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When malaria is diagnosed, it should be treated. Some malaria is resistant to some
drugs. Malaria is dangerous for children, and debilitating for adults. Clinics are
often poorly equipped, medicines in short supply and staff overworked.
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Image credit: Seeking permission
Image credit: Seeking permission
Image credit: Seeking permission
Image credit: Seeking permission
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Malaria Plasmodium life cycle
Somehow, the malaria plasmodium life cycle needs to be broken, and the malaria parasite
removed from the human host. The symptoms for an individual patient may be relieved by
drug therapy, but the public health issue remains as long as there are malaria parasites
resident in any human host.
Bigger image ... more info
Surveillance ... diagnosis
Control of any epidemic is facilited by early detection and early intervention. This is
one of the challenges of malaria because malaria occurs in many places where public health
facilities are rudimentary. The use of medication needs to be associated with actual cases
of malaria, and not merely with malaria-like symptoms. Malaria is best diagnosed by a
simple blood smear, and looking for the typical ringform ... easy with trained personel, a
microscope and the necessary supplies, otherwise very difficult.
Quinine ... Chloroquine
Quinine was the first medical treatment and used for decades to mitigate the impact of malaria.
Chloroquine was the first medically developed drug, and became very widely used both as a prophylactic
and for treatment. By the 1970s resistance started to become significant, and 30 years later
chloraquine is rarely effective, though it is still being widely used where medical services
are limited or unavailable.
Newer more expensive drugs
Newer more expensive drugs have been developed ... but they are not widely available and not
widely affordable. It is not clear whether the price of these more expensive drugs is a result
of blatant profiteering by all concerned, is a result of short supplies in a global market economy
or is a legitimate reflection of the drug costs.
Research
Research needs to be ongoing ... there is an existing crisis, but it could get worse, and
more scientific knowledge might help in handling a future more problematic situation. At the
same time, the work that needs to be done NOW is to use what is already known to mitigate the
current crisis in the best possible way.
Resistance
The build up of resistance to malaria treatment using drugs is a problem that concerns malariologists.
Where, health policy relies mainly on curative care using drug treatment in an environment where
malaria is endemic and reinfection rapid and persistant, then there is going to be a high risk of
rapid resistance build up.
Reducing the pool of malaria parasite
As much as anything else, the goal of medical treatment should be to reduce the pool of malatia
parasite in the human population so that there can be as fast a reduction in the transmission
of the parasite to others. Medical case management needs to be an integral part of a comprehensive
integrated malaria management program
Metrics of success
One of the key metrics of success is the reduction in the prevalence of the malaria parasite in the
human population. The number of malaria cases is an indicator of progress ... but the goal is not
pnly to reduce cases but to have the whole population malaria parasite free.
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IMM
About Integrated Malaria Management
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Surveillance, data collection and analysis
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Environmental clean-up
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Source control
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Interior residual spraying
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Ultra Low Volume (ULV) spraying
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Personal protection ... insecticide treated bednets
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The medical dimension
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