Prevention and Management of Malaria

Prevention/Management of malaria is discussed below. We begin  with preventive/control measures. 

Prevention/Control of malaria : Prevention and control of malaria mainly depend on (a) control of mosquitos through spraying of insecticides like DDT or malathion (b) active and passive  surveillance of the areas where annual parasite  incidence is more than 2 and (c) presumptive and radical treatment of cases of malaria. Let us learn about these measures. 

A) Spraying of Pesticides : The  spraying of insecticides like DDT or malathion is done twice or thrice in an year wherever the annual parasite incidence (number of confirmed cases of malaria during one year per 1000 population) is  more  than 2. 

B) Active Surveillance : Under active surveillance one health  worker  will visit each house in his area, consisting of 1000 households, once  every fortnight. He will enquire whether anyone in the house had fever during the previous fortnight or at the time of the visit. In both the instances, blood  film is collected. He then distributes a single dose of four tablets of chloroquin (drug used  for malaria treatment). This is known as presumptive treatment. 

C) Radical  Treatment : If the blood film is positive, appropriate radical treatment is given. This consists of giving chloroquin along with primquin to kill the parasite. 

In addition to the above measures other methods of prevention/conrol include : 

D) Protection against mosquitos : Protection against mosquitoes can be done by adopting the following four measures: 

• to do  away  with the conditions which render possible the breeding of mosquitoes. 
• to destroy mosquitoes at some period of their life. This can be done by spraying DDT or  spraying kerosene oil, diesel or  fuel oil on the  surface of stagnant water (this suffocates the law  as they cannot breathe) or by introducing larvicidal fish into pools of water  where mosquitoes breed. 
• to prevent the mosquito from biting the man. In endemic areas, the person must be advised to sleep under mosquito nets to prevent mosquito bites. Insect repellents (such as odomos) which are applied to the skin may also help. 
• to attack the parasite as it circulates in the  blood of man. Anti-malarial drugs (chloroquin. pyrimethamine) can  be used for the purpose. 

E) Environmental Sanitation : Improvement of environmental sanitation through filling of drains and stagnant pools is one of the permanent ways of reducing mosquito breeding. In the rural areas, the household drain water should be let  into soak pits instead of letting out into open drains. 

You can also help in the control of malaria  to a certain extent. In areas, where malaria is endemic, assume that all cases of fever are malaria. In  such cases, arrange for presumptive treatment after a blood  film is collected from them. Simultaneously, ensure that  the  health authorities carry out spraying operations to control the mosquitos. If the slide was positive  for malaria the patient  should be educated to  take radical treatment. You can also educate the community  to remove mosquito breeding places such as stagnant pools, cess pools etc. 

Management of malaria : Treatment of confirmed cases of malaria with oral Chloroquin and primaquin is recommended. In acute cases intramuscular chloroquin can be given.