CME : Your SA Journal of CPD - Volume 26, Issue 6, 2008
Volume 26, Issue 6, 2008
Source: CME : Your SA Journal of CPD 26 (2008)More Less
Source: CME : Your SA Journal of CPD 26 (2008)More Less
When I was a child I lived in Lusaka and travelled to Bulawayo to go to school - always by train. One of the things I had to carry with me was a circle of wire for keeping my hated mosquito net up above my bed at boarding school, and then again when I got home. I didn't know anything about the disease - just hated sleeping under a mosquito net, and one trip, the home run back to Lusaka, I left the wire on the train. As it happened that was my final trip anyway.
Author Karen I. BarnesSource: CME : Your SA Journal of CPD 26, pp 278 –279 (2008)More Less
Karen Barnes' main interest is in improving the routine case management of malaria in southern Africa, and her research focus is the comprehensive evaluation of malaria treatment policy changes in this region. She is a temporary advisor to the World Health Organization on various malaria treatment policy committees, and an active member of the National Malaria Advisory Group and the Regional Malaria Control Commission.
Author Cheryl CohenSource: CME : Your SA Journal of CPD 26, pp 280 –282 (2008)More Less
Human immunodeficiency virus (HIV) infection affects the clinical presentation, severity and response to treatment of malaria cases, and malaria may affect the progression and transmission of HIV. In addition, there are potential interactions between drugs used for the treatment and prevention of malaria and antiretroviral therapy. The clinical impact of these interactions varies depending on the intensity of malaria transmission in the area (and consequent level of host immunity) and the individual affected (e.g. adult, child or pregnant woman).
Author Lee BakerSource: CME : Your SA Journal of CPD 26, pp 284 –289 (2008)More Less
Malaria is a common and potentially severe disease that is endemic in more than 100 countries worldwide. It is estimated that more than 125 million international travellers visit these countries every year, many of whom fall ill with malaria while in these countries and more than 10 000 fall ill on returning home. It is said that more than 3 million South African residents travel to malaria areas each year and are at risk of contracting malaria.
Source: CME : Your SA Journal of CPD 26, pp 290 –292 (2008)More Less
The key issues in the successful management of malaria are early and accurate diagnosis and urgent treatment with effective drugs. Disease presentation is, however, not specific - progression to complicated disease may be rapid in non-immune persons, particularly in young children and pregnant women, and parasite drug resistance significantly influences treatment outcome.
Author Gary MaartensSource: CME : Your SA Journal of CPD 26, pp 294 –295 (2008)More Less
Infection with Plasmodium falciparum induces changes in red blood cells that cause them to adhere to each other and to the endothelium. These changes in the red cells reduce their deformability. Red cells become sequestered in the microcirculation (Fig. 1) where maturation of the parasite occurs prior to haemolysis and infection of new red blood cells. Blockage of the microcirculation by sequestered red cells may result in organ dysfunction and failure, which is responsible for most of the manifestations of severe malaria. Pro-inflammatory cytokines, notably TNF-α, also play an important role in the pathogenesis of severe malaria. Red cell sequestration does not occur with the other plasmodium species and, apart from extremely rare cases, they do not cause severe malaria or death.
Source: CME : Your SA Journal of CPD 26, pp 297 –298 (2008)More Less
Febrile patients in malaria-endemic areas need rapid and accurate diagnosis to ensure prompt access to antimalarial treatment to avoid severe disease. As most fevers in malaria-endemic areas of South Africa are not caused by malaria, and symptom-based diagnosis is highly nonspecific, rapid demonstration of the presence or absence of malaria parasites reduces delays in appropriate management of non-malarial fever, saves resources by reducing use of antimalarial drugs, and helps to determine true malaria prevalence. The introduction of malaria antigen-detecting rapid diagnostic tests (RDTs) has extended the possibility of such accurate, rapid diagnosis to the whole population for the first time.
Author U. MehtaSource: CME : Your SA Journal of CPD 26, pp 300 –302 (2008)More Less
NM, a 34-year-old woman, is brought to your hospital's emergency room in a semi-conscious state, with a high fever, sweating and rigors. Her husband provides the following history : NM lives in a rural village in KwaZulu-Natal on the Mozambican border. She visited a private general practitioner 4 days before with a 4-day history of headache, fever, joint pains, nausea and vomiting. She was given 3 sulfadoxine / pyrimethamine (Fansidar) tablets and sent home with paracetamol. She vomited soon after leaving the doctor and continued to deteriorate over the next 3 days until she became confused and very sleepy. Her husband took her to the traditional healer who gave her a special tea that he claimed would help her, but she did not improve.
Author Rajendra MaharajSource: CME : Your SA Journal of CPD 26 (2008)More Less
Although the incidence of malaria in South Africa has decreased dramatically over the past 5 years, it remains one of the major public health problems within the southern African region. Efforts to control malaria are generally two pronged : the mosquitoes are the focus of vector control interventions, while the parasites are targeted by means of case management.
Source: CME : Your SA Journal of CPD 26, pp 304 –308 (2008)More Less
With the massive rise in international travel over the last 10 years, the world has become a smaller place and it is probably easier nowadays to contract an infectious disease than in years gone by. Malaria kills up to 2 million people worldwide every year, the majority of whom are Africans. Effective prophylaxis against malaria is widely available and deserves to be prescribed diligently by health professionals for travellers to malaria areas. Of course, the use of mosquito repellants and other physical protectants with the oral prophylaxis is mandatory.
Author Chris BatemanSource: CME : Your SA Journal of CPD 26, pp 310 –311 (2008)More Less
South Africa :
Tunisian doctors help with staff shortage
Cholera victims in Soweto
Government wants to appoint health pricing 'facilitator'
Manto's plan could endanger SA hospitals
Ebola hits Ugandan health workers
The next killer disease?
Stem cells from menstrual blood?
Brain exercise boosts IQ?
New way to suppress HIV
Alzheimer's - potential cure
Anti-addiction medicines up suicide risk
Author Jane BadhamSource: CME : Your SA Journal of CPD 26, pp 312 –314 (2008)More Less
Everyone seems to know and take for granted that vegetables and fruit are good for you. As a result the health promotion message to eat plenty of vegetables and fruit doesn't get a voice among the ever-increasing and competing health messages communicated to the public. The reality is that knowledge does not always translate into action and a lack of action in even the most basic of health messages often results in a public health issue.