Malaria Control

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Malaria Control

• Jody Collinge
• Global CHE Network

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Where does malaria occur?

• Areas at risk

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How does malaria spread?
Source Roll Back Malaria. What is malaria?
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What determines the spread of malaria?

• Malaria spread depends on
• Rainfall pattern
• (How does this affect mosquito breeding?)

Female Anopheles mosquito What do you notice
about it?

• Types of mosquitoes in the area
• How close are people to the breeding sites?
• Some areas constantly have a high rate of
  malaria.
• Other areas have malaria seasons or occasional
  epidemics of malaria.

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How often does malaria occur in your area?

• Is it common and frequent throughout the year?
• Young children and pregnant women are at highest
  risk in these areas
• With frequent exposure, adults develop some
  immunity to malaria
• Or is it seasonal, occurring in bursts during
  rainy season or times of flooding?
• Who is at risk in these areas?

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What problems does malaria cause?

• Every 30 seconds, a child dies from malaria.
• Nearly one million people die from malaria every
  year.
• Most of those dying are African children.
• About one half of the worlds population is at
  risk of malaria.
• Malaria also hurts the economy.
• That sounds pretty bleak.
• What hope do we have?

Source of statistics WHO. 2009. Malaria Fact
Sheet.
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Malaria is preventable and curable.

• The focus of this talk will be on preventing
  malaria.
• But it is also important to stress early and
  effective treatment of malaria.

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• Main Symptoms
• Fever
• Headache
• Chills
• Vomiting
• These usually start about 10 to 15 days after the
  mosquito bite.

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Severe Malaria

• There are 4 types of malaria.
• One of them, falciparum malaria, can cause severe
  malaria.
• How common is falciparum malaria in your area?

• Severe malaria can cause
• Coma
• Breathing problems
• Anemia
• Jaundice
• Kidney failure
• Shock
• Death

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Mosquitoes and Malaria

• The spread of malaria depends on the life cycle
  of the mosquito.
• Adult mosquitoes lay their eggs on water.
• The eggs hatch to become larvae and then pupae,
  before turning into adults.
• Adult females mosquitoes only live 2 to 4 weeks.
• So you can reduce malaria by attacking any of
  these four stages of the mosquito.

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What is happening here? Why?
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Where do mosquitoes breed?
Irrigation water
Tire tracks
Any place there is water! So what is one way to
reduce malaria?
Rice paddies
Rice paddies
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Describe what is happening.How does this reduce
malaria?
Source Health Education Program for Developing
Countries. 2009.
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How can you kill mosquito larvae?

• Some fish, such as mosquitofish, carps, and
  Tilapia, eat mosquito larvae.
• Dragonflies, and perhaps also birds, bats, and
  lizards also kill larvae.
• Larvae can also be killed by surface films or by
  some chemicals such as methoprene that are toxic
  to mosquitoes.
• Check with your local health department to see
  what steps they are taking.

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The main strategy for malaria control Attack the
adult mosquitoes, or prevent them from biting
people.

• What is happening here?

Can you think of any risks to these approaches?

• Some risks
• Toxicity of DDT
• Resistance of mosquitoes

How does indoor residual spraying work?
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What are ways to prevent mosquito bites?

• Use mosquito repellants.
• Wear long pants and long sleeves.
• Wear light-colored clothes.
• Use window screens
• Use bed nets.

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What are different types of bed nets?

• Traditional bed nets
• Insecticide-treated nets (ITNs)
• Long-lasting insecticidal nets (LLINs)

Which type of nets do you use? How do nets that
are treated with insecticides work?
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Insecticide-Treated Nets (ITNs)

• What is happening here?
• What needs to happen within six months?
• Can you think of any practical challenges?

Source HEPFDC, 2009.
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Long-Lasting Insecticidal Nets (LLINs)

• These are pretreated with insecticides.
• They last about 3 to 5 years, and do not need to
  be retreated.
• They are an effective and inexpensive way to
  prevent malaria.
• They are recommended by the World Health
  Organization
• Are you using them?

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Other Ways to Prevent Malaria

• Who is at the highest risk of malaria?
• Travelers to an area high in malaria
• Travelers often take prophylactic (preventive)
  medicines to prevent malaria.
• Pregnant women (especially those with HIV)
• Pregnant women are given intermittent preventive
  treatment. They are given at least 2 doses of a
  malaria drug during their pregnancy.
• Young children
• How can you protect young children?

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Malaria Vaccine

• Scientists are working on a new malaria vaccine.
• The vaccine would help protect children from
  deadly malaria.
• The vaccine boosts the immune response against
  malaria.
• However, the vaccine is still being tested.

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Early and effective treatment

• Children are at a high risk of malaria.
• They have little immunity or defense against
  malaria.
• So be sure to
• Diagnose malaria early. In malaria areas, any
  child with a fever may have malaria.
• Treat children with malaria promptly.
• Use a combination of medicines, so there is less
  resistance to the treatment.

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Suspect malaria when a child in an area of
malaria risk has a fever.
Source World Health Organization/ UNICEF.
Integrated Management of Childhood Disease chart
booklet.
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What can you do?

• What are some ways that your CHE teams can work
  to prevent malaria?
• What are practical steps that you can take?
• What can you do?
• Make a list

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1. Find out about malaria in your community

• Do PLA activities focused on malaria.
• Visit families to ask them about their
  experiences with malaria.
• Ask about bed nets.
• Check for standing water.
• Visit the local health center.
• Use KAP surveys.

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2.Teach about malaria

• Teach about malaria and malaria prevention.
• Use health stories for malaria teaching.
• You will enjoy the malaria comic book.
• Do skits make posters tell stories be
  creative!

Go to our Global CHE Network site for stories and
lessons about malaria, for both adults and
children.

• Where can you teach about malaria?
• During home visits
• In community meetings
• At the health center and local school

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3. Do community cleanup

• Check with your health center. They may work
  together with you on this.
• Get rid of any sources of standing water (old
  tires, cans, jars, pools of water).
• Cover any water containers.

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4. Encourage the use of long-lasting insecticidal
nets

• Ask
• Where can you buy them?
• How much do they cost?
• How can you distribute them?
• On home visits?
• During vaccination campaigns?
• On another heath campaign?
• How can you teach about them and encourage
  families to use them?

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5. Investigate indoor residual spraying

• Who is doing it in your community?
• What chemical are they using?
• Are there any problems or side effects?
• What does it cost?

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6. Know how to recognize malaria and where to go
for malaria care

• CHEs should know when to suspect malaria and when
  to refer people for health care.
• Check with your health center How is malaria
  diagnosed and treated in your area?
• Dont wait! Be sure to get treatment right away.
• Learn how to use the IMCI chart. (IMCI is
  Integrated Management of Childhood Illness.)
• CHEs can help families get health care and also
  do follow-up visits.

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7. Do home visits

• Has anyone been sick with malaria?
• What are they doing to prevent malaria?
• Are they using bed nets?
• Is the area around the home clean and free of
  standing water?
• Do a KAP survey.
• Teach about malaria.
• Help the family get medical care when needed.

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Resources on the Global CHE Network website

• Go to http//chenetwork.org/member_resources/mala
  ria.php
• You will find
• Malaria lessons for adults and children
• Malaria stories for adults and children
• A malaria comic book
• A movie on the Malaria Initiative

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In conclusion

• Malaria is a serious disease that kills up to 1
  million people a year.
• But malaria can be prevented.
• And malaria can be treated.
• We need to work together to prevent malaria and
  to encourage prompt and effective treatment.
• What steps are you taking to prevent malaria?
• Have you taken our malaria survey yet?
• Join the Global CHE Network in our malaria
  campaign.

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References

• Centers for Disease Control and Prevention. 2010.
  Anopheles Mosquitoes. Available from
  http//www.cdc.gov/malaria/biology/mosquito/index.
  htm
• Centers for Disease Control and Prevention. 2010.
  Malaria. Available from http//www.cdc.gov/malari
  a/
• Health Education Program for Developing
  Countries. 2009. Available from
  http//www.hepfdc.info/
• Wikipedia. 2010. Malaria. Available from
  http//en.wikipedia.org/wiki/Malaria
• Wikipedia. 2010. Mosquito. Available from
  http//en.wikipedia.org/wiki/Mosquaito
• Wikipedia. 2010. Mosquito control. Available
  from http//en.wikipedia.org/wiki/Mosquito_contro
  l
• World Health Organization. Integrated Management
  of Childhood Illness chart booklet.
• World Health Organization. 2009. Malaria Fact
  File. Available from http//www.who.int/mediacent
  re/factsheets/fs094/en/index.html
• World Health Organization. 2010. Ten Facts on
  Malaria. Available from http//www.who.int/featur
  es/factfiles/malaria/en/index.html
• World Health Organization. Roll back malaria.
  Available from http//rbm.who.int/cmc_upload/0/00
  0/015/372/RBMInfosheet_1.htm