Is It Always Malaria?

Malaria is transmitted by the bite or injection from a female Anopheles mosquito. The mosquito needs human blood to cater for its cyclical reproductive demands. In exchange, it releases its saliva into the human blood stream. Africa bears 80% of the global malarial burdens of which Nigeria accounts for about 29% of it together with Democratic Republic of Congo. In Nigeria, it is responsible for 60% of patients in the clinic and 30% of hospital admissions, 11% of fatal deaths, 25% of deaths in infections and 30% of deaths in children aged below 5 years. These are very weighty figures but it gets even more serious as we move off the malaria endemic regions like Nigeria. The last wish of a white man from United States visiting Nigeria or any of the sub-Saharan countries for the first time, is to demand to sleep outdoors in a marshy region infected with mosquitoes without at least a mosquito net. He may soon need to start writing his death will.

So who are the most affected here? Pregnant women, children aged under 5 years, severely malnourished children, people whose body soldiers (the immunocompromised) have been excessively weakened and the elderly because of age related waning of their immune system.

Malaria has been thought in the past to be due to stress, prolonged standing under the sun, bad air (mal-meaning bad, and aria-meaning air), eating too much oily foods and funnily enough consuming too much pawpaw and oranges!

It may interest you to know that mosquito bites are not the only means whereby transmission of malaria usually since. A mother can also pass the baton to her unborn child in which case it is called congenital malaria. Another means of transmission is by transfusing infected blood into uninfected persons.

Many time, we have all had a fair experience of what it feels like to suffer from malaria, however there are other medical conditions that could present like malaria, for example typhoid, flu or rhinitis, hence, proper diagnosis is as important as the appropriate treatment. We do not want to end up filling a perforated basket with our expensive fruit juice. In many remote places where there are no sophisticated equipment used in diagnosing malaria, they rely solely on the jurisprudence and interpretations of the physician relating to the symptoms presented by the patient. These symptoms include Fever which is high grade and comes mostly in the evenings, headaches, chills and rigors (shaking vigorously from feeling cold), vomiting, and prostration due to general weakness in the joints and muscles. In severe cases of malaria, the sufferer may become anemic, vomit profusely, become hypoglycemic (greatly reduced sugar in the blood less than about 4mmol / L), may fall into shock, have kidney failure, respiratory problems and sometimes abnormal bleeding. If you are unsure that it is malaria, do not start treating for typhoid without confirmation using the Rapid Diagnostic Test (RDT) or Microscopy to test for presence of malaria parasites. Widals test should be repeatedly done to confirm Typhoid fever.

Let us start with our environmental sanitation practices, periodic drainage evacuation, elimination of mosquito breeding sites, proper waste management, puncturing of cans before disposal, sand filling of identified breeding sites, and flood control strategies.

Next, we should make use of the available LLIN's (long lasting insecticidal nets) or the ITNs (insecticide treated nets). Another alternative is the use of IRS (indoor residual spraying) where the walls and ceilings of our homes are sprayed 3-4 times every year with insectides. For pregnant women IPTp (intermittent preventive treatment) is the way to go in addition to the aforementioned measures. There are other methods of preventing malaria as these are not mentioned here.

Malaria treatment is usually a 3-day course modality. However, be sure you are treating malaria by performing a RDT or Microscopy to ascertain the presence of malaria parasite. Any modern health care center close to you should have these facilities. Get appropriate advice from the doctor about what sort of drugs you should use, what works for Mr A may not necessarily work for Mr B. Most drugs available in your pharmaceutical outlets are ACTs (artemisinin-based combination therapy). Severe cases of malaria may require admission with immediate administration of IV (intravenous) drugs / drips. Do not throw the tablets under your bed or into the pit latrine as malaria often relapses when not properly treated, this is for those who despise using drugs!