L13 - Treatment and prevention of malaria Flashcards Preview

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Flashcards in L13 - Treatment and prevention of malaria Deck (21):
1

Which species of malaria causes the most deaths?

plasmodium falciparum

2

Which species of malaria associated with severe disease alongside plasmodium falciparum

P. vivax

3

Which species of malarian is acquired via mosquitoes from monkeys?

P. knowlesi

4

how has malaria been found worldwide and how has it changed? what has been responsible

there are los of countries that WERE infected with malaria, NY, boston, toronto, northern Australia

mainly improvements in living conditions that has killed it in developed areas, moreso than medical advances

5

__ million episodes in 2014 - most in ___, but burden in __ higher than realised

214 million episodes in 2014 - most in africa, but burden in asia higher than realised

6

true or false

the burden of malaria is predominantly in children under 5, pregnant women and their babies

true

major financial burden on exposed communities

7

How does severe malaria present in african children?

severe anaemia
acidosis may accompany - urgent transfusion needed

cerebral malaria in older kids usually - peak 3-4 years - paraistes in the brain cause coma

complications:
hypoglycaemia
convulsions

8

What is the mortality of childen with severe malaria in africa

10-15%

quite high, even with drugs

9

Why do some people get severe malaria?

Host - RBC genetics, for instance if heterozygous for sickle cell allele = good

parasite - the proteins they export to stick to endothelial cells

Environment - availability of drugs

10

in africa _ in 4 women have placental malaria

There are ____ maternal anaemia deaths

1 in 4

10000 maternal anaemia deaths

11

true or false malaria is the leading preventable cause of LBW in africa

true

12

How can we prevent malaria?

control the vector - mosquite repellent, insecticide treated bed nets (reduce by 20%, transmission, 90%). Indoor residual spraying

Drugs - low dose in foods, but frequent drugs prevent immunity.

Vaccines - 47% reduction in svere malaria

intermittent preventititve treatment in pregnancy

seasonal malaria chemoprevention in children

13

What is an ideal drug for malaria prevention?

safe, cheap, single dose, long half-life, effective, stable (for transport)

14

What are some interventions for pregnant women?

antenatal care

bed nets

intermittent preventititve treatment in pregnancy

15

What is intermittent preventititve treatment in pregnancy?

the delivery of a treatment dose of an antimalarial at pre-specified times, regardless of the presence of symptoms or infection

WHO plicy for africa: at leasat 3 doses at least a month apart

16

What is seasonal malaria chemoprevention?

the delivery of a treatment dose of an antimalarial to children during the malaria seasin in areas of highly seasonal transmission

aim: to prevent malaria by keeping therapeutic bllod concentrations of antimalarial during the risk periods

17

What are the two current drug treatments for malaria

ACT - artemisinin combination treatments

and DHA; coartem

18

true or flase

drug resistance is a mjor problem, especially in thailand and cambodia, often due to improper use - not full course

true

spread of resistance to africa would be a disaster

19

What is the gold standard drug and why?

artestunate - because it acts on the whole parasite lifecycle

20

What are the current challeges in malaria control?

building on the gains - death decreased 66 from 2000-2015 in africa from bed net use and ACT availability

need new tools for malaria elimination
drug/insecticide resistant parasites

21

What new tools do we need to fight malaria?

-Access - coverage of interventions
- safe new drugs
- artesunate
- maintain funding

ongoing surveillance and good health systems

vaccine

better diagnostics

mass drug administration