VC1A WASH Cluster – Emergency Training VC 1 Vector Control Module 1A Malaria

VC1A WASH Cluster – Emergency Training VC 2 Worldwide Malaria Incidence Key cause of morbidity and death in Afghanistan, Pakistan, Yemen, Timor, Aceh Indonesia, all Sub Saharan humanitarian crises plus others

VC1A WASH Cluster – Emergency Training VC 3 Malaria’s toll

VC1A WASH Cluster – Emergency Training VC 4 Many types of mosquitoes, but 3 main Anopheline species transmit malaria in AfricaMany types of mosquitoes, but 3 main Anopheline species transmit malaria in Africa Up to 500 million people infected each year million deaths annually

VC1A WASH Cluster – Emergency Training VC 5 Behaviour of mosquitoes GenusBreeding siteDisease and distribution Anopeline mosquito Anopheles gambiae arabiensis funestus Biting period : NIGHT Non polluted water: Edges of rivers, swamps, tanks, rice fields, saltwater without wave action, Malaria : Tropical and sub-tropical Filariasis : Asia and Africa Aedes mosquito Biting period : DAY Small water containers: Cans, jars, gutters Yellow fever : Africa and Americas Dengue : Africa and Americas, Asia Filariasis : Pacific Culex mosquito Biting period : NIGHT Any dirty water: Waste water ditches, latrines, septic pits, Filariasis : Most tropical areas Encephalitis virus: worldwide

VC1A WASH Cluster – Emergency Training VC 6 NATURAL DISASTERS African anopheles species are very efficient vectors, well adapted to breeding in clean flood waters I.E. NE Kenya Flooding 1997, 2006, 2008 Aceh, Indonesia – Tsunami Dec 2004 Some Asian anopheles species breed efficiently in brackish water (Aceh & Burma)

VC1A WASH Cluster – Emergency Training VC 7 What causes malaria? Mosquitoes transmit malaria parasites to humans when they bite them and feed off people’s blood. There are four types of malaria but only one type that kills. This is the most common type in Africa. Falciparum

VC1A WASH Cluster – Emergency Training VC 8 Locating the host While many mosquitoes may bite in the day, ones carrying malaria bite only after dusk and before dawn.

VC1A WASH Cluster – Emergency Training VC 9 WHAT ARE THE SIGNS AND SYMPTOMS OF MALARIA UNCOMPLICATED Fever Headache Vomiting Diarrhoea Cough Chills, Muscle pains COMPLICATED Confusion or drowsiness with extreme weakness May develop: coma, convulsions, jaundice, high fever, shock, abnormal bleeding

VC1A WASH Cluster – Emergency Training VC 10 Children can die within 8 hours from onset of clinical symptoms so rapid and effective treatment seeking is vital.

VC1A WASH Cluster – Emergency Training VC 11 Effective malaria case management Rapid malaria tests Artemisinin based combination therapy (ACT) for uncomplicated malaria IM artemether treatments for severe cases

VC1A WASH Cluster – Emergency Training VC 12 Disease burden of malaria is increasing because…. War and conflicts Disasters No effective vaccine Drug resistance: parasite and vector Population growth in endemic areas Population migrations

VC1A WASH Cluster – Emergency Training VC 13 Stable War Refugees/ IDPs >90% of falciparum cases occur in sub Saharan Africa >90% of all malaria deaths occur in sub Saharan Africa Epidemic / / /7

VC1A WASH Cluster – Emergency Training VC 14 Malaria Prevention Tools / Strategies in Complex Emergencies Personal protection from vectors Vector control Chemophylaxis (anti- malarials only) Intermittent Preventive Treatment (malaria only)

VC1A WASH Cluster – Emergency Training VC 15 Anopheles: clear ground water

VC1A WASH Cluster – Emergency Training VC 16 Issue for Control Most insects have short flight ranges but Anopheles can fly 2 km to find host: All Breeding sites within that zone must be eliminated for this strategy to be effective Slashing grass and maize has no impact on mosquito biting

VC1A WASH Cluster – Emergency Training VC 17 Environmental Control Generally this means the elimination of mosquito breeding sites. This is not usually feasible because of human resources needed, the extent of the breeding sites and operational cost. Some breeding sites may also be the only available water for the population. Breeding sites for malaria mosquitoes are extensive a they can breed in the water left in a footprint!

VC1A WASH Cluster – Emergency Training VC 18 Other vector control modules Information education and communication Net distribution Insecticide treated material