Treatment for malaria in Africa

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QUESTION:

What is the treatment for malaria in Africa?

ANSWER:

The appropriate form of treatment for malaria, regardless of where you are, depends on the type of malaria you have. This can be determined through diagnosis; each of the main malaria parasites that ordinarily infect humans (P. falciparum, P. vivax, P. malariae and P. ovale) looks slightly different under the microscope, although you have to be well trained to tell them apart! Rapid diagnostic tests (RDTs) can also sometimes distinguish between malaria species, although many RDTs only test for P. falciparum, he most acute, severe and deadly of the species.

In much of Africa, P. falciparum is the most common and dangerous form of the disease. In some places, it can be treated with chloroquine, though in many places the parasite has developed resistance to this drug, so other treatment is necessary.

The most common drugs given in areas with known chloroquine-resistant strains of P. falciparum are ACTs (artemisinin-based combined therapies). There are some parts of Africa where other forms of malaria, such as P. ovale and P. vivax, can also occur – it is important to know whether a patient is infected with these species as they require an additional form of treatment, the drug primequine, in order to kill dormant liver stages that characterise these species and can lead to a relapse of infection months or even years after the initial exposure.

Are these malaria symptoms?

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QUESTION:

My daughter (10yrs) had high fever with chills till 4 days back but now she has low or no fever but feels cold at intervals & for that duration she is feeling giddy & vomittish. A little cough is also their . During this duration she is very uncomfortable & feels she has very high fever. Does all this reflect as malaria symptoms or it is some other problem. Please respond immediately with your suggestions.

ANSWER:

The best thing to do would be to take your daughter IMMEDIATELY to a hospital or to see a doctor. Her symptoms are consistent with malaria, but likewise could be caused by a number of other diseases. The only way to know for sure whether she has malaria is through diagnosis via a blood film or blood test – such diagnosis is crucial to ensure that she is treated promptly and accurately.

Malaria Self-Diagnosis

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QUESTION:

I live in Nigeria and was wondering if there are ways to find out if I malaria without going to the doctor or a hospital?

ANSWER:

The current “gold-standard” for malaria diagnosis, at least of active infections, is through microscropy, where a trained technician looks at a droplet of your blood on a slide, and sees if any of your red blood cells are infected with the malaria parasite. Given the expertise required for this procedure, it is usually only available through a doctor or in a hospital setting. Moreover, this technique is not reliable for very low numbers of parasites, though most active malaria infections will be positively diagnosed.

However, in the last ten years, there has been a rise in the availability and effectiveness of so-called rapid diagnostic tests (RDTs) for malaria, which can be self-administered and so are able to be bought in a pharmacy and used at home. There are a wide variety of these tests, which work by using antibodies to detect the antigens produced by the malaria parasites. As such, the tests seem to be able to detect even low levels of parasitaemia, and in some cases can even tell you which kind of malaria you have. The tests usually come with all necessary materials, which include a lancet for pricking the fingertip for a drop of blood, although you should always check that everything is within the packaging (I have bought tests in Uganda which came without the buffer solution; this had to be purchased separately in this case). The WHO maintains a list of currently available RDTs (PDF).

Make sure the test you purchase is suitable for the type of malaria that is found in your region; many only test for P. falciparum, for example, which might not be appropriate for a region with high levels of P. vivax or other species.