Cholera, tuberculosis, AIDS and malaria

One problem with cholera is that it is so easily spread, due to its water borne nature and the fact that it can survive anywhere there are humans and a water system, such as a sewerage works. This means that in developing countries, particularly those with large cities whose populations have grown considerably in recent times, but as yet do not have proper sewerage treatment or a clean water system, perfect conditions for the cholera causing bacterium vibrio cholerae exist, thus allowing it to spread rapidly amongst the population.

The aforementioned problem is only exacerbated further in countries that are racked with debts and cannot afford the funding for schemes to create proper sewerage systems, or water treatment facilities, or even cholera eradication programs as the drugs and upkeep are expensive. Also people in countries such as China, and other poorer countries such as Chile, irrigate crops with raw human sewerage; this spreads the disease very far a field, and is difficult to control due to the distribution network of the farm produce.

Many people who travel to cholera endemic countries do not take the required precautions, such as washing hands thoroughly and using selected water sources and eating only well cooked food, along with not taking the prescribed vaccinations for cholera, thus they may catch it and upon returning to their area, spread it amongst the community. All the aforementioned causes prevent the transmission cycle being broken, and thus prevent any attempt at eradication from being successful. Also as cholera is such an indiscriminant disease it is difficult for epidemiologists to target or study a particular ‘target audience’, as well as a successful vaccine being difficult to manufacture as vibrio cholerae hides in the stomach, thus protein vaccinations cannot get to it without being destroyed in the stomach.

Malaria: Malaria, like cholera is also very easily spread, due to it also being indescriminant in infecting people as the female anopheles mosquito, plasmodium falciparum’s vector, does not target a specific group or type of person. Therefore anywhere the anopheles mosquito lives malaria will probably be endemic; making it very difficult to avoid, and easy to spread. Also the larvae that carry the protozoa live and grow in any body of stagnant water, such as a pond or large puddle; this makes control of the anopheles mosquito very difficult also, thus making malarial control even more difficult and complicated.

Though there exist drugs to treat the disease through killing the protozoa, many strands of plasmodium have mutated to become resistant to the prophylactic drugs such as quinine and chloroquine, thus making effective vaccinations even more difficult and expensive to find or synthesise. The anopheles mosquito also developed resistance to chemicals used to kill it such as DDT, making the disease’s spread even more difficult to control.

Doctors often misdiagnose malaria as flu if they have not had much experience with it before, due to the similarities of the symptoms, this leads to larger numbers of untreated cases that can result in loss of life. Also people going to malarial countries may get infected due to not taking the drugs, or not completing the course, and thus may succumb to the consequences. Though the WHO organised a scheme to eradicate malaria from the world it proved to be very expensive to run, and was also very unpopular as DDT was poisonous and often destroyed systems of biological control resulting in many villagers losing their homes to caterpillars that would have been killed parasitic wasps, that were killed by dieldrin in this example, this caused villagers to hunt down spray teams and kill them, decreasing the scheme’s effectiveness and preventing malarial control.

Also in many African countries where malaria is endemic the fragile political makeup made effective control programs difficult to run. AIDS: This is such a socially damaging as the HIV virus can remain dormant for a long period of time, during which time the infected person may have sex a number of times or share hypodermic needles with people, spreading the virus to even more people, who in turn spread it to more people etc. even before the initial infected person develops full blown AIDS.

Due to increased sexual promiscuity, both hetero and homosexual, the HIV virus is spreading even more rapidly. AIDS is now widespread in Africa, to some extent it is due to bigamous and polygamous ideals, along with the influence of superstitions that having sex with a non-AIDS infected virgin will cure those infected. However, AIDS is having an adverse affect on the economic development of countries in the region as it affects sexually active people I their 20s and 30s who are also potentially the most economically productive and the purchase of expensive treatment drugs drains government funding.

Lack of funds leads to a higher risk of other diseases prevailing and opportunistic infections killing AIDS sufferers; poor sanitation and housing due to a lack of funds aids the spread of tuberculosis and cholera, as well as other diseases. Preventative measures are often abandoned by governments due to potential unpopularity of the program, such as the contact tracing program; many governments feel this is encroaching upon people’s civil liberties and rights.

Also the fact that no cure exists at the moment means that control of the spread, or at least successful treatment its almost impossible to attain. Tuberculosis: This is a highly contagious disease as it is spread in micro-droplets from the body that are inhaled by others into the respiratory tract, thus it is easily spread. Also in countries where poor housing and sanitation exist, cramped conditions increase the spread of the disease, also as TB is an opportunistic disease, these countries are often endemic in AIDS, and thus TB can spread more easily and can kill more effectively.

Though TB was thought to be eradicated it has undergone resurgence and is now posing a much greater threat, as due to mutations and people not completing antibiotic courses the bacterium that causes the disease has mutated to MDR-TB, multi-drug resistant tuberculosis. A large proportion of the population is thought to have TB, around 30%, but not have symptoms, yet still be passing on the disease that may become active later on in life and cause illness to a large number of people, rather than just a few.

Also people refuse to take the course of medication once they are infected as it can last up to nine months and can mean confinement, preventing people from working. So many refuse and pass on the disease while they should be treating it and be in isolation. The Role of Drugs Cholera; drugs used and information: Vaccine injected to try and destroy vibrio cholerae, yet they are not very effective as bacteria remain in alimentary canal, preventing blood borne drugs from reaching them.

Oral vaccines are being worked upon, yet they are difficult to make as they have to pass through the stomach without being destroyed to get to the small intestine, cholera’s site of action. At the moment medical rehydration using, salt/glucose/water solutions are used. Malaria; drugs used and information: Quinine and chloroquine, also used as prophylactic drugs, to prevent infection occurring. Both inhibit protein synthesis and prevent parasite spreading within body. Though not always effective as resistant strands of plasmodium have evolved, nullifying vaccine.

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