MALARIA

EPIDEMIOLOGY
A science that is concerned with:

Describing the pattern of occurrence of disease in a

population
Determining the factors that influence disease
distribution
Ultimate objective of providing the basis for prevention
and control

HOST (man) AGENT (Plasmodium sp.)

VECTOR
(Anopheles sp.)

ENVIRONMENT
 Guidelines on the elimination of residual foci of malaria transmission, WHO 2007

BIOTOPE (territory)

Mosquito hemi-population

Human Parasite
Adult Larval

Animal

Figure 1. Focus of malaria as an ecosystem

 HOST
Factors Inherent in Man
Race
Immunity
Age
Sex
Immunity in malaria is only partial

More susceptible population

Young children
Pregnant women
Non-immunes
Activities
Place of work
Sleeping habits
Night time activities
 Malaria Parasites
Plasmodium falciparum

Most common in the Philippines, around 70% of

cases
Causes severe/complicated malaria and death if not
treated promptly and appropriately
Plasmodium vivax
Around 30% of cases in the country
Very rarely causes severe disease
Relapse is common if not treated adequately
Plasmodium malariae
Less than 1% of cases in the country
Infection is usually not severe but may last up to 50
years if not treated
Plasmodium ovale
Very rare
Relapse may occur if not treated adequately
 Characteristics of the 4 Species of Human
Malaria
P. falciparum P. vivax P. malariae P. ovale

Exo-erythrocytic 6-7 days 6-8 days 12-16 days 9 days

cycle
Erythrocytic cycle 48 hrs 42-48 hrs 72 hrs 50 hrs

Prepatent period 6-9 days 8-12 days 15-18 days 10 14 days

Incubation period 16 18 days

6-25 days 8-27 days 16-40 days
or more
Appearance of About 10 About 3rd About 3rd About 3rd
gametocytes generation generation generation generation
Hypnozoite stage None present No present

Duration of 1-2 years 1.5-4 years 3-50 years

untreated infection
Periodicity of febrile None 48 hrs 72 hrs
attacks
Duration of febrile 16-36 hrs or 8-12 hrs 8-10 hrs
paroxysms longer

Center for Infectious and Degenerative Diseases

Department of Health
 VECTOR
The male Anopheles feeds
exclusively on nectar and fruit
juices
Female Anopheles feeds
primarily upon blood. Need
blood for egg development
Most Anopheles species feed
on warm-blooded animals, with
some preferences for humans
or certain animal hosts
Female Mosquito Bites Every 3 to 4 days
Bites Bites Bites Bites Bites Bites Bites

Lays eggs

ROUTINEOF FEMALE MOSQUITOES

Bite Rest Lays eggs
Anopheles flavirostris-
PRIMARY VECTOR
breeds in slow-flowing, partly shaded clear streams
indoor and outdoor biter
bites both man and animals
flight range of 1.5 to 2.0 kms
peak biting time 10:00 pm and 2:00 am
SECONDARY VECTORS
Anopheles litoralis
Vector in coastal areas
Anopheles maculatus
Semi-stagnant streams along
sides of shallow rivers with
mat of algae
Anopheles mangyanus
Slow flowing streams in wooded
areas
Anopheles balabacensis
Stagnant water in forest areas,
hoofprints, animal wallows
Wellcome Trust Image Collection
 ENVIRONMENTAL FACTORS AFFECTING
TRANSMISSION
Most important factors:
Temperature
The best conditions for the development of malaria parasite in the
mosquito and the transmission of infection are when the mean T is
within the range of 20 30C, while the mean relative humidity is at
least 60%
Malaria parasites cease to develop in the mosquito when the
temperature is below 16C
Rainfall
Numerous breeding places are created
Increase density of mosquitoes
Rise in relative humidity
Higher probability of survival of mosquitoes

Relative Humidity
A high relative humidity lengthens the life of the mosquito and
enables it to live long enough to transmit the infection to several
persons
 OTHER INTER-RELATED SOCIO-
ECONOMIC, BIOLOGICAL &
ENVIRONMENTAL FACTORS
Drug & insecticide resistance

Socio-political conflict

Population movement (work opportunities)

Location of houses in relation to breeding places

Structure of houses