MALARIADESCRIPTION

• Malaria is caused by aparasite calledPlasmodium, which istransmitted via the bitesof infected mosquitoes.In the human body, theparasites multiply in theliver, and then infect redblood cells.

SIGNS & SYMPTOMS• Recurrent chills

• Fever• Profuse sweating• Anemia• Malaise• Hepatomegaly• Spleenomegaly

Incubation period• 12 days for P.

Falciparum

• 14 days for P. vivax and ovale

• 30 days for P. malariae

Risk factor

• The variety that causes the most lethal complications ismost commonly foundin:

• African countries south of the Sahara desert

• The Indian subcontinent

• Solomon islands, Papua New Guinea and Haiti

Risk factor• Risks of more

severe disease People at increased risk of serious diseaseinclude:

• Young children and infants

• Travellers coming from areas with no malaria

• Pregnant women and their unborn children

Infectious agent• Malaria is produced

by intraethrocytic parasites of genus plasmodium.

• There are four parasite species that cause malaria in humans:• Plasmodium falciparum

• Plasmodium vivax• Plasmodium malariae

• Plasmodium ovale.

Transmission

• Malaria is transmittedexclusively through the bites of Anopheles mosquitoes. The intensity of transmission dependson factors related to the parasite, the vector, the human host, and the environment.

• Other modes of transmission Because the parasitesthat cause malaria affect red blood cells, people can also catch malaria from exposures to infected blood, including:

• From mother to unborn child

• Through blood transfusions

• By sharing needles used to inject drugs

Early diagnosis & prompt treatment

• Early diagnosis is the identification of a patient w/ malaria as soon as he/she is seen, through clinical and/or microscopic method.

• Clinical method

Chemoprophylaxis

• Only chloroquine drugs should be given. It must be taken at weekly intervals, starting from 1-2 weeks before entering the endemic area. In pregnant women, it isgiven throughout the duration of pregnancy.

Sustainable preventive & vectorcontrol measures• Objective : To reduce

the source of infectionin the human population; man – vector contact, and the density of the mosquito vector population.

• Insecticide – tx of Mosquito Net

• House Spraying • On stream Seeding• On Stream Cleaning

Recommended anti-malarial drugs• blood schizonticides –

drugs acting on sexual blood stages ofthe parasites w/c are responsible for clinicalmanifestations.

• Chloroquine phosphate 250 mg (150mg base/ tablet

• Sulfadoxine (or sulfalene) 50mg- pyrimethamine 25mg/tab

• Quinine sulfate 300mg tab

• Quinine hydrochloride300mg/ml, 2ml ampule

• Tetracycline hydrochloride 250mg/capsule

• Quinidine sulfate 200mg/durules

• Quinidine glucolate 80mg (50mg base) ml, 1ml vial

Other preventive measures

• Wearing of clothing that covers arms & legs in the evening.

• Avoiding outdoor night activities, particularly during thevector’s peak biting hours from 9PM- 3AM.

• Using mosquito repellents such as mosquito coils, soap lotion or other personal protection measures advocated by the DOH/MCS- Malarial Control Service.

• Planting of neem tree or other herbal plants w/c are (potential) mosquito repellents as advocated by the DOH/MCS

• Zooprophylaxis- the typing of domestic animals like carabao, cow etc., near human dwellings to deviate mosquito bites from man to these animals.

Complications

• In most cases,malaria deaths arerelated to one ormore of these seriouscomplications:•Cerebral malaria.If parasite-filled bloodcells block smallblood vessels to yourbrain (cerebralmalaria), swelling ofyour brain or braindamage may occur.

•Breathingproblems.Accumulated fluid inyour lungs(pulmonary edema)can make it difficult tobreathe.

•Organ failure. Malaria cancause your kidneys or liver tofail, or your spleen to rupture.Any of these conditions can belife-threatening.

•Severe anemia. Malariadamages red blood cells, whichcan result in severe anemia.•Low blood sugar. Severeforms of malaria itself can causelow blood sugar, as can quinine— one of the most commonmedications used to combatmalaria. Very low blood sugarcan result in coma or death.

Nursing Diagnosisand Nursing

Interventions forMalaria

• Changes in nutrition less than body requirements related to inadequate food intake, anorexia, nausea / vomiting

Nursing Intervention :• Give extra food to eat

little and small.Rational: gastric dilatationmay occur when feeding too fast after a period of anorexia.

• Maintain a schedule of regular body weight.Rational: Monitors the effectiveness of weight loss or nutrition intervention.

2. High risk of infection related to a decrease in body systems (main defence is inadequate), invasive procedures.

Nursing Intervention:

• Monitor body temperatureincreases.Rational: Fever caused by the effects of endotoxin on the hypothalamus and hypothermia are important signs that reflect the development status of shock / decreasein tissue perfusion.

• Observe the chills and diaphoresis.Rational: Shivering often precedes the height of thetemperature on a common infection.

3. Hyperthermia is related to increased metabolism of circulating germ dehydration direct effect on the hypothalamus.

Nursing Intervention:• Monitor patient's

temperature (degree andpattern), note the chills.Rational: Hipertermi showed an acute infectious disease process. The pattern of fever indicatesa diagnosis.

• Monitor the temperature of the environment.Rational: The temperature of the room / the number of sheets should be changed to maintain the temperature close to normal.

Nursing management:

1. The patient must be closely monitored.

• A. Intake and output should be closely monitored to prevent pulmonary edema.

• B. Daily monitoring of patient’s serum bilirubin, BUN creatinine, and parasitic count

2. If the patient exhibits respiratory and renal symptoms, determine the arterial blood gas and plasma electrolyte

3. During the febrile stage, tepid sponges, alcohol rubs, and ice cap on the head will help bring the temperature down.

4. Application of external heat and offering hot drinks during chilling stage is helpful.

5. Provide comfort and psychological support.

DiagnosticProcedure

• Malarial smear – In thisprocedure, a film of blood is placed on a slide, stained, and examined microscopically.

• Rapid diagnostic test (RDT) – This is a blood test for malaria that can be conducted outside the laboratory and in thefield. It gives a result within 10 to 15 minutes. This is done to detect malarial parasite antigen in the blood.