Let me state some medical facts;
♥ It is medically wrong, for people, that live in malarial-endemic regions to take prophylactic drugs for malaria. Reason – this lowers their immunity so that any subsequent malaria infection, could lead to cerebral malaria, with its fatal consequences.
♥ However those travelling from temperate regions, where there is no malaria to regions where malaria in endemic, are advised to take prophylactic antimalarial like pyremithamine (daraprine), for the duration of their visit. For the same reason that they have no immunity, so any acute malarial infection, might result in cerebral malaria and become fatal.
♥ Those returning permanently to malarial-endemic regions, after being away for years, example students, and having lost their immunity. Are advised to take the anti- malarial-prophylaxis, and gradually wean themselves off them, after 6 weeks.
♥ This is because when individuals are repeatedly infected with malaria, they develop some immunity to the parasite, but it is maintained only as long as the person remains in the malarial endemic area, and mild infections persist.
♥ Immunity is lost if the person leaves the endemic area and malaria infection stops. Thus adults from tropical Africa are liable to develop a severe attack of malaria on their return from 2 to 3 year visit to an area where malaria does not occur.
♥ We know that malaria in man is nearly always due to infection with Plasmodium (P) falciparum, P malariae, P vivax or P ovale. Occasionally, cases of infection with other malaria parasites like Aedes africanus and Aedes aegypti which also transmit yellow fever, have been recorded.
How often should we take anti-malarial drugs?
■ There are no hard and fast rules. Treatment of malaria should be symptomatic. Sometimes one person is infected with more than one type of malaria parasites, sensitive to different drugs. Hence the malaria parasites, might not be cleared with one type of drug.
■ One thing we must not rule out, is to attribute all weaknesses, all fevers and all headaches to malaria.
■ When patients go to a doctor, they will say, “doc, I have this headache, fever and generalised weakness, and I think it is malaria. How can they always conclude that it is malaria?
■ Some will add that they have taken anti-malarial, without the fever subsiding. So it must be typhoid-fever. Subsequently they will order the doctor to give them anti-typhoid drugs.
■ There is a new rule for treatment of malaria, which every doctor knows, which we always try to inculcate into our patients. We know that majority of our patients self-medicate when it comes to treatment of malaria. If they have pronounced fever, headache and weakness, and do not want to see a doctor. They should get anti-malarial that they could finish within 24 hours.
■ This is very precautionary, in case what they have is not malaria. So that within 48 hours, if symptoms persist, they could then consult their doctors.
■ Imagine a situation, where a patient who has fulminant enteric fever (typhoid fever), and mistakes it for malaria, and then goes to a chemist and buys those anti-malarials, that one has to take for 3 to 5 days to complete a dosage. Of course the patient will not think of seeing the doctor until he finishes his drugs after 5 days. Disaster could strike, the fulminant typhoid could perforate his intestine and death could occur.
■ So please whenever in doubt about what to do about your symptoms, please consult your doctor.
■ Let me again sound a note of warning. A chemist not even a pharmacist, who thought he was doing his patient a favour, told him ” every two-weeks you will come here for treatment of malaria, why not take this latest Sunday-Sunday medicine, for the prevention of malaria, so that you will get rid of this malaria once and for all”. The patient acquiesced. Took the drugs for 3 months. His immunity dropped and he ran out of drugs. He was rushed into Jos University Teaching Hospital(JUTH), unconscious. It was only by a stroke of ingenuity that our Professor’s mind went to “cerebral malaria”, since his relatives said he had never travelled out of Nigeria since he was born. So, it was a given, that he must have immunity for malaria. It was only when he regained consciousness that he told us about his wonder Sunday-Sunday medicine.
What is our take this week?
♥ There is no need for anybody who lives in Nigeria to take the so called “Sunday-Sunday medicine to prevent malaria.
♥ Make your environment as mosquito-free as possible – treated mosquito nets, insecticides etc etc.
♥ Take full treatment for malaria when there are symptoms.
♥ If symptoms persist, after full treatment, please consult your doctor.
♥ We frown at continuous self-medication. So if you take a particular brand of anti-malarial and there is no improvement, consult your doctor.
♥ Anti-malaria prophylactics are for those from non-endemic regions, on visits to malarial-endemic regions.
♥ Please be properly guided.
Dr Ojum Ekeoma Ogwo.