Malaria

MALARIA MALARIA IS A LIFE-THREATENING DISEASE CAUSED BY A PARASITE TRANSMITTED VIA THE BITES OF INFECTED MOSQUITOES. IN THE HUMAN BODY, THE PARASITES MULTIPLY IN THE LIVER, AND THEN INFECT RED BLOOD CELLS. IT IS BOTH PREVENTABLE AND CURABLE HALF THE WORLD IS AT RISK 219,000,000 1,666 Most malaria cases and deaths occur in sub-Saharan Atrica. However, Asis, Latin America, and to a lesser extent the Middle East and parts of Europe are also affected In 2011, 99 countries and territories had ongong malaria transmission NEW CASES NEW CASES 660,000 5 DEATHS DEATHS EVERY YEAR IN THE NEXT Mortalty rates have tellen 25% gkbally since 2000 Mortality rates have tallen by 33% in the WHO Atricen Region FOUR MINUTES HIGH RISK GROUPS: 70% OF MALARIA DEATHS ARE CHILDREN YOUNG CHILDREN os vaessio as teve er er d d A tya o NON-IMMUNE PREGNANT WOMEN M andcan io UNDER FIVE YEARS OLD SEMI-IMMUNE PREGNANT SEMI-IMMU NE HIV-INFECTED PREGNANT WOMEN stbera la n Wemen es t he ace he ar psg H on oerte PEOPLE WITH HIVAIDS INTERNATIONAL TRAVELLERS From endeas dece y k IM MIGRANTS FROM ENDEMIC AREAS AND THEIR CHILDREN ONE CHILD DIES EVERY MINUTE FROM MALARIA IN AFRICA 50% OF ABSENTEEISM IN AFRICAN SCHOOLS MALARIA ACCOUNTS FOR 68% OF GLOBAL MALARIA DEATHS OCCUR IN THE 10 HIGHEST-BURDEN 10 MILLION Malaria prevents COUNTRIES from attending school than any other disease MISSED SCHOOL DAYS EACH YEAR Surviving patients have an increased risk of neurological and cognitive deficits, 575,000 behavioral ditficulties nd epilepsy making cerebral malaria a leading cause of childhood neuro-disabilily in the region. CHILDREN IN AFRICA DEVELOP CEREBRAL MALARIA NIGERIA 162,000,000 CASES 155,000 DEATHS NIGER 16,080,000 CASES DEATHS BY COUNTRY 119,100 DEATHS GHANA AFBHANISTAN. GUYANA 25,000.000 CASES 23,600 DEATHS CONGO, D.R 67,730,000 CASES 145,800 DEATHS HAITI ARGENTINA HONDURAS ARMENIA INDIA AZERBALIAN INDONESIA. CÔTE D'IVOIRE BANGLADESH. IRAN UGANDA 20,200,000 CASES 32,000 DEATHS RAQ 34,550,000 CASES 111.000 DEATHS BENIN. KENYA . ВНUTAN KYRGYZSTAN BOLMA BOTSWANA LIBERIA BURKINA FASO 17,000,000 CASES 184,100 DEATHS TANZANIA LIBYA CAMEROON 20,010,000 CASES 15,426 DEATHS 45,100,000 CASES 44,700 BURKINA FAS0 . MADAGASCAR. DEATHS BURUNDI. MALAYSA CAMBODIA MALI CAMEROON MAURITANIA MOZAMBIQUE CENTRAL AFRICAN REPUBLIE. MAURITIUS 23,900,000 CASES NEARLY 1 IN 5 PEOPLE IN BURKINA FASO DIE снАп . MIXICO 176,100 DEATHS CHINA MOROCCO FROM MALARIA MOZAMBIQUE. COMOROS NEPA COSTA RICA NICARADUA CÔTE D IVOIRE NIGER CONGO, DEM REP NIGERIA KOREA NORTM DOMINICAN REPUBLIC OMAN ECLIADOR PAKISTAN . OVER 40% EDYPT PANAMA FAPLA NEW BUINEA - EQUATORIAL GUINEA FARABUAY OF ALL DEATHS OCCUR IN FRITREA PERU NIGERIA AND ETHIOPIA • PHILIPPINES GABON RWANDA D.R. OF CONGO BAMBIA : SAO TOME AND PRNCIPE BEDROIA SAUDI ARAA DHANA SENEGAL . GUATEMALA SOLOMON ISLANDS GUNEA-BISSAU . SOMALIA INFECTION Malaria infection begins when an SOUTH AFRICA eu femate anopheles monouite hites a person, necting Plasmod parasites from its saliva, in the form ot soorozoites, into the bloodstream SUDAN MIGRATION TO LIVER The sporozoites pass quickly into the human liver where they intect hepatocytes SURINAME SWAZILAND SYRIA TAJIKISTAN TANZANIA e PARASITES MULTIPLY TIMOR-I ESTE LIFE CYCLE OF The soorozoites multiplyasexualy in the liver cells over the next 7-10 days, causing no symptorms TURKEY MALARIA PARASITE TURKMENISTAN UBANDA UNITED ARAB EMIRATES UZBEKISTAN VANLIATU GAMETES DEVELOP AND MIGRATE MENIZUELA The gametes develop into sctively moving ookinetes that burrow through the mosquito's midgut wall and form oocysts Inside the cocyst, thousands of active sporozoites devekp The 0ocyst eventually bursts, releasing sporozoites that travel to the mosquito salivary glands. The cycle of human in taction begins again when the mosquto btes another person. YEMEN. ZAMA . LIVER CELLS BURST The parastes, in the form of merorotes, burst from the Itver ZIMBABWE cells in vesicles, journey through the heart, and arrive in the lungs, where they settle within Lung capillaries. The vesicles RG eventualb disintegrate MOSQUITO INFECTION When a mosquito bites an infected human, freeing the merozoites to enter the blood phase of their development. it ingests the gametocytes, which develop further into mature sex cells called gametes. RED BLOOD CELLS INFECTION In the bloodstream, the and multiply again unti the cells burst. Then they invada more erythrocytes This cycle is repeated causing fever meroz otes invade erythrocytes each time parasites break free and invade blood cells SYMPTOMS APPEAR GAMETOCYTE DEVELOPMENT Same of the infected blood cells leave the cycle of asexusl mult plication. Instead of replicating, the merozoites in these cells develop into sexual forms in the bloodstream 10-15 DAYS AFTER MOSQUITO BITE of the parasite, called gametocytes, Malaria is an acute febrile illness. In a non-mmune individual, symptoms usually appear 10-15 days after the infective mosquito bite. The first symptoms, below, may be mild and difticult to recognize as malaria MALARIA CAN QUICKLY BECOME HEADACHE LIFE-THREATENING BY DISRUPTING FEVER CHILLS THE BLOOD SUPPLY TO VITAL ORGANS. VOMITING Children with severe malaris frequently develop one or more of the tollowing symptoms: severe anaemia respiratory distrese, or cerebral malaria as ogo e ca y ko pars in noassoovicesoes o es venea s easa Tresesesodesense on er er es s honres Rostio onnd ant ea voeredar ese tcsre d caw INFECTED CELLS STIFFEN BY 50X MORE THAN HEALTHY CELLS AND TEND TO STICK ALONG BLOOD VESSEL WALLS, IMPEDING THE FLOW OF BLOOD TO CRITICAL ORGANS SICKLE-CELL TRAIT stoe yof ese nenon IF NOT TREATED WITHIN 24 HRS P. FALCIPARUM MALARIA CAN PROGRESS TO SEVERE ILLNESS LEADING TO DEATH DIAGNOSIS AND TREATMENT Eyda aet 25% The beeahe ri pariderty or eanonmonasa -sed corasoay CT CARRY SICKLE-CELL TRAIT wH0 dsutacaesof d ma de co ed ddaosreslbeload g IN WEST AFRICA contoaton cabe rl Dientsainyonihe b ptos only de co redw apas auosetposs Mweded e a e the for rteeatarularia becend o VACCINES AGAINST MALARIA Tereaecaety esed aconsgs eranyer rse Oe rerchce agaerea ias S SOSL satonced Tis accieis ameesy deing ao argecial a 7cotenAa. Aof Aagt 2, eaa acie becae the dreo pronde 18 proecnag he deme, con g entand urpngayterpmien malar ceiinddeme be imtedrshern da HUMAN HOST ENVIRONMENT Human immunty is an important factor in transmission intensity, esoacially among adults in areas of moderate or intense transmission conditions. Partisl immunity is developed over years of exposure, and while it never provides complete protection, it does reduce the risk that malaria infection will .cause severe disease. For this reason, most malaria deaths in Atrica occur in young Transmission depends on climatic condtions that may a tlect the number and survival of mosquitoes, such as rain tall patterns, temperature and humidity. In many places, transmission is seasonal, with the paak during and just ofter the rainy season. Malaria epidemics can occur when climate and other conditions suddenly favor transmission in areas where children, whereas in areas wth less transmission and low immunity, all age groups are at risk paople have little or na immunity to malaria. se occur wten ceple with low munty m an areas with intense malaria tranemission, for instance to tind work, on vacation, or as retugees TRANSMISSION INTENSITY PARASITE VECTOR Malaria is caused by Flasmodium parasites. The parasites are spread to people through the bites of indected Anopheles mosquitoes, known as "malaria vectors". Four parasite species cause malaria in humans Malaria is transmitted exclusvely through the bites of female Anopheles mosequtoes 20 different Anopheles species are localb mportant around the world PLASMODIUM FALCIPARUMO PLASMODIUM VIVAX Anopheles mosquitoes breed in water and each specias has its own breeding preference, for example some preter shallow collections of fresh water, such Bs pudles, rice fields, and hoot prints PLASMODIUM MALARIAE PLASMODIUM OVALE oecesrs see coses f va eakaoctw Pases Transmission is more intense in places where the mosquito lifespan s longer so that the parasite has time ta complete its davelopment inside the mosquito and where it prefers to bite hurmans rather than other animals. For example, the long lifespan and strong human-biting habit of the African vector species is the main reason why more than 90% of the world's asof Sauh- A ANTIMALARIAL DRUG RESISTANCE malaria deaths are in Africa Resisanceinoloraiedcessa ig pras ofkn po of di nchora ALL OF THE IMPORTANT PARASITE RESISTANCE VECTOR SPECIES CAMBODIA MYANMAR THAILAND VIET NAM BITE AT NIGHT. INSECTICIDE RESISTANCE Mdehreare stac e remere d h e ofaora anea eer der sobeanpesrder aralare udmoetw perin he pd dppe eofal e ressc sem t andsec pas s persisnwpaoiseir bo es procidad t anACT ree para arve nd can be peed on inmmgaoand en fresiserea s dsandsawes reater larpe pogapticalaros, rbechit cmegencecae dre, ve be rarnte PREVENTION Vactor contral is the main way to reduce malaria transmissicn at the community level. It is the only intervention that can reduce malaria transmission from very high levels to close to zero. For individuals, personal protection aganst moequito btes represente the tirst line of defence or malaris preention Two forme of vector control are effective in a wide range of circumstances INSECTICIDE-TREATED MOSQUITO NETS cong-lasringctioAs are epretevee of ITNr pachid pr s m recoend coverage eralatm penos andno ses Thet costetveyacehs provn eee se tee eN INDODE SPRAYING RESIDUAL SPRAYING nder redul aw y dy re l n pei oettener s eses easne the ericeedatheea w ces sess rsenS progoes, ae ANTIMALARIAL MEDICINES ELIMINATION Aviularal ed canao beade prt mal can epreveed r Malaria eliminetion is detned es interrupting local mosquito-borne malaria tranemission in a detined geographical area, i.e. zero incidence of locally contractad cases. Malara eradication is detinad as the permanent reduction to zero of the worldwide incidence of malaria intection caused by a specific agent; i.e. applies to a particular malaria paraste species s ey preve essean o ds pr emwee derierinture uet ore lving in bigt ramnre atchtedd an tr he Many countries - especially in temperate and sub-tropical zones - have been successtul in eliminating malaria. The global malaria eradication campaign, launched by WHO in 1955, was successtul in eliminating the disease in some countries, but ultimately failed to achieve its overall goal, thus being abandoned less than twa decades later in tavour of the less ambitious goal of malaria control In recent years, however, interest in malaria eradication as a long-term gosl has re-emerged. s 3ss a ett e t ws epyn sode d aknde e a 22, M caon S M a tpr o Large-scale use of WHO-recommended strategies, currently available tools, strong national commitments, and coordinated e tforts with partners, wil enable more countrie- particularly those where malara tranamiosion is low and unstable - to progress towards malaria elimination. In recent years, 4 countries have been certified by the WHD Director-General as having eliminated malaria: United Arab Emirates (2007), Morocto 12010 Turkmenistan 120101, and Armenia (2011) CONCEPTA DESION Ly Ca SOURCE WridHeth Drgan catn, Tiuliilii |