Malaria in Children

1. Malaria in Children Presented by Amanda Larson Masters of Public Health Student Public Health 6165 Walden University January 20, 2013

2. Order of Presentation • Introduction of Malaria • Mode of Transmission • Geographical Distribution • Risk Factors • Signs & Symptoms • Disease Burden • Treatment • Methods of Control & Prevention

3. Introduction of Malaria • The Centers for Disease Control Definition (CDC, 2012)

4. Mode of Transmission • Infection from bite of mosquito • Only Anophelesmosquitoes • Danger = dusk to the early morning • Not spread by causal contact • Found in RBCs • Only spread when blood is exchanged (APHA, 2004) & (CDC, 2012)

5. Geographical Distribution (CDC, 2012)

6. Risk Factors for Malarial Infection Every 30 seconds, a child somewhere dies of malaria. Photo Courtesy of The Ifakara Health Research &Development Centre and the Rufiji District Council Health Management Team, Tanzania (MFI, 2013)

7. Mortality Risk by Age Group Figures: Courtesy of World Health Organization. (2003). The African Malaria Report 2003.

8. Incubation Period Early Signs & Symptoms • ≈ 8 days to 4 weeks • Rarely 8 to 10 months Signs & Symptoms Figure: Courtesy of Travel Health Matters (APHA, 2004)

9. Classification • Malaria is diagnosed as severe when any of the following criteria are present, otherwise it is considered uncomplicated: • Decreased consciousness • Significant weakness such that the person is unable to walk • Inability to feed • Two or more convulsions • Low blood pressure • Breathing problems • Circulatory shock • Kidney failure or blood in the urine • Bleeding problems, • Pulmonary edema • Low blood glucose level • Acidosis or high lactate levels • A high parasite level in the blood World Health Organization. (2003). The African Malaria Report 2003.

10. Treatment • The treatment of malaria depends on the severity of the disease. • Uncomplicated malaria may be treated with oral antimalarial medications. • Severe malaria requires the intravenous administration of antimalarial drugs. World Health Organization. (2012). World Malaria Report 2012. Retrieved from http://www.who.int/malaria/publications/world_malaria_report_2012/wmr2012_full_report.pdf

11. Local Burden International Burden • Malaria: • Increases school absenteeism • Decreases tourism • Inhibits foreign investment • Affects crop production • Increases hospital expenditurea • Despite the advances of the past decade, malaria is still one of the five leading causes of child under-five mortality worldwide.b • 100 countries report cases of malaria in 2005. • 54 countries reported deaths caused by malaria in 2005. Disease Burden a: World Health Organization. (2012). World Malaria Report 2012. Retrieved from http://www.who.int/malaria/publications/world_malaria_report_2012/wmr2012_full_report.pdf b: Hartman, A. F. (2013, January 15). World Malaria Report: Are We in Danger of Replicating History? Retrieved from http://blog.msh.org/2013/01/15/world-malaria-report-in-danger-of-replicating-history/

12. Methods of Control & Prevention • Local community methods: • Insecticide-treated mosquito nets (ITNs) • Indoor residual spraying with insecticides (IRS) • Vector control by eliminating mosquito breeding sites • Intermittent preventative treatment with full dose of antimalarial drug for pregnant women • Blood donors should be questioned for history of malaria American Public Health Association. (2004). Control of Communicable Diseases Manuel (18th ed.). (D. L. Heymann, Ed.).

13. Methods of Control & Prevention cont. • Personal Protective Measures • Avoid going out between dusk and dawn • Apply insect repellent to exposed skin • Use screens over doors and windows, or close them at night • Seek medical help if malaria is suspected American Public Health Association. (2004). Control of Communicable Diseases Manuel (18th ed.). (D. L. Heymann, Ed.).

14. Review Learning Objectives • What is Malaria? • Mode of Transmission • Geographical Distribution & Risk Factors • Signs & Symptoms • Disease Burden: Internationally & Locally • Treatment • Methods of Control & Prevention

15. Additional Reading Suggestions • The Malaria Journal • http://www.malariajournal.com/ • Malaria Elimination Group • http://www.malariaeliminationgroup.org/index.php • The American Journal of Tropical Medicine & Hygiene • http://www.ajtmh.org/ • Understanding Malaria: Fighting an Ancient Scourge • US Department of Health & Human Services • http://www.niaid.nih.gov/topics/malaria/documents/malaria.pdf

16. References • American Public Health Association. (2004). Control of Communicable Diseases Manuel (18th ed.). (D. L. Heymann, Ed.). • Centers for Disease Control. (2012). Malaria: Frequently Asked Questions. Retrieved from http://www.cdc.gov/malaria/about/faqs.html • Centers for Disease Control. (2012). Malaria: Where Malaria Occurs. Retrieved from http://www.cdc.gov/malaria/about/distribution.html. • Hartman, A. F. (2013, January 15). World Malaria Report: Are We in Danger of Replicating History? Retrieved from http://blog.msh.org/2013/01/15/world-malaria-report-in-danger-of-replicating-history/ • Malaria Foundation International. (2013). About Malaria. Retrieved from Malaria Foundation International: http://www.malaria.org/index.php?Itemid=32&id=8&option=com_content&task=section • World Health Organization. (2003). The African Malaria Report 2003. • World Health Organization. (2012). World Malaria Report 2012. Retrieved from http://www.who.int/malaria/publications/world_malaria_report_2012/wmr2012_full_report.pdf