Malaria: An emerging public health concern

Published at December 08, 2017 12:58 AM 0Comment(s)3280views

In Jammu Kashmir, malaria has increased from 216 cases in 2015 to 242 cases in 2016 


Malaria: An emerging public health concern

Dr. Tasaduk Hussain Itoo

drtasadukitoo@gmail.com

Malaria is a disease that’s most often caused by mosquito bites from mosquitos that carry malaria parasites. There are at least five types of Plasmodium parasites that infect people, although P. falciparum and P. vivax are the most common and deadly. If left untreated, those with malaria may develop severe complications and even die.

Although there's currently no effective vaccination against malaria, treatment is usually very successful at curing it. Successful treatment depends on your ability to recognize your risk factors and symptoms and get treatment as early as possible.

Extent of disease

As per World Malaria Report 2017 by World Health Organization(WHO), in 2016, there were an estimated 216 million cases of malaria in 91 countries, up from 211 million cases in 2015. The estimated global tally of malaria deaths reached 445'000 in 2016 compared to 446'000 in 2015.

Every two minutes, malaria kills a child under 5-years of age thus rendering the children most vulnerable to the disease. As per the same report, India recorded six percent of the world’s new malaria cases in 2016. India had also witnessed a total of 331 malaria deaths in 2016, making it the highest in the entire Southeast Asia region.

As per another report, in the State of Jammu Kashmir, malaria has increased from 216 cases in 2015 to 242 cases in 2016. Thus it becomes important to take necessary preventive measures to put a stall on this emerging trend.

Recognizing symptoms of malaria

Diagnose malaria. You can be diagnosed with malaria no matter where you are. There are doctors that know and can recognize the symptoms all over the world. To get diagnosed, a single drop of blood will be taken and evaluated under a microscope.

The doctor will check for the presence of the parasite inside your red blood cells. This is the most definitive test, since you can actually see the live parasite in your blood cell.This is complicated by individuals falling victim to other tropical diseases while being immune to malaria.

Watch for a high fever. One of the primary symptoms that is so common with a malarial infection is a high fever, at least 102°F (38.9°C). It's also one of the first symptoms to appear as early as seven days (although usually between 10–15 days) after getting bitten by an infected mosquito.

Often the fever comes and goes randomly.The fever and other initial symptoms may be mild and mimic less serious viral infections, such as the common cold and influenza.Usually symptoms don't appear for about two weeks after being bitten.

Take notice of severe shaking chills. The other primary symptom of malaria is severe shaking chills with intermittent periods of sweating. Again, shaking chills are typical of many other types of infections, but they are usually more pronounced and severe with malaria. They can cause teeth to chatter and even prevent sleep.

When they're severe, the shaking can be mistaken for seizures. The chills from malaria are usually not remedied by blanket cover or by wearing warmer clothes.

Although, the primary symptoms of malaria typically begin within a few weeks of being bitten by an infected mosquito, some types of malarial parasites can lie dormant in the body for up to a year or more.

Look out for headaches and muscle pains. Secondary and less specific symptoms of malaria are moderate-to-severe headaches, often combined with mild muscle aches. These secondary symptoms often occur a short while after the above-mentioned primary symptoms as the parasite needs a little more time to proliferate in the liver and spread around the body in the bloodstream.

Headaches and muscle aches are also very common with most other infections, as well as from the bites of other insects and spiders.The bites from female Anopheles mosquitoes are not very noticeable (a small, red, itchy bump), unlike the bites of some other insects and spiders that can cause similar symptoms.The initial headaches of malaria are typically dull in nature (like a tension headache), but as the parasites start to infect and destroy red blood cells, they can become pounding in nature (more like a migraine).The achy pain is usually most noticeable in the leg and back muscles because they are larger, more active and get more of the infected blood.

Be suspicious of vomiting with diarrhoea. Other non-specific secondary symptoms of malaria are vomiting and diarrhoea, multiple times per day. They often occur in combination with each other, which mimics the initial symptoms of food poisoning and other bacterial infections. The main difference is that the vomiting/diarrhoea caused by food poisoning fades away within a few days, whereas it can remain for a few weeks with malaria (depending on treatment).Unlike the explosive and bloody diarrhoea of some bacterial infections, particularly Shigella, there's usually no blood or severe cramping with malaria.

Recognize the advanced symptoms. If the advancing primary and secondary symptoms don't prompt the infected person to seek medical attention and get treatment (which may not be possible in the developing world), then symptoms begin to appear that signify serious injury / damage to the body. When these advanced symptoms of malaria appear, the risk of health complications and death significantly increase.

  • Confusion, multiple convulsions, coma and neurological impairment indicate brain swelling and injury (Cerebral Malaria).
  • Severe anemia, abnormal bleeding, deep labored breathing and respiratory distress indicate advanced blood infection and lung involvement.
  • Jaundice (yellowish skin and eyes) is evidence of liver damage and dysfunction.
  • Kidney failure.
  • Liver failure.
  • Shock (very low blood pressure).
  • Enlarged spleen.

Preventing malaria

Use a mosquito net. Mosquito nets are lightweight, tightly-woven nets that keep mosquitoes out of your tent or bed at night. Set the net up over your sleeping area each night before you go to sleep. You can also use them to cover any open windows or doors. Get dressed inside your mosquito net in the morning.

Make sure to check it regularly for tears. You might want to bring an extra net as a backup. Buy mosquito nets treated with permethrin for the best protection.

Keep doors and windows closed. If possible, you should keep doors and windows tightly sealed while you're indoors. People who sleep outside or are exposed to the outdoors at night are at much higher risk of contracting malaria.You may not be able to close the doors and windows if you're in a very hot, muggy place. Whether you can or not, use a mosquito net over your bed for added protection.

Wear long pants and sleeves. You'll reduce the number of mosquito bites you get if you wear long pants and sleeves while you're out and about during the day.Bring high-quality lightweight clothing that will allow your body to breathe while protecting you from bites.

Use mosquito spray. Choose the mosquito spray that's most effective in the area where you're traveling. Talk to your doctor about your options and to get recommendations. If you have children, consult their pediatrician about what types and strengths are safe for use on children.

In almost all areas where malaria is present, DEET is the most commonly used compound. DEET is a chemical compound known as N,N-Diethyl-meta-toluamide, or just diethyltoluamide. This repellent comes in many different concentrations, from 4% to 100%.

Apply the spray to your clothing and the room where you're staying for best results. Combining insect sprays with permethrin-treated clothing and gear offers the best protection. The Center for Disease Control (CDC) provides guidelines for the use of DEET. Read them carefully before using this product. Improper usage can lead to health problems.

Stay inside between dusk and dawn if possible. Try to plan activities that permit you to be in protected areas between dusk and dawn. The mosquito that transmits malaria is most active at night.

Treating malaria

Contact your medical professional. Regardless of whether you're showing symptoms, you should always let your doctor know immediately when you've travelled to a high risk area.

While those in high-risk areas sometimes "wait and see" if uncomplicated malaria will progress, people in low-risk areas should not. If you feel sick and are worried you were exposed to malaria, see a doctor right away. It's important to get treatment as soon as possible. Early malaria symptoms are generally non-specific, but may include the following:

  • High fever
  • Shaking chills
  • Profuse sweating
  • Headache
  • Vomiting
  • Diarrhea

Get treatment. Many medications that you can take, which will be taken for a minimum of seven days. However, the length of time you need to take the medications will vary depending on the severity of your case and how much the rest of your body has been affected. All malaria medications are safe for children. Possible medications you may be prescribed include:

  • Mefloquine
  • Atovaquone-proquinal
  • Sulfadoxine-pyrimethamine
  • Quinine
  • Clindamycin
  • Doxycycline
  • Chloroquine
  • Primaquine
  • Dihydroartemisinin-piperaquine

Stay comfortable during treatment. The best thing you can do is get plenty of rest during the recovery process. Because there are so many options for treating malaria, not everyone will have the same experience.

However, common side effects include blurred vision, nausea, diarrhoea, vomiting, and stomach pain or upset. Some of the drugs also cause heartburn, insomnia, anxiety or mental clouding, and dizziness or coordination problems.

Pay attention to your body to pick up on these side effects, and report them to your doctor when you experience them. They may be able to give you additional medications to help combat them.Drink lots of fluids to prevent heartburn.Fluids are especially important if you are experiencing vomiting or diarrhoea. You lose a lot of water through these side effects, and have to rehydrate yourself to keep your body as healthy as possible. Stick to a bland diet to treat stomach upset.Stay off your feet, and don't over-exert yourself if you're having coordination problems.

 

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