Principles and Practice of Malaria - Research Paper Example

? Malaria of Introduction Malaria is a parasitic disease, common in the tropic and the subtropics and is characterized by shaking chills, high fever, flu-like symptoms, and anemia. The malarial parasite is transmitted via the bite of an infected female Anopheles mosquito. Once infection occurs, the sporozoite parasites are transported in the victim’s bloodstream to the liver where they mature into merozoites, which re-enter the bloodstream and infect the red blood cells (Shah, 2010). After multiplying in the cells, the parasites break out after 48 to 72 hours. For the female Anopheles mosquito to live and reproduce it must first consume blood meals, which provides the link between human beings and the mosquito genus’s life cycle. There are several vital factors that support the development of the malaria parasite in the mosquito from the "gametocyte" to the "sporozoite stage” stage. Mosquito’s Life Cycle These factors are humidity and temperature, which are directly proportional to the parasites’ rate of growth into adult mosquito. The female anopheles mosquito undergoes the four life cycle stages of egg, larva, pupa, and adult with the first three stages lasting between 5 and 15 days, varying from one mosquito species to another. It is in its adult stage, which lasts between 1 week and 1 month that the female anopheles mosquito acts a malarial vector (Fairhurst & Wellems, 2009). It lays between 50 and 200 eggs on water surfaces, which hatch after 2-3 days into the larvae stage in which the head, spiracles-for breathing, larvae thorax, segmented abdomen, and mouth brushes for feeding are developed. At the pupae stage, which could last between 5 and 14 days, the head and the thorax merge to form the cephalothorax as the abdomen curves around underside. The adult stage is characterized by slender bodies composed of head, thorax and abdomen. Epidemiology According to the World Health Organization (WHO), of the 216 million reported cases of malaria in 2010, 655,000 deaths were reported, implying 2000 deaths due to malaria every day. Reportedly, most of the reported cases affected children of five years and below in age (Shah, 2010). The other vulnerable group is pregnant women with about 125 million pregnant women reported to be at risk of infection each year. Regionally, sub-Saharan Africa is the most affected by malaria in general and maternal malaria in particular, the latter resulting in an estimated 200,000 infant deaths every year (Shah, 2010). Although no efforts have been spared in eradicating and treating malaria in the last two decades, little has been achieved in reducing its risks and effects. This situation is made worse by the fact that malaria cases in the remotest parts of the world are not reported or treated as would have been expected. In accessibility and unavailability of health care facilities and information are specifically to blame for the negative effects of malaria and the lack of documentation of many cases of malaria from all over the world (Shah, 2010). Signs, Symptoms, Tests, and Diagnosis of Malaria The well known signs and symptoms of malaria are as caused by the release of merozoites into the bloodstream and the anemia, which results from the destruction of the red blood cells. Besides the female anopheles mosquito, mother-to-baby transmission and blood transfusion are the other mechanisms by which malaria could be transmitted (Fairhurst & Wellems, 2009). As mentioned earlier some of the signs and symptoms of malaria are anemia, bloody stools, convulsion, muscle pain, nausea, chills, coma, sweating, fever, headache, jaundice, and vomiting. The diagnosis of malaria is a rather crucial step in its treatment hence should be highly regarded by patients and physicians. In medical examinations, enlarged liver and spleen could indicate the presence of malaria. However, confirmation using malaria blood smear at 6-12 hour intervals is highly recommended. To confirm the presence of malaria-related anemia, a complete blood count (CBC) should be conducted. The two main ways of diagnosing malaria are thus, the microscopic examination of blood using blood films and the use of antigen-based rapid diagnostic tests. In case a laboratory cannot be availed for use, one’s history of subjective fever may indicate malaria. Classifications and Treatment of Malaria and Prognosis Malaria, particularly, the Falciparum strain, may call for a medical emergency and a hospital stay. However, the kind of treatment for a given case of malaria depends on factors such as the severity of the disease, the type of medication/drug one can take, and the assessment or the experience of the physician, which are fairly critical in malaria diagnosis and treatment (O'Brien et al., 2011). Malaria is classified as either severe or uncomplicated with the former being characterized by decreased consciousness, inability to feed, circulatory shock, convulsions, low blood pressure kidney failure, significant weakness, breathing problems, and pulmonary edema. In cases of uncomplicated malaria, oral medication is often used. In the case of Plasmodium falciparum, the use of artemisinins is recommended as most effective. However, this class of drugs should be used in combination with other anti-malaria drugs, an approach referred to as artemisinin-combination therapy (O'Brien et al., 2011). Artemisinin could be combined with drugs such as lumefantrine, mefloquine, or amodiaquine. For severe malaria, parenteral administration of anti-malarial drugs is often applied. Although widely used in the late 1990s and early 2000s, quinine has since been replaced by artesunate, which has proved to be more effective for sever malaria than the former in adults and children. There are several supportive measures for malaria treatment including fever and seizure management. In addition, respiratory depression, hypokalemia, and hypoglycemia should also be monitored malaria treatment. Although quick recovery could be achieved after obtaining malaria treatment, there are case in which a severe case of malaria could rapidly progress and result in death in a matter of hours or days. What is more, there are cases in which malaria-related developmental impairment has been reported in children who once suffered severe episodes of the disease. Among the complications that may result from malaria are destruction of blood cells, also referred to as hemolytic anemia, brain infection, meningitis, respiratory failure as fluid accumulate in the lungs, kidney failure, liver failure, and rupture of the spleen/internal bleeding. Because of its effects, it is advisable that malaria is prevented at all costs, rather than wait for it to be cured. Prevention of Malaria Malaria could be prevented by several techniques. First, while those inhabiting malaria-prone zones may develop resistance to the disease, visitors to such areas should visit their physicians and take preventive measures such as medications. Health facility visits are especially necessary since treatment may require to be done two weeks in advance and extend to a month after a tour of malaria-prone zones. According to a CDC report in 2006, most U.S travelers to malaria-prone regions contracted the diseases since they failed to take the necessary preventive precautions. However, the fact that one has taken anti-malarial medication does not imply he/she cannot be infected: more precaution should be taken by way of wearing protective clothing over the arms and legs, or by using screens on windows and insect repellent in rooms and on body. Thus, medications, mosquito eradication, and the prevention of bites are the major methods of preventing malaria. The use of these strategies should be guided by the factors that promote malaria such as high mosquito population density, high human population density, and high rates of humans-to-mosquito and mosquito-to-human transmissions (Fairhurst & Wellems, 2009). To control mosquito population, vector control programs should be implemented in addition to the monitoring and the treatment of the infected. For instance, improved sanitation and the draining of marshy areas have been quite effective in controlling the malaria vector. Other general malaria prevention strategies are indoor residual spraying, use of mosquito nets, health education, awareness promotion, community participation, intermittent preventive therapy, and mass drug administrations. Conclusion Despite of the slow pace of at which the anti-malaria efforts are bearing fruits, the future looks bright as more effective preventive and treatment strategies are sought. In fact, the recent trend in which new drugs to which the parasite is not resistant are developed, tried, and used spells hope for the anti-malaria campaign. In addition, more people in malaria-prone areas such as the tropics and the subtropics continue to develop resistance to the disease. However, visitors and the inhabitants of these regions must double their efforts in preventing, treating, and managing the disease to curb its toll on the world. References Fairhurst, R. M., Wellems, T. E. (2009). Plasmodium species (Malaria). In: Mandell, G. L., Bennett, J. E., and Dolin, R., eds. principles and practice of infectious diseases, seventh edition. Philadelphia, Pa: Elsevier Churchill Livingstone. O'Brien, C., Henrich, P. P., Passi, N., and Fidock, D. A. (2011). Recent Clinical and Molecular Insights into Emerging Artemisinin Resistance in Plasmodium Falciparum. Current Opinion in Infectious Diseases. 24 (6): 577. Shah, S. (2010). The fever: how malaria has ruled humankind for 500,000 years. Macmillan. Read More