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Essays > Malaria (October 19, 1999 by Pat Heyman)
The army doctors had paid him a visit in the afternoon; there was now no doubt. The Happy Valley fever was malaria. That night Struan lay awake in the four-poster beside May-may. The windows were open to the moon and to the breeze that carried a bracing salt tang. Outside the vast net which enclosed the bed a few mosquitoes relentlessly sought an entrance to the food within. Unlike most of the Europeans, Struan had always used a mosquito net. Jin-Qua had advised it as good for health, years upon years ago.
Struan was brooding about the malarial night gases, afraid that he and May-may were breathing them right now. –Tai-Pan, James Clavell (1966)
- Krogstad, D.J. (1996) Malaria as a reemerging disease. Epidemiologic Reviews 18(1), 77-89.
- This article deals with malaria as an emerging disease. It describes malaria education, drug resistance, Anopheles insecticide resistance, and vaccine development. The article weighs currently available interventions such as bednets and insect repellents versus possible future interventions such as better treatments and vaccine. He believes that an effective vaccine and safe, non-toxic treatments are the solution. Although vector control helps to reduce the intensity of transmission, there is enough natural Anopheles reservoir to keep transmission relatively high. Ancillary measures such as bednets are helpful, they are not enough on their own. The main problem with his interventions is that they do not yet exist. Plasmodium parasites have shown a tremendous penchant for developing drug resistance, so even if they do develop successful vaccines and treatments, there is no guarantee for how long.
- World Health Organization (1996) Malaria: A manual for community health workers:
- The WHO focuses on preventing mosquito bites by vector control measures and ancillary measures such as the use of bednets and mosquito coils. For a detailed description, see the prevention measures above. The main benefit of the WHO measures is that they are available immediately, and they were the same measures used by the United States which had one of the greatest successes of malaria eradication ever. The main drawback is that studies show that although vector control reduces the intensity of transmission, it does not eliminate the disease (Krogstad, 1996).
- Carlisle, D. (1999) Once bitten. Nursing Times 92(37), 42-43.
- A writer for the Nursing Times contracted malaria while in Afganistan. She developed the disease six months later while in London. Her primary care physician did not accurately diagnose her and admitted her to a hospital. One of the nurses recognized her symptoms and promptly put her in isolation because the hospital staff thought it was infectious. It took the efforts of a recently immigrated Zimbabwean nurse to convince the staff that she was not infectious and give her proper support and treatment. The author stated that although it’s not possible for everyone to know everything, it is important to work in a well rounded with a variety of experience and expertise. This is excellent advice for any level of healthcare. Add to it, be willing to use experts and specialists.
Etiology
Pathogenesis
Morphology
Clinical Manifestations