malignant malaria
My son (15) had malignant malaria. Following a doctor?s advice he took chloroquine and the fever went away. But it recurred within a couple of weeks. What?s wrong with him?
Probably your son has been infected with malaria parasites resistant to drugs. Such multidrug-resistant strains are prevalent in malaria-prone areas of our country. Study shows that 12 per cent of the patients are sensitive to chloroquine, 24 per cent resistant to it but sensitive to other drugs; this indicates a high prevalence of the types of the parasite that are drug-resistant. Despite this, chloroquine is still the first choice among the drugs against malignant malaria. But, early and late treatment failures due to presence of parasite in the blood pose a threat to a patient?s life. For your son herbal drugs can be prescribed as they are widely used as the first line of defence against malignant malaria. Even a combination of various drugs is often resorted to. Quinine can be kept as a reserve as resistance to quinine has not yet developed. Among other drugs, primaquine is prescribed to kill gametocytes, a phase in the parasite?s life that develops in the human body.
blood test
Yes, it increases the chances of detecting malaria parasites in a patient?s blood. After intruding the human body the parasite lodges itself in the red blood cells (RBCs) where it divides and then comes out, rupturing the cells and liberating toxins. This triggers immune response, giving rise to fever. As infected RBCs are destroyed the chance of detecting parasites in them is lesser when fever is not there. During fever, however, multiplied parasites roam in the blood and invade new RBCs, which can be easily detected. It is also important to undertake both thin and thick blood films for examination under microscope to detect the malaria parasite. On rare occasions you may have to get your blood examined more than once. Nowadays, several tests are available. For such tests, a drop of blood is enough and it takes only 20 minutes.
endemic zone
Recently I?ve shifted to a place where malaria is an endemic problem. Is there any way to prevent an infection?
There?s no fool-proof preventive medicine for malaria, although some people take chloroquine as that. However, its prolonged use can be harmful for the eyes. What?s more, chloroquine?s protective shield is lost as soon as it is withdrawn. This paves the way for the malaria parasite to launch a fresh attack. Sometimes the parasite evades drugs and flares up after the withdrawal of the drug. There is a group of drugs called Prognanil which are known to disrupt the development process of the malaria parasites in the liver and red blood cells. There are also drugs that prevent the parasites? development in the red blood cells but cannot inhibit their development in the liver. Due to the emergence of multidrug-resistant malaria parasites, much emphasis is given on a preventive treatment. Chemoprophylaxis (prevention of a disease by chemical means) is no longer prescribed for children or older people, especially in a malaria zone. But it is prescribed for pregnant women to reduce the chances of malaria among them, as well as the birth of low-weight babies or infant mortality.
hidden parasites
I live in central Calcutta. Recently when I had a viral fever a doctor asked for a blood test. It revealed malignant malaria. Is it a rare phenomenon?
You must have been harbouring malaria. In malaria-prone areas it?s not uncommon. Between 1997 and 2003, a study from a malaria zone in Calcutta revealed the presence of the parasite in a large number of people (38 per cent). Several such cases of undetected malaria can be found if a broader survey is undertaken. Your problem stresses the need of a long-term surveillance in the city.
YOUR HEALTH
We invite readers’ queries on health problems. Eminent doctors will respond to them in thiscolumn every week. Mail yourletters to:
KnowHOW,
The Telegraph, 6, Prafulla Sarkar Street, Calcutta 700 001
email: knowhow@abpmail.com
