جمهورية مصر العربيةوزارة الصحة والسكان
Egypt MINISTRY OF HEALTH & POPULATION . GENERAL DEPARTMENT OF MALARIA FILARIA & LEISHMANIASIS.
MALARIA SITUATION IN EGYPT BY Dr. Ibrahim Abd Elwahab Elaish Dawoud Director of Malaria control department
Situation Analysis Egypt is one of African countries , it occpies the east northen corner of the Africancontent with an extension across the Gulf of Sues into Senai region with political frontiers on the east with Palastine and Israel , its boundaries are Mediterranean basin in the north , Res Sea in the east , Lybian from the west and Sudan in the south .
Demography - The total population reach about 70 millions according to the latest census .- The area of Egypt exceed one million square km. ( about 1,002,000 ) - About 57.6 % of population lives in rural area and 42.4 % in urban area .- Femal / male raio is about 48.8 – 51.2 % .- population growth rate is incrasing by 20.7/1000 .
Geography - The plan area is formed the largest percentage of area in Egypt , the delta region found around the banks of the longest River Nile which extend through many African countries until reach Oghanda .- The Nile valley formed 6 % of the area , it extend from 2-15 km. Around the Nile banks where it formed the main resident and cultivated area in Egypt .
Climate and agriculture - Egypt have a moderate climate all over the year the temperature varies from 30 + 15 , the humidity range about 60 + 10 and it increase in costal areas .- The rainfall during months of December , January , February and increase in costal areas - Egypt has a great agricultural project , all types of crops are present all over the year by using recent technological methods.
EgyytMOH &P 1st US for 1ry health &preventive sectorUS of Endemic disease G.D.Mal.,Fil., & Leish.,control depatment.US &GD of health directorates ( at Gov.level)Director of Endemic diseasesDirector of health district.Mal.&Fil. Control units (205) & PHCu(4000)
Health care systemThere are about 250 general and central hospitals for health services and refer cases from from rural hospitals supplied with all measures , equipment with an efficient medical staff and 4000 PHCu scattered all over the country for early diagnosis of disease and family planning and maternal health care.
Malaria Control Programme.It apply through 102 units & 205 sub- units distributed all over the country and four training centers supplied with all facilities recommended for continue preparation of new Malaria staff . The Malaria units supplied with all measures for early diagnosis ( ACD&PCD)with proper treatment and facilities for vector control measures .
MALARIA IN EGYPTMalaria is present in Egypt since dawn of history , as evidenced by the document hieroglyphics on wall of temples .- The anti Malaria work in Egypt started by Ross 1903 in Canal zone . He reported that Malaria cases were corresponding to about 1/3 of the population of that locality at that time . The first step towards Malaria contol in Egypt was taken in 1914 , were Malaria control was assigned to the control and prevention of infectious disease section of the department of public health .
- High Malaria committee was formed of represetatives of different Government department with the objective of organizing a Malaria control program focused its interest on the Canal zone , the main activities filling in , drainage or clearance of vegitation of stagnant water sites and ponds, borrow, pits or swamps , the use of larvicides as paris green and oil , in addition the prohibition of rice cultivation within a radius of 2 km. From town .
-The mosquitoes were surveyed by Kirk Patric , 1925 and his valuable monogragh still remains an important reference . In 1927 , the 1st Malaria station began to operate in Edkou Behera Governorate under the supervision of the control and prevention of infectious disease section . In 1930 , the 1st Malaria control and research station was established in Khanka . Shousha 1948 recorded that Malaria cases were estimated as 150,000 cases with 12,000 deaths . Farid 1980 reported that 180,000 deaths were recorded in fulminating Malaria epidemic 1946 .
Malaria Epidemic On 1942 – 1946 a sever epidemic wave of Malaria had been started in upper Governorate extend from south of Asswan to south of Assiout (500 km.)duo to invasion of Anopheles Gambia mosquitoes coming from Sudan leading to fetalities of thousands of the residents. An strong eradication campaign was done against parasite and vector to cut man vector contact with participating of WHO untile complete eradication of Anopheles Gambia from upper Egypt and had been declared on January 1946 .
Present Malaria Situation 1. Malaria parasite - All Egyptian Governorates are free from Malaria parasite except some imported cases from other endemic countries . - The tables(1&2) shows the Malaria cases since 1960, the numbers of plasmodium vivax, plasmodium falciparum were present and the imported Malaria cases 2001-2002. - These imported cases must be put under control program to exclude of 2ry Mal. cases.
Recorded Imported Malaria cases 2001-2002(No. of slides Taking from ship passengers travelling between Asswan- wady Halfa with no. of positive cases.. 2001 –2002 respectively No of examined positive PF. PV. 2237 9 9 - 2398 10 8 2
The annual imported Malaria cases return to increase movement of the resident to other countries with Malaria trannsmission activity also increase migration to and from endemic areas either to work or learn in AL Azhar university.- There is no resistance of plasmodium falciparum strain to anti Malarial drugs . -The surveillance system for Malaria aim to protect Egypt from any unexpected Malaria foci by collection of all relevant information and any change in localities from monthly existing reports.
2. Anopheline species in Egypt Kenawy 1990 mentioned that 11 indigenous Anopheline mosquitoes in Egypt of which two are still questionable , A . (Cellia ) hispaniola,Theobald in Sini needs further confirmation whether it is the Meditterranean hispaniola or A.(Cellia ) turhudi , and A.(Cellia stephensi , which has been recorded for the first time in one area only ( Shokeir ) on Gulf of Sues . The other nine species can be generaly classified according to their role in Malaria transmission in Egypt as follows:.
1.Proven vectors : A.(Cellia) pharoensis Theobald and A.(Cellia) sergenti,Theobald.2. Suspected vectors:A.(Cellia) multicolor, Cambouliu , A.(Cellia) superpictus, and A(Cellia) d,thali,3. Non vector playing no role in Malaria transmission : A.(Anopheles) algeriensis, Theobald , A.(Cellia) turkhudi , A.(Anopheles ) tenebrosus.and A.(Cellia) rupicolous .
- Senai is the richest area in the number of species present .- Three species which are , A.pharoensis , A. Sergenti and A.multicolor are generally the common anophelines in Egypt .- Fayoum is secod in importance having 4 species , A.pharoensis ,A.segenti , A.multicolor and A.tenebrosus . The occurrence of the first two vectors together is responsible for Malaria transmission in Fayoum.
Roll Back Malaria in Egypt Introduction :We are aware of the value of RBM to initiate political , social and technical movement to support and strengthening the information and surveillance system aim to prevent introduction of Malaria parasites through gametocyte carriers coming from endemic countries to maintain freeness of the country from indigenous cases , this will be achieved through intersectorial and interministrial co-operation .
National goal : Maintain Egypt free from Malaria and prevent of reintroduction of gamitocyte cariers. Strata :1. Large artificial Naser lake in the southern part of Egypt 500 km. Between Egypt and Sudan wh
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