Factm malaria 3

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Factm malaria 3

  1. 1. Malaria 3 Public Health, Travel & Expedition Medicine FACTM Pt 1 Tim Inglis Division of Microbiology & Infectious Diseases, PathWest Laboratory Medicine, WA
  2. 2. Malaria series Malaria 1 Clinical Tropical Medicine Malaria 2 Clinical Parasitology Malaria 3 Public Health, Travel & Expedition Medicine Malaria 4 Clinical Entomology
  3. 3. Study materials Manual of Travel Medicine & Health. 3rd 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/
  4. 4. Outline • Timeline • Epidemiology • Pre-travel risk assessment & planning • Expedition contingencies journey aftermathpreparation
  5. 5. Risk atlas • Global distribution • Regional distribution • Australian receptive zone Source = WHO Roll Back malaria Programme; http://www.who.int/entity/health_mapping
  6. 6. Epidemiology
  7. 7. Pre-travel preparation • Risk assessment: location, activities, duration, complexity • Personal measures: clothing, repellent, bed nets, activity • Chemoprophylaxis: – options include • Atovaquone/proguanil; Mefloquine; Doxycycline … – Specific issues • Short notice • Pregnant women • Children • Long stay
  8. 8. Expedition Medicine • Personal measures – Personal protection – Chemoprophylaxis • Group measures – Group prophylaxis – Area control measures – Rapid tests – Antimalarial therapy, SBET • Local people • Medevac arrangements
  9. 9. 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 – Other arthropod borne infections in DD – Indications of resistance – Compliance, esp after arrival in Aus journey aftermathpreparation
  10. 10. 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

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