1. MALARIA

2. MALARIA Agent: Plasmodium sp. P. falciparum P. vivax P. ovale P. malariae Vector: Anopheline Reservoir: Man

3. MALARIA Mode of Transmission: Mosquito Man Man Mosquito 1-3 yrs : P. vivax 1 yr : P. falciparum Incubation period:- P. vivax: 14 days P. falciparum: 12 days

4. Factors Influencing Transmission: Host factors Parasite factors The vector The environment

5. MALARIA Host factors: -A-Age and sex - Immunity - Pregnancy - Genetic factor

6. MALARIA Parasite factors: -S-Species - Strain tage - Antigenic diversity - Resistance to Chemotherapeutics

7. MALARIA The vector: -D-Distribution & Density esting area - Blood meal preference - Frequency of meals - Duration of sporogony - Longivity (survival) - Flight range - Resistance to insecticide

8. MALARIA The environment: - Temperature - Humidity - Rainfall

9. MALARIA Importance: 3.2 Billions (> 100 countries) > ½ W. pop. 500 millions infection /year. 200 millions disease /year.

10. MALARIA Importance: Major killer in the tropics Mainly P. falicparum Children with other problems Untreated P. falicparum < 25%

11. MALARIA Endemicity: (Spleen rate) Hypoendemic 0-10% Mesoendemic 11-50% Hyperendemic 51-75% Holoendemic >75%

12. MALARIA Hypoendemic 0-10% Unstable Mesoendemic 11-50% Malaria Hyperendemic 51-75% Stable Holoendemic >75% Malaria

13. MALARIA Immunity: Unstable malaria: All population groups. Stable malaria: Newborn (immune mothers): 3-6/12 (IgG). Clinical malaria throughout childhood: Intermittent absence of parasitaemia. Lower parasite density. Premunition. Splenomegally.

14. MALARIA Immunity: Stable malaria: Adolescents and adults: Parasitaemia: sometimes Clinical symptoms: occasional Pregnant: especially primigravidae Use of prophylaxis: Delays the process of immunity Serious disease on re-exposure

16. MALARIA Control (and Prevention): Vector Reduction Vector-host contact reduction Parasite reduction Research

17. MALARIA Control (and Prevention): Vector Reduction: Breeding sites Destruction of larvae Adult anophelines

18. MALARIA Control (and Prevention): Vector-host contact reduction: Well screened areas. Mosquito nets (ITN). Cover most of the body. Use repellent on exposed skin. Insecticide spray. Antisporozoite vaccine?

19. MALARIA Control (and Prevention): Parasite reduction: Chemotherapy Chemoprophylaxis Antimerozoite vaccine? Antigamitocyte vaccine? Research

22. MALARIA The problem is increasing (resurgence): Vector: Breeding site Cost and resistance Changing habits Parasite: Resistance and Cost

23. MALARIA (resurgence) Population: Movement. In-cooperation. Neighboring countries Inadequate Control: Political and economic. Technical.

24. MALARIA RBM - ITN - Treatment - Anemia - IPT