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VECTOR BORNE DISEASESVECTOR BORNE DISEASESIN PAKISTANIN PAKISTAN


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DISEASE VECTORS IN PAKISTANDISEASE VECTORS IN PAKISTAN

Pakistan being a sub-tropical country has a richfauna 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 for number 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 BORNEMAJOR VECTOR BORNE

DISEASESDISEASES

MALARIA Malaria is by far the major vector borne diseases in the

country.

Malaria in Pakistan is typically unstable.

Both Plasmodium falciparum and Plasmodium vivaxare

widely distributed in Pakistan.

Major transmission period is post monsoon i.e. from Julythrough November.


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Mosquito Species and MalariaMosquito Species and Malaria

Vectors in PakistanVectors in Pakistan

There are over 22 anopheline species and sub-species so far recorded from Pakistan

Anopheles culicifacies and An. Stephensiare theprimary malaria vectors

Anopheles culicifacies is 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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LESIHANIASISLESIHANIASIS 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 inMajor epidemics of leishmaniasis in

PakistanPakistan

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 PAKISTANSANDFLY FAUNA OF PAKISTAN

Sub genus

Phlebotomus

Paraphlebotomus

Larroussius

Adlerius

Euphlebotomus

Anaphlebotomus

Species

papatasi

alexandri: nuri: sergenti

kandelakii burneyi, keshishiani;major

salangensis, hindustanicus

argentipes

colabaensis

In addition 10 species of

Sergentomyia reported.

(Munir et al 1987, 1994)


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VECTORS OF LEISHM

ANIASISVECTORS OF LEISHM

ANIASIS

ZCL: P.papatasi, P. salehi

ACL: P.sergenti

VL: P. hindustanicus (AJK)

P. Keshishiani (Northern Areas)


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CCHF IN PAKISTANCCHF 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 CCHFVectors of CCHF Ticks belonging to the Genus Haemaphysalis

and Hyalomma were the dominant species

collected from domestic animals during CCHFout-breaks in Baluchistan, but virus could not be

isolated.

Further studies are required to study tick faunaand isolation of virus from the ticks to identify

vector species.


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Major Outbreaks of CCHF inMajor Outbreaks of CCHF in

Pakistan from 1976Pakistan from 1976--20002000

Rawalpindi-1976

Quetta-1978

Quetta-1987

Sibi-1994

Kohlu-1995

Kohlu-1998

Peshawar-1998

Sibi&Quetta-2000

LakkiM

arwat-2000

Peshawar-2000

Loralai&Quetta-2000

Karachi-2000

Area

0

10

20

30

40No. of Cases No. of Deaths


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DENGUE HAEMORRHAGICDENGUE HAEMORRHAGIC

FEVERFEVER 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 DENGUEVECTORS OF DENGUE No information is available on the vectors of Dengue

from Pakistan.

The species recorded from NWFP Pakistan listfollowing species of aedes mosquitoes:

Aedes albopictus,Aedes albolateralis,Aedes vittatusandAedes pseudotaeniatus.

Another survey of mosquitoes in Karachi in 1983

showed the abundance ofAedes aegypti


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SCRUB TYPHUSSCRUB TYPHUS First out-break reported in Pakistan in 1961

in 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 USEINSECTICIDES IN USEINDOOR 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 1995Temephos 500-E

Fenthion


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ITN Study in Four VillagesITN Study in Four Villages

of Sindof Sind

Odds Ratio (O.R.) - protective effect of bednet useagainst falciparum malaria

- In children below 5 yrs ____ 0.22 (0.05 - 0.9)(significance level 0.016)

- 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 level 0.003)


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Prevalence ofPrevalence ofFalciparum MalariaFalciparum Malaria inin

different age groupsdifferent age groups

in ITN Intervention and Control Groupsin ITN Intervention and Control Groups

1.6

2.3 2.1

7.1

4.4

5.6

below 5 years above 5 years TOTAL

0

2

4

6

8

%fa

lciparum

cas

es

intervention control


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RESISTANCE STATUS OFRESISTANCE STATUS OF

MALARIA VECTORS

MALARIA VECTORS

Anopheles culicifacies and Anopheles

stephensi are resistant to Organochlorines

(DDT and Dieldrin/BHC)

Anopheles stephensi resistant to

Organophosphate (Malathion)


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