Primaquine must be taken
by every patient of Malaria.
Read this if you want to
live long.
Malariasthan is a good name for our country.Each
one of us can get malaria.
First Indian had National Malari Eradication
Programme. ( called NMEP ) We know that malaria can not be eradicated. So now
it is called , National Malaria Action Programme.( called NMAP ). Malaria is one of the major public health problem of
the country.
Malaria is so common that NMAP has an Axiom. When ever one gets fever,
treat it as Malaria, unless proved other wise. When ever one has fever NMAP
advices that we must check a drop of our blood for malarial parasite. NMAP does
it free of cost at all government hospital
and dispensaries.
On an average NMAP examines 80-90 million fever cases. That is about 1 crore. Of these about 20 lakh ( 2 million) samples show malaria parasite. Thus every fifth fever patient seen by NMAP had malaria.
Malaria can kill. If you survive it makes you weak too. You need complete cure. It
is your birth right. You must not spread it. For this you must receive a
medicine called Primaquine if you get malaria.
Malaria is caused by a parasiste called
plasmodium. It is a single cell like amoeba.
On August 20th, 1897, Ronald
Ross, a British officer in the Indian Medical Service, was the first to
demonstrate that malaria parasites could be transmitted from infected patients
to mosquitoes. In further work with bird malaria, Ross showed that mosquitoes
could transmit malaria parasites from bird to bird. This necessitated a
sporogonic cycle (the time interval during which the parasite developed in the
mosquito). Thus, the problem of malaria transmission was solved. For his
discovery, Ross was awarded the Nobel Prize in 1902..Incidently this work was
done in Hydrabad.
How we get malaria?
Mosquitoes give us malaria. When
a mosquito bites a man having malaria,and sucks his blood, along with the
blood, the malarial parasites also reach the stomach of the mosquito. Here the
male and female parasites unite and give birth to many parasites. When this
mosquito bites another person, he gets malaria.As mosquito bites us these
parasites enter our blood stream. They are picked up by liver cells. These
parasites multiply in our liver cells.
When the liver cell breaks, they again come in blood & enter red blood cells.
Here they multiply again and these red cells break.This is the time when we get
fever with chills.
Red blood cells carry oxygen for us. Without them we can die.
The cells loaded with malarial parasites enlarge in size. These enlarged red
blood cells block body’s smallest blood
carrying pipes called capillaries. As blood supply to various parts like brain
is affected one can die.
Malarial parasite,i.e. Plasmodium has 4 species or subtypes.. Of these one
named vivax causes 50-55% and another
named falciparum cause 48-52% of total cases currently in
Plasmodium Vivax that may cause relapsing
malaria but seldom death
P. falciparum that causes malignant malaria and
may lead to death .
. The P.falciparum species is spreading wider due
to migration of population from endemic to non endemic areas and vis-ŕ-vis has
increased tremendously.
One of the reasons attributed
to rise in P.falciparum is resistance to drug chloroquine, which is
being used as a first line of treatment for malaria cases.
It is observed that P.falciparum
infection may lead to complications in 0.5% to 2% of cases. Mortality may
result in about 30% of such cases if timely treatment is not given. The WHO
technical advisory group on malaria has recommended that the Member countries
should be discouraged from implementing presumptive, single-dose and incomplete
treatment with chloroquine. If a patient is suspected of having malaria which
cannot be immediately confirmed, full treatment with recommended drugs should
be given.
National
Anti-Malaria Drug Policy
According
to WHO: An antimalarial treatment policy is a set of recommendations and
regulations concerning the availability and rational use of antimalarial drugs
in acountry It should be the part of the national essential drug policy and the
nationalmmalaria control policy and in line with the overall national health
policy.
The main purpose of the
national anti-malaria drug policy is to provide a framework for the safe and
effective treatment of uncomplicated and severe malaria as well as prevention
of alaria in travellers and vulnerable groups, such as pregnant women and young
children. All health care providers in both the public and private sectors must
be aware of, understand the rationale for, and implement the national
anti-malaria drug policy.
The treatment schedule
followed under the programme is given in Annexure I. Categories for the
treatment of malaria include drugs for first line of treatment (treatment given
to clinical or confirmed malaria), second line of treatment: treatment (given
to Treatment failure), severe and complicated malaria, pregnant women,
travelers and mass treatment (recommended in epidemics)