World Malaria Day...

April 25, 2009 marks World Malaria Day; a day to focus on how we can play a role in reducing the impact of malaria world wide.

The impact of malaria hit home once again this week when I met Mohamed.
Mohamed is 8 years old and came to the clinic on Thursday with a temperature of 39.7
He had been sick for only two days but looked ill enough to be prioritized.
Sure enough the lab results showed he had malaria: 3+ - a high parasite count.
After drinking ORS he was looking a little better so I decided to try oral treatment.
If he vomited either of the anti-malarial drugs, I would refer him.
Thankfully he kept the drugs down and even managed to eat rice in the afternoon.
That is when I had to decide: refer for in-patient treatment or treat as out-patient.
The never-ending dilemma of a shortage of beds and financial strains.
Since he took the oral meds, I decided on out-patient treatment, taking a slight risk.
And sure enough, once Mohamed left the clinic I started having second thoughts.
Maybe he really was too sick to send home, maybe he would only get worse in the night.
My decision had been made and he was gone; it could go either way.
I hoped I had made the right decision.
At least his mother was sensible and knew where to take him if he got worse in the night.
I was to see him again on Friday morning, Lord willing.
I thought about him multiple times through the night.
At 7:50 am on Friday I headed over to my office wondering if Mohamed would come.
As I passed the main gate, I was thrilled to see Mohamed sitting there with his mom.
He made it through the night, was looking a bit better and even gave me a smile!
I made him take his second dose of his anti-malarial drugs in the clinic.
And had him wait another hour to make sure he did not vomit them.
This time he did not just lay around and sleep the whole time like he did the previous day.
He was slowly improving.
I gave him some other medications cause his hemoglobin had dropped a bit.
And I told him to come again next week Wednesday.
If he'll also take my advice to use an insecticide treated net I will be even happier!

In the outpatient clinic I see malaria every day of the year.
Some children are only mildly ill, others moderately ill and some severely.
It's not uncommon for me to have to refer a seriously ill child due to malaria.
Or refer for a blood transfusion due to the severe anemia (Hb <5g/dL) it causes.
And unfortunately at times these children die.
They die a death that could have been prevented.
We can keep children from getting malaria.
We can cure children who get malaria.
But it requires resources; nets, spraying, diagnostic measures, treatment.
We need to work together to decrease the burden of malaria.

Visit: http://www.rbm.who.int/worldmalariaday/index.html