CASE 5: A Trip to Southern Khartoum

Objective 1: Epidemiology of Malaria Definition Acute protozoal disease that becomes chronic if not properly treated. Malaria is a complex disease with a broad clinical spectrum from asymptomatic infections to disseminated intravascular coagulation, pulmonary edema and death. Public health significance and occurrence It is the most prevalent parasite all over the world, tropical & subtropical Africa, Asia, Central & South America. Endemic in 92 countries, with pockets of transmission in an additional eight countries. About 40% of the world s population is at risk (2 billions) Each year 300 million to 500 million clinical cases of malaria, >90% of them in Africa Two million deaths/year, 50% in children under 5 years of age The malaria situation worldwide is deteriorating. There are increasing levels of transmission and it has returned to areas where it had previously been eradicated. Drug resistance has increased and there has been a spread of vector resistance to insecticides. Mode of transmission 1. By the bite of infective female anopheles mosquito where the sporozoites are present in salivary glands. 2. Infected blood transfusion. Any blood component containing RBCs. Malaria can remain viable in stored or frozen blood for 19 days. 3. In utero infection may occur. Susceptibility and resistance Age: general, tolerance to disease is present in highly endemic areas Sex: male is more exposed usually due to outdoor life Genetics: Black African show natural resistance to infection with P.Vivax Socio-cultural: habits of population such as sleeping outdoors Immunity: - No natural immunity - Infection produces species specific immunity - People living in endemic area may develop some sort of active immunity Travel: people travelling to malarious areas are at risk Environment: - Season: highly prevalent in hot, humid seasons because it is suitable for the mosquitoes. - Rainfall: provide a suitable environment for breeding of mosquitoes.

Prepared by: HajarBaki

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