TREATMENT AND PREVENTION

Malaria is a tropical disease of humans caused by four species of the Plasmodium parasite. Other names for malaria, particularly used in European countries, are ‘Paludism’ or ‘Paludeen fever’. All four types of the malaria parasite are transmitted by mosquitoes of the genus Anopheles. Most fatal infections are caused by the falciparum species and are more likely to occur when diagnosis and treatment are delayed or inappropriate.

Malaria is a worldwide problem because two-thirds of the world’s population lives in malaria endemic regions. A conservative estimate is that there are 220 million new infections a year. In Africa alone, malaria causes over a million deaths each year. The problem has become worse in recent times because of mosquitoes becoming increasingly resistance to pesticides, and because of increasing drug resistance of the malaria parasites.

OTHER MOSQUITO AND INSECT-BORNE DISEASES

For some mosquito transmitted diseases, there are no known drug treatments or vaccines, so prevention becomes extremely important. This is certainly true for dengue fever, which occurs widely in the tropical regions.

Dengue (also called break bone fever) occurs about five to eight days after being bitten by an aedes mosquito infected with the virus. Classic symptoms include severe splitting headaches, high fever, backache, muscle and joint pains and skin rashes. The symptoms last from five to seven days.

Occasionally, the illness is complicated by a bleeding tendency and is then called dengue hemorrhagic fever, which sometimes can be fatal. In addition to the symptoms mentioned above, patients may also develop bruises and bleeding of the skin, nose and gums. Intestinal as well as other types of internal bleeding can occur.

Beware of mosquitoes! In the tropics, these blood-sucking parasites not only cause malaria but a whole host of viral diseases such as dengue fever, Japanese encephalitis and filariosis to name a few.

I am only too cognisant of the dangers mosquitoes can bring, ever since I myself was bitten by a mosquito which carried the dreaded dengue fever virus while vacationing in the Philippines. Dengue fever is also known as ‘break bone fever’ reflecting the intense suffering that occurs. Although it has been almost 13 years since my near tragic illness, I still can remember vividly the details of my ill-fated trip.

I took a four-week self-arranged vacation to the Philippines in July 1982. During the first week, I explored Manila, the capital of the Philippines, and its surrounding environs. The sprawling city was noisy, congested, polluted and teeming with humanity. After visiting most of the major attractions, riding the crowded ‘jeepneys’ and reveling in the vibrant night life until the wee morning hours, I decided it was time to get away from the frenzied pace of Manila and explore some of the serene tropical islands. After all, the Philippines has over 7,000 of them!. I took a ferry to the village of Panay where I stayed overnight. I then took a large outrigger boat to the idyllic island of Boracay, renowned for its pristine white sandy beaches...

Ralph, a 33-year-old surveyor from New Zealand, worked for a multinational lumber company in Kalimantan (formerly Borneo). Because of the nature of his work, he spent most of his time in Kalimantan, living in its rural areas and small villages. He was well aware of the risk of malaria, which was endemic within the region, and took his weekly antimalarial medications as directed. He felt reassured that the medications would protect him from malaria carrying mosquitoes that fly in swarms along the river banks. He heard of horror stories concerning others, less careful, who did not take antimalarial prophylactics.

Ralph remained relatively healthy and very busy supervising the logging operation. However, on a couple of occasions, he did feel feverish and had muscle aches but these discomforts were short lasting and never a concern to Ralph. Then, insidiously he noticed progressive swelling of both lower legs. He did not feel pain and he had no fever. Except for the swelling, he felt generally well and was able to continue with his work. However, there was no abatement of the swelling during the following week and he became very concerned. The swelling had now extended from both lower legs up to the groin and also involved his scrotum. His legs were heavy and walking cumbersome. Ralph’s company’s managing director made arrangements for him to fly to....