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Presentation121.pptx
1. INTRODUCTION
Malaria is a Protozoal disease caused by infection with parasites of
the genus Plasmodium and transmitted to man by certain species of
infected female Anopheline mosquito. A typical attack comprises
three distinct stages cold stage, hot stage, sweating stage. The clinical
features of malaria vary form mild to severe and complicated
according to the species of parasite present, the patient’s state of
immunity, the intensity of infection and also the presence of
concomitant condition such as malnutrition and other diseases.
2. DEFINITION
Malaria is an intermittent fever and also remittent fever caused by
a protozoan parasite which invades the red blood cells and
transmitted by female Anopheline mosquito.
3. INCIDENCE
IN WORLD
According to WHO latest world malaria report there were an estimated
241million malaria cases and 627000 malaria deaths worldwide in 2020.
IN INDIA
The total number of malaria cases reported in 2020 which is decreased as
compared to 2019.
IN WEST BENGAL
In 2020 about 14 thousand cases of malaria were reported in state of West
Bengal.
4. EPIDEMILOGICAL DETERMINANTS
AGENT FACTORS
AGENT –malaria in man is caused by four distinct species of malaria
parasite –p. Vivax, p. Falciparum, p. Malaria, p. Ovale.
VECTOR-out of about 45 species of anopheline only a few are
regarded as vector of primary importance . These are An.
culicifacies, An. Fluviatilis, An. Stephensi, An. Philippinensis, An.
Sundaicus , An. Maculatus. The vactors of major importance are An
culicifacies in rural areas and An stephensi in urban areas.
5. HOST FACTORS
AGE-malaria affects all ages. Newborn infant have considerable resistance to
infection with falciparum.
SEX-male are more frequently exposed to the risk of acquiring malaria.
PREGNANCY-It increase the risk of malaria.
SOCIOECONOMIC DEVELOPMENT -It is generally accepted that malaria has
disapper from most developed country.
HOUSING-the ill ventilated and ill lighted house provide ideal indoor resting
places for mosquito.
OCCUPATION-malaria is predominantly a rural disease.
6. MODE OF TRANSMISSION
Vector transmission: Malaria is transmitted by the bite of
certain species of infected female Anopheline mosquitoes.
Direct transmission: Malaria may be induced accidentally by
hypodermie intravenous & intramuscular injections of blood or
plasma. Eg: blood transfusion
Congenital malaria: Congenital infection of the newborn
from an infeced mother may also occur. But it is rare.
8. RISK FACTORS
Young children in stable transmission areas who have not yet developed
protective immunity .
Non immune pregnant women as malaria causes high rates of miscarriage &
can lead to maternal death.
Semi immune pregnant women in areas of high transmission.
People with HIV/AIDS.
International travelers from non–endemic areas because they lack immunity.
Immigrants and their Children living in non-endemic areas & returning to
home countries are at risk because of absent immunity.
9.
10. CLINICAL FEATURES
The primary fever is marked by paroxysm which correspond to the development of the parasite in the
RBC . The peaks of the fever coincide with the release into the blood stream of successive broods of
merozites. The typical attack comprises three distinct stages, ie, the cold stage, the hot Stage 2 the
sweating stage
Cold stage: The onset is with headache, nausea, chilly sensation followed in an hour on 90 by rigors.
The temperature rise rapidly to 39-41°C. Headache is often severe & commonly there is vomitting. In
early part of this stage skin feels cold later become hot. Parasites are usually demonstrable in the blood.
The pulse is rapid & weak. This stage is lasts for 1/4- 1 hour.
Hot stage: The patient feels burning hot & casts of his clothes. The skin is hot & dry to touch.
Headache is intense but nausea commonly diminishes. The pulse is full & respiration rapid. The stage
lasts for 2 to 6 hours.
Swearing Stede: Fever comes down with profuse sweating & Temperature drop rapidly & skin is
cool & moist. Pulse rate slower patient feels sleepy. This stage lasts for 2-4 hours.
11.
12. DIAGNOSTIC EVOLUTION
The following laboratory tests are available to diagnose malaria.
Microscopic: ‘Thick film & thin film' those type of blood film are useful in
Searching for & identification of malaria.
Serological test: The malaria fluorescent antibody test usually become
positive two weeks.
Rapid Diagnostic test: These test based on the detection of circulating
parasite antigens with Simple dipstick formet.
13. MANAGEMENT
Medical management: Treatment of malaria depends on many factors
including disease severity, the Species of malaria parasites causing the infection.
In patients - patient with elevated parasitemia (>5% of RBCs infected) CNS
infection or otherwise severe symptoms & those with p. falciparum infection
should be considered for impatiens treatment to ensure that medications are
tolerated. Obtain blood smears every day to demonstrate a response of
treatment.
Pharmacological management: The 4 major drug classes currently used to
treat malaria include quinoline related compound, artemisinin derivatives and
antimicrobial. Antimalarias:These agents inhibit grooth I Concentrating within
acid vasieles of the prarasite, inerease the internal Plot the organism. They also
inhibit hemoglobin utilization & parasite metabolism.
14.
15. Nursing Management
Monitor vital sign & intake output chart.
Tepid sponging to reduce the temperature.
Encourage the patient to take plenty of fluid.
Check for any complication.
Provide medication at right time as ordered.
Provide Trendelenury position to restore blood volume in brain in case of
shock.
If compication arises, inform physician.
Provide psychological Support.
Provide mosquito free envinonment & advice to take bed rest.
16. LEVEL OF PREVENTION
1.Primordial prevention:
Maintain environmental mygiene & improve Sanitation.
Make surrounding clean to avoid mosquito.
Eradicating stagnant water eg. Flower vas because it helps in breeding of
mosquito.
Use mosquito nets & mosquito repeurente.
Use long sleeve Cloths to avoid mosquito.
Protect children from mosquito bite.
Application of lervicides in stagnant water.
Pubilic spraying of mosquito repellants to prevent community malaria free.
Increase public awareness.
Take healthy diet & adequate water.
17. 2.Primary prevention:
Health promotion:
Maintain environmental hygiene.
Eradicate stagnent water to prevent breeding of mosquito.
Use mosquito nets & mosquito repellants.
Use long sleeve cloths.
Take healthy diet & adequate fluid.
Application of lervicides in stagnant water.
Public awarness.
Specific protection:
Setting up vector surveillance mechanism to cheak places with high mosquito density.
Use mosquito nets & mosquito repellants.
Sertinizing the sign & symptoms indication dongue as soon as possible.
Use fishes in ponds to eat the larvae of mosquito.
Isolate patient to prevent Spread.
18. 3.Secondary prevention:
Early diagnosis & promote treatment is necessary to avoid complications &
caring recovery as well as to reduce spreading.
Immediate hospitalization.
Close monitoring of patient vital signs, intake & outpud chart.
Tepid Sponging to reduce temperature.
IV fluid can also be given.
4.Tertiary prevention:
Treatment for Shock.
Avoid further organ damage.
Rehabilitation.
19. CONTROL
As the concept of control replaces that of eradication in many national programmes & recording of
priorites in the selection of control methods must occur. These priorities & approachs must be based
on epidemiological consideration, adverse effect on health, economy, technical seasibility, functional,
human resources & Community participation.
Strategie action plan for malaria control in India, 2008-2012, 2012-2017 & 2017-2022 were developed
by directorate of national vector Borne disease control programme.
1. Surveillance & case management: 1. Case detection 2. Early diagnosis 3. Sentinel survelliance.
2. Integrated vector management: 1. Indoor residual spray 2. Insectieide treated bed nets 3. Antilarval
measure including source reduction.
3. Epidemic preparednece & Early response.
4. Supportive interventions: 1. Capacity buiding 2. Behavioural change communicaton 3. monitoring &
evalution
Early diagnosis & treatment of malaria aims of: 1. Complete cure 2. prevention of death 3.
Interruption of transmission 4. minimizing risk of selection & spread drug resistant malaria parasite.
20.
21. CONCLUSION
Malaria is one of the oldest diseases known to man. It is
stoppable, yet 1 to 2 million people die of it every year.
There are several types of malaria & it reproduces in liver,
but affects the blood. Even though it is easy to treat, this
disease has killed million of people. So we need to work
together to prevent malaria & to encourage prompt &
effective treatment.
