Wednesday 21 September 2016

How to treat a patient with malaria

  1. The species of the infecting parasites: if one as infected with plasmodium falcipairium life threatening complications can develop rapidly. Infections caused by one of the three species of making are rarely lie-threatening.
  2. The density of parasites: if the percentage of red blood cells infected (parasite density) is over 50%s treatment may include medications given directly into a vein (1.1) rather than take by mouth.
  3. The clinical  status  of the  patient:   one  is  at  great  risk for developing complication if one is pregnant elderly, very young or has weak immune system.
  4. The are   where   an   infection   was  acquired   and   its   drug resistance status: fore instance in many areas plasmodium falcipariuim is resistant to the a long chloroquine.
  5. Drug allergies or other medication that  are  taken   by  the patients: in endemic areas, WHO recommends that treatment be started within 24 hours after the first symptoms appear. Treatment of patients with uncomplicated malaria can be conducted on an ambulatory basic without hospitalization bit patients with severe malaria should be hospitalized if possible in area where malaria is not enemies all patients with malaria (uncomplicated or severe) should be kept under clinical observation if possible, patients who have severe plasmodium falcipariuim malaria or who can not take oral medications should be given the treatment by continuous intravenous infusion in some counties, some anti-malaria drugs are found in suppositions which can also be used especially when other routes are considered not favourable.

 Control and prevention of malaria

The goal of malaria control in malaria endemic counties is to reduce as much as possible, the health impact of malaria as the population uses the resources available and taking into account other health priorities. In malaria endemic counties, malaria control does not aim to eliminate malaria parasite land thus the diseased would constitute eradication while eradication is more desirable, it is not currently a realistic goal for most countries where malaria is endemic.
Malaria control is carried out through the following interventions which are often combined.
  • Care   management:    diagnosis   and   treatment   of   patients suffering from malaria.
  • Prevention of the infection through vector control.
  • Prevention of the disease by administration of prophylactic population group such as pregnant women.
  • Care management:

People who are suffering from malaria should be treated promptly and correctly. Malaria is of ten a debilitating disease that when coursed by plasmodium falcipariuim can be fatal, in addition, treatment eliminates an essential component of the cycle (the parasite) and thus interrupts the transmission cycle. Who recommends that anyone suspected of having malaria should receive drug within 2 hours of the onset of the symptoms.
  • Prevention of the infection through vector control: Malaria infection can be prevented when malaria carrying anopheles mosquitoes are prevented from biting humans.

  • Larva control: This include drainage of stagnant water but where the water cannot be derived, they can be sprayed with oil or kerosene or DDT,

Use of insecticides which include:
  1. Wear protective clothing e.g long pants and long slaved shirts.
  2. Use insect repellant with DEET (N, N diethymetatoluamin) the repellant is available  in  varying  strengths  up  to   100%.   In young children, use a  preparation containing  less that 35% strength,   because   DEET  can   be  toxic  if  too   much   of the chemical is absorbed through the skin.
  3. Use bed nets (mosquito netting) sprayed with or soaked in an insecticide such as permethrin or deltamin.
  4. Use flying insect spray indoors around sleeping areas.
  5. Avoid areas where malarias and mosquito are prevalent if you are at higher risk (e.g in pregnancy, very young or very old).
  6. Use of electric fans.

  • Prevention of the disease by the use of prophylactic anti-malaria  drugs: Administration of anti-malaria drugs as prophylaxis to vulnerable population does not prevent the infection which occurs through mosquito bites, but the drugs can prevent disease. The solution of medication to prevent malaria depends on the geographical region where one may be exposed to malaria and one's health condition such as pregnancy, being elderly or young being or having immunity or resistance to malaria or having allergies or sensitivity to the medication the most current information about malaria is disease control and prevention (CDC) and the (WHO).

If one is planning international travel learn about risk of malaria in the medication. The majority of people who becomes infected with malaria do not take preventive malaria medication or do not follow correct dosage.
Medication to prevent malaria is most effective if one takes the recommendation dosage exactly as prescribed and for the length of time referred. Upon returning from an area where malaria is prevent, one should continue the medication for four week ensure that all parasites have been eliminated from the body. The standard medication used to prevent malaria in pregnancy includes:
a) Pytimethamine sulpadoxine combination
b) Chloroquine : Start treated 1-2 weeks before travelling to area where malaria is prevent, continue to take it weekly while in the area and four weeks after returning. Chloroquine can be taken to prevent plasmodium falciparium and   plasmodium vivax infection in are where medication 
resistance    to Chloroquine has not been confirmed

Malaria vaccines

Scientist are studying malaria vaccines to see weather the vaccines are effectively preventing malaria infection. To date there is no strong evidence that these vaccines are effective. Work continues of improving vaccines for malaria prevention 
• Partnership for malaria control successful  malaria  control activities required co-ordinator.

National authorities specially the ministry of health. 
International organization such as WHO and UNICEF. 
Government and non-government agencies. 
The private sector
The communities
• To enhance coordinate, various partnership have been formed the most prominent one being the role back malaria global partnership.

 Activities for Malaria Control

The main  activities  necessary for carrying  out  malaria  control intervention are:
• Health education (also called information education communication IEC) where the communities are informed of what they can do to prevent and control malarias.
• Training and supervision of health workers to ensure that they carry out their task correctly.
• Provision of equipment and supplies (e.g microscope,  drugs, bed nets) to allow the health workers and the intervention.
• Barriers to malaria control: malaria control is made difficulty be several technical and administrative problems.
• Drug-resistant: parasite hinder case  management  by decreasing the efficiency of anti-malaria drugs and by requiring the use of alternate drugs that are often more costly and not easily available
• Insecticide resistance decreases the efficiency of interventions that rely on insecticide such as insecticides sprayings
• Inadequate health infrastructures in poor and  developing countries leading to inability to conduct the recommendation intervention.
• The people most exposed to malaria are often poor and lack of education. They often  do  not  have  the  financial   means  to purchase the necessary product such as drugs or bed nets.

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