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Thank you for your very detailed observations.

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Thank you for your very detailed observations.

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Beyond climatic factors, some of you rightly pointed out that:
1) Social: living conditions (over crowding, stagnant water) can worsen the spread
2) Economic conditions (lack of access to healthcare can worsen spread) (See Qystyna’s ans)
3) Nature of disease (how the parasite is building resistance to medication) (see Celestyn’s ans)

Are we more vulnerable now to the spread of diseases?

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1) Good observation that death rates from malaria peaked in 2005 (Why do you think so?)
2) Countries with highest fatalities are less developed countries (some may even say least developed countries) (please don't say 'under developed')
3) Take note of where these countries are, not just LDCs, but also LDCs in the tropics.

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1) Describe HOW malaria is transmitted. 2) What conditions make it favorable for transmission?

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1) Describe HOW malaria is transmitted. 2) What conditions make it favorable for transmission?

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Refer to the resources below

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Where in the world has the highest rates of HIV cases?

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Read the article ‘The Diary of  Mosquito’ and watch the attached video.

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Read the article ‘The Diary of  Mosquito’ and watch the attached video.

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The video is somewhat technical. There is no need to remember the technical names of the parasite.

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Life Cycle of Plasmodium | Malaria and the Life Cycle of Plasmodium | Video for Kids

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Refer to the map attached about the number of cases of malaria deaths per 1000 people in 2010. Describe the global distribution of Malaria deaths.

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Refer to the map attached about the number of cases of malaria deaths per 1000 people in 2010. Describe the global distribution of Malaria deaths.

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With the use of case studies, describe one impact of the malaria outbreak in LDCs. Be specific.

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With the use of case studies, describe one impact of the malaria outbreak in LDCs. Be specific.

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Remember to attach the link to where you found your information from so that your friends can reference it.

You have a clear idea of different types of impacts. Please extend and draw links on how getting malaria leads to that impact. How will that impact affect a larger scale of people across time? Refer to Sherilyn's response.

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With reference to the video attached and other materials you have, assess one strategy that has been taken to manage the outbreak of malaria. Has it been successful? Why or why not.

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With reference to the video attached and other materials you have, assess one strategy that has been taken to manage the outbreak of malaria. Has it been successful? Why or why not.

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Malaria eradication: what we need to do.

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Zambia National Malaria Elimination Centre

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The path to eliminating malaria in sub-Saharan Africa requires bold steps to build on existing approaches-like using proven methods of protection against mosquitoes-with proactive, innovative ones-like targeting the malaria parasite in humans.

Zambia's National Elimination Strategic Plan 2017-2021 aims to cover all health facility catchment populations following the step-wise approach below. Each component has a corresponding set of actions to take as malaria transmission intensity changes.

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Elimination Components A-E - Zambia National Malaria Elimination Centre

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The path to eliminating malaria in sub-Saharan Africa requires bold steps to build on existing approaches-like using proven methods of protection against mosquitoes-with proactive, innovative ones-like targeting the malaria parasite in humans. Zambia's National Elimination Strategic Plan 2017-2021 aims to cover all health facility catchment populations following the step-wise approach below.

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Success stories of managing the malaria outbreak in Eritrea.

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Success stories of managing the malaria outbreak in Eritrea.

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an impact of malaria is the loss of productivity. in 2010, the WHO estimated that there were at least 216million malaria cases worldwide, of which 537009-907000 had died from the disease.
Most of these deaths are people from LDCs. Countries like Nigeria accounted for 40% of the death toll. This impacts the economy as there is a loss of productivity. people suffering from malaria may not be able to work due to their health, and results in loss of productivity in the work force. people may have died, and there would be lesser people working for the economy. lower productivity leads to slower economic growth. (Good link between health impact and impact on the economy)

For example, in Nigeria, because of Malaria, workers have to miss work for their health. Duration of spells of absence due to malaria ranged from 1.5 to 4.1 working-days, with general workers being the most affected. Incidence of absence was 143/155 (93.3%), with total of spells of absence of over a 5-month period totaling 224. Absence from work results in loss of significant proportion of income or earnings ,in instances where organisations do not compensate earnings during sick days. (Clear eg that matches the point described above)

from :https://malariajournal.biomedcentral.com/articles/10.1186/s12936-019-3021-6

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malaria is transmitted through the female anopheles mosquito via a mosquito-human chain.
1. a mosquito takes blood from an infected human with malaria parasites
2. the malaria parasites enter the mosquito and infects it
3. this infected mosquito bites another human and the malaria parasites are then injected into that person's bloodstream as a result. these parasites move to the liver where they can reproduce and spread into the bloodstream

conditions:
- stagnant water for the infected mosquitoes to reproduce and create more infected mosquitoes
- RH of 50-60% so the mosquitoes can be most active in spreading malaria as well as living longer to infect more people
- place where there's no heavy rain to "flush" out the stagnant water with the eggs of infected mosquitoes

"are we more vulnerable to diseases now"
- no because medical technologies has improved significantly and cures or vaccines are able to be administered to curb the impacts/spread of diseases. (as compared to the 1900s or early 2000s)
- yes because the world has a higher population density now and thus, the spread of disease can be really fast which may overwhelm medical facilities and strain medical resources

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1) malaria is transmitted by Anopheles female mosquitoes, which are only infected when they have drank blood from a person who also had malaria.
malaria can also be transmitted through blood transfusion, organ transplant, or the shared use of needles or syringes contaminated with blood, and may also be transmitted from a mother to her unborn infant before or during delivery
2) the three main climatic factors that directly affect malaria transmission are temperature, rainfall and relative humidity
another factor is that the parasites that cause malaria are able to develop a resistance to anti-malarial drugs.
increase of air travel could lead to the accidental transport of malaria-causing organisms to new areas
lastly, the overuse of chemical pesticide cause mosquitoes to build resistance against the chemical pesticide over a short period of time, thus making the pyrethroids ineffective.

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malaria is transmitted through female mosquitoes of the Anopheles species. Other mosquitoes takes blood from malaria infected people. These mosquitoes are infected with the malaria parasite. This infected mosquito then injects these parasites into other people when the take blood. The cycle repeats,spreading malaria

the conditions that make it favourable is close proximity to those with malaria and stagnant water. High rainfall and humidity

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malaria is transmitted through living organisms like mosquitos. the mosquito takes blood from a human infected with malaria parasites and the parasites infect the mosquito. the infected mosquito then bites another human and infects that person. conditions that encourage transmission includes temperatures of 22-30degrees, high rainfall, and higher humidity levels (50%-60%).  these factored increase the lifespan of mosquitos and encourage breeding of mosquitos in stagnant water.

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1) female mosquitoes of the Anopheles species transmit malaria through a human-mosquito chain. a mosquito takes blood from a human infected with malaria parasites. the malaria parasites enter and infect the mosquito. the infected mosquito bites another human. malaria parasites are then injected into that person. the parasites migrate to the liver where they can reproduce and spread into the bloodstream.

2) stagnant water (uncovered drains)

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malaria is transmitted by female mosquitoes of the Anopheles species, through a human-mosquito-human chain.
-a mosquito takes bloodmeal from a human who is infected with malaria parasite.
-Malaria parasites enter and infect the mosquito
-the infected mosquito then bites another human being resulting the malaria parasites to be injected into that person.The parasite migrates into the liver where they reproduce and spread into the blood stream.
This represents the human-mosquito-human Chain as malaria parasites are being transmitted by the mosquito and being spread to other human being and vice versa

conditions :
malaria is most widespread in the tropical and subtropical zones. (endemic disease) Malaria spread in poor sanitation conditions where the water bodies are not clean,poor drainage and stagnant water which makes it favourable for mosquitoes to breed in water
Another factor is the temperature,rainfall and relative humidity which has a direct impact on mosquitoes.Temperatures in the range of 22-30 degrees celcius increases the life span and the frequency of bites by the female mosquitoes.Heavy rainfall also leads to the pools of stagnant water which is favourable condition for the mosquitoes to breed and lastly, relative humidity that ranges from 50% -60% is need for the survival and activity of mosquitoes.

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1.malaria is transmitted by being bitten by an infective female Anopheles mosquito. Only Anopheles mosquitoes can transmit malaria and they must have been infected through a previous blood meal taken from an infected person. When a mosquito bites an infected person, a small amount of blood is taken in which contains microscopic malaria parasites. About 1 week later, when the mosquito takes its next blood meal, these parasites mix with the mosquito’s saliva and are injected into the person being bitten.

2.Anopheles mosquitoes thrive in regions with warm temperatures, humid conditions, and high rainfall. Thus, tropical and subtropical areas are ideal.

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1. malaria is transmitted from person to person via living organisms , commonly insects such as mosquitoes. female mosquitoes of the anopheles species transmit malaria through a human-mosquito-human chain .

2. -lack of proper sanitation where waste water is not disposed properly , allowing stagnant pools of water to form may lead to spread of malaria .
-overcrowded living conditions can lead to spread of malaria as large numbers of people live very close together in a small  area , thus diseases spread more quickly and easily

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death from malaria is more prominent in underdeveloped countries with equatiria climate, such as Africa, in which there are high percentage of malaria transmission of 1% to 20%. The global malaria deaths on a global scale peaks in 2005 at 1800 thousand deaths of all ages.
the number of malaria deaths is especially high in Africa, and those of age five and under are especially vulnerable, with highest deaths of around 1,000,000 deaths in 2005. Malaria also affects those who are of age 5 and older, totaling 600 thousand deaths in 2005.

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malaria is transmitted via human-mosquito chain from the female mosquitoes of anopheles species. mosquito draws blood from a person infected with malaria parasites,and passes it on to others and it continues to spread

warm temperature, high rainfall and humidity affect the mosquitoes as they encourage breeding
stagnant water provides suitable environment for the growth of mosquitoes

we are becoming less vulnerable to spread of diseases due to modern technology. we are able to use medicine to create vaccines to protect us against diseases.

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1. Malaria is transmitted via Anopheles mosquitoes. It is transmitted through a human-mosquito chain.
- A mosquito takes blood from a human infected with malaria parasties
- Malaria parasites enter and infect the mosquito.
- The infected mosquito bites another human. Malaria parasites migrate to the liver where they reproduce and spread to bloodstream and destroy red blood cells

2. Favourable conditions
- stagnant water
- unclean, dirty, untreated water
- eg drains

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1) malaria is transmitted by mosquitos. when a mosquito carries blood from an infected person to another person, it can also give the person malaria as the mosquito also carries the disease from the infected person.

2) the warm weather makes it favourable for mosquitos to breed.

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malaria deaths are more prominent in the African continent, especially central Africa, which is a less developed country.Burma which is in the asian region is also vulnerable to malaria. Countries that are developed such as USA and the European continent, has low malaria transmission counts.

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more cases of malaria as well as death caused by malaria are found in the LDCs such as the many countries found in Africa , Such as nigeria and congo

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1)
- malaria is transmitted by female anopheles mosquitoes
- mosquito takes blood from an infected person > malaria parasites enter the mosquito and infects it > mosquito bites another person > malaria parasite enters the person’s bloodstream and multiply > person has malaria

2)
- mosquitoes thrive in dirty and stagnant waters
- mosquitoes also thrive in warm environments

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1) Malaria is transmitted by infected female anopheles mosquitoes which carry malaria parasite.the parasite enters the blood stream when mosquitoes are feeding, carrying it into human liver  where it multiplies.The 3 main stages are gametocytes,sporozoites and merozoites.
2) environmental factor
-(large)bodies of stagnant water=easier for mosquitoes to breed
-dirty and overcrowded housing=easier for mosquitoes to transmit disease from one person to another (bacteria thrives in unsanitary conditions)
-temperature,rainfall and humidity affects the rate of breeding in mosquitoes(25-27  degrees celsius is the optimum temperature for mosquitoes to breed)
-high rainfall during monsoons create pools of stagnant water, suitable for mosquitoes to breed
social(economic) factors
-lack of education on malaria=people (in LDCs) that are less educated (cannot afford education)might not have knowledge on how to fight the spread of malaria and how to protect themselves.this increases the probability of getting infected as they did not take precautions to delay the onset of mosquitoes in the neighborhood
-limitations of health care : malaria parasites can develop resistance to anti-malarial drugs,this results in incomplete treatment of an infected person.hence, increasing the spread of malaria
-insecticide-resistant mosquitoes such as pyrethoids were ineffective.mosquitoes were able to build resistance against it.
-air travel leads to disease-causing organisms to be transported to new areas infecting more people

HENCE,WE ARE MORE VULNERABLE TO THE DISEASE NOW.The spread of malaria through mosquitoes that are anti-malarial drug resistant and insecticide resistant, increase the possibility of getting the disease.Air travel also enables the malaria to be infected to be more people worldwide.

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1) malaria is transmitted from person to person via living organisms, commonly insects such as mosquitoes. female mosquitoes of the Anopheles species transmit malaria by first taking blood from a human infected with malaria parasites. then, the malaria parasites enter and infect the mosquito. the infected mosquito bites another human and malaria parasites are then injected into that person. the parasites migrate to the liver where they can reproduce and spread into the blood stream.
2) places with poor sanitation and stagnant water

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- most of the malaria transmissions are in LDCs like Central African Republic as well as Nigeria, so on and so forth with transmission rates at 10-20%. this compared to developed countries like Australia with transmission rates at 0-1%
- most of the people who die from malaria are over 70 and a good amount of children under the age of 5 (totalling about 900 deaths alone)
- most of the people who die from malaria are from Africa, with the deaths due to malaria in Africa contributing to more than half of the global deaths due to malaria. (most deaths in Africa amounting to 1,000,000)

*most of the countries with either the highest death toll or highest percentage spread is located between the tropic of cancer and capricorn, that allows favourable conditions like warm weather and rainfall for the female anopheles mosquito and malaria parasites to thrive*

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having malaria in an LDC impacts individuals as they will require more medical attention and with more medical attention it requires more cost so people need to spend large amounts of money on treatment. when they are down with malaria, they are also unable to go to work which causes them to be unable to have an income for a period of time. companies suffer as well if their workers are unable to come for work due to malaria. all in all, the economy is affected as people are unable to work and if many people in the community are affected with malaria, higher skilled expats from other countries would not want to open their businesses in the country and hence the economic status will be very stagnant and will not be able to improve.

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Malaria is transmitted by the female anopheles mosquito that takes blood from humans infected with malaria parasites. The malaria parasites infect the mosquito and then the infected mosquitoes bites other humans and injects the malaria parasites Into the person

Temperature, high rainfall and humidity levels can affect the mosquitoes

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1) malaria is transmitted by infected female anopheles mosquitoes. when someone gets bitten by a mosquito, which carries the malaria parasite, the parasite enters into the bloodstream. it’s then carried into the liver where it multiplies. if a mosquito bites someone while they have malaria, it will get infected and it can then transmit the parasite to the next person it bites.

2) -warm weather conditions
-stagnant water

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Malaria imposes substantial costs to both individuals and governments.

Costs to individuals and their families include purchase of drugs for treating malaria at home; expenses for travel to, and treatment at, dispensaries and clinics; lost days of work; absence from school; expenses for preventive measures; expenses for burial in case of deaths.

Costs to governments include maintenance, supply and staffing of health facilities; purchase of drugs and supplies; public health interventions against malaria, such as insecticide spraying or distribution of insecticide-treated bed nets; lost days of work with resulting loss of income; and lost opportunities for joint economic ventures and tourism.

for example, the worsening case of malaria in nigeria where it  had the highest number of global malaria cases (27 % of global malaria cases) in 2019 and accounted for the highest number of deaths (23 % of global malaria deaths).

https://www.severemalaria.org/countries/nigeria

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1) Malaria is most commonly transmitted through forms of blood transfusions between a person with Malaria and a person without Malaria. Female Anopheles mosquitos would suck the blood of a person infected with Malaria and would keep the parasites in their body. The parasites reproduce to form another parasite which is then transmitted into a person’s blood stream. The parasites then reach the liver and reproduce some more and would return to the blood stream. The cycle then repeats from person to person.

2) stagnant water due to rainfall at temperatures of 22°C to 30°C and RH of 50% to 60% are most favourable for mosquitoes to breed and bite humans.

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among all the continents, africa sees the most number of malaria cases as compared to the others.
LDCs see more transmissions, of aroynd 10-20% whereas a DC like US sees under 0.1% transmissions.
Generally, people above 70 years old are more prone to dying because of Malaria

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how is malaria transmitted:
when a carrier of malaria parasites, the female anopheles mosquito bites a human infected with malaria, the mosquito will be infected by malaria (carry the malaria parasite — plasmodium) and will transmit the disease (germatocytes) to everyone else it bites — the malaria parasite (sporozoites) enters the liver through the bloodstream and (merozoites) multiplies in the bloodstream killing red blood cells.

conditions making it favourable for transmission:
climate change – when climates get warmer, temperatures increase, and places become favourable breeding sites for the mosquitoes due to the increased temperatures
poor living conditions — poor sanitation and overcrowding

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1)malaria is transmitted through parasites that are produced after an malaria carrying mosquito bites a person. These parasites attack the liver directly, and are formed through the mating of the male microgametes and the female macrogametes. Additionally, malaria can also cause symptoms such as fever, bone shaking chill, seizures etc and people such as children and pregnant women are highly vulnerable to this disease. 2) favourable conditions that that encourages the transmission and of malaria is through stagnant water. with the presence of stagnant water, it allows for the mosquitoes to further reproduce, producing more of its kind. Living near places with stagnant water  increases the chances of people getting bitten by an infected mosquito.

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malaria is transmitted through the female anopheles mosquito via a mosquito-human chain, or through blood transfusion, organ transplant, or the shared use of used needles or syringes that had been injected into the bloodstream, and may also be transmitted from a mother to her unborn infant before or during delivery.

a mosquito takes microscopic malaria parasitic blood from an infected human with malaria parasites -> the malaria parasites enter the mosquito and infects -> this infected mosquito bites another human and the malaria parasites that is in the mosquitos saliva are then injected into that person -> these parasites move to the liver where they multiply and spread into the rest of the bloodstream.

conditions for transmission:

- stagnant water (pots, uncovered drains) for the mosquitoes to breed

- no heavy rain or water that can kill the eggs of the mosquitos

- high rainfall so relative humidity of 50-60% so the mosquitoes can be most active in spreading malaria as well as living longer to infect more people

- temperatures of 22 to 30 degrees

we are more vulnerable due to climate change, as well as the mosquitos being more resistant to insect repellents as they are evolving to combat the drugs.

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people who die from malaria tend to be older, around their 70s. people from the LDCs have more death as the percentage of malaria is more in the LDCs. People in DCs do not as much death as LDCs, like the USA.

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many cases of malaria are found in LDCs in Africa like Madagascar and Uganda with 10%-20% cases of malaria transmission

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A Anopheles species mosquito takes the blood from a human infected with malaria parasites. Malaria parasites enter and infect the mosquito. The infected mosquito bites another human. Malaria parasites are then injected into that person. The parasites migrate to the liver where they can reproduce and spread to the bloodstearm

-stagnant water
- increasing temperature
-lack if proped sanitation
- lack of education
- high humidity

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•malaria is transmitted by the female mosquitoes of the anopheles species through a human -mosquito-human chain whereby a mosquito takes blood from a human infected with malaria parasites and in turn enter and infect the mosquito. the mosquito will then bite another human and malaria parasites are then injected into that person, thus infecting the person with material.

•social factors like lack of proper sanitation makes it favourable to the spread of the disease. for example, if east water is not disposed of properly, stagnant water will form and will then provide a favourable breeding ground for mosquitoes, increasing the population of mosquitoes and increasing risk of people getting infected.

•environmental factors like overcrowded living conditions also make it favourable to the spread of the disease as it would mean that there are a large number of people living very close to one another in a small area, allowing them to interact with each other more often, increasing chances of the disease being spread.

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LDCs experience more deaths from malaria as compared to DCs. some LDCs include nigeria and other parts of africa. malaria deaths are also more prominent amongst people of older ages who are in their 70s

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maleria is tranmitted through female mosquitoes called anopheles.
the infected mosquitoes will transmit maleria by biting humans. the non infected mosquitos will bite the infected humans, causing the maleria disease to be inside them and spread it by biting another non infected persom, infecting the persom

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Death from malaria is a lot more prominent in LDCs such as central Africa than it is in DCs. These regions have about 10%-20% probability of dying from malaria. Generally, people who are 70 years old and above account for more deaths by malaria.
Other places such as South America and and the west of North America and have under 0.1% of probability of dying from malaria.Haiti, which is at the south west of North America is an anomaly. North America generally has no malaria transmission at all but Haiti has malaria transmission and the probability of malaria death in Haiti is 1%-4.99%.

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malaria causes the costs for individuals to increase as they have to pay for treatment and medication. These people in LDCs are unable to afford the expensive medicine. Due to this, many can go into debt or have to live in extreme poverty in order to afford these medications.

costs for the government also increase as the government needs to buy the medicine for countries outside and import it. This is very costly and for a less developed country these costs can cause the country to have financial instability.

an exaple is the epidemic of malaria in India

https://borgenproject.org/malaria-and-poverty-in-underdeveloped-countries/

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The spread of malaria is found mostly in the continent of Africa. The central and North West section of Africa is highly affected with 10-20% of malaria transmissions occurring. The democratic Republic of Congo where 145.8 out of a thousand people get infected with malaria.

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1) malaria is spread through female anopheles mosquitoes
Infected person -> mosquito -> becomes infected with the parasite -> infects another person
The parasite will then attack the liver and enter the bloodstream and multiple even more.
2) they thrive in humid and warm conditions with places of stagnant water to reproduce and breed

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DISEASE BURDEN
The WHO African Region continues to carry a disproportionately high share of the global malaria burden. In 2019, the region was home to 94% of all malaria cases and deaths.
- estimated number of malaria deaths stood at 409 000 in 2019, compared with 411 000 deaths in 2018.

outbreak of other diseases alongside malaria  reduced access to health services for diagnosis and treatment for the major diseases that are endemic to the region

https://scholar.google.com.sg/scholar?q=impact+of+malaria+outbreak&hl=en&as_sdt=0&as_vis=1&oi=scholart#d=gs_qabs&u=%23p%3Dc4pzBXA_YlEJ

Case Study: India

• India contributes 77% of the total malaria in Southeast Asia
• burden of complicated malaria
- found that delayed diagnosis and comatose condition were the main causes of death
• burden of malaria on pregnancies
- may cause depression due to loss of child
• burden of malaria in terms of disability-adjusted life years (What is this?)

DALY (disability adjusted life years) means 1 lost year of healthy life on account of disease and is a common currency for disease morbidity and mortality expressed in time. This concept has gained importance in the past decade.

• socio economic impact
- Sinton calculated a total loss of Rupees 1237 lacs (£10 million at the then prevailing exchange rates, and ∼US$27.49 million).

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more people were confirmed with malaria in Africa then other parts of the world. asia is the second highest proportion of malaria cases, particularly in India, Indonesia and Myanmar. malaria is said to be epidemic in these countries.

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Because of the nocturnal feeding habits of most of Anopheles mosquitoes, malaria transmission occurs primarily at night. Protection against mosquito bites include the use of mosquito bed nets (preferably insecticide-treated nets), the wearing of clothes that cover most of the body, and use of insect repellent on exposed skin. Type and concentration of repellents depend on age and status.

With the measures taken to eradicate malaria such as the use of mosquito nets and mosquito repellents, the world has made tremendous progress in the fight against malaria in the past 15 years. According to the World Malaria Report, malaria case incidence was reduced by 41 percent and malaria mortality rates were reduced by 62 percent between 2000 and 2015. This showing the success of these measures

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GENERALLY, probability of dying from malaria is higher in less developed countries.This can be seen in the map where countries in south america such as Peru have under 0.01% of malaria transmission.On the other hand, countries in Africa such as Democratic Republic of Congo have 10%-20% of malaria transmission with the probability 145.8 per 1000 people dying from it.As compared to south america, the northern and central part of Africa is less developed.Thus,they have less resources to aid people who are infected by this disease.As LDCs are also underdeveloped infrastructure-wise, unsanitary living conditions may also result in the high amount of dieseases thriving and spreading.

Another reason why malaria is rampant in the LDCs is because they are in between the tropics of cancer and capricorn.Most LDCs experience equatorial or monsoon climates.The temperature,humidity and rainfall is high in these areas.Hence, more suitable conditions for mosquitoes to breed in the LDCs and compared to DCs

I can also observe that the more children fatalities due to malaria in age groups of 5 years and younger as compared to 5 years and older.In 2005, a total of 1000 children aged 5 and below died as compared to 600 people aged 5 and above dying due to malaria.This shows that malaria has a more significant impact on children as compared to older people

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most of the malaria deaths happen in less developed countries like Mali, Niger, Nigeria, Benin, Togo, Dem Rep Congo and Central, African Rep. These areas have 10% to 20% of malaria deaths in 2010. malaria kills children under 5 years most.

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fast response and surveillance so the government can track who has the disease and prevent more people from getting infected. it has been successful in areas with enough finances and resources to do such close tracking. however in some LDCs, they are unable to afford the cameras and tracking devices. even though senegal is an LDC, they were still able to control the malaria spread by using tight surveillance.

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any outbreak of diseases is costly to any country. however, in LDCs, the financial impact is much bigger than normal DCs.
LDCs already have tight finances thus with an endemic malaria outbreak, they would have to strain their resources even more, trying to get their country medical help or solutions. this would include but not limited to:
- hiring more doctors to take care of patients
- more hospital beds to accommodate the sudden influx of patients
- vaccines or preventive measures against malaria (may include upgrading infrastructures like dips in roads that can collect stagnant water or placing mosquito nets in people's homes)

* financial burden in countries, esp LDCs as they have to spread their resources across investing money in study samples for malaria cures/vaccines, medical facilities as well as in developing their country. thus, with more malaria cases, the country will feel pressured to invest more money in the study of malaria, thus causing a huge financial strain and burden on the countries.

https://malariajournal.biomedcentral.com/articles/10.1186/s12936-016-1506-0

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1)-Malaria is transmitted through anopheles female mosquitoes that carry a parasite with them
-Another person can also become infected if a female mosquito has drunk blood from another person with malaria
-Malaria can also spread through shared needles from a malaria infected person
- It can also be passed down from the mother to the child during pregnancy
2) Malaria favours
-Close proximity of stagnant waters
-Hot and humid areas

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Malaria transmission occurs in five WHO regions. Globally, an estimated 3.4 billion people in 92 countries are at risk of being infected with malaria and developing disease (map), and 1.1 billion are at high risk (>1 in 1000 chance of getting malaria in a year).

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Malaria can be an economic disaster. Countries with high malaria transmission have historically had lower economic growth than in countries without malaria. Those countries that have been able to reduce malaria have shown substantial growth and improved prosperity afterwards.
Every year malaria is estimated to cost Africa $US 12 billion in lost Gross Domestic Product (GDP). It is estimated the disease has slowed economic growth in Africa by 1.3 percent per year as a result of lost life and lower productivity. In Tanzania, for example, malaria accounts for 30 percent of the national disease burden.
https://www.malariaconsortium.org/userfiles/file/Past%20events/factsheet2%20-%20malaria%20and%20poverty.pdf

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most cases of malaria is in less developed countries like africa

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it can lead to a loss of productivity. people infected with malaria might not be able to work due to poor health. this results in loss of productivity for the workforce. lower productivity results in slower economic growth. for instance, economic growth in africa has been slowed by up to 1.3 percent per year.

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Most of the active cases and deaths from malaria are from LDCs such as Africa with high death rates of 10% to 20% in regions like Democratic Republic of Congo and Nigeria
Most malaria deaths are older people over the ages of 70 years with approximately 17000 deaths in 2005

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they will have impact on the population of countries, communities and households in the LDCs. In 2010, the WHO estimated that there were at least 216 million malaria cases worldwide. Of those, about 537000 to 907000 people were estimated to have die from malaria. This affects LDC more as they do not have the proper equipment and facilities to save those who have gotten the disease. Hence, the death rate in LDC due to malaria is higher than LDC

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The African continent is the most affected by malaria, with their highest being Burkina Faso with 184.1 people infected with malaria out of a 1000 people. The average percentage of getting Malaria in the African continent is 10-20% compared to North and South America which chances are 0.1%. This shows that LDCs such as countries in Africa and certain Asian countries like Burma, who are more prone to Malaria.

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deaths of malaria are most prominent in the continent of africa, which consists of many LDCs and transmission rates ranging mainly between 1%-20%. in other regions like the western region, transmission rates are relatively low ranging between under 0.1%-0.99%

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death in malaria is more prone in the africa content followed by asia.Percentage of malaria is 1%-20% This is due to the high numbers of LDC countries that can be found in those two continents.This is also because both  continents are near the equator which gives the Favourable conditions for the mosquitoes to breed.Compared to another continents such as europe and north america, the cases are relatively lower than cases in africa and asia as both continents are made up of mostly DC countries.

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an impact of malaria is the death rate and Infant Mortality Rate(IMR). in 2010, less than 2% of all deaths in the world were caused by malaria and most of these cases were from the LDCs. for example, the Democratic Republic of the Congo and Nigeria accounted for over 40% of the total global malaria deaths in 2010. similarly, out of every 1000 babies born alive in Nigeria, 140 die from malaria within their first year of birth. an estimate of 75000-200000 infants die every year within their first year of birth due to low birth weight caused by malaria infection during pregnancy.

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death from malaria is more prominent in LDCs such as africa. there are high percentages of malaria transmission from 1% to 20%, especially near the equator as well as the tropic of cancer. The global malaria deaths on a global scale peaks in 2005 at 1800 thousand deaths of all ages, with children under the age of five in africa coming in at 100,000 deaths and children over the age of five coming in at about 600,000 deaths. the malaria deaths by age are increasing with the highest at 2005 before decreasing. most of the deaths are under children or teenagers, however most of the deaths are children under the age of five, making it in at 900,00 deaths in a year.

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The human suffering and loss of life caused by malaria is often matched by the economic burden placed on families who bear the direct costs from their own pockets. Personal expenditure includes spending on insecticide-treated nets, doctors’ fees, anti-malaria drugs, transport to health facilities, support to the patient and funeral costs. This can put an unbearable strain on household resources – in Ghana malaria care can cost up to 34 percent of a poor household’s income
There are also indirect costs for families and households. The permanent neurological and physical damages caused by severe episodes of the disease hamper children’s schooling and their general well-being. This can directly affect their education and ability to earn in later life. Absenteeism from work also impacts on household income.

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Brindha: high public spending on healthcare

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Brindha: high public spending on healthcare

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Some of the social impacts of malaria include death rate. In 2010, less than 2% of all deaths in the world were caused by malaria. The democratic Republic of Congo and Nigeria accounted for over 40%of the total global malaria deaths in 2010

Due to such high numbers of malaria cases, an economic impact arises which is the cost of healthcare. Countries affected by malaria would need to set aside funds for the provision of healthcare. Malaria can account for as much as 40 percent of the public health spending in some countries according to WHO. People in LDCs who are infected with malaria may not be able to afford health care to recover from it. This may cause further transmissions of malaria and death to people.

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Malaria is more often found in LDCs as compared to DCs. The most prominent area with malaria being Africa, with central Africa being one of the most affected areas.

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The NMCP introduced a new first-line antimalarial drug and implemented an integrated vector control program using insecticide-treated nets, indoor spraying in selected areas, and other interventions. From 1999 to 2003, Eritrea succeeded in halving the malaria mortality rate among children under 5, reducing the number of malaria fatalities
to one of the lowest levels in Africa. These approaches have helped Eritrea meet targets set at the African Summit on Roll Back Malaria in Abuja, Nigeria, in April 2000, one of which is to reduce malaria incidence by at least 60 percent before 2010.This shows that the antimalarial drug is successful in treating malaria and helping to reduce the spread of Malaria

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Eritrea established a comprehensive National Malaria Control Program (NMCP) with support from the World Health Organization, the U.S. Agency for International Development (USAID), and the World Bank. Over the next several years, the
NMCP introduced a new first-line antimalarial drug and implemented an integrated vector control program using insecticide-treated nets (ITNs), indoor spraying in selected areas, and other interventions. It was successful because  from 1999 to 2003, Eritrea succeeded in halving the malaria mortality rate among children under 5, reducing the number of malaria fatalities to one of the lowest levels in Africa.

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Transmission of malaria
For non-endemic countries, does this mean that malaria will never be present there/ does this mean that mosquitoes cannot survive in those countries?

On page 204 of the textbook, the map shows death rates from malaria. Why is Libya considered a non-endemic country, even though it has a similar climate to its neighbours?

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1)Malaria is transmitted when a person gets bitten by an infective female Anopheles mosquito. Only Anopheles mosquitoes can transmit malaria and they must have been infected through a previous blood meal taken from an infected person. The mode of transmission is through a human-mosquito-human chain. A mosquito takes blood from a human infected with malaria parasites. The malaria parasites enter and infect the mosquito. The infected mosquito bites another human. Malaria parasites are then injected into that person. The parasites migrate to the liver where they can reproduce and spread into the bloodstream. Some of this parasites can develop into the malaria parasitesand the whole cycle repeats itself again.

2)social factors- lack of proper sanitation: waste water is not disposed of properly and stagnant pools of water may form, favourable breeding grounds for mosquitoes.

economic factors- limited provision of and access to health care: lack of health services in rural areas and cost of malaria treatment

environmental factors- overcrowded living conditions: people tend to share the same spaces and use the same items, also tend to interact with each other more often and more closely this diseases spread quickly and easily.

poor drainage and stagnant water: places where there is low awareness of malaria and no precaution is taken to remove pools of stagnant water this mosquitoes breed quickly and without interruption

effect of climate: temperature, rainfall and relative humidity have a direct impact on mosquitoes. monsoons, large amounts of rainfall—more breeding grounds/flush out the breeding grounds. temperature—higher temperatures shorten development time of the parasites in mosquitoes, become active and infectious sooner. humidity—higher humidity level leads to mosquitoes having a longer lifespan, and to infect more people

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Over the 8 years, malaria has resulted in a total of 5511 patients reported to the health facilities with malaria symptoms. Incidence per 1000 population at risk fluctuated over the years, but in general increased from 0.70 in 2012 to 1.65 in 2019, with the highest incidence of 3.19 reported in 2017. As a result, many people had been infected and has negatively impacted people and their quality of living

https://malariajournal.biomedcentral.com/articles/10.1186/s12936-021-03699-x

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malaria death is mostly found in less developed locations such as Africa, the highest cumulative probability of malaria death being 184.1/1000 population in Burkina Faso.

there was an increase of malaria deaths in 2005, reaching the highest number of deaths since malaria deaths began increasing in 1990. the number of malaria deaths among people of all ages globally increased by 800,000, from 1 million in 1990 to 1.8 million in 2005.

the number of malaria deaths among people under 5 years old in africa increased by 600 thousand, from 400 thousand in 1990 to 1 million in 2005. malaria death is mainly found in those under 5 years old.

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for countries with lower temperatures and humidity, can malaria mosquitoes still be present there?

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the most effective way to seem to best curb the effects of malaria is preventive measures such as vaccines or proactive constant testing of citizens to detect malaria infections. countries such as Nigeria, has significantly stepped up their tracing as well as vaccination measures to help the country cope with malaria.
- successful in Nigeria cause it managed to mitigate the impacts of it quite well; being about 70% successful at preventing the sudden and deadly outbreak of malaria
- not fully successful bc it's still an LDC so full preventive measures or a wide scale effort might be a little difficult

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the economic burden of malaria on individuals and household may include increased medical expenses. for example, in the Republic of Ghana, a country in west Africa, the economic burden can be as high as 34 per cent of a household’s income.

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The economic impact of Malaria
- Malaria has caused economic burdens on individuals and households due to increased medical expenses
-With higher percentages of their income being spent on high medical expenses, they have lesser money for basic necessities like food and water.
-Some families also send their children to school and may face money debt due to their medical expenses.
-Hence, this economically burdens families in Africa.
E.g: In the Republic of Ghana, West Africa, the economic burden of a households income could be as high as 34%

The social impact of malaria
- Phillipines had a death toll of 7 people in 2018 due to malaria
https://www.statista.com/statistics/689003/philippines-number-of-deaths-by-malaria/#:~:text=Malaria%20death%20toll%20in%20the%20Philippines%202009%2D2018&text=In%202018%2C%20about%20seven%20people,over%20the%20last%20ten%20years.

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Countries affected by malaria would need to set aside funds for the provision of health care to address the disease. Malaria can account for as much as 40% of public health spending in some countries, according to WHO. The funds are used for costs such as the building maintaining and investments in hospitals and clinics, and the purchase of medication and insecticide - treated nets.
https://pubmed.ncbi.nlm.nih.gov/11195165/

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Economic burden
- increased medical fees
- increased cost in healthcare sector
- lost in productivity can lead to decline of economy

Malaria’s impact on India
“indicate that the total economic burden from malaria in India could be around US$ 1940 million. The major burden comes from lost earnings (75%), while 24%comes from treatment costs.”
https://pubmed.ncbi.nlm.nih.gov/28607263/

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OUTBREAK OF MALARIA IN THAILAND
https://borgenproject.org/facts-about-malaria-in-thailand/
-32 million people are at risk of contracting malaria in Thailand.This is because Thailand is densely filled with 46 million acres of jungles.Warm and humid places are favourable for mosquito growth.Thailand's wet seasons are also a important time for mosquitoes breeding.
-As there are alot of villages in Thailand,it greatly impacted the health of the people living in the rural areas.Unsanitary and damp living conditions allow mosquitoes to breed and infect villagers.This reduces the productivity of these workers, leading to slower economic growth and lower SES for people

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malaria kills at least 1 million people every year in Africa alone. Of the 300 million to 500 million annual cases of malaria, 90 percent occur in sub-Saharan Africa. The World Health Organization reports malaria is responsible for one in five deaths of African children under age 5 every year.

aside from the lives lost, malaria affects medical costs, causing lost income, and reduced economic output. the annual direct and indirect costs of malaria in Africa are estimated to be more than US$2 billion, according to WHO. malaria is regarded as a cause of poverty. malaria slows economic growth in Africa by up to 1.3 percent per year.

those in poverty are at a great risk as they are least likely to have the means to prevent and treat malaria. thus, children miss school because of the disease, suffering both physically and intellectually, and often cannot contribute to their families’ income (through agricultural work). WHO reports that many families spend up to a quarter of their annual income for malaria treatment.

https://www.prb.org/resources/malaria-basics-global-impact-and-actions/

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There's currently no vaccine available that offers protection against malaria, so it's very important to take antimalarial medication to reduce your chances of getting the disease.

However, antimalarials only reduce your risk of infection by about 90%, so taking steps to avoid bites is extremely important, as the more people step up to prevent themselves  getting affected by malaria, there would be a significant decrease in transmission of the virus.

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minimising air travel can manage the outbreak. the movement of people spreads and transmit diseases to new locations, so the lesser people travel, the less transmitted diseases there will be.

the use of bed nets can also be one way to prevent the outbreak. we must also clear away stagnant water spots around us, to prevent mosquitoes from breeding and carrying the disease around.

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Thermal fogging
- it is the distribution of insecticide by using fog produced by heat
- In Thailand, under the malaria control programme, thermal fogging is applied during malaria outbreaks and in uncontrolled transmission area
- thermal fogging can help kill adults mosquitoes found outdoor
- however, thermal fogging can be expensive and must be carried out on a regular basis
- the thick fog can also cause visibility issues and cause road hazards

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Insecticide sprayed bednets
- Insecricide sprayed bedsheets have been introduced to the people of Africa in places like Zambia to reduce the rates of transmission. The insecticides help to ward off the mosquitoes that contain the parasite that causes malaria.
- People are only protected when they are covered by the bed nets. Hence, they are still vunerable to getting malaria at later parts of the day

Continued and immediate testing
- Though places in Eritrea, Africa, have reached low transmission rates of malaria, the people are still required to go for regular testing so as to prevent the reintroduction of malaria.
- People in high malaria affected areas like Eritrea are required to go for immediate testing for early diagnosis, so as to prevent it from escalating into something worse like seizures. They also go for immediate testing so as to contain the transmission of malaria
- This measure has proven to successfully contain malaria in many areas of Africa like Nigeria and the Republic of Congo due to rapid testing.

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detect malaria outbreaks as soon as possible and look out for areas prone to malaria, or have had severe outbreaks in the past. it is essential to quickly report any cases that arise and respond with investigation and treatment to prevent further spread will be key to maintaining elimination and preventing reintroduction. prevention is hetter than cure, so this is an essential step to prevent outbreaks.

However, it is up to citizens to abide by guidelines. even if an area is flagged as a site of growing malaria cases, citizens need to adhere to the measures to be safe and reduce malaria cases

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as LDCs do not have the facilities or enough money to treat malaria, they will go on a strike as seen by the haitian physicians. private hospitals and NGOs will be  overwhelmed with the influx of patients; and the situation is dire for the poorest of the poor. the strike is not only causing large public health challenges and limiting access to healthcare to seek prevention and treatment of malaria, it also is preventing these public hospital sites from reporting data on malaria – which will cause a gap in malaria data for 2016.

a variety of sociobehavioral barriers to prevention and treatment of malaria exist at individual, household, sociocultural, health infrastructure and policy and programmatic levels. for example, barriers include limited knowledge of prevention measures, negative perceptions of drug safety, logistical challenges (Reasons for spread) relating to seeking treatment, poor delivery of supplies, insufficient funding, and slow scale-up of programs, among others.

https://www.oatext.com/Malaria-Elimination-in-Haiti-Challenges-Progress-and-Solutions.php

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Rolling back malaria: The global strategy and booster program (since 2005)

the purpose of this program is to translate the World Bank’s corporate commitment into a serious effort to close the gap between knowing and doing in malaria control. implementation of the program will increase rapidly the scale and impact of World Bank’s support for the malaria control at  the country level, with a view to reducing the burden of economic loss, impaired development, preventable illnesses, and deaths due to malaria.

since the start of the project, more than 300000 village-based  volunteers have been trained in malaria case management and anti-malaria drugs were supplied to them. almost 3 million insecticide-treated bed nets have been distributed. local governments, community groups and NGOs have become actively involved in a number of activities, including distribution of insecticide-treated bed nets and community awareness campaigns. reported cases of malaria declined by 93.3%, 80.8% and 40.6% for the states of Maharashtra, gujarat and rajasthan respectively, from 1997 to 2002.

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the government need to be quick to respond to the outbreak of malaria to prevent more spread. however, this is only successful in DCs and they have the funds to do contact tracing. it is however still a major problems im LDCs like Nigeria since they have less money to curb the outbreak and it happens to people very frequently.

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- no permanent cure, so have to rely on prevention methods

prevention methods:
insecticide treated mosquito nets, education, insect repellent (eg. containing DEET)

MALARIA CASE MANAGEMENT
Malaria must be diagnosed and treated promptly with a recommended antimalarial drug to keep the illness from progressing and to help prevent further spread of infection in the community.

SUCCESS OF MALARIA CASE MANAGEMENT

did you know that china was certified malaria free by WHO recently on the 30th of June 2021?? waow🤩🤩

case study: China

• success of case management in china was largely due to the determination of government to fully eradicate malaria
• in 1967: "623 project"
- nation-wide research program which aimed to find new treatments for malaria
- involved 500+ scientists
- led to the discovery of artemisinin – the core compound of artemisinin-based combination therapies (ACTs), the most effective antimalarial drugs available today.
• in 1980s: china was the first country to extensively test the use of insecticide-treated nets (well before WHO recognized and encouraged its use)
- by 1988, more than 2.4 million nets had been distributed nation-wide
> use of such nets led to substantial reductions in malaria incidence in the areas where they were deployed
• China provides a basic public health service package for its residents free of charge
- as part of this package, all people in China have access to affordable services for the diagnosis and treatment of malaria, regardless of legal or financial status
• strict adherence of the "1-3-7 strategy"
-  “1” signifies the one-day deadline for health facilities to report a malaria diagnosis
- by the end of day 3, health authorities are required to confirm a case and determine the risk of spread
- within 7 days, appropriate measures must be taken to prevent further spread of the disease.

source: https://www.who.int/news/item/30-06-2021-from-30-million-cases-to-zero-china-is-certified-malaria-free-by-who

FAILURE OF MALARIA CASE MANAGEMENT

case study: USA
• National Malaria Eradication Program was a cooperative undertaking by state and local health agencies of 13 southeastern states and the Communicable Disease Center of the U. S. Public Health Service, originally proposed by Dr. L. L. Williams. The program commenced operations on July 1, 1947
- application of DDT to interior surfaces of rural homes
- drainage, removal of mosquito breeding sites, and spraying (occasionally from aircrafts) of insecticides.
• About 2,000 cases of malaria are diagnosed in the United States each year.

ps: I have no clue what the US is doing about it bc the website is so confusing 😵‍💫😵‍💫😵‍💫 so if u wna find out more: https://www.cdc.gov/parasites/malaria/index.html

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Countries with high malaria transmission have historically had lower economic growth than in countries without malaria.

• Every year malaria is estimated to cost Africa $US 12 billion in lost Gross Domestic Product (GDP). It is estimated the disease has slowed economic growth in Africa by 1.3 percent per year as a result of lost life and lower productivity – what economists call a “growth penalty”.

• For countries with a high malaria burden, the disease may account for as much as 40 percent of public health expenditure, with malaria accounting for up to 50 percent of outpatient.
In Tanzania, for example, malaria accounts for 30 percent of the national disease burden.

• Figures in Tanzania also show that malaria accounts for 43 percent of under-five outpatient attendance, 35 percent of under- five hospital admissions and 37 percent of under-five hospital death.
https://www.malariaconsortium.org/userfiles/file/Past%20events/factsheet2%20-%20malaria%20and%20poverty.pdf

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Malaria can cause economic losses in the country which can eventually affect people both economically and socially.

For example, in Nigeria, there are approximately 2 to 3 million deaths due to malaria, particularly amongst pregnant women and children below 5 years.

When a person gets infected with malaria and are unable to seek proper treatment, they are forced to stay away from school or work, this productivity in the country decreases.

When there is low productivity, the country is unable to earn money thus leading to a declining economy.

This means that the country would not be able to sanction enough money to healthcare to provide for proper treatment like in Nigeria where only 6% of the annual budget is allocated to the healthcare sector. This in turn resulted in poor health outcomes and increase in severity of diseases like malaria.

Source: https://www.hcs.harvard.edu/~epihc/currentissue/Fall2001/carrington.htm

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It can cost a country more money as having malaria cna lead to increased medical expenses. LDCs may feel the cost more then DCs as they may not have the same resources as DCs to set aside funds to address the problem of malaria. According to WHO, malaria can account for ss much as 40% of public health spending on some countries, countries need to have the funds to maintain and invest in hospitals and clinics and weIl as medication in order to combat malaria.

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-one way of managing malaria is to enforce strict surveillance in areas prone to malaria.mosquito repellent and disinfection is done at a large scale especially in villages.they are also educating citizens to protect themselves and reduce the spread of malaria (Which country implemented this? Were they successful in slowing the spread?)
-it is successful as when people mosquito repellent is used,the condition would not be suitable for mosquito breeding thus repelling them away.education also allows citizens to protect themselves by using mosquito nets
-not that successful as places are still unsanitary and malaria can still be spread easily by mosquitoes.presence of stagnant water bodies such as rice fields may also encourage mosquitoes breeding.when educating, only the older residents would understand and implement these strategies.However, young kids might not be knowledgeable and are more likely to get infected

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one form of malaria control uses interventions such as insecticide-treated bednets, indoor residual spraying (IRS), timely diagnosis, and effective treatment. these preventive measures are developed and put in place with the intention of preventing the spread of malaria through mosquito bites. however, this has proven to be relatively ineffective as the mosquitoes are able to build resistance to insecticides such as pyrethoids in a short amount of time. according to WHO, mosquito resistance to insecticides has been detected in 64 countries globally. (Good limitation identified)
in 2019, an estimated 46% of all people at risk of malaria in Africa were protected by an insecticide-treated net, compared to 2% in 2000. thus, this measure can be considered successful. globally, IRS protection declined from a peak of 5% in 2010 to 2% in 2019, with decreases seen across all WHO regions, apart from the WHO Eastern Mediterranean Region. the declines in IRS coverage are occurring as countries switch from pyrethroid insecticides to more expensive alternatives to mitigate mosquito resistance to pyrethroids. this measure can be considered unsucessful due to the very limited amount of coverage. however, it is likely to be a success if it were more cost-effective.