Myanmar

Identify selected topic and provide brief background to  the topic

Provide a critical reflection of the selected topic under the set objectives in relation to  your perspective on the

1:  Epidemiology

2. Social determinates

3. Burden of disease  

Introduction

Myanmar is a country situated in South East Asia and in the recent years the country has experienced an insurgence in the number of reported malaria cases with an estimated of thirty thousand reported cases annually.  This has being mainly attributed to the rise of resistance to both chloroquine and artemisinin. This resistance is mainly because in the South Eastern Asian region there is a lower level of natural immunity unlike other parts of the world. (World Health Organization, 2010, pg 7)

Epidemiology

It has been shown that unlike the other malaria a prone region where plasmodium falciparum is more prevalent, in Myanmar plasmodium vivax malaria is more prevalent. I think this means that it easy to reduce the number of malaria cases and this is because vivax malaria is known not to be as fatal (and it exhibits frequent lapses) as plasmodium malaria and it also has a short incubation period. Although the malaria vivax is not as fatal I think this can easily lead us to conclude that an enormous economic loss will be encountered. (Rollinson, Hay, Price & Baird, 2013, pg 16)

 It has been showed that the malaria containing parasites have shown degrees of resistance in Myanmar that is Mefloquine resistant falciparum and chloroquine resistant vivax. I think the best way to deal with such an issue is by conducting more researches so as to find more efficient drugs which the parasites will not be able to resist against. (Blas & Sivasankara, 2010, pg 60)

In Myanmar, just like in other Asian countries, malaria is common among the hard to reach population which mainly consists of the migrant population and the urban poor. In some areas though, the risk of contracting this disease depends on human behaviors. Since the risk of contracting malaria is not equal even in people in the same geographic region, I think there is the need to identify such populations and clearly understand the epidemiology of malaria among them so that the better interventions are sought.  I think their behavioral risk factors also need to be identified.  I also think it is important for these groups to access health care and this can be achieved through initiating control programmes. Although the prevalence of malaria in pregnancy is not common, I still think there is need to pay attention since prevention is better than cure.  

Following the frequent malaria outbreaks that have been reported over the past decade I think continuous eradication projects should be carried out so as to avoid resurgence of malaria after the eradication project in Sri Lanka in 1967-1967

Social determinates

It has been shown that in Myanmar malaria is most at times transmitted during migration times as people migrate from one place to the other for example during the times of epidemics such as earthquakes and migrants moving into the country, people massively migrate from one place to the other. Those travelling from malaria prone areas have usually being found to be the main people transmitting this disease. I think the best way to curb this is by the government restricting movements from the malaria prone areas and if the movement is necessary and unavoidable then these people should be secluded to particular areas until all the necessary tests have been done on them and it has being proved that they do not suffer from malaria. (Blas & Sivasankara, 2010, pg 39)

Illiteracy has also contributed to the spread of this disease and this is so because, with a low level of illiteracy, the level of awareness concerning the disease is then definitely low. The best way to curb this I think is by initiating programmes that will ensure people are educated on malaria focusing on issues such as its spread, measures to curb its spread, the signs and symptoms and the treatment. I also think this issue can be addressed through introducing malaria related topics in school so as to increase the awareness level among the locals. (Blas & Sivasankara, 2010, pg 36)

Poverty has also been shown to be a major malaria social determinant. Most of the poor families in Myanmar cannot sustain the preventative measure such as use of mosquito nets and repellants hence making the disease more prevalent among the poor population. Malaria treatment also requires money and this has been difficult to seek among the poor families hence retaining a high mortality rate among the poor due to malaria. If it was up to me, I think this can be addressed through the government of Myanmar in association with other organizations such as the World Health Organization carrying out programmes that will ensure that all the poor families get all materials they require to prevent malaria such as nets for free. The same should also be done when it comes to treatment. (Blas & Sivasankara, 2010, pg 45)

Poor health services in Myanmar which is indicated by the presence of very few hospitals and health practitioners in general is another great and grave issue which has significantly contributed to the spread of malaria in the region. I think this can be addressed by the government through the ministry of health by allocating more funds which will aid building new health facilities, refurbishing the ones present, employing more practitioners and initiating campaigns aimed at fighting malaria. (Jameson, 2013, pg 101)

The burden of the disease

The disease has had a major impact on the people of Myanmar. Malaria, HIV and TB ranked the 5th place in country’s burden of disease. The total years of life lost due to premature mortality by malaria were 2000. The financial cost used in fighting malaria enormous for example in 2013 US$ 22.5 million was used. Usually, when the bread winners of a family are affected by the disease for example when the bread winner succumbs to the death, the family social and economic status suffers. (Martini & Chesworth, 2010, pg 360)

In my opinion I think the government should set aside funds that will cater for the families who have lost their bread winners. I think the government should also source for more funds that will enable them fight malaria from organizations such as the World Health Organization

Conclusion

My contribution in the group presentation was on the epidemiology of malaria in Myanmar. I focused on several issues as follows

Firstly, was the population of people in Myanmar affected by malaria and I was able to find out that there is a high number of reported cases for example in 2013 there were 198 million reported cases of malaria with an estimated 584,000 deaths reported with about 78% of these death cases being of children under the age five years old. (World Health Organization, 2014, pg 56)

Secondly, was the morbidity and mortality cases of malaria where I was able to conclude that over the past years there has been a decrease both the morbidity and mortality rates. For example in 1988 the morbidity rate was at 25 people per a thousand while the mortality was at about 10 per a thousand people. In 2010 the morbidity rate had fallen to about 7 people per a thousand people whilst the mortality was now at about 2 people per a thousand people. (World Health Organization, 2014, pg 63)

Thirdly, was the distribution pattern of malaria cases in the country and was I was able to discover that the North Western region of Myanmar was the most affected with over 75 reported cases per a thousand people. This was followed by the Central and Eastern regions where reported cases per a thousand people ranged from 1 to 10 people. I then found out that over the years the male population was more affected by the disease compared to the female population. (World Health Organization, 2014, pg 67)

Lastly, was and the epidemiologic triangle of malaria in the country where I was able to generalize that the environment played a major role in the spread of the disease for example bush land, lakes and ponds and that the most vulnerable population was comprised of; Children under five, pregnant women, people living in swamps and coastal areas, the poor, people living in remote areas, illiterate citizens and the IDPs. I also found out that the best way to reduce the vulnerability of these people was through conducting educations on malaria related issues, eliminating potential sources for mosquitos’ life cycles, using of protective clothes, insecticides and mosquito nets and anti-malaria drugs. (World Health Organization, 2014, pg 70)

Epidemiology plays a major role in the global health education. I say this because epidemiology provides critical information such as the pattern of the disease and its prevalence among the population. With such information we are able to determine the major determinates of the disease and the vulnerable population. This provides a background that will enable us know how to eradicate the disease and carry out the necessary preventative measures. (Rollinson et al…, 2013, pg 87)

Epidemiology also helps us reduce the impact of a disease, for example it is through this study that it can be determined that the disease has greatly affected the education system in the country hence calling for the necessary actions such as initiating programmers that will ensure that all the children who have been orphaned by this disease get the necessary required education.

It is thus important for the society to help in the fighting of malaria in conjunction with other organizations such as the World Health Organization.

                                                                   References

Blas, E., & Sivasankara, K. A. (2010). Equity, social determinants and public health programmes. Geneva: World Health Organization.

World Health Organization. (2010). Guidelines for the treatment of malaria.

Geneva: World Health Organization.

Rollinson, D., Hay, S. I., Price, R., & Baird, J. K. (2013). The Epidemiology of Plasmodium vivax. Burlington: Elsevier Science.

Manguin, S. (2010). Biodiversity of malaria in the world. Chestghum: Health Sciences.

Martini, I. P.,Chesworth, W. (2010). Landscapes and societies: Selected cases. Dordrecht: Springer. World Health Organization, (2014). World Malaria Report.

Jameson, M. (2013). The impact of malaria in South East Asia and the tropical regions. Burlington: Elsevier Science.

Elizabeth, A., Casman, H.,& Dowlatabadi. (2010) The contextual determinants of Malaria. Springer Australia.

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