Malaria Control During Mass Population Movements and Natural Disasters (2003) / Chapter Skim
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2. Malaria and Mobility -- A Brief History and Overview
2. Malaria and Mobility -- A Brief History and Overview
Pages 8-23
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From page 8... ...
Seasonal movement of migrant farm workers from Central and South America has been associated with outbreaks of local transmission of malaria in the United States (Zucker, 1996) , raising concerns about the possibility of reestablishment of local transmission (Olliaro et al., 19961.
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From page 9... ...
Displaced populations can move into organized settings, such as planned refugee camps, into temporary or chaotic settings where minimal services are available, disperse into established communities, or remain highly mobile. The duration of dislocation or displacement can range from short (such as with seasonal work)
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From page 10... ...
During this period, the health profile of the displaced population returns to levels similar to preflight times and increasingly reflects the same communicable diseases that are present in the host population in the surrounding areas (Burkholder and Toole, 19951. It is during the postemergency phase that the focus of public health interventions for communicable diseases should shift from a predominantly curative approach to a sustainable, comprehensive approach that includes appropriate curative and prevention components, especially for common endemic diseases such as malaria.
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From page 11... ...
Surveys conducted in Somalia during 1980 showed that, while malaria was not one of the leading causes of mortality, it still accounted for 2 to 5 percent of all deaths (Toole and Waldman, 19881. In 1984 among Karen refugees fleeing Myanmar to western Thailand, the annual incidence rate for malaria was 1,037 cases per thousand, with over 80 percent of infections due to PlasmodLium falciparum, causing malaria control to be given high priority (Decludt et al., 19911.
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From page 13... ...
In Brazil large groups of people travel from nonendemic areas into malarious areas to obtain work in mining operations and then become ill at very high rates (Veeken, 1993; de Andrade et al., 19951. Large-scale irrigation projects or hydroelectric water production schemes have been shown in many instances to facilitate mosquito breeding and malaria transmission (Kloos, 1990; Singh et al., 19991.
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From page 14... ...
ENVIRONMENTAL AND NATURAL DISASTERS Natural disasters, such as floods or earthquakes, can precipitate mass population movements out of affected areas or can cause a normally dispersed population to crowd around food and water sources, health care facilities, or debarkation points. Disasters involving flooding or severe rains can increase mosquito breeding sites (Mason and Cavalie, 19651.
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From page 15... ...
Heavy Monsoon Rains/Floods Heavy monsoon rains or other causes of flooding can dramatically increase mosquito breeding sites and result in massive increases in mosquito numbers. As with other natural disasters, heavy rains or flooding can disrupt normal malaria control efforts and destroy shelter, putting inhabitants at increased risk of acquiring malaria.
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From page 16... ...
Poor or No Housing Studies conducted among stable populations living in malaria-endemic areas have shown that housing quality is associated with the risk of malaria infection (Koram et al., 1995a; Wolff et al., 20011. Similar problems have been noticed among refugee populations as well (Meek, 19891.
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From page 17... ...
Displaced populations may intentionally locate near water sources. While this facilitates the ready use of water, it may also put the population at increased risk of malaria if the water source is also a breeding site for mosquitoes.
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From page 18... ...
can increase people's exposure to malaria and the risk of introduction of the disease into malaria-free areas (Prothero, 19771. In Thailand a well-described cause of epidemic malaria is the movement of people between the forested areas of the Thai-Myanmar and Thai-Cambodian borders, where malaria risk is high, and nonendemic lowland villages.
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From page 19... ...
Because the overall level of immunity would be low, a significant risk of severe illness and death exists. In these situations an aggressive malaria control program becomes essential; not only is ready access to effective curative services needed, preventive measures, including comprehensive public education, should be included.
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From page 20... ...
Malaria infection can reduce the immune response to vaccines for tetanus, typhoid, and meningitis (Greenwood et al., 19811. Successful prevention of malaria through combined use of insecticide-impregnated bed nets and chemoprophylaxis resulted in a significant drop in mortality from all causes among Gambian children, suggesting a substantial indirect effect on nonmalarial illness (Alonso et al., 19931.
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From page 21... ...
Information collected during famine relief efforts suggests that nutritional rehabilitation of famine victims can induce recrudescence of sequestered parasites, causing an increase in malaria, and that refeeding programs should include provisions for malaria prevention (Murray et al., 1976, 1978; Shankar, 20001. The effects of specific micronutrient deficiencies on malaria morbidity and mortality is equally complex and requires more investigation.
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From page 22... ...
Overall, more than 90 percent of deaths from all causes occurred outside health care facilities, suggesting that health care services were not accessible to most of the population or that the demand for curative services overwhelmed the capacity of the organizations (Centers for Disease Control and Prevention, 19961. A malaria control strategy based on prompt, effective therapy of acute febrile illness can only be successful if people know where to go to get diagnosed and treated and if such facilities are easily accessible.
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From page 23... ...
Additionally, high-cost interventions may be introduced by comparatively well-funded international agencies that the inheriting local nongovernmental organization or government might have a difficult time sustaining. Examples include the first-line use of relatively expensive antimalarial drugs or rapid diagnostic ("dipstick")
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