Malaria Flashcards
How is malaria controlled in Malawi (2)
- malaria vector control
-ITNs
-Indoor residual spraying - case management
- diagnostic testing
-prescribing anti malarial drugs
Why is malaria a big deal (3)
- its a predominant disease burden in children under 5 and pregnant women
- its responsible for half a million deaths annually
- it can cause repeated admissions, chronic malaria, economic burden
What are the types of malaria (5)
- plasmodium falciparum
- plasmodium knowlesi
- plasmodium vivax and ovale
- plasmodium malariae
What is the most dominant type of malaria in malawi and what does it cause
-plasmodium falciparum
- it causes the most severe disease
What test do you do in a suspected uncomplicated malaria
MRDT
who do you suspect uncomplicated malaria in (2)
- a child with reported fever
- an adult with recorded fever and a correlated symptom
what test do you do in suspected complicated malaria
blood film
what rx should you start in someone with suspected complicated malaria
artesunate iv
what are symptoms for uncomplicated malaria (6)
- headache
-fever
-diaphoresis
-nausea and vomiting
-hepatosplenomegaly
-jaundice
what are signs of severe malaria (8)
-impaired consciousness
- respiratory distress (acidosis)
-> 1 convulsion
-shock
-pulmonary edema (ARDS) on CXR
- abnormal bleeding (DIC)
-jaundice
-hemoglobinuria (black water fever)
-AKI
what labs should you be assessing in severe malaria (6)
- severe anemia
-hypoglycemia
-renal impairment
-hyperparasitemia >10%
-high lactate
-acidosis
what severe presentation do you see in adults (5)
- AKI- acute tubular necrosis
-jaundice (due to hemolysis, cholestasis)
-ARDS
-secondary p vivax infection
-blackwater fever due to hemoglobinuria
what severe presentation do you see in children (5)
- cerebral malaria
-anemia
-acidosis
-hypoglycemia due to liver dysfunction, quinine
-blackwater fever
what does malaria do in pregnancy
produces an immunological response which renders your previous acquired immunity useless
what problems can malaria cause in pregnancy (6)
- maternal anemia
- fetal anemia
- LBW
- still birth
- spontaneous miscarriage/ abortion
- premature labor
whats the relationship between malaria and HIV (4)
-malaria worsens HIV by increasing the viral load
- HIV worsens malaria
-HIV patients are at increased risk for clinical malaria
- the risk of malaria is higher in advanced HIV
How can you prevent malaria in HIV (3)
- CPT (cotrimoxazole) reduces the risk of malaria
- ARV
-ITN
how to do manage a malaria patient
ABCDE
what key investigation do you do in malaria (3)
-RBS
-MRDT/ BF
-FBC
how do you treat uncomplicated malaria
lumefantrine artemether (LA)
how do you treat severe malaria
Artesunate IV
what is the best supportive management you can give (4)
-blood transfusion (Hb<6/ Hb<7 with acidosis or heart failure)
-fluids
-anti epileptic drugs like diazepam/ phenobarbitone
- concomitant bacterial infection (raised WCC)
Ho can you reduce mosquitoes
with indoor residual spraying (IRS) (its expensive)
how can you prevent mosquito bites
Insecticide treated nets (ITN)
what chemoprophylaxis can you use for prevention (3)
Pregnant- sulfadoxine-Pyrimethamine (SP)
HIV- CPT
Travelers- doxycycline, atovaquone-proguanil (malarone), mefloquine
malaria in pregnancy affects who
the fetus mostly
how do you treat malaria
with artemether based drugs
