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Dealing with malaria in children


A child with severe malaria Photo: William Daniels

Malaria is a common mosquito borne disease in most part of the world, which is more severe among children between the ages of six months to five years. Dr. Gbemisola Boyede, a Consultant neuro-developmental paediatrician at the Lagos University Teaching Hospital (LUTH) tells GERALDINE AKUTU about malaria in children and how parents can deal with it.

What causes malaria in children?
Malaria is caused by the malaria parasite, known as Plasmodium falciparum, which is usually injected into the blood of children by bites from infected female Anopheles mosquitoes.

What signs and symptoms should parents look out for?
Malaria’s most common symptom is intermittent high-grade fever (High Body Temperature). Other symptoms include poor appetite, weakness (malaise), vomiting, diarrhoea, cough, bitter taste in the mouth and so on. There are other serious symptoms in children with severe type of malaria, such as convulsions, yellowness of the eyes, reduction in urine output, etc.

How is it transmitted?
Malaria is transmitted through mosquito bites. When the mosquito bites someone with malaria, he sucks in the malaria parasites and when it bites another person without malaria, it releases the malaria parasites into the blood of the new victim, who will now develop malaria after nine to14 days period (incubation period), where the malaria parasite undergo some changes and multiplication. The malaria parasites multiply in the red blood cells of infected children and then burst, releasing certain substances, which often lead to the high fever and other symptoms of Malaria.

Who is at risk for malaria?
Everyone who lives in malaria endemic areas, such as Nigeria is at risk of malaria. However, children below the age of five, pregnant women, children with sickle cell anaemia and non-immune persons or travellers from malaria-free countries are at risk of having the severe type of malaria.

What are the treatment options?
There are readily available and effective malaria drugs. What is recommended, as the first line treatment, is the Artemisinin Based Antimalarial Combination Therapy (ACT). These medications are over-the-counter drugs and have the green leaf logo. Malaria treatment using just one drug, such as Chloroquine, Fansidar, Halfan, etc., are no longer recommended, as I still see parents doing this, which is wrong.You are also not to treat every fever as malaria. The diagnosis of malaria should be confirmed first by the malaria parasite blood test. Now, we have rapid malaria tests that will give you results in 15 minutes and can be done by anyone, and not necessarily a laboratory scientist.

Parents should endeavour to go for and do the Rapid malaria test first and if confirmed that the child has malaria, should give the three-day course of the ACT malaria treatment, which are usually available for all the age/weight ranges of the children for easy administration.

What measures should parents take to protect their child from malaria?
Measures to prevent malaria are many. The most important one for children is the use of long-lasting insecticide treated nets (LLITNs). Children and, indeed, the entire family should sleep under the LLITNs. These are more than just the ordinary nets, because they have been impregnated with chemicals that can kill the mosquitoes, which perch on them. Additionally, the children should wear long sleeve clothing outdoors in the evenings and early mornings, which are the peak period of mosquito bites, to reduce as much as possible mosquito bites. The environment should also be kept clean and free from mosquito breeding sites by regularly clearing bushes and drains.

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