Nursing Case Study on Malaria
Introduction
Malaria is a substantial public health problem in most parts of the tropics and nearly half of the world population is at risk of contracting the disease. Five parasite species of the genus Plasmodium can infect humans, but a vast majority of the infections are caused by Plasmodium falciparum and Plasmodium vivax.4 Although P. falciparum is the predominant species in Africa, both P. vivax and P. falciparum are prevalent in other parts of the world, including the Indian subcontinent. Due to the high number of people suffering from this tropical disease, there is need for detailed education of how to handle the situation effectively. This study digs into various questions and answers that provide knowledge about malaria causes, prevention, and treatment.
What is malaria?
It is a serious tropical disease spread by female anopheles mosquitos.
What increases transmission?
Rainy season and stagnant waters as this is where mosquitos breed.
High temperatures – 16-32 degrees.
High humidity, which is more likely in forested areas.
What reduces transmission?
High altitude.
Rainfall below 1000m.
How does one’s socio-economic environment affect malaria risks?
Housing quality as poorly fitted doors and windows don’t keep out mosquitos. Overcrowding also increases transmission.
Unsanitary conditions attract mosquitos which is more common in slums in urban areas.
Income as if you cannot afford repellants, nets, or coils, you are at a much higher risk.
Better education leads to a better understanding, so people are more likely to use prevention methods.
Distance from the hospital affects whether people get treatment or not.
What are the health implications?
Causes 1/6 of child deaths.
It can be hard to diagnose, meaning many suffer for long times.
Causes nearly 500,000 deaths per year.
What are the economic implications?
Expensive for individuals.
Accounts for 40% of public health spending in some areas.
Costs $12 billion a year globally.
The burden on local healthcare.
Can inhibit FDI and TNCs.
Causes school absences, decrease tourism, and affects crops.
How can it be mitigated and managed?
Prompt and effective treatment.
Widespread use of insecticide nets can reduce transmission by 90%.
Indoor sprays to control mosquitos.
Burning mosquito coils.
What are the WHO’s aims for malaria?
Aims to reduce the disease burden by 40% by 2020 and eliminate it from 35 countries by 2030.
Terms in this set (14)
How many people are at risk globally
3.3 billion
What parasite causes malaria
Plasmodium
How many cases per year
225 million
How many deaths per year
781,000
How often does a child die of malaria
30 seconds
Who is most vulnerable?
Pregnant women, underlying health conditions, traveling communities
What is stage 1 of malaria?
Transmission
What is stage 2 of malaria?
Liver cells invaded
What is stage 3 of malaria?
Red blood cells invaded
What is stage 4 of malaria?
Transmission back to the mosquito
What is stage 5 of malaria?
The parasite multiplies inside of a mosquito
Cost to the African economy
$8 billion
What percentage of drug expenditure does it make up in affected countries?
40%
What percentage of hospital admissions does it make up in affected countries?
30-50%
What’s malaria?
A parasites’ bourn disease passed in from the bite of a mosquito, which kills over 2.7 million people per year. It is a potentially fatal disease, and it happens when the mosquito that already is carrying malaria bites a human and transfers the disease into the human body. There are currently 300 people currently affected by the disease.
What are the symptoms?
Headaches
*Nausea
Fever
*Vomiting
*Flu-like symptoms.
What Happens when you have been bitten?
– the parasite enters the bloodstream and burrows into the liver, where over a week or two, it multiplies into 400,000 replicas where it destroys red blood cells reducing the amount of oxygen
The global distribution of malaria
Malaria is found in tropical areas. For example, in figure 1, most cases can be found in Africa, central South America, India, and northern Oceania.
Malaria transmission can be found in developing countries such as China and India, both emerging countries.
There is no transmission in colder climates such as the USA, Europe, and northern Asia.
Developed countries such as Australia have a warmer climate, yet they have not known Malaria transmission to occur.
It occurs in rainforest and savanna grassland with at least 1000, of rain per year
Prevalence of malaria
3.2 billion people are at risk of contracting malaria; more than 40% of the world pop
Two hundred fourteen million cases occur every year.
It is present in 97 countries across the world.
In 2015 the WHO estimated that there were about 438,000 deaths from malaria, which were mostly African children
main factors in affecting the incidence of malaria
Species of mosquito, the longer the lifespan of the insect, the greater time for the parasite to complete the lifecycle
Some species of mosquito prefer to bite humans
Human immunity, partial immunity, is developed over years of exposure to disease, which reduces the risk of severe illness. Therefore younger children lack the immunity
What Physical factors discourage malaria-carrying mosquitoes?
– nonstagnant water
– low altitude high humidity coastal areas
– higher altitudes over 1000m transmission falls
parasites require temps between 16-m3 to develop inside mosquitos
What are the socio-economic factors influencing the prevalence?
larger clusters of housing such as slums and shantytowns
rural areas with less economic activities
unsanitary conditions
large correlation between income and use of prevention methods
locations away from clinics and hospitals
Impacts on health
The common first symptoms include fever, headache, chills, and vomiting, and they appear 10-15days after being infected.
Without prompt treatment, malaria can be fatal
The disease also contributes to childhood anemia, a major cause of limited growth and development.
impacts on Economic wellbeing
having to take time off work
having to purchase interstice nets
25% born with a low birth rate
40% of public health expenditure
3/4 of American businesses affected
Impacts of malaria in Uganda
-2015- 3.6 million cases and 6000 deaths
– transmission is all year round due to high rainfall
– being low lying and near the lake, victories make it a large breeding zones
-insecticides are expensive, and some parasites’ have become resistant
-2009 farm opened in Kabul employing 5000 farmers to grow the drug
What mitigation strategies have been used
mosquito nets and protective clothing – this can be very heavy
education demonstrations in Tanzania are used to show how important insecticidal sprays are
natural remedies such as bark from the chloranthy trees
spraying of insecticides in Kolkata, India, kills larva of mosquitos and are frequently
What is the Roll Back Malaria scheme
set up in 1998 to keep malaria on the main agenda
governed by UNICEF and WHO
giving high-risk individuals bed nets such as pregnant people, children, and people with aids
they stopped 50% of malaria cases
Problems with initiative
used the nets for an alternative such as fishing
failed to replace damaged nets
some people who received the nets didn’t sleep with them
- “it’s estimated that 1.2 billion fewer malaria cases and 6.2 billion fewer malaria death occurred globally between 2001 and 2015,” a world malaria report.
The Role of NGOs in preventing the spread
Bill Gates pledged 3 billion pound’s over the next five years to encourage research
How many people are at risk of getting malaria?
3.4 billion people across 92 countries. 1.1 billion are at high risk.
What are the climatic factors that affect the distribution of malaria?
Temperature, humidity, and rainfall – the temperature is especially critical as temperatures below 20C mean that the mosquito’s complete growth cannot be completed, meaning that the disease cannot be transmitted.
Where is malaria prevented from spreading?
At very high altitudes, during colder seasons in some areas, in deserts, in countries where transmission has been stopped through control and elimination strategies.
What environmental conditions are ideal for the spread of malaria?
Temperatures between 16-32C, high rainfall above 2000mm, humidity over 60%, areas of vegetation, stagnant water.
Where are some regions most affected by malaria?
Tropics and subtropics, rainforests, and savannas.
4/5 of Malaria cases are in 13 countries, with the worst hit being Nigeria, Congo, Ethiopia, Tanzania, and Kenya.
How much economic loss does it cause annually?
It causes an average loss of 1.3% annual economic growth in countries with intense transmission.
How does malaria affect poverty and remoteness?
Malaria affects the poor and those living in rural areas more due to limited access to prevention and treatment. A cycle of poverty continues as malaria reduces productivity and social stability. Families affected by malaria clear 60% fewer crops than those free of the disease.
How is malaria-affected by age?
Malaria disproportionately affects children and childhood death rates – a baby girl born in sub-Saharan Africa faces a 22% risk of death before 15
Strategies of managing Malaria
Reducing stagnant water (Fill in and drain areas of stagnant water) – stagnant water.
Without water to lay their eggs, mosquito numbers will decline. Large areas of water are costly to fill in, it is almost impossible to fill in all areas, plus they can return quickly if it rains
Medication (such as quinine) – Drugs prevent the parasite from multiplying in the infected person stopping any symptoms. Drugs are very effective in most locations worldwide. However, these drugs are too expensive for people in developing countries to buy themselves
Reducing areas of shade (clearing trees & shrubs) – Removes shelter, which mosquitoes use to digest their blood meal. It is effective as locals can achieve it. However, it is labor-intensive and time-consuming
Education – Inform people of the basic steps to identify and treat malaria. With knowledge, people can take practical steps for prevention, identification, and care. In addition, ensuring people are treated early means fewer medical resources are needed to treat them so that more time can be spent treating those with other illnesses.
Physical barriers (insecticide) – Prevents a mosquito biting an infected person when sleeping. Nets are relatively cheap & are very effective when maintained hole-free. Locals may struggle to afford ones, but charities can provide them relatively easily due to the long-lasting effects
Malaria affects an individual
Symptoms include severe flu (headaches, fever, nausea, lethargy)
It can lead to death – particularly for under five-year-olds
Reduced work rate/unable to work
Subsistence farmers – unable to tend crops – lack of food.
Children exit education to earn money/tend crops/care for parents/siblings.
Malaria affects an area
Economics of a country are impacted – estimated that all African countries combined lose £7.7bn per year due to malaria
Work absenteeism is high, reducing productivity
Reduced crop production can lead to malnutrition and greater reliance on imports
Foreign investment inhibited.
Tourism is restricted
Up to 40% of medical spend is used on malaria treatment which means less money/resources to treat other illnesses
Reduced crop production – Can lead to malnutrition and greater reliance on imports.
What is malaria?
Malaria is a life-threatening disease caused by parasites that are transmitted to people through the bites of infected mosquitos
Global distribution
in over 100 countries in tropical regions (e.g., large areas of Africa and Asia)
Global prevalence
over 40% of the global population lives in malaria-risk areas, and ~300-600 million people suffer from it yearly
Impact of the physical environment
triggers infection as mosquitos rely on warm, shallow water to breed in
Impact of socio-economic factors
can enable the spread of diseases such as through overcrowding, high rates of urbanization, and poor-quality housing
Populations more at risk
Young children, pregnant women, people with HIV/AIDS, and travelers or immigrants with no immunity
Impact on health
symptoms can initially be mild (headache, vomiting, etc.) but can become very severe within 24hrs leading to death
Impact on economy
high medical costs, lost income, and reduced economic output (less money spent locally on other necessities)
The financial cost of malaria in Africa
$12 billion every year
Prevention
Antimalarial medicines for visitors and diagnosis/treatment prevents deaths and reduces transmission
Management
control vectors with bite prevention – e.g., mosquito nets and insecticide repellent
Eradication
cases are decreasing across 55 countries, but only four have eradicated malaria (UAE, Morocco, Turkmenistan, and Armenia)
