QUESTION:

Hi my twin sister is in Nigeria on a 5 month missions trip. She has just been diagnosed with Malaria, they believe she got it a year ago in El Salvador and that it has been dormant in her system, she has week kidneys and has chronic high blood pressure due to childhood illnesses she has had her whole life. She is in the Northern part of Nigeria and the hospitals there are no real help, my questions is…. in your opinion should come home now to recover?? I am sure the type of Malaria she has, I have been doing lots of research and I am extremely concerned for her health. She has always had health issues and I am wondering if the malaria will be even worse for her given her pre-existing health conditions. It is very hard to reach her so I am not able to ask her many questions, I know she is in pain, can’t keep food down and currently is not being treated in a hospital. Any thoughts or recommendations would be appreciated!!! ASAP Please! Thank You! Tasha

ANSWER:

Hi Tasha, I answered your question directly in response to the comment you made on the Malaria Symptoms post, but here it is again:

Sorry for the slow reply, I’ve been travelling. It sounds like your sister really needs urgent medical attention, and is not receiving that where she is in northern Nigeria. If possible, I would try to encourage her to seek further medical help, either in the area she is in or, if she is able to travel, in one of the major cities. If they have accurately diagnosed the type of malaria she has (which is presumably how they suspected she was infected in El Salvador, since it is likely not a species of malaria that is commonly found in Africa), it will be straightforward to give her treatment, but any physicians she sees must be made aware of her existing health conditions. If she has Plasmodium vivax, which is often found in Central America, she should also look into taking a course of drugs (called primaquine) which will prevent further recurrence of the disease at a later date. Hope this has been of some help and that she is on the road to recovery already.

AND:

In addition to the above, I have just received some advice from a medical doctor who is involved with our website:

If she contracted it in El Salvador, then Plasmodium vivax most likely and not a particularly resistant strain (generally chloroquine sensitive west of Panama Canal). I think this could be easily treated in Nigeria so long as the diagnosis is clear and there are drugs available – almost any standard regimen would be effective. Did she have anything with her for prophylaxis or stand-by treatment? Chloroquine/mefloquine/Malarone shouldn’t need much adjustment for her kidneys, but it would help to know what her renal function is (GFR/Creatine). The pain and nausea/vomiting present a problem in keeping the medication down, however, even IV hydration is an option if she is becoming dehydrated from the illness. In general, more details are needed, as worsening kidney problems from hydration or gall bladder problems from not eating could complicate the picture, even if the malaria is treated. I don’t know where home is, but she should at least get to a town where basic blood work can be obtained, and anti-nausea medication/IV fluids are available.