Practical Approaches in fighting Malaria

Only the female Anopheles mosquito caries malaria and only they put their tale up when they bite you. If the tail’s not up, it’s not a malaria mosquito.
I took this with my son’s camera at the YWAM Clinic in Kangulumira Uganda. You can see the distinctive double dotted ring form of P. falciparum malaria (lower middle), and two schizonts (upper left)

Practical Approaches in fighting Malaria

Insecticide-treated bed nets (ITNs)

ITNs protect millions of people from malaria, but Malaria3though they are subsidized in most developing nations, helping families afford to have them is a challenge. And for families, having to decide which of their children will sleep under a single net and which will remain exposed is a heart-breaking choice.

Indoor Residual Spraying (IRS)
The unjustifiable banning of all uses of DDT in Malaria41972 has been responsible for approx. 97 million preventable malaria deaths, an infanticide far greater than Stalin, Mao, and Pol Pot combined).
Malaria Clock) Only in the last few years has limited residential spraying again been allowed in some nations. Spraying DDT inside dwellings presents no discernible human or environmental hazard.

Effective Treatment – ACT
(Artiseminin Combination Therapy)

Malaria6With the Chloroquine quickly loosing it effectiveness to treat the most dangerous type of malaria (P. falciparum) due to increasing resistance, for the past 10 years we’ve been transitioning to a new and effective malaria treatment based on Artiseminin from  the Chinese Sweet Wormwood plant. However to try to slow the development of resistance to this drug, since about 2005 the WHO is only promoting its use in combination with another antimalarial in an Artiseminin Combination Therapy (ACT).  In Cambodia the derived compound Artusunate is combined with mefloquine; in West Africa with Amodiaquine but here in EastAfrica we’ve seen ih combinations with Lumefantrine and with Piperquine.

New Rapid Tests for P. Falciparum
In 1991 at Tulane we were developing rapid “inexpensive” antibody test for malaria, but I first saw them field tested in Sierra Leone in 2005, but this year is the first year we’ve had them widely available.

Microscopic Dx from thick & thin smears
Malaria8However even at US$1.50/test the Rapid Test is not affordable in many situations (and it only detects P. falciparummalaria) so at most clinics in Uganda the lab technician’s skills in microscopy are still necessary or in the many first line clinics, fever is just presumptively treated as malaria.

Better Malaria Education
Malaria5From Moscow to Miami, Nome to New Orleans, in most of the industrialized nations, malaria has been eradicated from it’s former range. While the mosquitoes are still there, a sustained collaboration between public health and household-level behavioral change has made a difference.


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