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Malaria makes a come back
WHO World malaria report 2013
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Malaria in Nepal in Bhutan
Malaria makes a come back
Malaria is a general term, which includes groups of diseases caused by a parasite called plasmodium, which has several species. The disease was described by Hippocrates, the father of medicine in the fifth century BC. It is a highly communicable disease and the word malaria is derived from mala-azia, which means bad air, as initially it was supposed to be transmitted rapidly by bad air.

It is estimated that around 100 million clinical cases occur each year and the actual number of persons infected is about 250 million. Many undiagnosed and sub-clinical cases may be the persistent sources of transmission to others.

Around the world 54 percent of the population lives in the areas where malaria exists. It is the most important public health problem in the tropical and sub tropical regions in summer seasons. In context of Nepal, it is very much prevalent in the Terai region. In each person with high-grade fever, malaria should be suspected if he / she is from Terai. The disease exists in areas less than 2000 m from the sea level.
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It is transmitted to man by certain species of infected female Anopheles mosquitoes. Male mosquitoes can't transmit it. When the parasite is injected into the bloodstream by a mosquito bite it first invades liver and later the red blood cells, destroying them.

After several steps of division and mutation it becomes infectious to others on 4 to 12 days of infection. Uncommon modes of transmission are via blood transfusion and from infected mother to newborn child. It is a disease of the poor, prevalent in developing countries including India and Nepal. Ill- ventilated and ill-lighted houses provide ideal indoor nesting place for mosquitoes. The anopheles mosquitoes lay eggs in stagnant water and thus clogging of water and poor drainage, as is commonly found in developing countries, provide favorable environment for mosquitoes. Pits, garden pools, irrigation canals, and engineering projects have led to the breeding of mosquitoes and an increase in the incidence of malaria.

What to do?
When one is infected with malaria parasite, he or she may develop high-grade fever in ten to twenty days. Fever may be present daily, in alternate days or after every two days. It is usually associated with chills or rigours.

There may be jaundice or severe weakness. Spleen and liver may get enlarged. Falciparum species of malaria can affect brain also leading to headache, irrelevant talking, convulsions and other neurological problems leading sometimes to coma. Some patients may pass very dark colour of urine.

Health When one has symptoms like these, he/ she has to visit doctor and examination of blood confirms diagnosis. As many anti-malarial drugs have developed resistance, treatment should be well supervised. Considering the morbidity and mortality due to malaria and its widespread prevalence, the prevention programs are far more important. Initially DDT was used to control mosquitoes but after initial spectacular success, the program began to lose momentum due to resistance to DDT and other technical problems.

There are many simple measures to be applied by the individual, which includes use of repellents like odomas, protective clothing, bed nets and screening of houses.

Destruction of adult mosquitoes by using domestic space sprays like Baygon before going to bed is another alternative. Peridomestic sanitation and intermittent drying of water container helps to minimize mosquito larvae. Filling of pits, small-scale drainage and other forms of water management reduce source for mosquitoes. As the disease is rapidly communicable through mosquitoes, early diagnosis and treatment should be the rule.


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Malaria Fact Sheet
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