Malaria

Malaria is a dreaded disease since primitive times and time immemorial.

There is no statistics on how many lives has been lost since the dawn of civilization, from this preventable malady…this far.

It is a vector borne disease caused by the parasite Plasmodium species transmitted by the ubiquitous mosquito…Anopheles type…the female variety.

The parasite variants are Plasmodium Vivax/Plasmodium Falciparum/Plasmodium Malariae and Plasmodium Ovale responsible for causing the different clinical types of Malaria, each with different characteristic features and morbidity potentials.

The essential symptoms are Fever with chill and rigor and a subjective combination of headache/nausea/vomiting/abdominal ache/body pain etc.in an apparently non-complicated case of malaria. In complicated cases, the signs and symptoms become more sinister.

The fever often takes a typical periodical rhythm and gets the typical name of Tertian/Quotidian types of fever…associated with other typical/atypical symptom complex. Out of the whole galaxy of Malaria variants, what is dreaded most by the medical fraternity is Falciparum Malaria…which often ends up with fatal complications unless treated promptly and appropriately. The usual complications are affection of the central nervous system (Cerebral Malaria) manifested by convulsions and passing of black urine ( hence the name of Black Water Fever)….due to massive intravascular haemolysis of the parasitised RBC-s and the haemoglobin finding its way out through the kidneys….ending up with Renal failure… ! However with prompt and adequate treatment ,the complications may be avoided completely !

The treatment of Malaria is simple following its correct diagnosis and goes by a certain protocol adapted from country to country depending on the epidemicity of the disease and the resistance/susceptibility pattern of the region to the different drugs meant for the same. The basic tenets of malaria treatment remains the same guided by the parasite species and the nature of treatment required…..prophylactic / therapeutic. Travellers destined for Malaria prone areas are recommended to undertake Malaria prophylaxis prior to travel in those countries.

For some species relapse of Malaria isa big potential problem and some typical medication needs to be taken to prevent this relapse,due to characteristics of its lifecycle in the Red Blood corpuscles in blood/liver…over a certain period of time.
Some typical drugs used in Malaria prophylaxis / treatment /relapse control are..Chloroquine/Mefloquine/Quinine/Artemisin group of Drugs/Primaquine etc. guided by the indication of the type of approach required.

Prevention of Malaria is a daunting and herculean task targeted to different strategies of vector control ,through adult and larvicidal measures and adopting self protective measures like avoiding mosquito bites at all costs and steps to drastically reduce the adult mosquito population through strategic measures.
Emphasis should be placed on diagnostic approach to Malaria by proper facilitation of blood collection through Smear preparation on slides….thin and thick smears ..and identifying the exact variant of the parasite and its density.

Immediate treatment begins as soon as results are available and confirmation is also seeked through Immunological Tests for Malaria. (Malaria Antigen)…on select cases,as per the decision of the clinician.
Trained manpower is also a perquisite in Malaria control at all stages of its management approach.
In spite of adopting all the recommended measures in Malaria control…old and new….the menace of the disease is far from over and the human race needs to take particular precautions to prevent its transmission and spread to the community and keep the mortality as low as possible !