Malaria Treatment, Symptoms, Prevention in india 2020

we’ll be talking about the new guidelines in malaria and the program for malaria that is national vector borne disease control program what are the new updates that have come now first of all what do you mean by a malaria suspect kills any person who is having fever which chills with out chills without any localizing signs and symptoms that means the person does not have cuff a cold or burning micturition or a skin lesion or something only plane fever is there then all such people will be considered as the suspects of malady now once you are suspecting your patient to be a malaria case what you should do is that you have to confirm it remember that the presumptive treatment of malaria is banned which means just on the basis of the signs and symptoms.

then our treatment of choice is going for chloroquine it’s a three-day regime and will be giving a total of 25 milligrams per kg of chloroquine over a period of three days so generally it is in a divided dose of ten milligrams ten milligrams and five milligrams per kg per day now along with the chloroquine in the case of the vivax will be also giving the radical treatment in the form of primer Queen now this primer Queen will have to be given for 14 days to achieve the radical treatment of malaria,

without a confirmatory lab diagnosis you should not and you cannot give treatment for malaria so you have to get this diagnosis of malaria confirmed using the lab test no what are our options you can go for the peripheral blood smear for malaria or you can also go for the new ones that is the rapid diagnostic test kits now both of these tests will be able to detect both the important types of the parasite that is the vibe acts as well as the falciparum type of the malaria now this person could be either a case of vivax malaria or it could be a case of falciparum malaria or it could be a case of mixed malaria wherein the person has got both vivax and falciparum together if it is a case of vivax malaria.

but before you administer primer Queen you have to be aware of certain contraindications of the primer Queen what are those Asians well of course it is contraindicated in infants because the safety is not assured pregnant ladies in all the three trimesters it is also contraindicated in those individuals who are g6pd deficient now suppose if someone is not aware about the g6pd state as in g6pd test is a genetic test which is not easily available in the peripheries so how do you go ahead with such patients so this is the case of I wax I want to give them primer queen but I don’t know what is their g6pd status so how do I go ahead with it what we do in such cases is we give hemoglobin we’d go for the hemoglobin test if the person is anemic then we do not take the risk of giving primer Queen so in most of these patients will have to avoid giving primer Queen till your the anemia is cured but if the person is not anemic a at that point then you can take the calculated risk of giving primer Queen under supervision but then the patient has to be told of the warning signs of hemolysis and this would be dark-colored mature Asian representing him bacteria or central cyanosis developing in the patient so if these symptoms develop they’re supposed to immediately stop taking primer Queen and report to a health center.

now coming to the falciparum treatment as you know the falciparum is showing a great amount of resistance to the chloroquine so there is no point in giving chloroquine and increasing the resistance further so in the case of the falciparum patients we go for eight CT that is the artesunate combination treatment now the guidelines for the a CT are different in the northeastern states of india and the other states of the india in the predominant other states of the india the treatment guideline that we follow is a three-day regime of artesunate on day one two and three in addition you will be giving a single dose of sulfur dachshund and pyrimethamine now this is generally given on the day one of the treatment along with the artisanal and the third drug would be a single dose of primer Queen which will give on d2 now the primer cone which you are giving over here is not for the radical treatment of falciparum because you do not required in falciparum here the primer queen is basically for it is gamma 2 C del action so it is required for the primary treatment of this material episode in the northeastern states we give combination of our team ether and lumefantrine and again you have to give a single dose of primer kun to boost this treatment for them so in the majority of the states the non northeastern states will be giving artesunate sulfur docks in pyrimethamine and primer Qin in the northeastern states will be giving activator lumefantrine and primer Qin so we give this three drug combination for falciparum now so far we talked about the treatment of eye wax and the treatment of the falciparum in the non pregnant individuals.

but what if you require the treatment to be done in pregnancy now if you have a pregnant woman who is suffering from vivax malaria then remember that chloroquine is a very very safe drug so you can give it in any trimester of the pregnancy and as far as the primer queen is concerned of course it is contraindicated for the radical treatment yeah so when it comes with treatment of the falciparum malaria in the third and the second trimester pregnancy is there and she’s suffering from let us say falciparum so can I give her artesunate well yes artesunate can be given in the second in the third trimester can I give her sulphur ox environmental mean yes you can give that also can I give primer queen of course not so in the second and third trimester pregnancy you can give the two drugs that is artesunate and sulfur oxygen pyrimethamine but primer queen will have to be avoided and you should not give this primer Queen after pregnancy because this is not for radical treatment but if it is the first trimester pregnancy then can I give our tissue net sulfur oxygen pyrimethamine or primer Queen well unfortunately no all these three drugs are contraindicated in the first trimester of pregnancy so what do we give to the pregnant women in the first trimester for the treatment of falciparum the drug of choice is Queenie so we’ll be giving Queen in for the treatment of falciparum malaria in the first trimester in pregnant what about those people who are having mixed malaria which means they are having the falciparum also and they’re having the why what’s also in such individuals of course you have to treat them as falciparum malaria but since these people also have why wax you have to give them additional 14 days of primer Queen over and above the primer Queen that you had given as part of the primary treatment so you will be given the single dose of primer Queen as treatment of the files malaria plus we’ll be giving 14 days of primer Queen for the radical treatment of the vivax melody now remember that the doses are different what we are giving for the primary treatment of the falciparum is point 75 milligrams per kg of primer queen and what we are giving for the radical treatment is point 25 milligrams per kg of the primer cool over a course of 14 days so that is the treatment that we follow in the mixed malaria cases suppose if it’s the case of mixed malaria in the second or the third trimester of pregnancy then you will be giving only the treatment of falciparum in the form of artesunate and sulfur toxin pyrimethamine and the pemmican would be avoid but of course you will give radical treatment after pregnancy if it is the first time is mixed to malaria case then you will be giving queen eel as the drug for treating.

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