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Factm malaria 3

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Factm malaria 3 Factm malaria 3 Presentation Transcript

  • Malaria 3 Public Health, Travel & Expedition Medicine FACTM Pt 1 Tim Inglis Division of Microbiology & Infectious Diseases, PathWest Laboratory Medicine, WA
  • Malaria series
    • Malaria 1 Clinical Tropical Medicine
    • Malaria 2 Clinical Parasitology
    • Malaria 3 Public Health, Travel & Expedition Medicine
    • Malaria 4 Clinical Entomology
    • Study materials
    • Manual of Travel Medicine & Health .
    • 3 rd Edition, Steffen R et al . 2007. Decker.
    • Oxford Handbook of Expedition & Wilderness Medicine
    • Johnson C et al. 2008, Oxford
    • FACTM study notes
    • Specialist review articles
    • Self-assessment questions
    • Blog http://micrognome.priobe.net
    • Web www.priobe.net
    • FACTM http://lifeinthefastlane.com/exams/actm-fellowship/
  • Outline
    • Timeline
    • Epidemiology
    • Pre-travel risk assessment & planning
    • Expedition contingencies
    journey aftermath preparation
  • Risk atlas
    • Global distribution
    • Regional distribution
    • Australian receptive zone
    Source = WHO Roll Back malaria Programme; http://www.who.int/entity/health_mapping
  • Epidemiology
  • Pre-travel preparation
    • Risk assessment: location, activities, duration, complexity
    • Personal measures: clothing, repellent, bed nets, activity
    • Chemoprophylaxis:
      • options include
        • A tovaquone/proguanil; Mefloquine; Doxycycline …
      • Specific issues
        • Short notice
        • Pregnant women
        • Children
        • Long stay
  • Expedition Medicine
    • Personal measures
      • Personal protection
      • Chemoprophylaxis
    • Group measures
      • Group prophylaxis
      • Area control measures
      • Rapid tests
      • Antimalarial therapy, SBET
    • Local people
    • Medevac arrangements
  • On return
    • May present after interval, up to 1yr after end of journey
    • Exclude malaria in anyone with fever who has travelled to an endemic area
    • Detailed history of location, duration & intensity of exposure to biting insects, PPM and CPx used
      • Thai/Myanmar border area; PNG
      • O ther arthropod borne infections in DD
      • Indications of resistance
      • Compliance, esp after arrival in Aus
    journey aftermath preparation
  • Emerging Issues
    • Highland malaria
    • Unusual malaria transmission methods
    • Malaria & air travel
    • Changing resistance
    • Use for portable rapid diagnostic methods
    • SBET in pregnancy
    • CPx for long stay
    • Prep for AUSMAT members