VECTOR BORNE DISEASES

IN PAKISTAN
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 for
number of vector born diseases including
arboviruses.
 Research on vector borne diseases is sketchy accept
for few. Major vector borne diseases in the country
include malaria, leishmaniasis.
 MAJOR VECTOR BORNE
DISEASES
MALARIA
 Malaria is by far the major vector borne diseases in the
country.

 Malaria in Pakistan is typically unstable.

 Both Plasmodium falciparum and Plasmodium vivax are

widely distributed in Pakistan.

 Major transmission period is post monsoon i.e. from July

through November.
 Malaria Control Programme - 2001 Data

Malaria Annual Parasite Incidence (API)/1000 Population by

District

API/1000 population

4.0 & above

1.6 – 3.9

1.0 – 1.5

Less than 1.0

No data available
 Mosquito Species and Malaria
Vectors in Pakistan
 There are over 22 anopheline species and sub-
species so far recorded from Pakistan

 Anopheles culicifacies and An. Stephensi are the
primary malaria vectors

 Anopheles culicifacies is considered to be the most

important vector in the rural areas and Anopheles
stephensi) in the urban areas.

 Both species are endophilic and chiefly zoophilic

 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

 Major epidemics of leishmaniasis in
Pakistan
Year City Province No. of cases
1935 Quetta Baluchistan Un-known
1971-72 Multan Punjab 2,500
1974 Army Personnel Baluchistan 892
(ZCL)
1975 Army Personnel Baluchistan 502
(ZCL)
1977-81 Uthal (ZCL) Baluchistan 700
2001 Kurrum Agency NWFP 1200
(ACL) (FATA)
2001 Larkana, Dadu Sindh 11,700
(ZCL)
 SANDFLY FAUNA OF PAKISTAN
Sub genus Species
 Phlebotomus papatasi
 Paraphlebotomus alexandri: nuri: sergenti
 Larroussius kandelakii burneyi, keshishiani;
major
 Adlerius salangensis, hindustanicus
 Euphlebotomus argentipes
 Anaphlebotomus colabaensis
In addition 10 species of
Sergentomyia reported.
(Munir et al 1987, 1994)
VECTORS OF LEISHMANIASIS
 ZCL: P.papatasi, P. salehi

 ACL: P.sergenti

 VL: P. hindustanicus (AJK)

P. Keshishiani (Northern Areas)
 CCHF IN PAKISTAN
 CCHF is and endemic tick-borne viral
disease.

 Geographical distribution includes the cold,

arid regions of Pakistan.
 Vectors of CCHF
 Ticks belonging to the Genus Haemaphysalis
and Hyalomma were the dominant species
collected from domestic animals during CCHF
out-breaks in Baluchistan, but virus could not be
isolated.

 Further studies are required to study tick fauna

and isolation of virus from the ticks to identify
vector species.
 Major Outbreaks of CCHF in
40
Pakistan from 1976-2000
No. of Cases No. of Deaths

30

20

10

0
6 8 7 4 95 98 98 00 00 00 00 00
97 19
7
19
8 99 9 9 9 0 0 0 0 0
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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
 VECTORS OF DENGUE
 No information is available on the vectors of Dengue
from Pakistan.

 The species recorded from NWFP Pakistan list

following species of aedes mosquitoes:
Aedes albopictus, Aedes albolateralis, Aedes vittatus
and Aedes pseudotaeniatus.

 Another survey of mosquitoes in Karachi in 1983

showed the abundance of Aedes aegypti
 SCRUB 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.
 INSECTICIDES IN USE
INDOOR RESIDUAL SPRAYING
Organochlorines
 DDT: 1963-79
 BHC: 1972-1983
Organophosphate
 Malathion: 1984-97
Pyrethroids
 Deltamethrin: 1998 till date
Larvicides
 Following larvicides belonging to
Organophosphates are in use since 1995
– Temephos 500-E
– Fenthion
 ITN Study in Four Villages
of Sind
Odds Ratio (O.R.) - protective effect of bednet use
against 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)
 Prevalence of Falciparum Malaria in
different age groups
in ITN Intervention and Control Groups
8
7.1 intervention control

6 5.6
% falciparum cases

4.4
4

2.3 2.1
2 1.6

0
below 5 years above 5 years TOTAL
 RESISTANCE STATUS OF
MALARIA VECTORS
 Anopheles culicifacies and Anopheles
stephensi are resistant to Organochlorines
(DDT and Dieldrin/BHC)

 Anopheles stephensi resistant to

Organophosphate (Malathion)
THANK YOU