HLTC23H3 Lecture 9: Malaria and AIDS orphans in Africa LECTURE NOTES AND SUPPLEMENTARY READING NOTES

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17 Aug 2012

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Appears to directly affect the central nervous system. Most common form of malaria occurs 85% in sub-saharan africa. Lecture 9: malaria and aids orphans in africa. Famous author wilbur smith: i was born of british stock on january 9, 1933 in northern. As an infant of eighteen months i was struck down by cerebral malaria, delirious for ten days. The doctors told my parents that it was probably better if i died, because if i survived i would be brain damaged. Despite the primitive medical facilities available in africa in those days, their prognosis proved correct; i survived and am now only mildly crazy. Sequelae = a condition that is the consequence of a previous disease or injury. Has killed more people than all wars and other plagues combined. The protozoan parasites live inside cells, where they are largely hidden from the immune response. Infection has a profound effect on the immune system and can cause immune suppression.

Related Questions

An area has two different Anopheles species, both of which can vector Plasmodium, although Plasmodiumdevelops best and is transmitted best by species B. Species A is dominant because its larvae outcompete species B in the main shared breeding sites, small lakes and ponds. Therefore the population of B is currently small. The small lakes and ponds are also the source for the main food source in the region, fish, grown in fish farms. There is grazing land, but other than chickens, the local population does not have livestock. Species A is largely endophagous and endophilic, species B is exophilic. In other sites, both species A and B will also feed on cattle, and B appears to prefer cattle. Both species also like to roost during the hot day in rock overhangs and small caves. To give some context to your answers use the IPM terminology considered in class.

A) The national malaria control agency sends in a new person to develop a malarial control strategy. (S)he recommends oiling the lakes and ponds, and intensive house spraying . Discuss why each of these two options would be a good or bad idea. In your answer consider effects on species A, species B, and malaria incidence. And remember, the idea is to help the local population.

B) Develop an alternative targeted strategy that might work well in this situation. Explain why this would be a good fit. Use only strategies that have been used successfully in the field, and avoid "just spray everything" strategies. Explain why your strategy should work.

After roughly 15 years we have the first malaria vaccine going into phase 4 trials. Meanwhile a Zika vaccine is starting phase 2b trials, only 2-3 years after the first major outbreak in Brazil.

A) Discuss in some detail why it is so much more difficult to develop a vaccine for malaria than for e.g. the Zika or rubella virus. I am looking for at least 2 reasons, and a brief explanation of those reasons. Just stating that one is complex and the other simple is insufficient. If that is what you want to say, back it up with facts.

B) Both the CRISPR bacterial defense system and the adaptive immune system in mammals have means to recognize âsignaturesâ of invading organisms. In what way are the two systems different?

The malaria control team in a given area has access to 5 different drugs, chloroquine, mefloquine, pyrimethamine, amodiaquine, and artimisinin. Nothing else will be available for the foreseeable future. Some resistance to all 5 is already observed.

A) Provide a strategy to maximize the time you can cure malaria using these 5 drugs. Explain why you want to use this strategy (what is the idea behind your plan), and be precise: when do you plan to use what drugs. What are the potential problems you can face and how do you plan to deal with them? Remember, you are working with humans, not robots.

B) Hypnozoites are forms of P. vivax and P. ovale that are dormant, with barely any metabolic activity. After long periods of time (months, a year), they can be re-activated start invading red blood cells, and causing malaria. Explain why artemisinin would or would not be a good drug for people suspected of carrying hyponozoites.

Provides substantial and thoughtful response, reflection â in-depth and detailed for the following post. Please don't copy past from the web

Yellow Fever â Another Reason to Hate Mosquitos

Out of the blue one day you begin to run a fever. The fever expands into loss of appetite and vomiting. A few days later, the vomiting continues and you develop jaundice; you even begin to bleed from your mouth, nose, and eyes. Eventually you die. This is the experience of 7% of the individuals who are infected by Yellow Fever (WHO, 2017).

Yellow Fever is a preventable disease that is spread through mosquitos. The disease has the potential to kill its victim (WHO, 2017). It has an inexpensive vaccine that provides a lifelong immunity to the disease (WHO - French Guiana). As of 2016, there have been reported outbreaks of Yellow Fever in six countries; three in Africa, and three in South America (Yellow Fever in Africa and the Americas, 2016).

According to the World Health Organization, Yellow Fever is spread through mosquitos. A mosquito bites an infected carrier (either a person or monkey). The same mosquito then bites an uninfected person or monkey and spreads the disease to that individual. Yellow Fever will incubate in the new carrier for three to six days before symptoms begin to show. The symptoms begin as body aches, fever, nausea and vomiting. It is at this point that the disease is often misdiagnosed as other illnesses and diseases such as poisoning, malaria, hepatitis, etc. Within another three to four days, most patients improve. However, 15% of infected patients will progress to a second stage of symptoms that are much more severe. This stage exhibits symptoms such as jaundice, continued vomiting, and even bleeding out of the mouth, nose, and eyes. The patientâs kidney functions deteriorate and half of these patients will even die (WHO, 2017).

Thankfully, there is a vaccine for Yellow Fever. The vaccine requires ten days to become affective and it will last the entire life span of the patient. The only issue is getting the vaccine to the affected areas and raising awareness of the disease and the vaccine to the population in that area (WHO - French Guiana).

A 2017 report in the Weekly Epidemiological Record, says that in 2016, the world saw six countries where there was a Yellow Fever outbreak. The three African countries where the outbreak occurred are Angola, Uganda, and the Democratic Republic of the Congo. Africa had 130 confirmed deaths from Yellow Fever as a result of that outbreak. The death rate was 13.4% of the confirmed cases; this is about double the expected death rate (Yellow Fever in Africa and the Americas, 2016). This high death rate might be attributed to the poor sanitation and lack of access to medical treatment in those areas. According to the World Health Organization, the only way to treat Yellow Fever is with hydration, antibiotics, and supportive care for respiratory failure (WHO, 2017). These treatments are likely less common in East-Central African countries.

The other three countries listed in the 2017 report were in South America. These countries are Brazil, Columbia, and Peru. There were less cases of Yellow Fever in these countries when compared with Africa, but the death rate was a shocking 28.2% (Yellow Fever in Africa and the Americas, 2016)! The same reasons for the high death rate likely apply to these countries as well (poor sanitation and lack of access to medical treatment).

Yellow Fever is a preventable disease that has a simple method of exposure. Most of its victims do not die, and it is currently limited to countries where the mosquito population is less controlled and there is limited access to medical treatment. The World Health Organizations advice is to limit travel to countries where a Yellow Fever outbreak has occurred, but if a person does travel there, they should receive the vaccine ten days prior to their travel. Additionally, the World Health Organization stresses limiting exposure to mosquitos. The World Health Organization proposes that the citizens in these areas should be educated on the disease and its vaccine (WHO - French Guiana). By following these instructions, Yellow Fever should likely be contained to a few countries throughout the world, and possibly even eradicated one day.

References:

Yellow Fever in Africa and the Americas, 2016. Weekly Epidemiological Record, 32, 442-452. Retrieved fromhttp://web.b.ebscohost.com.proxy195.nclive.org/ehost/pdfviewer/pdfviewer?vid=2&sid=1b24418c-8c06-466d-8578-4bd75e665959%40sessionmgr104

World Health Organization (August 30, 2017). Yellow Fever âFrance-French Guiana. Retrieved from http://www.who.int/csr/don/30-august-2017-yellow-fever-french-guiana/en/

World Health Organization. Yellow Fever. Retrieved from http://www.who.int/csr/disease/yellowfev/en/

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QUESTION 1 1. The relative importance or burden of a disease within a population will depend on a number of factors including : A. Disease frequency B. Disease severity C. Disease consequences D. All of the above

QUESTION 2 1 . With the epidemiologic transition, there is a reduction in malnutrition and _____ . A. Communicable diseases B. Injuries C. Non-communicable chronic diseases D. Mental health disorders

QUESTION 3 1. A major challenge to developing a burden of disease profile in low and middle-income countries relates to A. Unwillingness to share complete information B. Conflicting disease definitions C. Challenges obtaining information related to cause of death D. All of the above

QUESTION 4 1. The demographic transition describes which of the following changes to society A. Changes in birth and death rates that reflect a modern society B. Declines in mortality followed by a reduction in fertility C. A change in the age structure of the population D. All of the above

QUESTION 5 1. Measures of health status that combine mortality and morbidity data A. Facilitate comparisons both within and across populations B. Help estimate the quantitative health benefits from interventions C. Serve as tools to assist with resource allocation D. All of the above

QUESTION 6 1. The disability-adjusted life year is defined as A. A health gap population summary measure that combines time lost due to disability with that lost due to death B. A measure to compare the gap between the current situation to that of an ideal situation C. A measure that combines the amount of healthy life lost due to morbidity with that lost due to injury. D. Answers B and C

QUESTION 7 1. True or false? A key limitation to mortality-based indicators is that they fail to account for the morbidity caused by disease. True False

QUESTION 8 1. The most widely used composite measure of population health is the DALY, and this epidemiological measure is the sum of morbidity and ________data. A. Years of life lost (YLL) B. Morbidity C. Infant mortality rates (IMR) D. none of the above

QUESTION 9 1. What would be the best source of information on adult and infant mortality (in high income countries)? A. Disease registers B. Vital statistics C. Special survey study D. Hospital clinic statistics

QUESTION 10 1. Which term is best used to describe the proportion of people in a population who have a defined disease at a specific point of time? A. DALY B. Incidence C. Mortality rate D. Prevalence

QUESTION 11 1. Which term is best used to describe new cases of disease occurring in a population? A. DALY B. Incidence C. Mortality rate D. Prevalence

QUESTION 12 1. Which term is used to describe the absence or presence of illness or disease? A. Demography B. Morbidity C. Mortality D. Vitality

QUESTION 13 1. Mortality (death indicators) include: A. Mortality rate B. Infant mortality rate C. Neonatal morality rate D. All of the above

QUESTION 14 1. True or false? The value of life is often implicit in the way resource allocation decisions are made, which suggests that these decisions should be as explicit, open, and transparent as possible. True False

QUESTION 15 1. _________________is projected as the number one leading cause of disease burden in 2030. A. Ischemic heart disease B. Diabetes mellitus C. HIV/AIDS D. Unipolar depression

QUESTION 16 1. Some of the negative aspects of globalization include A. Greater insecurity of employment B. Poorer housing and sanitation due to rapid urbanization C. Greater vulnerability to environmental degradation D. All of the above

QUESTION 17 1. Current concerns about climate change focus on several developments including A. Rising global average land and sea surface temperature B. Increasing frequency of extreme weather conditions C. Both A and B D. None of the above

QUESTION 18 1. True or false? Diseases carried by mosquitoes are especially sensitive to meteorological conditions because they are vulnerable to changes in the ambient temperature. As a result of changing temperatures, infectious diseases such as malaria and dengue have decreased in incidence and geographic range. True False

QUESTION 19 1. True or false? International cooperation of infectious disease control has a long history that includes obligatory reporting of outbreaks of specific diseases. However, compliance with obligatory reporting has been poor due to economic consequences that have often accompanied notification of disease outbreaks. True False

QUESTION 20 1. True or false? Globalization is a relatively new phenomenon that began in the mid-20th century. True False

HLTC23H3 Lecture 9: Malaria and AIDS orphans in Africa LECTURE NOTES AND SUPPLEMENTARY READING NOTES

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