Malaria, the raw facts. Tim Inglis. World impact. c ommon parasitic infection 1 million deaths each year mainly in children mainly in Africa. Disease patterns stable unavoidable unstable preventable ? travel-related preventable. Clinical features.
Malaria, the raw facts Tim Inglis
World impact • common parasitic infection • 1 million deaths each year • mainly in children • mainly in Africa
Disease patterns stable unavoidable unstable preventable ? travel-related preventable
Clinical features • Setting: history of travel to or residence in endemic area • Symptoms: • COLD - initial shaking/rigor; then • HOT - fever (may be >40oC), restlessness, vomiting & convulsions; then final • SWEATING - temperature returning to normal & possibly sleep. • Timing: • Generally days to weeks after return from endemic area • Overall, 6-10hr between paroxysms
The parasitea protozoan called Plasmodium MOSQUITO HUMAN
Its vectorfemale Anopheles mosquito proboscis palp FORE-LEG antenna HEAD eye WING scutum THORAX scutellum halter femur ABDOMEN tibia MID-LEG tarsus claw HIND-LEG
Investigations • Key questions: • Does the patient have malaria? • Does the patient have P. falciparum malaria? • Does the patient have another infection? • Blood films • Rapid tests • Other infections
Antimalarial treatment WHO guidelines: • ACT: Artemisinin-based Combination Therapy for uncomplicated malaria • Artesunate for IV treatment in low transmission areas & later pregnancy • General rules: • start immediately if P.falciparum malaria • wait for results of blood film if benign malaria, • treat uncomplicated malaria as outpatient • advise return if worsens or no improvement
Expedition Medicine • Personal measures • Personal protection • Chemoprophylaxis • Group measures • Group prophylaxis • Area control measures • Rapid tests • Antimalarial therapy, SBET • Local people • Medevac arrangements
http://www.priobe.net http://micrognome.priobe.net • The Anopheles mosquito is a self-propagating, self-propelled syringe • armed to the teeth with malaria parasites.