Question

An American visited Ghana with an old friend (Kofi) who has an African descent, who was born in Ghana and has both parents living in Ghana but stays with the American in Canada. the American took antimalarial prophylaxis before his visit to Ghana but Kofi had some misconceptions about the efficacy and side effects of the medicine for prophylaxis so he declined the use before travel and while he was in Ghana. Kofi developed serious malaria whilst in Ghana and almost died.

1. It is believed that those who live in malaria endemic zones have protection from getting malaria illness, so in Kofi's case explain what could be the possible reason(s) why he suffered almost fatal malaria.

2. for Kofi's case what will be the recommended antimalarial and how would it be administered and for what duration to ensure total cure and parasite eradication.

3. Supposing Kofi suffered seizures, was hemiplegic and went into coma as part of the complications observed while on transition to the hospital or in the hospital, what terminology would you use to describe this type of complication from severe malaria illness. Give reason(s) for your answer.

4. List other symptoms or signs of malaria to severe and complicated malaria and indicate how it should be managed therapeutically or non-therapeutically, backed by current evidence of safety and efficacy.

5. When discharged from the hospital, List appropriate strategies that should be applied to prevent Kofi from having reinfection.

Answer 1

1.It is believed that those who live in malaria endemic zones have protection from getting malaria illness, so in Kofi's case explain what could be the possible reason(s) why he suffered almost fatal malaria?

Kofi was of an African Descent where was the 93% of malarial burden experienced. Though there is a chance for him him to develop partial immunity against malaria, he could not acquire it as he lost the exposure to the same, being in Canada. So he is like any people who are prone to Malaria while entering an endemic zone.

2. for Kofi's case what will be the recommended antimalarial and how would it be administered and for what duration to ensure total cure and parasite eradication?

• Artesunate - 2.4 mg/kg/dose
• artemether - 3.2 mg/kg/dose
• Quinie hydrochloride - 20mg/kg
• Primaquine - 0.75 mg/kg
• spray mosquito repellants

3. Supposing Kofi suffered seizures, was hemiplegic and went into coma as part of the complications observed while on transition to the hospital or in the hospital, what terminology would you use to describe this type of complication from severe malaria illness. Give reason(s) for your answer.

The condition is known as CEREBRAL MALARIA which is potent to cause MALARIA ASSOCIATED SEIZURE [MAS]. It is known to be the most heard neurological complication of Plasmodium falciparum malaria. It is most prevalent in endemic zones of Africa.

4. List other symptoms or signs of malaria to severe and complicated malaria and indicate how it should be managed therapeutically or non-therapeutically, backed by current evidence of safety and efficacy

• chills
• rigor
• fever
• headache
• fatigue
• abdominal pain
• vomiting
• jaundice
• hypoglycemia
• shock
• renal failure
• dehydration
• bruises
• epilepsy

5. When discharged from the hospital, List appropriate strategies that should be applied to prevent Kofi from having reinfection

• use mosquuito repellants
• use covered clothes
• consume vitamin and mineral rich diet
• be punctual with medicines
• take good rest
• avoid all chances for a mosquito bite

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