Which of the following describes the current state of malaria treatment and/or prevention?
Malaria is a disease caused by the parasite Plasmodium, which is transmitted by the bite of an infected mosquito. Only the Anopheles genus of the mosquito can transmit Malaria. The symptoms of the disease include fever, vomiting, and/or headache. A characteristic malarial fever has ‘hot', ‘wet', and ‘cold' phases and appears 10 to 15 days after the mosquito bites. To diagnose malaria, blood slides are examined under a microscope, where the parasite is seen inside red blood cells. Rapid diagnostic test kits (RDTs) are used for diagnosing malaria in remote areas where microscopes cannot be used. Show
Plasmodium vivax or P. falciparum are the most common malarial parasites, while P. malariae and P. ovale are other rarer forms. Of these, infection with P. falciparum is the most fatal if left untreated, possibly leading to kidney and brain complications, and even death. Chloroquine was the treatment of choice for malaria and is still followed in most countries for treatment of P. Vivax, but P. falciparum has developed resistance to it. As a result, Artemisinin-based combination therapy is now presently advised as the primary treatment for malaria. Among preventive measures, the use of insecticide treated nets at home and indoor residual spraying of insecticides are recommended for malaria. These precautions act by decreasing exposure to bites of infected mosquitoes. Key facts
Malaria is caused by parasites of the species Plasmodium. The parasites are spread to people through the bites of infected mosquitoes. There are four types of human malaria:
Plasmodium falciparum and Plasmodium vivax are the most common. Plasmodium falciparum is the most deadly. In Americas 77% of the infections are due to Plasmodium vivax. TransmissionMalaria transmission rates can differ depending on local factors such as rainfall patterns (mosquitoes breed in wet conditions), the proximity of mosquito breeding sites to people, and types of mosquito species in the area. Some regions have a fairly constant number of cases throughout the year - these countries are termed "malaria endemic". In other areas there are "malaria seasons" usually coinciding with the rainy season. Large and devastating epidemics can occur when the mosquito-borne parasite is introduced into areas where people have had little prior contact with the infecting parasite and have little or no immunity to malaria, or when people with low immunity move into areas where malaria cases are constant. These epidemics can be triggered by wet weather conditions and further aggravated by floods or mass population movements driven by conflict. Do all mosquitoes transmit malaria? SymptomsThe common first symptoms - fever, headache, chills and vomiting - usually appear 10 to 15 days after a person is infected. If not treated promptly with effective medicines, malaria can cause severe illness and is often fatal. Who is at risk? Most cases and deaths are in sub-Saharan Africa. However, Asia, Latin America, the Middle East and parts of Europe are also affected. In 2015, malaria was present in 91 countries and territories. Specific risks follow.
TreatmentEarly treatment of malaria will shorten its duration, prevent complications and avoid a majority of deaths. Because of its considerable drag on health in low-income countries, malaria disease management is an essential part of global health development. Treatment aims to cure patients of the disease rather than to diminish the number of parasites carried by an infected person. The best available treatment, particularly for P. falciparum malaria, is a combination of drugs known as artemisinin-based combination therapies (ACTs). However, the growing potential for parasite resistance to these medicines is undermining malaria control efforts (see below). There are no effective alternatives to artemisinins for the treatment of malaria either on the market or nearing the end of the drug development process. WHO recommends:
WHO guidelines for the treatment of malaria | FAQ Drug ResistanceDrug resistance to commonly used antimalarial drugs has spread very rapidly. In order to avoid this for artemisinins, they should be used in combination as ACTs, and artemisinin monotherapy (use of one artemisinin drug versus the more effective combination pill) should not be used. The less effective single-drug treatment increases the chance for parasites to evolve and become resistant to the medicine. Intensive monitoring of drug potency is essential to protect against the spread of resistant malaria strains to other parts of the world. WHO recommends continuous monitoring and is assisting countries as they work to strengthen drug observation efforts. PreventionPrevention focuses on reducing the transmission of the disease by controlling the malaria-bearing mosquito. Two main interventions for vector control are:
These core interventions can be locally complemented by other mosquito vector control methods (for example, reducing standing water habitats where insects breed, among other approaches). Insecticide resistanceMosquito control efforts are being strengthened in many areas, but there are significant challenges, including:
There are no equally effective and efficient insecticide alternatives to DDT and pyrethroids, and the development of new pesticides is an expensive, long-term endeavour. Vector management practices that enforce the sound management of insecticides are essential. Insecticide resistance detection should be a routine feature of national control efforts to ensure that the most effective vector control methods are being used. For more information on Vector Control: PAHO | WHO Economic impactBeyond the human toll, malaria wreaks significant economic havoc in high-rate areas, decreasing Gross Domestic Product (GDP) by as much as 1.3% in countries with high levels of transmission. Over the long-term, these aggregated annual losses have resulted in substantial differences in GDP between countries with and without malaria (particularly in Africa). Malaria's health costs include both personal and public expenditures on prevention and treatment. In some heavy-burden countries, the disease accounts for:
Malaria disproportionately affects poor people who cannot afford treatment or have limited access to health care, and traps families and communities in a downward spiral of poverty. EliminationRecent data shows that large-scale use of WHO recommended strategies could rapidly reduce malaria, especially in areas of high transmission such as Africa. WHO and Member States have made significant gains in malaria elimination efforts. For example, the Maldives and Sri Lanka have been certified recently for having eliminated malaria. Country successes are due to intense national commitments and coordinated efforts with partners. Which of the following has occurred in response to the Affordable Care Act ACA )? Quizlet?which of the following has occurred in response to the Affordable Care Act (ACA)? The current PPO model that has become dominant in U.S. healthcare delivery places an emphasis on primary care. Home health services may include hemodialysis and cancer therapy.
Which of the following major determinants of population health exerts the least influence?Personal health care is only one, and perhaps the least powerful, of several types of determinants of health, among which are also included genetic, behavioral, social, and environmental factors (IOM, 2000; McGinnis et al., 2002).
Which statement characterizes the health in all policies approach to public policies?What characterizes the Health in All Policies approach to public polices? It considers health implications of decisions, seeks synergies and avoids harmful health impacts.
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