4. Malaria
Look at this 360 VR on Malaria in Tanzania
What is malaria and how is it transmitted?
How common is malaria in the world and in a selected Asian country?
Who are the vulnerable groups exposed to malaria?
Malaria in the world and in Asia (e.g. India, Bangladesh, Indonesia)
· – Transmission via mosquito-human-mosquito chain
– Extent of spread: number of cases and geographical spread in an Asian country and in the world
o Endemic to certain regions and countries
Endemic disease because consistently occur in an area or community (tropical and sub-tropical zones)
2012 World Malaria Report reported 655 000 malaria deaths worldwide and 90% of them occurred on the continent of Africa
Malaria mortality rates highest in Africa in 2011 because the African mosquito species have a relatively long life span and prefer to bite humans over animals
Therefore, a high incidence of malaria cases and this led to high death rates
Also present in India, Indonesia and Myanmar (ASIA) as Endemic disease
Incidence of malaria infections sometimes increases greatly after disasters for example, when Indonesia was hit by a tsunami in 2004
Pool of stagnant water left behind by the tsunami and heavy rains provided mosquitoes with suitable breeding conditions
– Pattern of spread of disease: expansion diffusion
– Vulnerable groups: pregnant women and children
for example, children have lower immunity against diseases
According to WHO, about 600 000 children under the age of five die from malaria each year in Sub-Saharan Africa
Click on this link to access an interactive map showing the spread of malaria in the world:
http://www.map.ox.ac.uk/explore/about-malaria/spatial-limits-malaria/.
1. Access this webpage showing the spatial distribution of malaria incidences in Indonesia: http://www.map.ox.ac.uk/browse-resources/transmission-limits/Pf_limits/IDN/
2. Describe the spread of malaria of Indonesia with reference to the map of Indonesia for names of regions: http://commons.wikimedia.org/wiki/File:Indonesia_map.png
· What conclusions can you make about the spread of malaria in the world?
· Which parts of the world is malaria most widespread? Provide examples of countries in those regions.
What factors contribute to the spread of malaria?
Social
o Lack of proper sanitation
Waste water not disposed of properly may form stagnant pools of water, which provides a favourable breeding ground for mosquitoes
When located near settlements, it increases the risk of people being infected with malaria
Economic
o Limited access to and provision of healthcare and preventive measures such as nets and insect repellents.
Shortage of doctors, lack of health services in rural areas and the cost of malaria treatment can contribute to the spread of malaria
According to United Nations Development Programme (UNDP), despite having the highest number of malaria cases, that there is a critical shortage of doctors in India (6 doctors for every 10000 people and India only spends 4% of the GDP on healthcare)
Medication is available in medical centres but is usually far from people’s homes in the rural areas and thus there is delay in receiving treatment and this contributes to higher chances of people spreading the disease
Malaria treatment is also unaffordable in rural areas where malaria is prevalent
As a result, those who cannot afford medication resort to cheaper but ineffective treatment or receive no treatment thus increases the spread of malaria
Environmental
o Poor drainage and stagnant water
Poor drainage of water creates conditions favourable for the growth of mosquito populations
For example, in the state of Rajasthan, India, water from 8000 kilometres of canals in the Great Indian Thar Desert leaks into many places
This has created swamps which have formed breeding ground for Anopheles mosquitoes, increasing the spread of malaria
As a result, there have been regular outbreaks of malaria in the desert areas of western India since the 1980s
o Effect of climate
Monsoons create favourable conditions for mosquitoes to breed by bringing large amounts of rainfall
Heavy rain form pools of water often due to blocked storm water drains caused by accumulations of debris
These pools of water provide ideal and secure breeding grounds for mosquitoes
Post-monsoon period poses more risk for malaria to spread
When flooded areas dry up, they leave pools of stagnant water which causes epidemics of malaria to take place in areas such as Pakistan in 2006 and 2009
Impacts of monsoons is particularly obvious when comparing forested areas with plains, where infection tends to be consistent throughout the year
For example, in the forested villages in Orissa, India
Malaria incidence is dependent on the intensity and duration of monsoon rains and on the timing of the start of winter
o Overcrowded living conditions
In such conditions, people tend to share the same spaces and use the same items
Interact with each other more often and more closely
As a result, diseases spread quickly and easily
For example, the housing for refugees and migrant workers is often overcrowded and have unhygienic conditions
Houses do not have proper doors and windows to keep out Anopheles mosquitoes at night
The crowded living conditions mean that mosquitoes can go easily from person to person, spreading the disease, increases the spread of malaria
Role of climate in the spread of malaria
Temperature
Temperatures ranging from 22°C to 30°C increase the lifespan and the frequency of bites by, female mosquitoes
Higher temperatures shorten the development time of the parasites in the mosquitoes host
As a result, mosquitoes become active and infectious sooner
Aquatic life cycle of mosquitoes will be reduced from 20 days to 7 days when temperature increases causing malaria to spread more easily
Precipitation
Pools of stagnant water allows mosquitoes to breed and infect more people\
During times of the year when there is insufficient rainfall for stagnant pools to form, such habitats will not be created
Habitats may be removed when rainfall is too high since the stagnant water will be washed away by the rain .
Relative humidity
Relative humidity ranges from 50% to 60% is needed for the survival and activity of mosquitoes
Higher humidity level leads to mosquitoes having a longer lifespan, and are able to infect more people
Watch the video below for insight into Malaria:
There is social and economic impact of malaria.
Death rate
World Health Organisation (WHO) estimated that in 2010, of the 216 million cases of malaria, about 537 000 to 907 000 people were estimated to have died from malaria
However, the number of people falling ill or dying from malaria varies from country to country
For example, the Democratic Republic of Congo and Nigeria accounted for over 40% of the total global malaria deaths in 2010
Infant mortality rate
High infant mortality rate could be high For example, in Nigeria, 140 died from malaria out of every 1000 children born alive
Women who have contracted malaria during pregnancy may have infected the unborn child
Estimates suggested that between 75,000 to 200,000 infants died every year within their first year of birth due to low birth weight caused by malaria infection during pregnancy
What are the impacts of malaria?
Social
o Death rate
World Health Organisation (WHO) estimated that in 2010, of the 216 million cases of malaria, about 537 000 to 907 000 people were estimated to have died from malaria
However, the number of people falling ill or dying from malaria varies from country to country
For example, the Democratic Republic of Congo and Nigeria accounted for over 40% of the total global malaria deaths in 2010
o Infant mortality rate
High infant mortality rate could be high For example, in Nigeria, 140 died from malaria out of every 1000 children born alive
Women who have contracted malaria during pregnancy may have infected the unborn child
Estimates suggested that between 75,000 to 200,000 infants died every year within their first year of birth due to low birth weight caused by malaria infection during pregnancy
Economic
o Loss of productivity resulting in slower economic growth
People infected with malaria are not able to work due to their poor health, resulting in loss of productivity for the workforce
Poor productivity produced less goods and service for export, thus results in slower economic growth
For example, areas endemic to malaria like Africa has slowed down their economic growth by 1.3% each year
o Burden of malaria on households
Economic burden of malaria includes increased medical expenses
In the Republic of Ghana, West Africa, the economic burden can be as high as 34% of a household’s income
o Cost of health care
Countries affected by malaria would need to set aside funds for the provision of health care to address the disease
Funds used for costs such as building maintenance and investments in hospitals and clinics, purchase of medication and insecticide-treated nets can account for as much as 40% of public health spending in some countries
Watch the video below on the Community-Led Total Sanitation (CLTS) in Mozambique to help to manage the spread of infectious diseases.
Read the article on the large-scale Vaccine against Malaria @
http://www.straitstimes.com/world/africa/first-large-scale-malaria-vaccine-trials-for-africa
Where will the vaccine against Malaria be carried out?
When will the vaccine against Malaria be carried out?
Who are the ones most affect by Malaria in Africa?
Why is there a need for the large-scale vaccine against Malaria?
What other preventive measures are carried out against the spread of Malaria?
How are the countries selected for the trial?
