MALARIA

WHAT WE NEED TO KNOW

Agenda
g
Today we will be looking at:
What is Malaria
Malaria Transmission
Sign and Symptom
Diagnosis and Treatment
Prevention

Malaria: what is malaria?

Malaria is a life-threatening
g disease caused by
yp
parasites
(P.falciparum, P.vivax, P.ovale, P.malariae, P.knowlesi)

WHO: Globally an estimated 3.4

3 4 billion people are at risk
of malaria, 200 million cases per year with > 600,000
death, mainly 70% children under 5 years old
Indonesia malaria area:
Hi
High
h risk:
i k P
Papua, W
Westt P
Papua, NTT,
NTT Maluku,
M l k North
N th Maluku
M l k
Medium risk: Kalimantan, Sulawesi, Sumatera
Low risk: Java (Pangandaran, Ujungkulon)

Indonesia endemic area

Transmission
Malariaistransmittedbyinfectedfemaleanophelesmosquitoes
Theystartbitingbylateeveningandthepeakofbitingactivityisat
midnightandearlyhoursofmorning
AdultAnophelescanbeidentifiedbytheirtypicalrestingposition:males
p
y
yp
gp
andfemalesrestwiththeirabdomensstickingupintheairratherthan
paralleltothesurfaceonwhichtheyareresting

Anopheles, Aedes & Culex

Anopheles
p

Aedes

C l
Culex

Transmission
When someone is bitten byy an infected mosquito,
q
, the
parasites enter their blood stream and move to their
liver.
Malaria can also be transmitted:
via infected blood transfusions
from mother to baby during pregnancy.

Malaria: life cycle

y

Malaria: Sign
g and Symptom
y p
Incubation period: 7-30
7 30 days
The signs and symptoms of malaria are non-specific
Clinically
y suspected
p
mostly
y on the basis of fever

Malaria: Sign & Symptom

Sign
Anemia
Jaundice
Hepato-splenomegaly

Symptom

Malaria: fever pattern

p

Malaria: diagnosis
g
Malaria is a MEDICAL
EMERGENCY

It is important you act

immediately. Your first priority is to
seek medical attention.
The diagnosis of malaria is
confirmed by a blood test. A
negative test does not exclude
malaria and may need to be
repeated.
You need to inform your
medical doctor that you have
been to a malaria area and need
to be tested for malaria

Rapid diagnostic test (RDT)

Blood smear

Malaria: treatment
Malaria is treatable with medication
Drugs used against the parasite:

chloroquine
atovaquone-proguanil (Malarone)
artemether-lumefantrine (Coartem)
mefloquine (Lariam)
quinine
quinidine
d
doxycycline
li ((used
d iin combination
bi ti with
ith quinine)
i i )
artesunate
primaquine

Malaria: Prevention
There is no vaccine against malaria yet.
Malaria is preventable through preventing
mosquito bites
bites. Take steps to prevent being
bitten throughout the day and night, both inside
and outside.
Outside
Clothing: Cover as much of your skin as possible.
Wear long sleeves, long pants, and socks and
covered shoes
shoes. Light coloured clothing is less
attractive to mosquitoes than dark colours.
Repellents: Use repellents on exposed skin. DEET,
Picaridin, Oil of Lemon Eucalyptus and IR3535 are
effective Clothing can be treated with repellent
effective.
repellent.
Coils: Burning mosquito coils releases pyrethroids
that repel mosquitoes.

Malaria: Prevention
Time of day: Mosquitoes that carry malaria
are more active from dusk to dawn. Avoid
being outdoors at these times
times.
Stay away from risky areas: Mosquitoes
are more likely to be found in areas where
they can breed, such as stagnant pools.
Avoid mosquito-attracting smells:
Perfume fragrances and sweat both attract
mosquitoes. Shower to remove sweat, and
avoid perfumes. Choose unscented
sunscreen, shampoos and other personal
hygiene items.
Eliminate mosquito breeding grounds:
make sure there are no unnecessary
collections of water (e.g in old tyres, pot
plant dishes, etc.)

Malaria: Prevention
Inside
Use an insecticide-treated bed net: Make sure
the net does not have any tears
tears. Tuck the ends in
under the mattress, or make sure it reaches the
floor.
Use insecticide sprays or vaporizers: Spray
bedrooms before going to sleep
sleep. Plug
Plug-in
in electric
vaporizers release insecticide.
Install insect screens on doors and windows:
The mesh size should be less than 1.5mm.
If possible use air conditioning: Mosquitoes are
less active at cooler temperatures.

Malaria: Prevention
The risk of developing malaria
is also reduced by taking
preventive medication.
Medications must be prescribed
b ad
by
doctor, ffor an iindividual
di id l
patient.
Medication is started prior to
entering
t i M
Malaria
l i area, d
duration
ti
varies depending on medication
prescribed by the doctor.
M di ti ffrequency and
Medication
d
duration vary and detailed by
prescribing doctor.