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Written by Angelina Phang, Pharmacist

What is Malaria?

Malaria is a serious mosquito borne disease caused by Plasmodium genus parasite that transmitted by Anopheles mosquitoes, infected mosquitoes. Malaria have been the major public health problem in Malaysia since 1900’s, reported 50,500 cases in 1990, and the incidence rate reduced to less than 1 per 1000 population since 1998. The Ministry of Health (MOH) Malaysia targeted “zero human indigenous malaria” status in the year 2020 and followed by three consecutive years where all the Malaysian must show commitment in the efforts to prevent malaria.

 

There are 5 main malaria precautions such as:

A = Awareness

  • Be Aware of the risk and the symptoms of malaria.

B = Bite Prevention

  • Avoid being Bitten by mosquitoes, especially between dusk and dawn.

C = Chemoprophylaxis

  • If prescribed to you, use Chemoprophylaxis (antimalarial medication) to prevent infection.

D = Diagnosis

  • Immediately seek Diagnosis and treatment if a fever develops one week or more after being in a malaria area (up to one year after departure)

E = Emergency

  • Carry a stand-by Emergency treatment kit if available and recommended (the kit that contains malaria treatment).

Symptoms:

  • Headache
  • Lassitude
  • Fatigue
  • Abdominal discomfort
  • Muscle and joint aches
  • High fever (>40⁰C)
  • Chills
  • Perspiration
  • Anorexia
  • Vomiting
  • Worsening malaise

Malaria treatment by Ministry of Health (MOH) Malaysia:

New blood stage infection

  1. In area with chloroquine-susceptible infections, treat adults and children with an artemisnin-based combination therapy (ACT) or chloroquine.
  2. In area with chloroquine-resistant infections, treat adults and children with an ACT.
  3. Treat pregnant women in their first trimester who have chloroquine-resistant with quinine.

Preventing relapse

  1. The G6PD status of patients should be used to guide administration of primaquine for preventing relapse.
  2. To prevent relapse, treat malaria in adults and children with a 14-days course of primaquine in all transmission settings.

Pregnant and breast feeding women

  1. In women who are pregnant or breastfeeding, can consider weekly chemoprophylaxis with chloroquine until delivery and breastfeeding are completed, then, treat with primaquine to prevent future relapse.

Who is at HIGH risk for malaria?

  • Travelers or visitors to endemic areas
  • Army personnel
  • Loggers/rubber tappers
  • Workers in endemic areas (example: construction or plantation)

Malaysia’s Health Ministry effort in Malaria Awareness:

  • With the Malaria Elimination Program in place, MOH have successfully combated malaria, from 4,164 cases in 2011 to 0 (zero) case in 2018.
  • National Malaria Elimination Strategic Plan was introduced in 2018 with the target of “malaria free” status by the year 2020.
  • In conjunction with World Malaria Day 2019, WHO had themed “Zero Malaria Starts with Me” on 25th April 2019.
  • “Ready to beat Malaria”, 25th April 2018.
  • “ LETS Close The Gaps”, 25th April 2017
  • “End Malaria For Good”, 25th April 2016
  • “Invest In The Future: Defeat Malaria”, 25th April 2013, 2014, 2015
  • “Sustain Gains, Save Lives: Invest in Malaria”, 25th April 2012
  • “Achieving Progress and Impact”, 25th April 2011
  • “Counting Malaria Out”, 25th April 2009, 2010
  • “Malaria: A Disease Without Borders”, 25th April 2008

Reference:

  1. World Health Organization. Guidelines for the Treatment of Malaria. Second edition. 2010. Geneva: WHO Press.
  2. Deen JL, von Seidlein L, Pinder M, Walraven GE, Greenwood BM. The safety of the combination artesunate and pyrimethamine sulfadoxine given during pregnancy. Trans R Soc Trop Med Hyg 2001;95:424–28.
  3. Ministry of Health Malaysia. National Antibiotic Guideline 2008.
  4. The Star Online. (2019). Malaysia on track to meet zero malaria target by 2020, says Health Ministry. Retrieved December 9, 2019, from https://www.thestar.com.my/news/nation/2019/05/05/malaysia-on-track-to-meet-zero-malaria-target-by-2020-says-health-ministry.
  5. Centers for Disease Control and Prevention. Treatment of Malaria (Guidelines for Clinicians).April 2011 http://www.cdc.gov/malaria/resources/pdf/clinicalguidance.pdf
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