H&D Malaria

Question 1

Socio-economic factors leading to spread of malaria?
LOL

Answer 1

LOL
1. Lack of proper sanitation facilities
- Improper disposal of waste water ->stagnant pools
- Breeding grounds
- Increased risk of spread when settlements near stagnant pools

2. Overcrowded living conditions
   - Large amt of ppl packed in cramped areas
   - Mosquitoes go person to person quickly
   - Increases spread
3. Limited provision & access to healthcare
   - Shortage of doctors & spending esp. rural areas
   - Medical centres far away in urban areas, delayed treatment, higher spread
   - High cost of antimalarial drugs (ACT) , cannot afford

India:
6 doc/10k ppl only 4% GDP spent on healthcare

Question 2

Environmental factors leading to spread of malaria?
POE

Answer 2

PE
1. Poor drainage & stagnant water
- Poor drainage-> stagnant pools -> breeding grounds
[Rajasthan, India]
8000km canals leak in Great Indian Thar Desert
Created swamps created breeding grounds since 80’s

2. Overcrowded living conditions
   (Same as social)
3. Effect of climate
   - 22-30°C high humidity increased lifespan for mosquitoes
   - Monsoons bring heavy rainfall ->stagnant pools of water, blocked drains-> breeding grounds
   [Pakistan]
   Malaria outbreaks in ‘06 & ‘09 after monsoons

Question 3

Social impacts of malaria?

Answer 3

1. Death rate
   40% of global malaria deaths from DRC & Nigeria in 2010
2. IMF
   140/1000 deaths in Nigeria

Question 4

Economic impacts of malaria?
BLC

Answer 4

BLC

Burden on households
- Increased medical expenses
[Ghana]
- 34% of income medical expenses

Loss of productivity
- Workers fall sick often -> decreased production -> Less economic growth
- Children sick -> less days in sch -> loss of education opportunities -> affects skills & future employability
- Africa losses productivity 1.3% /year

Cost of healthcare
- Demand for healthcare increased, overall costs increase
- More funds spent on healthcare, less channelled to education, transport, housing
- Slows economic growth

Question 5

Reasons for re-emergence of malaria?
RICA

Answer 5

RICA

1. Resistance to antimalarial drugs
   - Caused by incomplete or counterfeit doses, parasites develop resistance
   - Drug resistant mosquitoes from migrant workers in Thailand going back to India
2. Insecticide resistance
   - Pesticides changed from DDT to Pyrethroids, mosquitoes developed pyrethroid resistance, found in 64 countries
3. Climate change
   - Climate getting warmer
   - Temperatures are higher at higher altitudes ->favourable breeding sites
   - Mosquitoes now in Central Highlands, Kenya
4. Air travel
   - Increase in air travel, vectors spread to new areas
   - Re-emergence of malaria in France, reported in 1995

Question 6

Socio-economic challenges for managing malaria? (also human activities)

Answer 6

1. Limitations to healthcare (resistance)
   - Ability of parasites developing resistance to anti-malarial drugs
   - Due to incomplete or counterfeit doses
2. Population movement
   - Movement of people across borders, transmitting diseases to other areas
   - Vol & speed of transportation is faster due to better transport links & efficiency of modern transportation
   - Border controls necessary to control spread of drug-resistant malaria
3. Forest clearing
   - Cleared land, less water seeps into ground, water accumulates and forms stagnant water
   - Water is more pH neutral in forest areas, suitable for mosquito larvae
   - Biodiversity loss of mosquito predators allows them to thrive
   - Flooded rice fields allow conducive environment for breeding

Question 7

Environmental challenges for managing malaria?

Answer 7

1. Climate
   - Increased temp -> higher rate of breeding & maturing
   - Increased rainfall -> stagnant pools breeding grounds
   - Lengthens period of mosquitoes able to breed & transmit malaria
2. Monsoons
   - Malaria increases during monsoon season, more stagnant pools
   India,
   Pakistan in ‘06 & ‘09