MALARIA; A LIFE THREATENING DISEASE

Size: px

Start display at page:

Download "MALARIA; A LIFE THREATENING DISEASE"

Kelly Cobb
5 years ago
Views:

year, Most of the deaths occur in poor countries of the tropics and sub-tropic region, it is transmitted by a range of Anopheles mosquitoes and the risk of disease varies greatly across the continent.

1 MALARIA; A LIFE THREATENING DISEASE Sagar D Chavare Satara College of Pharmacy, Satara. Prof. Kailas M. Karande Satara College of Pharmacy, Satara. ABSTRACT: The World Health Organization (WHO) reports that malaria, a parasitic disease transmitted by mosquitoes, malaria is a serious tropical disease that causes more than one million deaths each year, Most of the deaths occur in poor countries of the tropics and sub-tropic region, it is transmitted by a range of Anopheles mosquitoes and the risk of disease varies greatly across the continent. Most malaria infections cause symptoms like the flu, such as a high fever, chills, and muscle pain. Symptoms tend to come and go in cycles. In this study various treatments are available against plasmodium parasites and various mosquito repellent formulations are available to prevent the malaria. Keywords: Malaria, Plasmodium parasites, trimester, Mosquito Repellent. INTRODUCTION Malaria is among the most adverse health problems at present that needs attention all the time because it can be severe & cause death due to increase prevalence of resistance to standard antimalarial drugs. Malarial kills about 3 million persons each year, including one child every 30 seconds. Source: Malaria cause by mosquitoes transmitted disease to more than 700 million persons annually, also insect transmitted disease remain a major source of illness and death worldwide. Insect borne diseases currently represent a greater health problem in tropical and subtropical climate. No part of world is immune to their risks. In very rare cases, people can Special Issue 2, Nov.,

2 get malaria if they come into contact with infected blood. A developing fetus may get the disease from its mother. You cannot get malaria just by being near a person who has the disease. Malaria is a serious disease that causes a high fever and chills. It from a bite by an infected mosquito. Most malaria infections cause symptoms like the flu, such as a high fever, chills, and muscle pain. Symptoms tend to come and go in cycles. Some types of malaria may cause more serious problems, such as damage to the heart, lungs, kidneys, or brain. These types can be deadly. A bite from a parasite-infected mosquito causes malaria. There are five species of Plasmodium (P.) parasites that infect people. 1) Plasmodium falciparum 2) Plasmodium vivax 3) Plasmodium malariae 4) Plasmodium ovale 5) Plasmodium knowlesi SYMPTOMS A malaria infection is generally characterized by recurrent attacks with the following signs and symptoms: Symptoms Symptoms 1. High temperature 13. Sweating 2. Red eye 14. Yellowish eyes 3. Vomiting 15. Body pain 4. Shivering 16. Diarrhea 5. Loss of appetite 17. Sour mouth 6. Headache 18. Convulsion in children 7. Energy less /Body weakness 19. Cough 8. Joints pains 20. Feeling thirsty 9. Dehydration checked by pale eyes 21. Flu 10. Abdominal pain 22. Tears in eyes 11. Dry mouth 23. Weight loss 12. Ichy body 24. Wounds in the mouth Source: Madina Mohmad adia: Medicinal plants used in malaria treatment by prometra herbalists in Uganda. DEATH RATE OF MALARIA "At present, the death figures are only those which have been confirmed as caused by malaria by a lab. We have started collecting new data from the field. The new malaria mortality figures should be available by the end of 2013." The total estimates that India records between 30,014 and 48,660 malaria deaths per year. "On an average, 40,297 Indians die of the mosquito-borne disease every year. Overall, the number of malaria cases is 9.75 million." The government has said only 1,023 Indians died of malaria infection in A Lancet study published in 2011, on the other hand, said malaria actually killed an estimated 46,800 Indians in The Lancet study estimated "4,800 malaria deaths in children younger than 5 years and 42,000 malaria deaths in those aged 5 years or older" for 2010 as against "19,000 malaria deaths in children younger than 5 years and 87,000 malaria deaths in those aged 5 years or older in 2002". Special Issue 2, Nov.,

3 According to the World Malaria Report 2011, over 70% of India's populations face the risk of malaria infection. Around 31 crore people face the "highest risk" of getting infected. India has over 10 crore suspected malaria cases but only 15.9 lakh could be confirmed in TREATMENT Guidelines for treatment of malaria according to WHO I. Recommendations unchanged from the first edition of the Guidelines (2006) A. Treatment of uncomplicated P. falciparum malaria Artemisinin-based combination therapies (ACTs) are the recommended treatments for uncomplicated P. falciparum malaria. The following ACTs are recommended: (1) Artemether plus lumefantrine, artesunate plus amodiaquine, artesunate plus mefloquine, and artesunate plus sulfadoxine-pyrimethamine. The choice of ACT in a country or region will be based on the level of resistance of the partner medicine in the combination. Artemisinin and its derivatives should not be used as monotherapy. Second-line antimalarial treatment: a) Alternative ACT known to be effective in the region; b) Artesunate plus tetracycline or doxycycline or clindamycin; any of these combinations to be given for 7 days; c) Quinine plus tetracycline or doxycycline or clindamycin; any of these combinations should be given for 7 days. B. Treatment of uncomplicated P. falciparum malaria in special risk groups Pregnancy First trimester: Quinine plus clindamycin to be given for 7 days (artesunate plus clindamycin for 7 days is indicated if this treatment fails); An ACT is indicated only if this is the only treatment immediately available, or if treatment with 7-day quinine plus clindamycin fails or uncertainty of compliance with a 7-day treatment. Second and third trimesters: ACTs known to be effective in the country/region or artesunate plus clindamycin to be given for 7 days, or quinine plus clindamycin to be given for 7 days. Lactating women: lactating women should receive standard antimalarial treatment (including ACTs) except for dapsone, primaquine and tetracyclines. Infants and young children: ACTs for first-line treatment in infants and young children with attention to accurate dosing and ensuring the administered dose is retained. Travellers returning to non-endemic countries: Atovaquone-proguanil; Special Issue 2, Nov.,

4 Artemether-lumefantrine; Quinine plus doxycycline or clindamycin. C. Treatment of severe malaria Severe malaria is a medical emergency. After rapid clinical assessment and confirmation of the diagnosis, full doses of parenteral antimalarial treatment should be started without delay with whichever effective antimalarial is first available. For adults, artesunate IV or IM: Artemether or quinine is an acceptable alternative if parenteral artesunate is not available. For children, artesunate IV or IM artemether or quinine is an acceptable alternative if parenteral artesunate is not available. Give parenteral antimalarials in the treatment of severe malaria for a minimum of 24h, once started (irrespective of the patient s ability to tolerate oral medication earlier) and, thereafter, complete treatment by giving a complete course of: An ACT; Artesunate plus clindamycin or doxycycline; Quinine plus clindamycin or doxycycline. If complete treatment of severe malaria is not possible, patients should be given prereferral treatment and referred immediately to an appropriate facility for further treatment. The following are options for pre-referral treatment : rectal artesunate, quinine IM, artesunate IM, artemether IM. D. Treatment of uncomplicated P. vivax malaria Chloroquine combined with primaquine is the treatment of choice for chloroquinesensitive infections. In mild-to-moderate G6PD deficiency, primaquine 0.75 mg base/kg body weight given once a week for 8 weeks. In severe G6PD deficiency, primaquine is contraindicated and should not be used. Where ACT (exception AS+SP) has been adopted as the first-line treatment for P. falciparum malaria, it may also be used for P. vivax malaria in combination with primaquine for radical cure. Artesunate plus sulfadoxine-pyrimethamine is not effective against P. vivax in many places. II. Additional recommendations in the second edition of the Guidelines (2010) A. Malaria diagnosis Prompt parasitological confirmation by microscopy or alternatively by RDTs is recommended in all patients suspected of malaria before treatment is started. Treatment solely on the basis of clinical suspicion should only be considered when a parasitological diagnosis is not accessible. B. Treatment of uncomplicated P. falciparum malaria Special Issue 2, Nov.,

5 Artemisinin-based combination therapies should be used in preference to sulfadoxinepyrimethamine (SP) plus amodiaquine (AQ) for the treatment of uncomplicated P. falciparum malaria. Strong recommendation, moderate quality evidence. ACTs should include at least 3 days of treatment with an artemisinin derivative. Strong recommendation, high quality evidence. Dihydroartemisinin plus piperaquine (DHA+PPQ) is an option for the first-line treatment of uncomplicated P. falciparum malaria worldwide. Strong recommendation, high quality evidence. Addition of a single dose primaquine (0.75 mg/kg) to ACT treatment for uncomplicated falciparum malaria as an antigametocyte medicine, particularly as a component of pre-elimination or an elimination programme. C. Treatment of severe P. falciparum malaria Intravenous (IV) artesunate should be used in preference to quinine for the treatment of severe P. falciparum malaria in adults. Strong recommendation, high quality evidence. D. Treatment of uncomplicated P. vivax malaria In areas with chloroquine resistant P. vivax, artemisinin-based combination therapies (particularly those whose partner medicines have long half-lives) are recommended for the treatment of P. vivax malaria. Weak recommendation, moderate quality evidence. At least a 14-day course of primaquine is required for the radical treatment of P.vivax. Strong recommendation, very low quality evidence. Marketed Formulation for Mosquito Repellent Recently in market various and wide ranging mosquito repellent formulation are available. a. Allout liquid b. Mortein coil and liquid c. Good knight coil and liquid d. Kachhua chap coil e. Simba mosquito repellent stickers f. Good knight sticks g. Mosloc Mosquito repellent patches h. Good knight advanced fast card These formulation are used as mosquito repellent and these formulation content are poisonous to health of human. In formulation DEET, Transfluthrin, Metofluthrin contents are present. these content are toxic to human health. Insect repellent liquids or mats like All out or Good night etc emit fumes which are toxic to the mosquitoes and may cause health problems for humans, if used for prolonged periods. Though liquid repellents are safer than coils and mats whose fumes can cause exacerbation of asthma, hypersensitivity pneumonitis etc, there may be side effects if the liquid repellent is used for prolonged periods. Most common reported side effects are eye Special Issue 2, Nov.,

6 irritation, headache, frequent allergic rhinitis or colds and difficulty in breathing especially for asthmatics. The side effects are more commonly seen in young children and babies. Hence, they should be kept away from such repellents as much as possible. If any cough, breathing difficulty, eye irritation etc is noted. CONCLUSION Malaria is the life threatening disease then it will work on grass rout level. Due to the disease of malaria 40,297 Indians die of the mosquito-borne disease every year. Overall, the number of malaria cases is 9.75 million. To reduce this number of death, certain precaution is necessary which will reduce national expenditure and increase social health of the nation. REFERENCES 1. Adeniran O. I.* and Fabiyi E. et-al 2012, A cream formulation of an effective mosquito repellent: a topical product from lemongrass oil, Scholars research Library, J. Nat. Prod. Plant Resour., 2012, 2 (2): B.Solomona,b, F.F. Sahlea, T. Gebre-Mariamb,*, K. Asresc, R.H.H. Neubetta et-al (2012), Microencapsulation of citronella oil for mosquito-repellent application: Formulation and in vitro permeation studies, European Journal of Pharmaceutics and Biopharmaceutics,80(2012), Christophers SR, Bentley CA. 3. Malaria in the Duars. Simla: Government Press; Kochar DK, Thanvi I, Joshi A, Subhakaran S, Aseri B, Kumawat I. Falciparum malaria and pregnancy. Indian J Malariol 1998; 35: Kondrachine AV. Malaria in WHO Southeast Asia Region. Indian J Malariol 1992; 29: Lt Col P Jaiswal,Col S Srinivasan, Col VK Mehta*, Col A Banerjee(retd)**, Lt Col I Acharya** et-al (2007), Malaria on the move: Ecological Considerations for the Armed Force.MAFI 2007;63: Mdina Mohmad Adiaa,*, Godwin Anywarb, Robert Byamukamaa, Maud Kamatenesi- Mugishab, Yahaya Sekegyac, Esezah K. Kakudidib, Bernard T. Kiremirea, et-al (2014), Medicinal Plants used in malaria treatmrnt by prometra herbalists in Uganda, Journal of Ethnopharmacology 155(2014), Michelle Schoffro Cook et-al (2013), Natural Mosquito Repellent, 9. Prabhakargouda Basanagouda Patil1, Shrinivas Venketesh Kallpur2, Vasant Laxmanrao Kallapur1, Shankar Narayanrao Holihosur1* et-al (2014), Clerodendron inerme Gaertn. Plant as an effective natural product against dengue and filarial vector mosquitos, Asian Pacific Journal of Tropical Disease,2014(Suppl 1): S453-S Subhi Sharma, Unjan Jadon et-al (2011) A Review on low cost herbal Mosquito repellent from Begunia Leaf, IJARPB:2011,1(1), World Health Organization World malaria report. 1. Geneva. Available from: accessed on August 7, Special Issue 2, Nov.,

38 Current Concepts in

38 Current Concepts in Management of Falciparum Malaria Abstract: Artemisinin based Combination Therapy (ACT) is the preferred agent to treat drug resistance uncomplicated Plasmodium Falciparum (PF) Malaria.