Medicine for Malaria

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QUESTION

is rotam and maladar malaria medicine?

ANSWER

I have never heard of Rotam, but Maladar is the brand name of a combination sulfadoxine-pyrimethamine, and is used to treat malaria. However, it should be noted that it is not recommended by the World Health Organization as a first-line treatment option, due to concerns about drug resistance, and also lack of efficacy against certain types of malaria.

Instead, first-line recommended treatment is of an artemisinin-based combination therapy, or ACTs, which combine an artemisinin derivative (such as artesunate, artemether or dihyrdoartemisinin) with another anti-malarial drug, such as lumefantrine, piperaquine or mefloquine. Common brand names include Coartem, Lonart and Duo-Cotecxin.

Malaria in Pakistan

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QUESTION

4 years ago I traveled to FATA Pakistan and in every year in the month of August I caught malaria. Last few days I feel much Headache and fever in the evening and go to doctor. He diagnosed malarial parasites in blood and has advised me take tab artem ds 2 BD for three days after complete the course I feel same headache fever with shivering. Please recommend something.

ANSWER

I am not sure which malaria treatment you have taken—was it just artemisinin, or a combination drug which also included another anti-malarial? The latter type is what is recommended by the World Health Organization (WHO); treatments only containing artemisinin are very effective short term, but can sometimes leave a few parasites alive at the end of the course, which not only may result in a recurrence of symptoms (known as recrudescence) but is very bad in terms of leading to drug resistance in the malaria parasite. However, it is also possible that you are merely experiencing some slight side effects to the medication you took; often these mild side effects are very similar to the symptoms of malaria! If you don’t feel better in a few days, it might be worth visiting the doctor again to check that you don’t still have malaria parasites in your blood.

Malaria Deaths

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QUESTION

How many people have died from malaria since 1966?

ANSWER

Accurate counts of the number of people who die from malaria are notoriously hard to make, since often the infection goes diagnosed, or the cause of death is not reported. However, the World Health Organization has estimated that until recently, about 1 million died each year from malaria. So, without taking into account changes in population size or other demographic factors, that means roughly 45 million people have died from malaria since the mid 1960s.

In the last few years, large-scale coordinated global efforts as well as numerous grass-roots campaigns have sought to reduce the number of deaths from malaria, mainly through improved preventive methods, education, diagnosis and treatment availability. As such, in 2010, it was estimated that deaths were down to about 700,000 per year, though that figure is contested by some, who argue it should be far higher. Organizations such as Malaria No More and the Roll Back Malaria consortium seek to prevent all deaths from malaria by the year 2015, and are working tirelessly to achieve that target.

Free Medical Care for Malaria

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QUESTION

Can you get free medical help for someone In Nigeria that has malaria?

ANSWER

Theoretically, the Nigerian government should provide basic services, including malaria diagnosis, through primary care clinics which are administered by local government. In addition, Nigeria has recently instituted a National Health Insurance program, which again should assist in providing health care to many sectors of the population. However, in practice, public health care in Nigeria is still hugely underfunded and not very comprehensive—the World Health Organization (WHO) recently ranked it 187 out of 191 country health systems worldwide!

As such, I would be wary of the quality and accuracy of malaria diagnosis and treatment if you obtained it for free in Nigeria—while you might get perfectly decent care, the statistics suggest the chances of this are slim. You would probably be better off looking for a private clinic, where I imagine the cost will still be quite reasonable (especially if you are part of the National Insurance program there) and the quality of care might be more reliable. Having said this, I have no personal direct experience with health care in Nigeria, public or private, so if other readers of this site have other information, please share it in the comments section below.

Malaria Statistics 2008-2012

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QUESTION

Where i go if i want statistic of malaria from 2008-2011

ANSWER

Without more information, I am assuming you would like statistics on malaria cases and deaths for 2008-2012. The best data on malaria comes from the World Health Organization, which retrospectively publishes its best estimated for malaria in its annual World Malaria Reports. Each report publishes the figures from the previous year, and the 2012 report has not yet been published, so at this point the WHO can only provide data for 2008-2010. It is also worth mentioning that as more information is collected, past estimates can sometimes be revised, but here I will present the figures from each annual report itself, rather than longer retrospective estimates.

In 2008, the number of cases was estimated at 243 million, with 863,000 deaths. In 2009, the report did not explicitly summarize the number of cases, but reported that deaths were down to approximately 781,000. In 2010, the number of cases and deaths both dropped yet further, to an estimated 216 million cases and 655,000 deaths. Despite these gains, the aim is to work towards a world with no malaria deaths at all by the year 2015, so much control work remains to be done.

Is Malaria Incurable?

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QUESTION

is malaria incurable?

ANSWER

No. Malaria can usually be very easily treated, if diagnosed early and if appropriate medication is given promptly.

The World Health Organization recommends artemisinin-based combination therapies (ACTs) as the first line treatment against uncomplicated malaria; intravenous quinine is usually the first-line recommended treatment for severe, complicated malaria.

Duration of Malaria Fever for Child

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QUESTION

Can fever duration in malaria is 5-6 Hours for back?

And if I m giving 5 ML of Lariago to my 5 Yr Child how many days it will take to reduce the fever or increase the gap of fever coming back in 5-6 hours.

ANSWER

Please give more information regarding the first part of your question – I am not sure what you are asking regarding malaria fever duration? Regarding Lariago, its active ingredient is chloroquine phosphate, which is NOT effective against malaria in many places, due to widespread resistance. This is particularly true of Plasmodium falciparum, the most deadly kind of malaria. A blood smear can determine the species identification of malaria. As such it is important to know whether malaria in your area is known to have resistance to chloroquine prior to using chloroquine derivatives such as Lariago. Regardless, the World Health Organization now recommends artemisinin-based combination therapies (ACTs) as first line treatment for all non-complicated malaria. If a patient is suffering from complicated/severe malaria, or is unable to ingest malaria medication, they will require hospitalization, and likely be treated with intravenous quinine or artemisinin-derivative suppository, depending on their age and condition.

Can’t Get Rid of Malaria

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QUESTION

Each and every month I am suffering from malaria ..Treatment is also going on but I am unable to get rid of it.

ANSWER

It is very unusual to be reinfected so constantly with malaria. First of all, how are you getting diagnosed? You should be getting a blood test, and not relying on symptoms only; the symptoms of malaria are very general and it could be that you are suffering from something else entirely. The two main methods for accurate diagnosis are blood smear and rapid diagnostic test. The blood smear is used throughout the world, but can sometimes miss light infections (though if you feel sick, your infection is likely heavy enough to be detected by this method). The problem is that it requires a trained technician to take the sample, prepare it properly, and read it thoroughly and accurately. In my experience, many clinics, especially if they are rushed and busy, will not take the time to read a blood slide properly, and will just diagnose malaria without looking. This is really bad! It is very important to be properly diagnosed, so you can get the correct treatment, and if you don’t have malaria, you can be diagnosed for something else. The second kind of diagnostic is a rapid diagnostic test, or RDT. This looks for antibodies to malaria in your blood, and is very sensitive and quick. In an ideal world, you should try to have both done, to cross-check the results.

The next thing is to check whether you are receiving the correct treatment for the type of malaria that you have (if you are positively diagnosed with malaria). In many parts of the world, malaria has become resistant to some of the main medications used against it. Notably, this is the case in many places with Plasmodium falciparum, the most dangerous kind of malaria, which has become resistant to chloroquine in many parts of the world, to sulfadoxine-pyrimethamine (sold as Fansidar in many places) and also to mefloquine (sold as Lariam) in some places. As such, the World Health Organisation NEVER recommends these treatments be given as first line drugs against P. falciparum malaria – instead, they recommend artemisinin-combination therapies (ACTs), such as Alu, Coartem or Duo-Cotecxin. If you have been diagnosed with P. falciparum, you must try to take these kinds of drugs first. No resistance to ACTs has been reported, so if you take the full dose correctly, as prescribed by your doctor (and check to make sure the drugs are not expired), then you should be cured of malaria.

However, treatment does not stop you from getting infected again, and this is where prevention comes it. Preventing malaria is a cornerstone of control efforts. Since malaria is transmitted by a mosquito, preventing mosquitoes from entering the house, and particularly stopping them from biting you at night, is crucial. Screening all doors and windows can help stop mosquitoes from getting in, and in high transmission areas, many people will also spray inside their houses every once in a while with insecticides to kill any lingering insects. In addition, sleeping under a long-lasting insecticide treated bednet can drastically reduce the number of mosquitoes that are able to bite you at night. If you already have a net, it may be worth re-dipping it in insecticide (usually permethrin) to make sure it is still working effectively. The mosquitoes that transmit malaria feed at night, so if you are walking around outside in the evenings or at night, it is important to try to wear long-sleeved clothing, to prevent them from accessing your skin. All of these efforts will help prevent you from getting malaria again in the future.

Malaria Statistics 2008-2012

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QUESTION

What are the malaria statistics for 2008-2012?

ANSWER

Without more information, I am assuming you would like statistics on malaria cases and deaths for 2008-2012. The best data on malaria comes from the World Health Organization, which retrospectively publishes its best estimated for malaria in its annual World Malaria Reports. Each report publishes the figures from the previous year, and the 2012 report has not yet been published, so at this point the WHO can only provide data for 2008-2010. It is also worth mentioning that as more information is collected, past estimates can sometimes be revised, but here I will present the figures from each annual report itself, rather than longer retrospective estimates.

In 2008, the number of cases was estimated at 243 million, with 863,000 deaths. In 2009, the report did not explicitly summarize the number of cases, but reported that deaths were down to approximately 781,000. In 2010, the number of cases and deaths both dropped yet further, to an estimated 216 million cases and 655,000 deaths. Despite these gains, the aim is to work towards a world with no malaria deaths at all by the year 2015, so much control work remains to be done.

Vaccine for malaria? Differences with yellow fever?

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QUESTION

Is there a vaccine to prevent malaria?
What is the difference between yellow fever and malaria?

ANSWER

In answer to your first question, no, there is not currently a vaccine available to prevent malaria. The best current candidate, the RTS,S vaccine which was developed by GlaxoSmithKline, is currently undergoing Phase III clinical trials in Africa. Although preliminary results showed up to a 50% rate of protection against malaria in some age groups, the trials will not conclude until 2014 and so full results will not be known until after that date.

As for your second question, while yellow fever and malaria are both transmitted by mosquitoes, they share few other similarities. Yellow fever is caused by a virus, for example, whereas malaria is caused by a single-celled parasite of the genus Plasmodium. The group of organisms that Plasmodium belongs to is often called “Protista” (the exact grouping and classification constantly changes!), and they more generally belong, based on cell type, to the Eukaryotes, an enormous group of organisms which also includes all mammals and even humans! Viruses, on the other hand, are tiny pieces of genetic material wrapped in a protein coating, and can hardly be described as alive in a conventional sense.

While both yellow fever and malaria are transmitted by mosquitoes, yellow fever is transmitted by the genus Aedes, whereas malaria is exclusively transmitted by the genus Anopheles (at least in humans, and all other mammals for that matter).While spraying inside households may reduce the prevalence of  both types of mosquitoes, Aedes mosquitoes tend to feed during the day, so sleeping under an insecticide-treated bednet is less protective against yellow fever than it is against malaria. Also, a vaccine is available for yellow fever (and has been available for over 50 years), whereas as I describe above, no such vaccine yet exists for malaria.

Finally, while superficially the symptoms of yellow fever and malaria may seem similar (fever, nausea, aches), other manifestations of the disease can be very different. Yellow fever is technically considered a hemorrhagic disease, since it can cause increased tendency to bleed in patients. Also, in some patients, the initial symptoms are followed by an acute liver phase, causing jaundice which can turn the patient yellow (and hence the name). Malaria can also affect the liver, and cause ild jaundice, but usually not to the extent of yellow fever.  Once a patient has been diagnosed with yellow fever, there is no specific treatment, and the patient is merely treated based on symptoms, to ease their discomfort. Vaccination is the mainstay of control of this disease, and has been very successful in many places; the total number of worldwide cases is estimated by the World Health Organization to be around 300,000, with 20,000 deaths, mainly in Africa.

The burden of malaria is also mainly felt in Africa, though the number of cases and deaths is vastly higher – globally, there are approximately 200 million cases of malaria in 2010, with almost 700,000 deaths. Along with the general symptoms of fever and nausea, the most dangerous manifestation of malaria is when it causes cerebral symptoms; this is usually only caused by Plasmodium falciparum malaria, and can lead to impaired consciousness, coma and even death. Also in contrast to yellow fever,  the mainstay of control is a combination of prevention (mostly with vector control, i.e. using bednets, indoor residual spraying and destruction of breeding habitats and larvae) and treatment (using a variety of medications).