80% of the cases) P. falciparum causes most deaths (15% of infections and 90% of deaths) Other Plasmodium species also infects birds, reptiles, rodents, monkeys and apes
    • Mosquito vectors Primary hosts and transmission vectors are the female Anopheles mosquito Only the female feed on blood Mosquito ingests parasite from infected human blood whilst feeding Carry sporozoites in the salivary glands There is a complex life cycle within the mosquito
    •  Parasite relatively protected from the human immune system because it hides in the red blood cells or in the liver. Circulating infected cells can be destroyed in the spleen Parasite infected cells stick to blood vessel walls (to avoid the spleen) – can cause strokes in cerebral malaria.
    • Exogenous phase(in mosquito) Sexual cycle (sporogony) Human phase` Sporozoites reach Oocyst grows salivary glands Outer layer of Sporozoites fromstomach wall and mosquito encysts enter human Human blood Ookinete enters mosquito Microgamete Zygote (fertilization) Macrogamete
    • Endogenous phase(in human)Mosquito asexual cycle (schizogony) phase Exo-erythrocytic stage Sprozoites Mature Merozoites Schizont Immature Erythrocytic Enter trophozoite cycle RBC Microgamete Mature Ring (differntiation) trophozoites trophozoites Macrogamete
    • References Essentials of Medical Pharmacology - K.D. Tripathi 6th edition Principles of Pharmacology - Sharma and Sharma 1st edition 2007 Textbook of Preventive and Social Medicine - K .Park 15th edition