Liang Huan QiangTHE DRY season in West Africa has already passed and the rainy season has arrived. In Ghana, when it rains, the weather delivers a bit of clear and cool atmosphere for people.

However, the rainy season is when people get attacked by malaria more than in the dry season in Africa.

How do people prevent malaria illness and reduce attack rate and spend the rainy season safely and soundly?

It is important for doctors to give a useful direction for preventing malaria.

In Ghana, malaria is endemic throughout the country and is recognized as the leading public health problem. The incidence of clinical malaria is about 3 attacks per child per year.

Most of the cases are caused by plasmodium falciparum, which is transmitted through the bite of the female Anopheles mosquito. it is estimated that malaria contributes about 44% of all out-patient cases and about 22% of all deaths in children under five.

In pregnant women, about 13% are affected and 10% go on admission with the disease. As much as 9% of pregnant women die from malaria.

Since the commencement of the rains this year, most areas in Ghana, for example, Greater Accra Region, Ashanti Region, Brong-Ahafo Region, Central Region, Eastern Region, Volta Region, Western Region, Upper East Region, Upper West Region and Northern Region have experienced an increase in the statistics of malaria cases.

About 70 per cent of the patients seen in Korle-Bu Teaching Hospital in Greater Accra Region suffered from malaria, which had caused suffering and sometimes death to many people, especially infants.

Malaria is a common all-year-round disease in Ghana, where people generally take poor anti-malarial measures, with most not taking any preventive care.

To prevent and reduce the incidence of malaria is the common goal of Korle-Bu Teaching Hospital’s consultants and medical workers in Accra.

Malaria is preventable, so how do we prevent and reduce its incidence?

Because of the heavy rains, stagnant waters create a good breeding place for flies and mosquitoes. since mosquitoes carry the parasite which causes malaria, and reproduce in large numbers, maintaining general sanitation is very important as a preventive measure.

Because mosquitoes can bite anybody at night, people should popularize the use of mosquito nets when sleeping at night.

They should use insecticide-treated mosquito net (ITN) or medicated nets which kill mosquitoes, and must disinfect rubbish dumps if possible.

Clearing grass around the compound and maintaining hygienic conditions indoors and outdoors will also help. Indoor spraying and mosquito-repellent skin creams also help to prevent mosquito bites.If one is bitten by a mosquito which carries plasmodia, and the body cannot resist, he or she may get the malaria soon after.

If you are attacked by uncomplicated malaria disease, you will have headaches, sore throat, pains in the abdomen or limb joints, feel tired and have no appetite, which will be followed by a high body temperature. you feel cold and emit cold sweat as well as show signs of insufficient energy.

These symptoms will last on and off for about a week or so. If something like this happens to you, you should go and see a doctor and take medicine at once without any delay.

The complicated (severe) malaria disease is also prevalent in Ghana. when you suffer from the complicated (severe) malaria disease, the symptoms can be anaemia, convulsion, yellow eyes and diarrhea, dehydration, have low sugar, feel weak and the kidneys may not work well. The complicated (severe) malaria disease patients are often seen at Korle-Bu Teaching Hospital.

In case you get this type of the disease, know that it is a very dangerous. it is very important to take action to get treatment immediately.

Artesunate-Amodiaquine is the combination drug of choice for treating uncomplicated malaria. Alternate drugs are Artemether-Lumefantrine and Dihydroartemisinin-Piperaquine.

Severe malaria is managed with quinine injection. In treating cases of severe or complicated malaria, the five support therapies are recommended when and where necessary:

1. Transfusion for severe anaemia.

2. Infusions to correct fluid electrolyte imbalance.

3. Anti-convulsants for convulsions.

4. Anti-pyretics for hyperpyrexia.

5. Prevention and treatment of hypoglycaemia.

Oral Quinine is used to treat pregnant women with uncomplicated malaria in the first 3 months of pregnancy. Oral quinine or the combination of Artesunate-Amodiaquine can be used in the 4th to 9th months. The treatment of pregnant women with severe malaria is the same as the treatment of severe malaria for the general population.

Intermittent Preventive Treatment (IPT) is based on the use of an anti-malaria drug Sulfadoxine-Pyrimethamine which is given in treatment doses at predefined intervals after quickening (first 12 weeks of pregnancy) to reduce malaria parasitaemia and poor pregnancy outcomes.

It is assumed that every pregnant woman living in areas of high malaria transmission has malaria parasites in her blood or placenta, whether or not she has symptoms of malaria.

The major aim of IPT in pregnancy is preventing the parasites from attacking the placenta so that the foetus can develop normally and avoid low birth weight.

The specific anti-malarial, Qing Hao Su, which is produced by China, is very effective for preventing and treating the malaria disease.

Qing Hao Su derivatives are the basis for Artemisinin combination drugs which are the cornerstone of malaria treatment today.

It should be the concern of all to know about the prevention, timely cure, as well as propagate and popularize issues concerning malaria.

Knowledge is the best preventive measure in the struggle against this killer disease. By Liang Huan Qiang, Professor of the Jinan University, China

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