CHRONIC ILLNESS Reducing Malaria infections and Malaria Deaths in Children
It was the World Malaria Day recently on the 25th April 2016. The theme for this year was on ending Malaria for good! What a lofty but achievable dream.
On the Ask The Paediatricians Facebook Group we had a Group Discussion on Malaria anchored by Dr Chudi Godsons.
Here are some important facts about Malaria in Children you need to know.
As parents, you are part of the Squad in the fight to eradicate Malaria completely. Knowledge is very key in this war. This post gives all the information you need to know about Malaria.
What causes Malaria in Children?
Malaria is caused by a parasite called plasmodium, which is transmitted via bites from mosquitoes (female anopheles) which introduce the parasite into the bloodstream.
This is the commonest means of transmitting malaria in children, however there are other ways of transmitting this infection including blood transfusion (infected blood) and trans-placental (through the placenta in pregnant women).
The Malaria parasite lives and feeds on blood (blood borne infection), specifically the red blood cells (RBCs).
Why is Malaria in Children important?
Children are vulnerable to malaria attacks and also are more likely to have severe forms of the infection compared to adults.
Young children, having a poorly developed immune system, can easily develop malaria even with just one bite from mosquitoes.They are also at increased risk of adverse clinical outcomes including anemia and death.
Can malaria be completely eradicated/ prevented among children?
Inasmuch as it might sound oversimplified, the answer is yes. But ALL hands must be on deck to achieve this common goal.Matter of fact in well developed countries, malaria is a rare occurrence. We can replicate same in sub Saharan African including Nigeria.
What are the common symptoms/ presentation of malaria in Children?
- Fever
- Sweating
- Diarrhea and vomiting,
- Chills and shivering
- Headaches (children that are old enough to express themselves can give a history of persistent headaches)
- Fatigue, weakness
- Poor appetite & cough
- Anemia – shortage of blood is a symptom that follows malaria
- Enlargement of the spleen
- Dehydration
What are the risk factors of malaria in children?
- Residence in, or travel through, a malarious area (endemic area)
- No previous exposure to malaria (hence no immunity), for example foreigners.
What are the complications of severe malaria?
Malaria can be fatal, especially the variety that’s common in tropical parts of Africa. In most cases, malaria deaths are related to one or more serious complications listed below:
- Cerebral malaria – this is one of the dreaded complications of severe malaria. It is a common outcome of poorly treated or untreated malaria in children. Here the parasite-filled blood cells block small blood vessels to your brain (cerebral malaria), leading to swelling of your brain or brain damage may occur. This may cause coma and death.
- Breathing problems due to accumulated fluid in the lungs of children.
- Multi Organ failure. Malaria can cause the kidneys or liver to fail and even the spleen to rupture. Any of these conditions can be life-threatening.
- Anemia – Malaria damages red blood cells, which can result in anemia.
- Low blood sugar. Severe forms of malaria itself can cause low blood sugar, as can. Very low blood sugar can result in coma or death.
So how is the diagnosis of malaria in children made?
The gold standard is blood tests for malaria parasite. This can show the presence of the parasite and same time, help tailor treatment by determining whether your child has malaria. Some blood tests can take several days to complete, while others can produce results in less than 15 minutes.
What are the treatment options of malaria in children?
Artemisinin-based Combination Therapy (ACT) are the anti-malarials recommended in Nigeria. They are safe and well tolerated by young children. Examples of such ACTs include arthemeter-lumefantrine, artesunate-camoquine and so on.
For severe malaria, the children may require injectable antimalaria initially at the beginning of the treatment.
Please avoid the use of antimalarials like Chloroquine which are no longer in use due to malaria parasite resistance to them. Such practice delays effective treatment and can lead to complicated malaria that can result in deaths.
Also avoid random self-medication and treatment of every fever as Malaria. Malaria must be confirmed by the laboratory tests before treatment.
Always go to the hospital for the tests and prescription of antimalarials by the doctors.
Ensure children take the adequate doses and complete the full treatment even if they are already feeling better.
The preventive steps for Malaria are simple and include:
- Use of long-lasting insecticidal treated nets. If we prevent the contact between mosquitoes and children, then ultimately, we will banish malaria to pits of hell.
- Indoor residual spraying – this helps to kill off mosquitoes in households
- Intermittent preventive treatment of malaria in children especially in areas of high malaria transmission.
In conclusion, Malaria is common here in Nigeria and many parts of Africa; and virtually everyone has had malaria at one point in time or the other. Yet it is important to know that Malaria is a killer especially in young children and pregnant women.
Early confirmation and diagnosis will lead to early treatment with safe ACT antimalarials.
Armed with correct information, together as parents we can end Malaria for good by year 2030!!!
Thank you for reading and I look forward to reading your questions and comments.
You can also join the live discussion on the Ask The Paediatricians Facebook Group.
Good day doc, my question goes thus
1- is it possible for a child to have malaria without having fever as a sign
2- am a nursing mother on an antimalarial drug n also av catarrh, can I combine both d antimalarial drug and loratadine together?I want to know if it won’t affect my baby n me.
3- is it true that when my baby have catarrh or cold I can take d drug so he would suck thru breastfeeding since am on EBF.
Hi Muhibat.
1. Yes it is possible
2. If prescribed your doctor, yes.
3. Not true…You are not meant to take drugs on behalf of your baby to pass through breast milk.
Kindly take the baby to see a doctor for proper evaluation and treatment directly if the baby is sick.
Please what’s the best insecticide to use in the house when you have a newborn and you feel there is mosquito around the house. Because I heard baygon is too strong for a new born. Thank u
What we recommend is for the baby and indeed the entire family to sleep under long-lasting insecticide-treated nets! If you want to use the sprays, please ensure that the room is well-aerated afterwards before bringing the baby back in so as not to affect the baby!
Hello doctor. Is it okay to treat a 2month old baby for malaria as a preventive measure? The child would be taken to a pediatrician for proper prescription.
No! We do not give prophylactic antimalaria treatment to children any longer. They will be treated when they have malaria. Meanwhile prevent Malaria by ensuring the baby sleep under long-lasting insecticide treated nets.
Hello doc, my 10weeks old was admitted and was been treated for malaria, vomiting and stooling, she was even transfussed they used quinine antimalaria for her they also gave as the oral one after she was discharged for 7days, she is fine now but according to ur post that it is not effective in treating malaria does that mean she still has malaria? She is 12weeks now.
Hi Gloria. Quinine is one of the effective antimalarials in fact we reserve it for treating severe malaria. I hope you are not confusing Quinine with Chloroquine? They are not the same drugs. It is chloroquine that is no longer effective. I am sure your baby is fine now. So there is no need for you to worry!
Dr my baby is stooling and vomiting since yesterday and she is crying and feeling weak. I have given her ors and zinc tablet but she is still stooling out water. Pls wat do I do and what could be the cause
Take her to the hospital Jennifer. Read more here
pls ma, my four months old baby sweats profusely even when all others are feeling cold, she has chills n fever. She has mosquito bites as well. I have been advised by a doctor to treat her for malaria. Please should i go ahead an treat her n what drugs can I give her. She’s just four months.
You should first take her to the hospital and have the malaria confirmed by having the Malaria tests done along with some other tests. There are many causes of fever in infants apart from Malaria so doctors should not just advise treating malaria without seeing the child and doing appropriate laboratory investigations. The same doctor will then recommend appropriate antimalarial drugs and the dose is based on the weight of the child. It is not what I can do online. So I will advise you take the child to the hospital.
Please doctor, my toddler weight at birth was 2.2kg, at six weeks his weight was 4.5kgkg and now he’s four month and weighs 7.7.
Should I be worried?
No! The weight is fine.
Read about what your baby’s weight should be here What is my baby’s ideal weight?