Monday, 22 September 2014

PREVENTION AND CONTROL OF MALARIA

It is an insect borne communicable disease,caused by Sporozo parasites belonged to genus plasmodium,characterized by intermittent fever.chills.cold,shivering,enlargement of spleen and a tendency to relapse.Temperature may shoot up to 39-40 centigrade,make patient shivering and finally wet stage with sweating brings down temperature.It may occur daily,alternative days or 36-48 hours.Each lasts 10-15 hours and rarely up to 24 hours or longer. Diagnosis is confirmed by microscopic examination of blood smear,There are 2 types of malaria commonly depend upon severity of paroxysms of the species of plasmodium i.e. benign Tirtian fever and malignant Tirtian fever.Relapses are more common in benign malaria and is not common in malignant tertian..The parasite has to under go 2 cycles that is,namely sexual cycle in mosquito and asexual cycle in man by the bite of infected female Anopheles mosquito.
2.Incubation period is period in human being is 14 days and in mosquito is 10-14 days.Man has no immunity against malaria.There are 3 recognized malaria zones,those are the tropical zone between
the cancer and Capricorn,has almost universal endemic malarial area.The malaria season is long in areas near equator it may last throughout the year.In India malaria transmission season is from July to November with its peak in September.A secondary infection occurs in April-May relapsed and delayed primary attacks by malaria.In southern India the season varies according rainy season.In hill areas the disease occurs from February to June,meanwhile in plain areas malaria occurs in autumn or in early of spring corresponding the starting of monsoon.In Assam malaria
 is high just arrival of monsoon from March to June with a peak in May and June.
3.Anti malaria measures;There are three broad Groups of antimalarial measures aimed at breaking the "man-mosquito-man" cycle of transmission.namely,personal protection against mosquito bite,chemo prophylaxis and chemotherapy.
Individual protection against mosquito bite obtained by the use of net,application of repellents to exposed skin parts when not under net,and protection by proper use of clothing from dusk to dawn.Of all these measures,the use of mosquito net is the most useful single measure.Screening of homes and public buildings had been tried in so many places in south east Asia,but it is not practicable or economical.
Chemo prophylaxis is a supplementary measure under high risk situations,but it is not a substitute for other control measures.It reduces clinical attacks by suppressing the malarial parasite,sporozites induced per infected mosquito bite.Theoretically it is possible to control malaria in a country by giving radical treatment with ideal and specific drugs,but this can be achieved rarely in practice. Chemotherapy reduces the parasite count in community and it is an ideal and valuable aid in control programmes.
Health education among public regarding transmission of disease from mosquito to man and important of personal protective measures.to prevent mosquito breeding,residual insecticide spray and etc.
Space spray is carried out once in week in a highly malarious area to be occupied for purposes of industrial .defense and engineering projects at short notice.to control quickly an epidemic or as a remedial measure in the locality where local transmission is detected.
Malaria control in India in its first phase till 1934 larval control was the main method used.Few achievements were gained due engineering methods and larvicidal oils were used.They were slow,expensive and laborious.
An ideal anti-malaria drug for use in mass control program-me should be a prophylactic drug against all species of sporozites of malaria i.e.it should not allow to develop further,it should be a radical curative i.e it should destroy all types malaria parasite and should possess very low toxicity and should be available readily at a low cost.The drugs at present available have various limitations.
Mass chemotherapy may also be used after withdrawal from or passing through a hyper endemic. area.
pm kutty

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