MALARIA : SYMPTOMS,DIAGNOSIS, TREATMENT, PREVENT AND CONTROL

Millions of people die of malaria every year, especially in tropical and subtropical regions. In india alone, it annually costs about half a million lives. Malaria is caused by a protozoan parasite, Plasmodium, which is transmitted by a vector, female anopheles mosquito. The parasite was first discover by Charles Laveran (1880). Sir ronald Ross, a doctor in the India army, first observed oocysts of plasmodium in female anopheles.   

Symptoms :

Clinical symptoms of the disease are chill, fever with period of latency, enlargment of sleepen and secondary anemia. A typical attack of malaria comprises three successive stages.

1. Cold stage or Rigor stage :

The fever comes with rigor and sensation of extreme cold, which lasts from 15 minutes to an hour.

2.  Hot stage or Febrile stage :

The temperature of the body increases to 106 degree F, which lasts for about 2 to 6 hours, associated with intense headache.

3. Sweating stage or Defervescent stage :

Fever comes down with profuse sweating, which lasts for 2 to 4 hours.

Malaria in man is caused by four different species of malaria parasite. They are plasmodium vivax, plasmodium falciparum, plasmodium malariae and plasmodium ovale. P.vivax has the widest geographic distribution in India 70% of the total infection is due to p.vivax, 20-30% due to p.falciparum and only 4.8% due to mix infection. P.ovale is a very rare in human population and mostly confined to tropical Africa.

Diagnosis :

Malaria can be diagnosed by a rapid diagnostic test (RDT). This test is used in the field by ASHA workers and primary health centers, especially in remote areas. And malaria can also be diagnosed by a laboratory blood test.It examining a drop of patient's blood under a microscope for ascertaining the presence of the parasite.

Treatment :

The following drugs are recommended for treating malaria fever.

1. Chloroquin
2. Primaquin
3. Atovaquon - Proguanil combination
4. Artemether - Lumefantrine combination
5. Mefloquine
6. Quinine
7. Quinidine
8. Doxycycline in combination with quinine
9. Clindamycin in combination with quinine
10. WHO recommends Artemisinin - based combination therapies (ACTs)

Prevention and control of malaria :

In 1979, the WHO expert committee on malaria summarized antimalaria measures as outlined below.

• Use of mosquito repellents, bed-nets and screening of houses.
• Use of domestic space spray including aerosol.
• Destruction of mosquito larvae by larvicides or by introducing larvivorous fishes like Gambusia.
• Filling of small scale drainage and other forms of water management.
• Chemoprophylais or taking little dose of quinine in malaria prone area and chemotherapy by taking medicines like Quinine, Paluidrine, Camoquin, Resochin, Mepacrine, Lavagnin, Daraprim etc.

In April, 1953 National Malaria Control Programme ( NMCP) was lunched, which was changed to National Malaria Eradication Programme (NMEP) later in 1958.