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Control and Prevention of

Control and Prevention of. Dengue fever Malaria and Leishmania. Objectives: You students will be capable to. identify the epidemiology of above arthropods transmissible infectious diseases

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Control and Prevention of

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  1. Control and Prevention of • Dengue fever • Malaria and • Leishmania

  2. Objectives: You students will be capable to • identify the epidemiology of above arthropods transmissible infectious diseases • assist the community in the prevention and control programs of the above mentioned infectious diseases.

  3. Leishmania is a parasitic disease spread by the bite of infected a. aedes aegypti b. culex c. anopheles d. sand flies e. aedes albopictus

  4. Dengue: The vectors Aedes aegypti and A. albopictus

  5. Aedes Dengue fever in Saudi Arabia

  6. The world distribution ofAedes aegypti

  7. Dengue (1999): WW Areas infested with Aedes aegypti Areas with Aedes aegypti and recent epidemic dengue

  8. Dengue WW, 2008 • Dengue

  9. Aedes Aegypti: most common breeding places

  10. Aedes aegypti adult male

  11. Aedes albopictus adult male

  12. Life cycle of Aedes Aegypti

  13. Feeding. Females feed on any vertebrate host, but prefer humans. They fly upwind following odors. The first step can be to enter a house. Blood feeding and oviposition occur mostly in the morning and in the late afternoon.

  14. Dengue fever • Clinical Picture, diagnosis, treatment • Dengue virus infection • Dengue fever • Dengue hemorrhagic fever • Dengue shock syndrome (Read the attached file)

  15. Malaria • World Malaria Day: April 25th , 2009. • Malaria: plasmodium falciparum, vivax, malariae and ovale. (Read the attached file)

  16. Map

  17. Malaria patient

  18. Malaria • In 104 countries • 300-500 million cases/year • World 1.1 to 2.7 million deaths/year • Africa deaths 961000 • SEAR countries 53000 • India 20000 • KSA???

  19. Anopheles mosquito

  20. Group 1: 10 countries interrupted transmission: Bah, Cyp, Jor, Kuw, Leb, Lib, Pal, Tun, UAE Group 2: 4 countries targeting elimination: Egy, Mor, Oma, SyrGroup 3: 4 countries low- moderate endemicity: Ira, Iraq, Pak, KSAGroup 4: 5 countries high burden: Afghanistan, Dji, Som, Sud, Yem

  21. Leishmaniasis • What is Leishmaniasis? • Life cycle. • Mode of infection. • Control and Prevention. • Read also the attached file.

  22. Leishmaniasis is a protozoal disease caused by Leishmania parasite, which is transmitted by the sand fly . • Leishmaniasis is of three types ; cutaneous leishmaniasis, muco-cutaneous and the visceral (Kala-azar )

  23. 2 1 8 3 7 4 6 i 5 i d d Leishmaniasis Life Cycle Sand fly Stages Human Stages Sand fly takes a blood meal Promastigotes are Phagocytized by macrophages Divide in midgut and migrate to proboscis (Injects promastigote stage into the tissue) Promastigotes transfer into amastigotes inside macrophages Amastigotes transform Into promastigote stage in midgut Ingestion of Parasitized cell Amastigotes multiply in cells (Including macrophages) of Various tissues Sand fly takes a blood meal Infective stage (ingest macrophages Infected with amastigotes ) Diagnostic stage

  24. Leishmaniasis: Mode of infection • Sand fly bite • Others (infected blood transfusion and Pregnancy in (VL), physical contact in CL)

  25. Sand fly

  26. Leishmaniasis • Sand Flies are vector of the disease. More than 500 species and subspecies in the world. of which, only 35 types are known to transmit the disease, Phlebotomus in OCL, and Lutzomia in NCL. • There are more than 21 Leishmanial species .

  27. Clinical features. Smear from the base of the ulcer stained with Wright‘s stain detects round or ovoid parasite in the cytoplasm of macrophages. Leishman test: Intradermal injection of leishmanial antigen causes a delayed tuberculin type of reaction. Leishmaniasis Diagnosis:

  28. The dogs in the Mediterranean countries The man in the Middle East The wild rodents in Asia and Africa Leishmaniasis Reservoirs Reservoirs

  29. Leishmaniasis WW W • Leishmaniasis O R L > 12 Million people infected in 88 countries > 350 Million people are risk D Annually,0.5M (VL)80,000 Deaths,1.5M(CL) Visceral Leishmaniasis Cutaneous Leishmaniasis Mucocutaneous Leishmaniasis

  30. Leishmaniasis • Types Visceral * Fever * Hepatosplenomegaly * Weight loss • Death, 90% in • Bangladesh, Brazil, India, Nepal,and in Sudan Cutaneous • Skin ulceration, • 90%Afghanistan • ,Syria,Iran,Iraq,Brazil,Peru, • and Saudi Arabia Mucocutaneous * Skin and mucus membranes affection • Might be fatal. 90% • in Bolivia, • Brazil and Peru

  31. Leishmaniasis in KSA • Leishmaniasis: It is known in the Kingdom back to 1950. Ministry of Health has established the leishmaniasis unit in the 1980 Under The precautionary medicine to follow-up the diseasein the Saudi cities

  32. Leishmaniasis in KSA • Types There are VL and CL. VL caused by L.Donovani LON 42, and the Rattus rattus is the reservoir. 2 types of CL(ZCL and ACL) In the Riyadh and Eastern province, ZCL transmitted by P.Papatasi and caused by L.Major LON4

  33. Leishmaniasis in KSA • Cont. CL in Southern region is ACL transmitted by P.Sergenti and caused by L.Tropica LON 72

  34. Leishmaniasis in KSA • Sand flies: There are 20 types of Sand Flies in the KSA. 7 are Phlebotomous and 13 are of Sergentomyia type.

  35. Visceral Leishmaniasis N Northern Al-jouf Tabouk • A area Medina Riyadh Makkah Eastern Baha Najran Aseer Jazan Affected area

  36. Reported Cases of VL 1984-2004 • RCVL

  37. Cutaneous Leishmaniasis Cutaneous leishmaniasis has many local names

  38. CL: Seasonal Variations • CL: The peak of cutaneous leishmaniasis is in August, October, December, Januaryand February. The least number of cases are reported in May and June.

  39. CL: Geographical Dist. Northern 8.4 % Al-jouf 2001 Tabouk 18.2 % • CLGD 7.6 % Hail Qaseem Alhsa only 41.2 % Medina Riyadh 9.6 % Makkah Eastern Baha Najran Aseer N Jazan

  40. CL: cont. Northern 9.1 % Al-jouf 2004 Tabouk 26.6% • GD 18.5 % Hail 4.1 % Qaseem Alhsa 20.9% Medina Riyadh 4.1 % Makkah Eastern Baha Najran Aseer N Jazan

  41. Reported Cases of Cutaneous L. 1983-2004 • CL

  42. Reported Cases of CL 1983-2004 • CL

  43. Cutaneous Leishmaniasis in Infants 1403-1424 H (Infants) Leishmaniasis usually affects children more than other age groups .

  44. Hyperkeratotic Mucosal Lymphangitis after Pentostam treatment Nodules Clinical Types of CL • CL

  45. Recidivans Plaque Erysipeloid Lupoid/Disseminated Clinical Types of CL. • Types

  46. VBD Prevention Programs • Efforts should focus on sustainable environmental control rather than eradication • Control programs should be community-based and -integrated. They cannot rely solely on insecticides nor require large budgets • Need to promote VBD as a priority among health officials and the general public

  47. Community Approaches • Define communities geographically • More likely to be sustainable • Advantages: built-in manpower, help develop resources and empower community organizations • Disadvantages: more difficult to organize, take longer to get off the ground

  48. Community Participation • First must educate the public in the basics of VBD, such as: • Where the mosquito lays her eggs • The link between larvae and adult mosquitoes • General information about VBD transmission, symptoms and TTT.

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