PUBLIC HEALTH

IMPORTANCE AND
CONTROL MEASURES IN
MALARIA
 APPROACHES TO MALARIA
CONTROL
• A. MANAGEMENT OF MALARIA CASES
IN THE COMMUNITY

• B.ACTIVE INTERVENTION TO
CONTROL MALARIA TRANSMISSION IN
THE COMMUNITY
A. MANAGEMENT OF MALARIA
CASES
• 1. CASE DETECTION

• 2.TREATMENT

• 3.MASS DRUG ADMINISTRATION

 CASE DETECTION

• ALL FEVER CASE ATTENDING TO

PHC/DISPENSARIES /HOSPITALS
SHOULD BE PRESUMED TO BE
SUFFERING FROM MALARIA
 TREATMENT
• CHLOROQUINE
-1ST LINE OF DRUG

1.VIVAX - CHL - 25 MG/KG BW(3

DAYS)
PRIM -0.2 MG/KG BW (14

DAYS)
• 2.FALCIPARUM
-25MG/KG BW(3 DAYS)
-PRIMAQUINE 0.7 MG/KG(1ST
DAY)
3.CHL- RESISTANT FALCIPARUM
MALARIA - ARTESUNATE
COMBINATION THERAPY
-QUININE
UNCOMPLICATED MALARIA
• 1 .CHLOROQUINE DAY CHILD ADUL
REN TS
1 10MG/ 600MG
KG
2 10MG/ 600MG
KG
3 5MG/K 300
G MG
• 2. PRIMAQUINE -P.FALCIPARUM

ABOVE 15 YEARS - 45 MG
SINGLE DOSE ON
DAY 1
LESS THAN 15 YEARS-7.5 -30 MG
P.VIVAX-

ABOVE 15 YEARS-15MG DAILY

DOSE FOR 14
DAYS
LESS THAN 15 YEARS -2.5-10 MG
• 3.ARTSUNATE
+SULPHADOXINE+PYRIMETHAMINE

ADULTS (ABOVE15 YRS)

AS-4 TABS ON 1,2,3 DAYS
SP-3 TABS ON DAY 1

CONTRAINDICATION-PREGNANCY
 SEVERE AND COMPLICATED
MALARIA
• 1 . QUININE INJ –
-10MG/KG I.V DRIP IN 5%
DEXTROSE SALINE TO BE RUN
OVR 4 HRS

2.ARTESUNATE -
-2.4 MG/KG BW I.M OR I.V
FOLLOWED BY 1.2 MG/KG BW AFTER 12 HRS,
THEN 1.2 MG/KG BW ONCE DAILY FOR 4
DAYS
• 3.ARTEMETHER
-1.6MG/KG BW I.M FOLLOWED
BY 1.6MG/ KG BW DAILY FOR 4 DAYS

4.ARTETHER
-150MG DAILY I.M FOR 3 DAYS
• 5.ARTEMISININ
-10MG/KG BW AT 0 & 4 HRS
FOLLOWED BY 7 MG/KG BW AT
24,36,48,60 HRS
 SIDE EFFECTS
• CNS -BLURRING OF
VISION,HEADACHE,RETINAL
DAMAGE
• GIT -CRAMPS, NAUSEA, VOMITING

• CVS –CYANOSIS
MASS DRUG ADMINISTRATION
• RECOMMENDE IN HIGHLY ENDEMIC
AREAS
• ANTI MOSQUITO MEASURES TO
FOLLOW
• NOT RECOMMENDED IN CHILDREN
BELOW 5 YEARS -INTERFERE WITH
DEVT. OF
PROTECTIVE
IMMUNITY
 -ACCELERATE DEVT OF
DRUG RESISTANCE
- INCREACE RISK OF
RETINOPATHY
 CHEMOPROPHYLAXIS
• RECOMMENDE FOR

TRAVELLORS,SOLDIERS.POLICE,PREGN
ANCY

• CHOLOQUINE -300MG ONCE A WEEK

• PROGUANIL -200MG ONCE A DAY
MEFLOQUINE ,QUINE, DOXY CYCLINE
 ACTIVE INTERVENTION
MEASURES
MOSQUITO CONTROL MEASURES
• ANTI LARVAL MEASURES -
ENVIRONMENTAL CONTROL -
CHEMICAL CONTROL -
BIOLOGICAL CONTROL
• ANTI ADULT MEASURES -RESIDUAL
SPRAYS -SPACE SPRAYS -
GENETIC CONTROL
• PROTECTION AGAINST MOSQUITO
BITES
-MOSQUITO NETS
-SCREENING
-REPELLENTS
 ANTI LARVAL MEASURES
• ENVIRONMENTAL CONTROL
-SOURCE REDUCTION
-FILLING, LEVELLING AND
DRAINAGE OF BREEDING
PLACES
-WATER MANAGEMENT
-FOR ANOPHELES-FILLING AND
DRAINAGE
• CHEMICAL CONTROL

MINERAL OILS
PARIS GREEN
SYNTHETIC INSECTICIDES

-
• MINERAL OILS
-ADDITION OF OIL TO WATER
-DIESEL OIL, FUEL OIL,
KEROSENE OIL ETC.
-FORMS A THIN FILM AND CUTS
OF AIR SUPPLY
-40 TO 90 LITRES PER HECTARE
-KILLS LARVA AND PUPA
 - APPLIED ONCE IN A WEEK
-MAKES WATER UNFIT FOR
DRINKING AND KILLS FISH

PARIS GREEN –COPPER ACETO ARSENITE

-STOMACH POISON
-KILLS SURFACE FEEDERS
-I KG PER HECTARE
 -DOES NOT HARM FISH ,MAN,
AND DOMESTIC ANIMALS

SYNTHETIC INSECTICIDES -
FENTHION,CHLORPYRIFOS AND
ABATE
-ORGANOPHOSPHORUS COMPOUNDS
-HYDROLYSE IN WATER
-WATER CONTAMINATION & RISK OF
RESISTANCE
• BIOLOGICAL CONTROL
-GAMBUSIA & LEBISTER
RETICULATUS
-EFFECTIVE ONLY WHEN
USED IN CONJUNCTION
WITH OTHER METHODS
 ANTI ADULT MEASURES
• RESIDUAL SPRAYS

DDT,MALATHION,PROPOXUR
-DDT -1-2 GMS/MTRE SQ
-MALATHION -2 GMS /MTRE SQ
-LINDANE -0.5 GMS/MTRE SQ
- RESISTANCE IS THE MAIN PROBLEM
• SPACE SPRAYS
-SPRAYED INTO ATMOSPHERE
IN THE FORM OF MIST OR FOG
-PYRETHRUM EXTRACTS IS
NERVE POISON AND KILLS
INSTANTLY
-O.I%PYRETHRIN
-DOORS AND WINDOWS CLOSED
FOR HALF AN HOUR
 -NO RESIDUAL ACTION
-RESIDUAL INSECTICIDES ARE
ALSO USED

GENETIC CONTROL
-STERILE MALE
TECHNIQUE
-CYTOPLASMIC
INCOMPATABILITY
 -SEX DISTORTION
-GENE REPLACEMENT
-THEY ARE MORE
EFFICIENT AND CHEAPER
 PROTECTION AGAINST
MOSQUITO BITES
• MOSQUITO NETS -MATERIAL USED
SHOULD BE WHITE TO
ALLOW EASY
DETECTION OF MOSQUITOS
-TOP AND SIDES SHOULD
BE OF NETTING
-NO HOLES OR RENTS
-HOLE SIZE-0.0475 INCHES
 -150 HOLES PER SQUARE
INCH

SCREENING -COPPER OR BRONZE

GUAZE
-16 MESHES PER INCH
-APERTURE -0.0475 INCH
-COSTLY BUT EFFECTIVE
• REPELLANTS
-DIETHYLTOLUAMIDE
-INDALONE
-DIETHYL PHTHALATE
- MAINLY ACTIVE AGAINST
CULEX MOSQUITOS
-SHORT DURATION OF PROTECTION