Clinical Manifestation of Malaria
The clinical manifestation of malaria depends on species. However, the clinical manifestation of malaria depends on species, however, the incubation period is between 9-37 days varying with the species involved.
Plasmodium falciparium 9-14 days
Plasmodium malariae 18-37 days
Plasmodium viviax 12-18 days
Plasmodium ovale 12-16 days
Human malaria presenta with the following signs and symptoms. Fever, headache, nausea, weakness, chills and rigors, altered behavior, chest pain, pallor, vomiting, Diarrhea, point pain, malaise, dizziness, altered samarium, breathiness, cough, convulsion, jaundice, coma. However, sever and complicated malaria can present with hyperparastaemia shock electrolyte and acid base imbalance, cerebral coma, hypoglycemia venal filure, hyperpyrexia and jaundice,
Diagnosis of Malaria
A diagnosis of malaria is made by the identification of the parasite in the blood. In endemie areas, malaria should be suspected in adults with fever associated with child's rigors and joint pain. It is also suspected in children with fever. Clinical acumen is highly needed in the diagnosis of malaria. The ability to get a good history from the patient and physical examination is very important but a good laboratory investigation of malaria parasite in a thin blood film using Giemsa stain and wrights gives confirmatory result. Other tests based on immunologic principles exist including RDT'S (rapid diagnostic tests) approved for use in U.S in 2007 and the polymerase chain reaction (PCR) test these are not yet widely available and are more expensive than the traditional Giesma blood smear.
Treatment of Malaria
The treatment of malaria can be supportive management and specific treatment.
Supportive Management
This is based on relieving symptoms according to their severity in high temperature, tepid sponging is needed and antipyretics such as paracetamol are given. To prevent dehydration which could be due to vomiting and diarrhea, adequate fluid therapy is given. In cases of severs anemia, blood transfusion would be required adequate diet, ferrous sulphate and folic acid should be given to help build up the body during convalescence.
Specific Treatment
The major goal of specific treatment is to reduce or clears the number of malaria parasites in the blood and tissue the drugs used are targeted at the life cycle of plasmodium more especially asexual cycle in humans.
Blood Schiyzoyticides
They attack malaria parasites within the granulating blood cells examples.
a. Chloroquine tablet/syrup 10mg/kg start, them 10mg/kg 6 hours later and 5mg/kg for the next 2 days in adults.
b. Quinine 20mg/kg loading dose when 10mg/kg slowly for 10-14 days.
c. Pyrimethamine 25 mg weekly (Daraprim).
d. Mefloquine
f. Proguadine
Tissue Schizonticides
These drugs eradicate the plasmodium form the liver tissues more especially plasmodium vivax and plasmodium ovale. The drug are primaquine and fansider.
Drug combination
a. Malopin (pynmothamine and dapsone).
b. Fansider (pyrmethamine and sulphadoxine).
c. Artesunate
Other drugs are:
• Halofantrine
• Quinoghaosis
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clinical manifestation of malaria
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