(Primary Health Care)
– some simple teaching guidelines – part 1)
The scale of the problem faced
This remains a major killer disease. A recent
study in Ghana found that the average person could expect to be
bitten by a mosquito approximately 2000 times each year. Of these
bites a minimum of 100 will be malarial. At least 2 million people
die each year as a direct result of malaria (of which one million
are children) and the weakness brought on by recurrent bouts is a
major factor in the death of many more. It is estimated that at
least half the children currently living on the continent of Africa
are afflicted by a minimum of one serious bout of malaria before
their third birthday. Research recently released in Sierra Leone
show that more children have died as a direct result of malaria than
from the violence associated with the civil war.
Up to 30 percent of the 960,000 deaths
attributable to malaria in Africa each year occur in countries beset
by conflict, war or natural disasters, the World Health Organisation
(WHO) has reported. A number of organisations which work in
emergency situations gathered recently at WHO headquarters in
Geneva. They discussed ways of trying to improve the action plan for
malaria control response during and following emergencies. The
Global Partnership to Roll Back Malaria has set a goal of halving
malaria deaths world-wide in ten years. Partners include national
governments, the WHO, the United Nations Children's Fund (UNICEF),
the UN Development Programme, the World Bank, and bilateral
mosquito spreads the disease (see diagram) There are government
programmes to control malaria and everyone must be aware of how they
can prevent the spread of this killer disease.
Young people can help by preventing mosquitoes from breeding and
biting people and by knowing what to do when someone has malaria.
Malaria: some important facts
The germ, which causes malaria, is called
Plasmodium and is carried by the female Anopheles
mosquito. Other mosquitoes do not carry malaria but they may carry
other diseases. An Anopheles
mosquito can pick up the Plasmodium
germ by biting people who have malaria. The germ develops inside the
mosquitoes and then the mosquito can pass it on to another person.
When a female Anopheles mosquito bites a person, the malarial germ
enters the person’s blood. It then moves into the liver and back
out into the bloodstream. When this happens the person begins to
feel unwell. They will develop:
a fever –
that is a high temperature
The fever will go away but it may keep coming
back and may get worse each time it reappears. Treatment is
essential, or the person may become very ill. Children are
particularly at risk from malaria.
Anyone suffering from malaria should try to get
to a health centre. At a centre they will be asked to give a small
sample of their blood. Looking at it under a microscope the health
centre will test the blood sample. The health worker will be looking
for the Plasmodium germ in the blood. The more a person has been
bitten the more likely they are to have malaria.
Can we do something to reduce the risk of catching malaria?
Yes, we can but we must try to stop the Anopheles mosquito from biting us. There are several ways of doing
this. These are:
making it difficult for them to get near you – keep
windows shut or screened, especially at night. Try to keep your
doors shut, or covered by a material that does not allow the
mosquito to enter the house or room.
Using nets – though these cost money they do help
prevent the spread of malaria. If you follow some simple rules you
can reduce the chance of catching malaria. These are: put the net
over the bed before it gets dark at night. Tuck the net into the bed
and carefully check that no gaps have appeared. Regularly repair
your net. Some nets are sprayed with a chemical that mosquitoes do
not like. These are more expensive but are even better at keeping
the mosquitoes away from you. BUT
remember that mosquitoes can bite you through your net and
mosquitoes stay around until after sunrise, so don’t come out from
underneath your net just because it is getting light.
clothes that make it more difficult for mosquitoes to bite you.
Mosquitoes see you as a something that is hotter in some parts of
your body than in others. Your ‘hot spots’ are where your blood
passes close to the surface of your skin. So, try to be covered by
say a blanket or cloth around your neck, your elbows and your
Using mosquito coils – these also help but again
think of where you are most at risk and put the coils near to your
ankles. Let the smoke the coil gives off spread around your room.
Using a repellent, which are expensive but also help
keep mosquitoes away from you. Once again put them close to your
ankles, elbows and necks and they will give you more protection.
Some governments spray areas with chemicals to
try and reduce the mosquito population. The insecticide falls onto
the walls of buildings and any mosquito landing on it will die.
How can we prevent mosquitoes breeding?
There are things we can do but we must keep
doing them. We can:
put stones and earth into holes and puddles that are
near our house
put small fish into ponds and ditches that are near to
where we live
put oil on the surface of small ponds and ditches that
are near to where we live
cover water pots and containers with cloth
put special chemicals into latrines/toilets
What to do if a child look to have malaria
A child who appears to have what we call the
symptoms of malaria needs to see someone who can help them -
quickly. They must be taken to a health or medical centre. There
they will be given a medicine called Cholorquine.
It might also be called;
Malariaquin, Nivaquine or Resoquin. In some places other
medicines will be available –they all work to help cure the child,
so don’t worry. You must take the correct dose and use all of the
medicine, or you might not get better. Some medicines do not taste
very nice but they must be swallowed. Children suffering from the
sweats that often appear, as part of malaria need to be kept cool
but not cold. Putting cold water on a cloth and applying it to their
head can help this. Sometimes the child might start to shiver. But
don’t put too many clothes or blankets on a child with a high
fever during the shivering stage of an attack of malaria, for this
is dangerous. Medicines like paracetamol can help reduce temperature
but only take the recommended dose. Taking too many paracetamol
tablets can be very dangerous. When a child sweats it loses body
liquids and therefore should be made to drink more. As soon as they
feel able to eat again give them some food that helps build their
strength (later in the series we will be giving advice on diet and
Normal doses of chloroquine to treat malaria.
dose about 6 hours
One year old
1-3 years of age
4-6 years of age
7-11 years of age
Small 12-15 year
Large 12-15 year
are the recommended numbers of tablets containing 300mg-chloroquine
time: Let’s pretend to be scientists –Malaria Part 2