3a Malaria

Question 1

Vector of malaria

Answer 1

Anopheles mosquito

Question 2

Number of global cases in 2019

Answer 2

229 million

Question 3

Number of malaria deaths in 2019

Answer 3

409,000

Question 4

Percentage of malaria deaths in 2019 that were children under 5

Answer 4

67%

Question 5

Percentage of malaria cases and deaths in the WHO African Region

Answer 5

94%

Question 6

Total funding for malaria mitigation in 2019
Contributions of governments from endemic countries

Answer 6

US$3 billion
31%

Question 7

Malaria is endemic in what % of Ethiopia’s land area

Answer 7

75%

Question 8

Deaths of malaria in Ethiopia 2013

Answer 8

584,000

Question 9

Areas most at risk in Ethiopia

Answer 9

Western lowlands below 1500m in Tigray, Amhara and Gambella provinces

Question 10

Peak transmission rates

Answer 10

After rainy season (peak from Sept-Dec)

Question 11

Tranmission in midlands

Answer 11

Seasonal - occasional epidemics

Question 12

Central highlands prevalence

Answer 12

Malaria free

Question 13

Eastern lowlands malaria patterns

Answer 13

Afar and Somali provinces
Arid climate confines malaria to river valleys

Question 14

2 environmental factors influencing disease

Answer 14

Climate
Altitude/relief

Question 15

How does climate influence disease?

Answer 15

Warm, humid climates
Stagnant water - ideal breeding habitats for mosquitos

Question 16

How does altitude/relief influence disease?

Answer 16

Endemic in western lowlands - high temp and humidity, water collects in lakes and ponds
Absent in highlands

Question 17

7 human factors influencing disease

Answer 17

Population movements
Irrigation schemes
Urbanisation
Misuse of malarial drugs
Misuse of mosquito nets
Poverty
Healthcare

Question 18

How do population movements influence disease?

Answer 18

Harvest time - population movements between highlands and agricultural lowlands
Coincides with rainy season and peak malaria transmission period
Harvesting continues after sunset when mosquitos are most active and migrant workers sleep in the fields overnight

Question 19

How do irrigation schemes influence disease?

Answer 19

In Awash Valley and Gambella Province
Construction of micro-dams, and ponds - expanded breeding habitats for mosquitoes

Question 20

How does urbanisation influence disease?

Answer 20

Floods, garbage dumps, discarded containers - breeding sites

Question 21

How do misuse of malarial drugs influence disease?

Answer 21

More drug resistant

Question 22

How do misuse of nets influence disease?

Answer 22

Holes

Question 23

How does lack of healthcare influence disease?

Answer 23

40% of Ethiopians have no access to basic healthcare

Question 24

How does poverty influence disease?

Answer 24

Hunger and lack of maize
Undernutrition and malnutrition - susceptibility to disease

Question 25

Socio economic impacts of malaria in Ethiopia

Answer 25

- 70,000 deaths per year - Children hit the hardest - Absenteeism from work, slowing economic growth and reinforcing the cycle of poverty - US$12 billion lost production in sub-Saharan Africa per year - 40% of national health expenditure, 10% of hospital admissions, 12% of health clinic visits - Damage tourism and investment

Question 26

3 Strategies/management plans to control malaria

Answer 26

- Presidents Malaria Initiative and Global Health Initiative - 2008-2013, grants of US$20-43 million a year for malaria control - 2011, Ethiopian government - 5 year plan (partnership with UNICEF, WHO, World Bank, NGOs and OECD donor countries)

Question 27

Direct strategies of the 5 year plan

Answer 27

Eradicate mosquitos: - Periodic spraying with insecticides - Destroying breeding sites - Indoor Residual Spraying How do population movements influence disease

Question 28

Indirect strategies of the 5 year plan

Answer 28

Publicity campaigns to minimise potential breeding sites Early diagnosis and treatment of malaria Insecticide-treated bed nets

Question 29

Positives of strategies

Answer 29

Death rates halved 2000-2010 No major malaria epidemics (used to be every 5 years) Amhra - prevalence fell 4.6% to 0.8% from 2006 to 2011

Question 30

Negatives of strategies

Answer 30

Not enough nets and education on use DDT sprayed poisonous Resistance to draining of swamps = drinking water for cattle ACT drug expensive and high demand Epidemics need to be identified earlier 45 million still remain at risk of 68 million Drug resistance Shortage of trained manpower, drugs spray pumps and funds