Prevention of Malaria

There are many ways of preventing Malaria. You can also take medicine to cure Malaria. Besides indoor residual spraying for eliminating mosquitoes & use of mosquito nets coated with insecticides during night sleep and insecticide coated bed cloths give good results. Use of DDT in the endemic areas & DDT-spraying the interior walls of living spaces, where mosquitoes land, is an effective control. A new approach, announced in Science on June 10, 2005, uses spores of the fungus Beauveria bassiana, sprayed on walls and bed nets, to kill mosquitoes. While some mosquitoes have developed resistance to chemicals, they have not been found to develop a resistance to fungal infections. Use of prophylactic drugs can be another option: - Currently available anti-malarial drugs include:

· Artemether-lumefantrine (Therapy only, commercial names Coartem® and Riamet®)

· Artesunate-amodiaquine (Therapy only)

· Artesunate-mefloquine (Therapy only)

· Artesunate-Sulfadoxine/pyrimethamine (Therapy only)

· Atovaquone-proguanil, trade name Malarone (Therapy and prophylaxis)

· Quinine (Therapy only)

· Chloroquine (Therapy and prophylaxis; usefulness now reduced due to resistance)

· Cotrifazid (Therapy and prophylaxis)

· Doxycycline (Therapy and prophylaxis)

· Mefloquine, trade name Lariam (Therapy and prophylaxis)

· Primaquine (Therapy in P. vivax and P. ovale only; not for prophylaxis)

· Proguanil (Prophylaxis only)

· Sulfadoxine-pyrimethamine (Therapy; prophylaxis for semi-immune pregnant women in

endemic countries as "Intermittent Preventive Treatment" - IPT)

· Hydroxychloroquine, trade name Plaquenil (Therapy and prophylaxis)

Severity of Malaria

P. falciparum causes the most severe type of malaria. Consequence of severe malaria include coma & death if untreated (specially children & pregnant women). Splenomegaly (enlarged spleen), severe headache, cerebral ischemia, hepatomegaly (enlarged liver) & hemoglobinuria with renal failure may occur. Renal failure may also cause black water fever, where hemoglobin from lysed RBC leaks into urine. This form cause death within hours or days in more than 20% cases even with intensive care & treatment. P. vivax & P. ovale produces chromic malaria, unlike P. falciparum. In this case the disease relapse months or years after exposure, due to presence of latent parasites in the liver. The largest incubation period reported for a P. vivax infection is 30 years. Malaria is often associated with hypoglycemia which has four causes – (i) High parasitemia (parasite’s inefficient use of glucose); (ii) you don’t as much because of loss of appetite; (iii) depletion of liver glucose & (iv) inhibition of gluconeogenesis.