TREATMENT OF MALARIA IN PAEDITRICS: A REVIEW

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About Author:
Kambham Venkateswarlu
Final Year Graduate Student
Sri Lakshmi Narasimha College of Pharmacy,
Palluru, Chottoor-517132, Andhra Pradesh, India.
k.v.reddy9441701016@gmail.com

ABSTRACT:
Malaria is an infectious disease caused by a parasite (plasmodium) which is transmitted from human by the bite of infected female Anopheles mosquitoes. Four species of the parasite plasmodium are responsible for Malaria in humans: Plasmodium vivax, Plasmodium malariae, Plasmodium ovale, Plasmodium falciparum.
This disease cause a nearly 300 to 400 million clinical episodes of malaria occur worldwide, out of which 1.5 to 2 million die every year. So this is also a most dangerous disease in children. This review reveals the treatment of malaria in paediatrics.


Reference Id: PHARMATUTOR-ART-1623

I.INTRODUCTION:
Malaria is an infectious disease caused by a parasite (plasmodium) which is transmitted from human by the bite of infected female Anopheles mosquitoes.

II.DESCRIPTION OF MALARIA:
Four species of the parasite plasmodium are responsible for Malaria in humans:
* Plasmodium vivax
* Plasmodium malariae
* Plasmodium ovale
* Plasmodium falciparum

-    Over 90 million cases of malaria occur each year.
-    Advance in the chemotherapy of malaria was delayed until 1880, when Laveran finally identified the parasites in the blood.
-    In India 60% of infections are due to P.vivax.
-    In India 40% of infections are due to P.falciparum.
-    In India 1% of infections are due to P.malariae.
-    P.ovale: It is rare parasite of man, mostly confined to tropical Africa.

III.HISTORY:
The female anopheline mosquitoes ability or competence to transmit malaria governed by a complex interaction of environment, behavioural and biological features including vector density, blood meal preference, feeding and resting habits, flight range, longevity, humidity and temperature. Hence, agricultural development, irrigation, available of drugs and pesticides, knowledge of and attitude to the disease, nocturnal, etc., will all play a part in the local epidemiology of the disease.

IV.ETIOLOGY:
Malaria in man is mainly caused by above mentioned 4 distinct species.


Differentiating features of P.vivax and P.falciparum malaria: 

S.NO

P.vivax

P.falciparum

1

It is relatively benign and rarely produces serious complications of death.

It is associated with serious complications eg. Cerebral malaria, jaundice, renal failure including high mortality

2

In this type of malaria less than 1% of RBCs are parasitized.

In this the number of RBCs involved may go up to 35%

V.TYPES OF MALARIA:
According to severity of illness, malaria can be broadly classified into two types
1.      Benign
2.      Malignant

1. Benign Malaria:
*    Relatively milder disease.
*    Generally caused by P.vivax.
*    Seldom fatal.
*    The chance of involvement of other organs is much less.
*    Also referred to as Uncomplicated Malaria.
2. Malignant Malaria:
*    Severe.
*    Rapid downhill course.
*    Caused mainly by P.falciparum and rarely by P.vivax.
*    Poor prognosis.
*    Now a days “severe malaria” are used more frequently to describe this type of malaria.

VI.SIGNS AND SYMPTOMS:
*    Moderate to severe shaking chills.
*    High fever
*    Profuse sweating as body temperature falls
*    General feeling of unease and discomfort (malaise)
*    Headache
*    Nausea
*    Vomiting
*    Diarrhoea

VII.DIAGNOSIS:
Diagnosis of malaria involves identification of malaria parasite or its antigens/products in the blood of the patient. Although this seems simple, the efficiency of the diagnosis is subject to many factors. The different forms of the four malaria species; the different stages of the erythrocytic schizogony; the endemicity of different species; the population movement; the inert-relation between the levels of transmission, immunity, parasitemia, and the symptoms; the problems of recurrent malaria, drug resistance, persisting viable or non-viable parasitemia and sequestration of the parasite in the deeper tissues; and the use of chemoprophylaxix or even presumptive treatment on the basis of clinical diagnosis can all have a bearing on the identification and interpretation of malaria parasitemia on a diagnostic test.

The diagnosis of malaria is confirmed by blood tests and can be divided into microscopic and non-microscopic tests.

Microscopic Tests:
These tests involves staining and direct visualization of the parasite under the microscope
1. Peripheral Smear Study
2. Quantitative Buffy Coat (QBC) Test

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