The Point (Banjul)

11 December 2012

Africa: Why One Child Dies of Malaria Disease Every 30 Seconds in Africa

interview

Malaria is more than an ordinary disease on African continent. It has major implications on all essential aspects of our life - as individual, as families, as communities and as a nation.

DR AZADEH our health adviser a Senior Lecturer at the Medical school University of the Gambia focussing this week on Malaria disease, symptoms, diagnose and treatment. As we all know malaria cases can develop serious cerebral and deathly condition in particular in children ages from infant up to 8-10 years if they have not been early diagnosed and treated appropriately.

DR AZADEH what is actually Malaria disease?

Malaria disease is a parasitic disease; this means that it is caused by a parasite, a tiny organism that lives in or on other organisms called a host. This parasite host is a mosquito. The parasite is transformed to a potential victim when he or she is bitten by the mosquito in particular during the night or in extremely unhygienic environment. Although Malaria is preventable and treatable disease, annually this disease kills over one million around the world most of which in Sub Saharan Africa, even in the USA seen each year an average 0f 1,300 cases from immigrants.

How People Get Malaria (Transmission)?

Usually, people get malaria by being bitten by an infective female mosquitoes can transmit malaria and they must have been infected through a previous blood meal taken from an infected person. When a mosquito bites an infected person, a small amount of blood is taken in which contains microscopic malaria parasites. About 1 week later, when the mosquito takes its next blood meal, these parasites mix with the mosquito's saliva and are injected into the person being bitten.

Because the malaria parasite is found in red blood cells of an infected person, malaria can also be transmitted through blood transfusion, organ transplant, or the shared use of needles or syringes contaminated with blood. Malaria may also be transmitted from a mother to her unborn infant before or during delivery ("congenital" malaria).

Is malaria a contagious disease?

No. Malaria is not spread from person to person like a cold or the flu, and it cannot be sexually transmitted. You cannot get malaria from casual contact with malaria-infected people, such as sitting next to someone who has malaria.

Who is most at risk of getting very sick and dying frommalaria?

Plasmodium falciparum is the type of malaria that most often causes severe and life-threatening malaria; this parasite is very common in many countries in Africa including Gambia, south of the Sahara desert. People who are heavily exposed to the bites of mosquitoes infected with P. falciparum are most at risk of dying from malaria. People who have little or no immunity to malaria, such as young children and pregnant women or travelers coming from areas with no malaria, are more likely to become very sick and die. Poor people living in rural areas who lack knowledge, money, or access to health care are at greater risk for this disease. As a result of all these factors, an estimated 90% of deaths due to malaria occur in Africa south of the Sahara; most of these deaths occur in children under 5 years of age.

Signs and Symptoms

The Symptoms of malaria can vary greatly, from no symptoms at all to start or just head ach or mild to extremely serious and may even result in death. Malaria is often put into two different categories

One is uncomplicated and the other is complicated

Incubation period

Incubation period is from the time been bitten until the time symptoms appearing. Depending on the type of parasite the incubation period can range from a few days up to about 30 days. Some types of malaria can delay onset of symptoms even for up to one year.

Uncomplicated Malaria

The general(but very infrequent) attack of Malaria usually continues 6-10 hours There are 3 phases to this and these usually return 2 to 3 days depending upon the type of parasite. There are 4 types

A. The cold phase (headache, shivering, feeling cold)

B. The hot phase (vomiting, fever, headache, convulsions in children)

C. The sweating phase (sweating, normal temperature, sleepiness )

However, more often the affected person usually has the following signs and symptoms: chills, fever nausea and vomiting, headache, general uncomfortable and body aches.

There may also be: Enlarged spleen, fever, perspiration, general weakness. In P. Falciparum Malaria there may be these added findings enlarged Liver, mild jaundices, and increase respiratory (breathing) rates.

Complicated Malaria

This usually occurs where there is either low or no immunity to this disease, including locations where Malaria Disease is rare or immunity is low because of other health risks. Complicated Malaria results in blood and organ disorders, including fluid on the lung, and loss of kidney function.

In all areas of the world complicated Malaria Disease is an emergency and should be treated as quickly and intensely as possible because without treatment other major medical problems appear and eventually death does occur. AS with other conditions pregnancy is complicated by the disease resulting in possible early miscarriage, still birth and also in some cases curse abnormalities in unborn babies as this disease is extremely dangerous in pregnant women, people with ongoing and long standing diseases such as diabetes, liver, heart and kidney disease.

In addition, relapses are also known to happen, even months and years after the first attack. This is due to one genus of parasites having disease has been cured. There are medications that are able to prevent this and should be started as soon after the first attack as possible.

Treatment of Malaria disease

Appropriate diagnosis should be confirmed before any treatment is started. Laboratory tests should be performed and treatment must start as soon as possible. Not be able to perform laboratory diagnose patient can be treated on obvious symptoms by a well treat medical staff, limiting it to those situations where clear suspicion of a very extreme malaria diagnosed.

How effective is the new anti-malaria drug called Coartem In Africa including Gambia?

Preventable and curable malaria remains a devastating disease infecting millions of people each year and causing an estimated over one million deaths, its tool is heaviest among the young children in the Sub Saharan Africa including in the Gambia too.

Malaria parasite had developed some resistance to the older anti-malaria drugs such as chloroquine on which African countries had relied for decades. In some countries, cure rates had dropped as low as a single patient for every 10 patients treated Physicians was desperate for an effect new medicine.

Working with the partners in china, Novartis had developed coartem, the first of a new class of anti-malaria medicine, known as ACT. A component used for centuries in traditional Chinese medicine to treat fever. It has been reported that in clinical trials coartem achieved cure rates of up to 95%, even in areas of multi drug resistance.

During 2006, more than 62 million treatment courses of coartem were delivered to more than 30 countries across Africa, helping to save an estimated 200,000 lives.

Important information about Coartem

Coartem is used to treat malaria. Do not use Coartem to prevent malaria.

• Do not use this medicine if you are allergic to the drug.

• Before use Coartem, tell your Doctor if you have a history of heart disease, liver or kidney diseases.

• Take advice about the drug if you are suffering from a long-standing other diseases.

• Coartem should not be taken in early pregnancy; it is not known whether Coartem is harmful to an unborn baby.

• Tell your Doctor if you are pregnant or plan to become pregnant during treatment.

• This drug can make birth control pills less effective.

• No medicine is 100% effective in treating malaria. For best result, keep using the medicine as directed.

• Tell your Doctor if you have fever, vomiting, or diarrhoea during your treatment.

Conclusion

• Malaria kills thousands of people every day worldwide unnecessarily. With immediate and correct treatment people are able to recover from this disease with no problem.

• Malaria remains leading cause of morbidity (illness) and mortality (death)- much more than HIV/AIDS!

• More than 90% of the nation is highly endemic

• Focus on a rapid increase of coverage with preventive measures namely indoor residual spraying & insecticide nets

Seek advice about this deathly disease by Medical Professional wherever you living.

For further information, diagnose and treatment visit any of Government's Hospitals, Clinics, MRC and also NGO's and Private Clinics also "THE POINT" Health section E- Mail azadehhassan@yahoo.co.uk, call Dr Azadeh and Peter Gomez live Health show every Tuesday from 6-7pm or and call DR AZADEH on 7774469/3774469 working days from 3-6 pm.

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