Diagnosis And Treatment Of Malaria
Severe malaria: cases of finding malaria parasites that are negative, need to be distinguished from fever caused by other causes such as Dengue hemorrhagic fever, typhoid fever, curious fever, flu, sore throat, tonsillitis ... Fever Malignant malaria: if the result of finding the malaria parasite is negative, more tests need to be done, carefully exploiting the epidemiological factors to find other causes such as:
Implementing the quadrants
Based on three factors: epidemiology, clinical symptoms and laboratory testing.
Epidemiology: Currently living or living in malaria-endemic areas within 1 month or with a history of malaria in the last 2 years
Clinical symptoms: Common (severe malaria), severe and complicated (malignant malaria). Usually not specific to malaria.
Testing: Look for the presence of malaria parasites in the blood
* Severe malaria: cases of finding malaria parasites are negative and need to be distinguished from fever caused by other causes such as dengue hemorrhagic fever, typhoid fever, fever, flu, sore throat, tonsillitis ..
* Malignant malaria: if the result of finding a malaria parasite is negative, more tests need to be done, carefully exploiting the relevant epidemiological factors to find other causes such as:
Kissing tissue due to encephalitis, meningitis, severe infections ...
Jaundice, yellow eyes caused by helix, biliary tract infections, viral hepatitis, hemolysis .
Septic shock, septicemia, fever ...
Acute respiratory failure due to other causes .
Principles of treatment of malaria are to treat relapses (kill asexuals), fight relapses (kill the sleeping form in the liver) and fight the spread (kill gametocytes), combine specific treatment with million treatment evidence, support the patient's condition
There are many asexual drugs, but now due to the multi-drug resistance of Plasmodium falciparum and to prevent resistance. The World Health Organization recommends using a combination regimen with artemisinin (or derivatives), also called ACT (artemisinin - based combination therapy), to treat Plasmodium falciparum malaria. Here are some ACT regimens: artemether + lumefantrine, artesunate + amodiaquine, artesunate + megfloquine, artesunate + sulfadoxine - pryrimethamine, dithydroartemisinin + piperaquine.
For non-ACT combination regimens such as quinine + tetracycline / doxycyclineclindamycin, use as second-line treatment if the parasite relapses after using the regimen ACT mentioned above, and used for pregnant women in the first 3 months (quinine + clindamycin) because then there are contraindications to artemisinin and derivatives in the first 3 months of pregnancy.
Chloroquine is also a clones, currently mainly used to treat Plasmodium vivax.
Primaquine is used to make gametocyte (not growing in mosquitoes) and to kill the sleeping form in the liver of Plasmodium vivax, Plasmodium ovale.
Regarding the treatment of malaria in Vietnam: see the topic "Characteristics of malaria epidemiology and National malaria prevention program".
9 PREVENTING PREVENTION OF DISEASES
Prophylactic drug (chemoprophylaxis)
Malaria prevention is difficult because it depends on the situation of drug resistance of the place where you intend to live, travel ... that prophylactic medicine may be different. Need information about the situation of drug resistance, the composition of the malaria parasite (which species is dominant), the prevalence of malaria in the destination ... before choosing oral medicine to prevent.
At present, the prevention of malaria prevention for the entire population is not recommended because it will cause resistance, but only advocate for some special subjects such as pregnant women, tourists, and people going to fever areas. limited circulating cold due to work ...
Depending on the resistance situation of the destination, one of the following medications may be used for prophylaxis: chloroquine, sulfadoxine-pyrimethamine, mefloquine, proguanil, doxycycline, atovaquone-proguanil.
In Vietnam, there is no prescription for malaria prophylaxis, but instead self-medicating (see the article "Epidemiological characteristics of malaria and National Program on Prevention of Malaria"). .
The goals of the malaria vaccine
* Blood stage (erythrocyte): Stimulates immune response against surface proteins of the fragment, leading to reduced incidence and severity of the disease
* Stage in the liver (erythrocytes): Stimulating the immune response against parasites or parasitic liver cells, preventing the liver from being parasitic preventing the release of identical pieces from the liver.
* Preventing the spread of disease: Stimulating the immune response against the gametes, making it impossible to create germs, thus cutting off the path of disease transmission.
Vaccines RTS, SIAS01
Among the vaccines being tested, this is the most promising vaccine. Researched for more than 20 years, the vaccine aims to be the stage in the liver (erythrocytes). The vaccine contains a polypeptide chain that corresponds to a portion of the surface protein paste that is attached to the surface antigen of the hepatitis B virus, creating a hybrid molecule called RTS. The vaccine also includes a separate polypeptide b. . Dịch vụ: Thiết kế website, quảng cáo google, đăng ký website bộ công thương uy tín
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