February 6, 2011

1. Malaria Control & Prevention Gokwe District, Zimbabwe Adoniah M. Mukona, Ph.D. Student Community Health Promotion and EducationWalden UniversityPUBH 8165-1Instructor: Dr. Raymond W. ThronWinter Quarter, 2011 February 6, 2011

2. INTRODUCTION • Malaria is a problem world wide as shown on the map • 1 million people die from Malaria each year in Africa • The majority are children under 5 years of age • 91% of people die from malaria in Africa south of the Sahara • Malaria has been overcome in some parts of the world • We can do it here in Africa but it needs to start somewhere • Let us engage in Community Organizing and be involved

3. Evidence of the problem • Children are suffering daily • Cost of healthcare escalating • Expecting women are at risk daily • Miscarriages and risk of infection increasing • Children are missing school • Parents and family members are missing work • 25-40% of clinic visits are malaria related • The limited resources locally and nationally • Drought and HIV/Aids threaten on the other side • Economic burden on local councils

4. World Malaria Regions All the countries that are in red are malaria endemic areas

5. Where in the World is Zimbabwe

6. Map of Zimbabwe

7. Malaria Distribution in Gokwe

8. Ministry OF Health and Child Welfare Zimbabwe The Government Ministry responsible

9. Stake Holders in the Fight Against Malaria LOCAL COUNCILS GOKWE RESIDENTS PEOPLE OF ZIMBABWE: GOKWE RESIDENTS ,VISITORS, AND ALL ZIMBABWEANS

10. Yes You Have Partners Supporting the Struggle Source: (Mukona, 2010)

11. MALARIA PREVENTIONCAMPAIGN Motto: Stop Malaria from consuming our mothers and children

12. Get Involved and Join the Effort to Stop Malaria Source: (Mukona, 2010)

13. The different types of Mosquitoes • The anopheles mosquito is the one responsible for transmission of the causative parasite • Look at the difference on how they rest • Spreads P. falciparum a Plasmodium species

14. Mosquito sucking Blood From an Infected person • Anopheles mosquito biting its victim and drawing blood • From here it goes to another victim where it is going to deposit all the blood and parasites • Do not let this happen to you

15. Transmission of malaria Parasites • We need to break the cycle of the mosquito in order to control their population • Avoid mosquito bites at all cost • That will help eradicate the parasites

16. Parasites Transmission by Mosquito • Mosquito injects its saliva into victim to stop blood from clotting • This is followed by sucking the parasites • This an important phase in transmission • Avoiding bites can potentially break the cycle

17. Malaria Distribution in Midlands Province, Zimbabwe Source:

18. Statistics on malaria • HIV prevalence of 26% affects malaria • Globally: 247 millionAfrica: 212 millionAsia: 21 millionMiddle East: 8.1 millionAmericas: 2.7 million • Globally: 881,000Africa: 801,000Middle East: 38,000Asia: 36,000Americas: 3,000 • Figures on malaria deaths • 91% of deaths were in Africa • 85% of deaths were in children under 5 years of age • Population at risk 3.3 billion (half of the world population) • Number of countries affected 109(35 countries - 30 in Sub-Saharan Africa and 5 in Asia - account for 98 percent of global malaria deaths) • Child mortality from malaria 85% of deaths in children under 5 years old   Source: Global Malaria Action Plan (2008)

19. Doing the Right ThingMake-shift Clinics in Gokwe Source: (Mukona, 2010)

20. People queing for service at an outreach clinic in Gokwe, Zimbabwe Source: (Mukona, 2010)

21. More pictures of women waiting for services Source: (Mukona, 2010)

22. Malaria Prevention efforts • Identification of all prevalent and incident cases • Treatment and isolation during infective phase • Keep mosquitoes away from people • Control the environment by making sure there are no breeding grounds • Stay inside when time is rife for mosquitoes to attack (dusk and dawn) • We need to have all houses fully enclosed with netted windows and doors • Please know the signs and symptoms of malaria (CDC, 2010).

23. Malaria Prevention efforts • Use of malaria coils • Use agricultural accepted insecticides minimally if you have some in stock • Referring all affected people for treatment to ensure we kill all living parasites in people • Appropriate timing of chemical usage is vital • Avoid insecticide misuse for it leads to resistance

24. Signs and Symptoms of malaria • General malaise • Headaches • flulike fever • Chills • muscle aches • Nausea &vomiting • Coughing • Diarrhea • Cycles of chills, fever, and sweating that repeat every one, two, or three days are typical • Yellowing (jaundice) of the skin and whites of the eyes due to destruction of red blood cells and liver cells.

25. Malaria Treatment • Rush the sick to the clinics and hospital • Avoid wasting time especially with children and pregnant mothers • Time will save lives • Health personnel will confirm malaria infection with appropriate tests to detect the malaria parasites • Drugs will be appropriately prescribed to reat the infected • Differential test are necessary considering confusion with HIV/AIDS

26. DO’s and DO-NOT’s • No traditional healer is capable of dealing with malaria so do not consult them • Do not overuse or abuse medication • It is causing parasite resistance to treatment leading to problems (Moeller, 2005) • Use insect ides as recommended by manufacturers • Store chemicals responsibly too many suicides by their use • Avoid over-dosages-follow prescription guidelines • Do not self prescribe medications without consulting health care personnel

27. How Can Society Contribute • Everyone needs to know we have a problem • Awareness and Education are our main ammunition • Enforcing local ordinances to avoid pollution and misuse of pesticides to reduce drug resistance • It is hard but isolate victims from where they can be bitten by mosquitoes that can potentially bite others • Let us come up with a generation that is aware of the problems we face

28. Who, Why, an How Can you Help • Local people need to invest in their health • Yes it is the responsibility of the local and national government • Remember politicians do not live here inn Gokwe where the problem is • Local church organizations • Non-Governmental Organizations • Local school children both in primary and secondary schools

29. Methods of Prevention • Broad Scale measures include • Use of DDT selectively • Use of DDT substitutes • Government to promote resettlement schemes • Promote isolation of residential communities from farming land and pastures • Build protective homes-Avoiding mud and dagga housing is vital

30. Small Scale Barriers • Appropriate housing for all • Mosquito bed nets • Window nets • Mosquito repellants (chemicals) • Mosquito repellants (plants) • Just avoid bites • Keep animals kraals away from houses • No standing water on yards –No breeding grounds for mosquitoes

31. Conclusions • Community collaboration efforts in the Stop Malaria campaign • Use of school children to educate parents from information acquired from schools • Support efforts by donor agencies • Use resources wisely • Build new houses that will not permit mosquito entry easily • Resources for malaria prevention (http://blog.acumenfund.org/2010/12/08/beyond-a-pamphlet-books-of-hope-is-moving-against-malaria/)

32. REFERENCES • http://www.cdc.gov/malaria/http://docsdrive.com/pdfs/ansinet/pjbs/2004/1574-1576.pdf • http://www.rollbackmalaria.org/amd2003/amr2003/ch1.htm • http://blog.acumenfund.org/2010/12/08/beyond-a-pamphlet-books-of-hope-is-moving-against-malaria/ • Moeller, D. W. (2005). Environmental Health (3rd ed.). Cambridge, MA: Harvard University Press. • Mukona, M. A. (Photographer). (2010). Personal Pictures From Gokwe Zimbabwe [Motion picture]. United States: Personal pictures.