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Pediatric Malaria Treatment & Management

Pediatric Malaria Treatment & Management

by: Dr. Sorabh Goel
Consultant - Neonatology-Paras Bliss, Panchkula

Malaria is an infection caused by protozoa (small organism) plasmodium, which is transmitted among humans by mosquito bite. It is a disease characterized by fever with chills and rigors, at regular interval like daily or alternate day, sweating, anemia, fatigue and enlarged spleen. Malaria is of overwhelming importance in the developing countries with approximately 300-500 million cases per year and 1 million deaths each year.

Cause:

Infection is caused by protozoa; plasmodium. Four species plasmodium has been identified. Falciparum species is most notorious and known for causing severe complications of malaria. It is transmitted among human beings by mosquito bites which mostly bite at dusk and dawn.

Symptoms:

It is a disease characterized by fever with chills and rigors, at regular interval like daily or alternate day, sweating, anemia, fatigue and enlarged spleen. It may have atypical presentation like fever without any periodicity in the beginning. Complicated malaria can involve other organs also, so presentation may vary depending on organs involved. Liver is commonly involved in severe malaria and may present as jaundice, hepatitis, blood in vomiting or stools. Seizures, unconsciousness, coma may be the presenting complaint if infections involve the brain. Child may present with shock or low blood pressure.  Malaria causes decreased immunity, making patient susceptible to serious bacterial infections, which further worsens the disease.

Management:

Management includes timely diagnosis and treatment. Diagnosis can easily be done by blood smear examination by a trained pathologist. Various kits are also available in the market for rapid diagnosis.  Treatment includes control of fever with antipyretic medicines, good diet, adequate fluid intake, rest and specific medicines for killing the protozoa circulating in the blood. Child with complicated malaria needs hospitalization, ICU care and supportive care as per the organs involved. Complications can easily be prevented by timely diagnosis and early treatment.

Prevention of Malaria:

Malaria is easily preventable by taking few simple precautions.

Prevention of mosquito bites:

  • Full body covering clothes and use of mosquito nets can protect us from mosquito bites.
  • Screen on windows and doorways are effective method for preventing mosquito entry into the houses.
  • Use of mosquito repellents (after 2 months of age), which are available in many forms like bands, gels, creams, stickers etc when child is going out. Never forget to remove that once child is back.
  • Regular spray of mosquito killing agents both indoor and outdoor.

Chemoprophylaxis:

Drugs are available which are recommended for travellers travelling to malaria endemic places to prevent malaria even after mosquito bites.

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