Sunday, January 16, 2011

Malaria, Mosquitoes, ...

I recently read a really good series of articles online about malaria. They are quite detailed, a bit long and not dumbed down, but very readable for the layperson.

The articles were apparently written by a doctor who has lived in Uganda (a neighboring country of Tanzania) for many years and wanted to clear up the confusion around a disease that everyone knows about but with a lot of misunderstanding and misconceptions.

The articles are written as seven parts. I give a brief description of each part and provide a link to it.

Part 1. What happens when malaria gets into your blood stream and multiplies.

Part 2. Developing (partial) immunity. How the parasite actually reproduces and gets spread between people.

Part 3. Diagnosis, misdiagnosis, symptoms, and prophylaxis.

Part 4. Rapid tests for malaria and what can go wrong with them.

Part 5. Effective treatment, treatment options, risks.

Part 6. Prevention options, besides drugs.

Part 7. Prophylaxis drugs. Some thoughts about prevention.

For Diane and me, one thing I got from reading this series is that we are actually pretty unlikely to get sick with malaria, for several reasons.

First, it is only a certain kind of mosquito that can carry the malaria parasites. I have been looking carefully at the ones in our home that bite us. They are not the malaria kind. Also, we are rarely outside when it is dark, which is when the malarial mosquitoes are mostly out and about. My guess is that in our day to day life here in Mtwara our exposure to potentially infectious bites is really very low.

On the other hand, if we should go travel somewhere on a wildlife safari the exposure could shoot way up. As long as we are in Tanzania we should not become complacent.

Second, the fact that we are both taking a prophylaxis called mefloquine provides a lot of protection against the parasite should it be introduced into our bodies. According to the author, he has not seen a single case of a patient taking mefloquine properly who has had malaria. Other types of prophylaxis are also extremely effective.

Third, the symptoms that indicate possible malaria can all be caused by other diseases, of which there is a plethora in sub-Saharan Africa. Missing those others can be serious.

If we do get sick and suspect malaria we should be careful about the diagnostic process. Malaria seems to be greatly overdiagnosed.

In any case, besides the risk of malaria I get a fair number of mosquito bites that are just plain very itchy and annoying. So we use a mosquito net on our bed, I often wear long pants at home even when it's hot, and I keep insect repellant handy if we do go out at night. -Earl

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