Presentation Sudan 03
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VECTOR BORNE DISEASESIN PAKISTAN
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DISEASE VECTORS IN PAKISTAN Pakistan being a sub-tropical country has a rich
fauna of disease vectors including mosquitoes,sandflies, houseflies, biting midges, and other
dipterous flies. In addition there are soft ticks, hard ticks, lice, mites,
fleas, cockroaches, bed bugs which, account fornumber of vector born diseases includingarboviruses.
Research on vector borne diseases is sketchy acceptfor few. Major vector borne diseases in the countryinclude malaria, leishmaniasis.
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MAJOR VECTOR BORNE
DISEASESMALARIA Malaria is by far the major vector borne diseases in the
country.
Malaria in Pakistan is typically unstable.
Both Plasmodium falciparumand Plasmodium vivaxare
widely distributed in Pakistan.
Major transmission period is post monsoon i.e. from Julythrough November.
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API/1000 population
4.0 & above
1.6 3.9
1.0 1.5
Less than 1.0
No data available
N
S
Malaria Control Programme - 2001 Data
Malaria Annual Parasite Incidence (API)/1000 Population byDistrict
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Mosquito Species and Malaria
Vectors in Pakistan There are over 22 anopheline species and sub-
species so far recorded from Pakistan
Anopheles culicifaciesand An. Stephensiare theprimary malaria vectors
Anopheles culicifaciesis considered to be the most
important vector in the rural areas and Anophelesstephensi) in the urban areas.
Both species are endophilic and chiefly zoophilic
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LESIHANIASIS Leishmaniasis is the second major vector borne
disease
Prevalence of leishmaniasis is diffuse & wide spread
Three types of leishmaniasis are encountered
- ZCL found in the southwestern region
- ACL is seen in diffused foci in central region
- VL is endemic in the Northeastern Region
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Major epidemics of leishmaniasis inPakistan
Year City Province No. of cases
1935 Quetta Baluchistan Un-known
1971-72 Multan Punjab 2,500
1974 Army Personnel
(ZCL)
Baluchistan 892
1975 Army Personnel
(ZCL)
Baluchistan 502
1977-81 Uthal (ZCL) Baluchistan 700
2001 Kurrum Agency
(ACL)
NWFP (FATA) 1200
2001 Larkana, Dadu
(ZCL)
Sindh 11,700
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SANDFLY FAUNA OF PAKISTAN
Sub genus
Phlebotomus
Paraphlebotomus
Larroussius
Adlerius
Euphlebotomus
Anaphlebotomus
Species
papatasi
alexandri: nuri: sergenti
kandelakii burneyi, keshishiani;major
salangensis, hindustanicus
argentipes
colabaensisIn addition 10 species of
Sergentomyia reported.
(Munir et al 1987, 1994)
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VECTORS OF LEISHMANIASIS
ZCL: P.papatasi, P. salehi
ACL: P.sergenti
VL: P. hindustanicus (AJK)
P. Keshishiani (Northern Areas)
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CCHF IN PAKISTAN
CCHF is and endemic tick-borne viral
disease.
Geographical distribution includes the cold,
arid regions of Pakistan.
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Vectors of CCHF
Ticks belonging to the Genus Haemaphysalisand Hyalomma were the dominant speciescollected from domestic animals during CCHFout-breaks in Baluchistan, but virus could not beisolated.
Further studies are required to study tick faunaand isolation of virus from the ticks to identifyvector species.
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Major Outbreaks of CCHF inPakistan from 1976-2000
Rawa
lpin
di-1976
Quetta
-1978
Quetta
-1987
Sibi
-1994
Kohl
u-1995
Kohl
u-1998
Pesh
awar
-1998
Sibi
&Que
tta-2
000
Lakk
iMar
wat-2
000
Pesh
awar
-2000
Loralai
&Que
tta-2
000
Kara
chi-2
000
Area
0
10
20
30
40 No. of Cases No. of Deaths
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DENGUE HAEMORRHAGIC
FEVER DHF first reported in Pakistan in 1994 from
Karachi
Thousands of adults were affected.
In 1995 another 1800 cases of PUO reported
from, Hub district, Lesbella, Baluchistan, 40
Kilometres from Karachi Dengue type-II Confirmed on serology
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VECTORS OF DENGUE
No information is available on the vectors of Denguefrom Pakistan.
The species recorded from NWFP Pakistan listfollowing species of aedes mosquitoes:
Aedes albopictus, Aedes albolateralis, Aedes vittatusand Aedes pseudotaeniatus.
Another survey of mosquitoes in Karachi in 1983
showed the abundance ofAedes aegypti
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SCRUB TYPHUS
First out-break reported in Pakistan in 1961in Sialkot and then in 1967 from Kaghan
Valley, Gilgit, Multan and Lahore.
The vector species reported was Trombicula
delinese.
No recent studies.
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INSECTICIDES IN USE
INDOOR RESIDUAL SPRAYING
Organochlorines
DDT: 1963-79 BHC: 1972-1983
Organophosphate
Malathion: 1984-97
Pyrethroids
Deltamethrin: 1998 till date
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Larvicides
Following larvicides belonging to
Organophosphates are in use since 1995
Temephos 500-E
Fenthion
ITN S d i F Vill
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ITN Study in Four Villagesof Sind
Odds Ratio (O.R.) - protective effect of bednet useagainst falciparum malaria
- In children below 5 yrs ____ 0.22 (0.05 - 0.9)(significance level0.016)
- In patients above 5 yrs ____ 0.46 (0.2 - 1.07)
(significance level
0.072) -- not significant
- In all age groups _________ 0.36 (0.17 - 0.73)
(significance level0.003)
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RESISTANCE STATUS OFMALARIA VECTORS
Anopheles culicifacies andAnopheles
stephensi are resistant to Organochlorines
(DDT and Dieldrin/BHC)
Anopheles stephensi resistant to
Organophosphate (Malathion)
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THANK YOU