MALARIA
PART A
Atovaquone plus proguanil Dosage – the adult dose is 1 adult-strength tablet
a day. Child dosage is also once a day, but the amount depends on the child's
weight. It should be started 1 or 2 days before your trip and taken every day you're in
a risk area, and for 7 days after you return. A lack of clear evidence means this
antimalarial shouldn't be taken by pregnant or breastfeeding women. It's also not
recommended for people with severe kidney [Link] side effects –
stomach upset, headaches, skin rash and mouth ulcers.
Doxycycline (also known as Vibramycin-D)
Dosage – the dose is 100mg daily as a tablet or capsule. You should start the
tablets 2 days before you travel and take them each day you're in a risk area,
and for 4 weeks after you return.
Recommendations – not normally recommended for pregnant or
breastfeeding women, but your GP will advise. Not recommended for children
under the age of 12 (because of the risk of permanent tooth discolouration),
people who are sensitive to tetracycline antibiotics, or people with liver
problems.
Possible side effects – stomach upset, heartburn, thrush, and sunburn as a
result of light sensitivity. It should always be taken with food, preferably when
standing or sitting.
Mefloquine (also known as Lariam)
Dosage – the adult dose is 1 tablet weekly. Child dosage is also once a week,
but the amount will depend on their weight. It should be started 3 weeks
before you travel and taken all the time you're in a risk area, and for 4 weeks
after you get back.
Recommendations – it's not recommended if you have epilepsy,
seizures, depression or other mental health problems, or if a close relative
has any of these conditions. It's not usually recommended for people with
severe heart or liver problems.
Possible side effects – dizziness, headache, sleep disturbances
(insomnia and vivid dreams) and psychiatric reactions (anxiety,
depression, panic attacks and hallucinations). It's very important to tell your
doctor about any previous mental health problems, including mild depression.
Don't take this medication if you have a seizure disorder
Chloroquine and proguanil A combination of antimalarial medications called
chloroquine and proguanil is also available, although these are rarely recommended
nowadays because they're largely ineffective against the most common and
dangerous type of malaria parasite, Plasmodium falciparum.
TEXT B
MANAGEMENT OF UNCOMPLICATED MALARIA IN PUBLIC HEALTH FACILITIES
PART C
If malaria is diagnosed and treated promptly, a full recovery can be expected.
Treatment should be started as soon as a blood test confirms [Link] of the
same antimalarial medicines used to prevent malaria can also be used to treat the
disease. However, if you've taken an antimalarial to prevent malaria, you shouldn't
take the same one to treat it. This means it's important to tell your doctor the name of
the antimalarials you [Link] type of antimalarial medicine and how long you need
to take it will depend on:
the type of malaria you have
where you caught malaria
the severity of your symptoms
whether you took preventative antimalarial tablets
your age
whether you're pregnant
Your doctor may recommend using a combination of different antimalarials to
overcome strains of malaria that have become resistant to single types of
[Link] medication is usually given as tablets or capsules. If
someone is very ill, it will be given through a drip into a vein in the arm
(intravenously) in [Link] for malaria can leave you feeling very tired and
weak for several [Link] some cases, you may be prescribed emergency standby
treatment for malaria before you travel. This is usually if there's a risk of you
becoming infected with malaria while travelling in a remote area with little or no
access to medical care.
Examples of emergency standby medications include:atovaquone with
proguanil,artemether with lumefantrine,quinine plus doxycycline,quinine plus
clindamycin
If you're pregnant, it's advisable to avoid travelling to areas where there's a risk of
[Link] women have an increased risk of developing severe malaria, and
both the baby and mother could experience serious [Link]'s very important
to take the right antimalarial medicine if you're pregnant and unable to postpone or
cancel your trip to an area where there's a malaria [Link] of the antimalarials
used to prevent and treat malaria are unsuitable for pregnant women because they
can cause side effects for both mother and baby.
Mefloquine – not usually prescribed during the first trimester of pregnancy, or if
pregnancy is a possibility during the first 3 months after preventative antimalarial
medication is stopped. This is a precaution, even though there's no evidence to
suggest mefloquine is harmful to an unborn baby.
Doxycycline – never recommended for pregnant or breastfeeding women as it could
harm the baby.
Atovaquone plus proguanil – not generally recommended during pregnancy or
breastfeeding because research into the effects is limited. However, if the risk of
malaria is high, they may be recommended if there's no suitable alternative.
Chloroquine combined with proguanil is suitable during pregnancy, but it is rarely
used as it's not very effective against the most common and dangerous type of
malaria parasite
PART D
Malaria is a serious illness that can be fatal if not diagnosed and treated quickly.
Pregnant women, babies, young children and the elderly are particularly at
[Link] Plasmodium falciparum parasite causes the most severe malaria symptoms
and most [Link] complications of severe malaria can occur within hours or days
of the first symptoms, it's important to seek urgent medical help as soon as
[Link] destruction of red blood cells by the malaria parasite can cause
severe [Link] is a condition where the red blood cells are unable to carry
enough oxygen to the body's muscles and organs, leaving you feeling drowsy, weak
and [Link] rare cases, malaria can affect the brain. This is known as cerebral
malaria, which can cause your brain to swell, sometimes leading to permanent brain
damage. It can also cause fits (seizures) or [Link] complications that
can arise as a result of severe malaria include:
liver failure and jaundice – yellowing of the skin and whites of the eyes
shock – a sudden drop in blood pressure
pulmonary oedema – a build-up of fluid in the lungs
acute respiratory distress syndrome (ARDS)
abnormally low blood sugar – hypoglycaemia
kidney failure
swelling and rupturing of the spleen
dehydration
The World Health Organization (WHO) recommends that pregnant women should
avoid travelling to areas where there's a risk of [Link] you get malaria while
pregnant, you and your baby have an increased risk of developing serious
complications, such as:
premature birth – birth before 37 weeks of pregnancy
low birth weight
restricted growth of the baby in the womb
stillbirth
miscarriage
death of the mother
Visit your GP if you're pregnant and travelling to a high-risk area. They may
recommend taking antimalarial medication.
Questions 1-7 For each question, 1-7, decide which text (A,B,C or D) the
Information comes from. You may use any letter more than once. In which
text can you can find information about .
1. What is cerebral malaria?
2. Examples of emergency standby medications?
3. Complications of severe malaria?
4. First dose administered through direct observation of the HWs?
5. Lariam is not suggested if you have epilepsy?
6. Dose malaria has full recovery?
7. Pulmonary oedema?
Answer the questions,8-14,with a word or short phrase from the
texts. Each answer may include words, numbers or both.
8. Why doxycycline is not recommended for children under the age
of 12?
9. Which condition where the red blood cells are unable to carry
enough oxygen to the muscles and organs?
10. Which diagnostic test is used for suspected case of malaria?
11. Which medication should always be taken with food?
12. What is the standard dose of vibramycin-D?
13. Which parasite causes the most severe malaria symptoms?
14. To whom you need to consult if you are pregnant and travelling
to a high risk area?
Questions 15-20
Complete each of the sentences, 15-20, with a word or short phrase
from one of the texts. Each answer may include words, numbers or
both.
15. The type of antimalarial medicine and how long you need to take
it will depend upon the .................of your symptoms.
16. ......................suggests that pregnant women should avoid travelling
to malaria risk areas.
17. Complications of severe malaria can occur within ................... of
the first symptoms.
18. Antimalarial medications is usually given as.....................
19. Mefloquine should be started .................. before your travel.
20. ..........................................should be started as soon as a blood test
confirms malaria.
