Malaria is an acute life threatening illness spread to humans by certain types of mosquitoes, Anopheles mosquito being the most common vector for transmission in Kenya.
It does not spread from person to person.
It is is preventable and curable.
It presents suddenly over hours or days and should be suspected on the basis of typical symptoms like:
- Hotness of body
- Chills
- Nausea and vomiting
- Generalized body weakness
- Muscle pain and joint pains
- Severe acute anemia
- End organ damage involving brain, lungs or kidneys
- One should also be keen on history of recent travel to a Malaria-endemic region.
The most common causative agent in our setting is Plasmodium Falciparum.
Malaria proceeds through cycles of rising and falling body temperature followed by sweating as red blood cells burst and release the parasite into the blood.
Malaria is usually classified into four:
1. Uncomplicated malaria: General symptoms of fever, generalized body tiredness, nausea and vomiting and a positive malaria smear or test but no evidence of end organ damage.
2. Complicated or severe malaria: High level of parasitemia (parasites in the bloodstream) or evidence of end organ damage, including:
- Cerebral malaria (seizures, altered mental status)
- Pulmonary edema and hypoxemia (low level of oxygen)
- Kidney injury
3. Algid malaria (a rare complication of tropical malaria, occurs in 0.37%of cases. It presents with severe hypotension, shock and hypothermia.
4. Treatment failure: Persistent or worsening symptoms 2-3 days after initiation of drug therapy.
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MANAGEMENT OF MALARIA
For uncomplicated malaria, oral lumefantrine-artemether, commonly known by the names AL and Coartem) is the drug of choice in Kenya.
In severe complicated malaria, intravenous artesunate should be used.
Malaria has been a significant public health concern in Kenya, especially in certain regions with favorable conditions for mosquito breeding. Here are some key points about malaria in Kenya according to the WHO:
- Endemicity: Malaria is considered endemic in Kenya, meaning it is consistently present in certain areas and can cause regular outbreaks.
- Prevalence: Malaria is a major cause of ill health and death in Kenya, particularly among young children and pregnant women. The occurrence of malaria can vary by region and season.
- Vector: The primary vector for transmitting malaria in Kenya is the Anopheles mosquito, specifically Anopheles gambiae and Anopheles funestus.
- Species: Plasmodium falciparum is the most common species of the malaria parasite found in Kenya. It is also the most deadly species and is responsible for the majority of severe malaria cases.
- Interventions: The Kenyan government, in collaboration with international organizations and partners, has been implementing various malaria control and prevention strategies. These strategies include the distribution of insecticide-treated bed nets, indoor residual spraying, and effective case management using artemisinin-based combination therapies (ACTs).
- Diagnosis and Treatment: The Kenyan health system provides diagnostic testing and treatment for malaria, with a focus on prompt and accurate diagnosis using rapid diagnostic tests (RDTs) and microscopy.
- Challenges: Malaria control efforts in Kenya face challenges such as drug resistance, insecticide resistance, limited access to healthcare in remote areas, and environmental factors that promote mosquito breeding.
- Surveillance and Reporting: The Kenyan Ministry of Health, with support from WHO and other partners, conducts surveillance to monitor the malaria situation, track trends, and assess the effectiveness of control measures. A malaria vaccine (RTS, S/AS01) has since been introduced in parts of Kenya for children under 5 for severe malaria, it has been a game changer with a drop in under 1 and under 5 children deaths.
MALARIA PROPHYLAXIS
Ensure that your under 5 children have been vaccinated and also sleep under a treated mosquito net if you live in a malaria prone region.
It is also advisable to take malaria prophylaxis 1-2 days before travelling to a malaria prone regions. In Kenya, atovaquone-proguanil (Malarone) is one of the most common malaria prophylaxis.
Pregnant women are always advised to sleep under a treated mosquito net as well as take malaria preventive treatment during the antenatal clinic.