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The consequences of malaria

BY: Gifty Kumi-Ampofo
Malaria

Malaria has been a household name in my community since childhood. Though actually present and even implicated in many other diseases, it was rarely taken seriously.

Affectionately called the “fever illness”, it was thought to last only a few days with no associated fatalities. This article seeks to bring to light the dire consequences of malaria. 

My experiences through medical school and clinical practice made me appreciate the jaw dropping rates of irreversible complications and fatalities associated with malaria. 

Going down memory lane, I remember vividly as if it was yesterday the case of a two-year-old girl who was rushed to the emergency room with a febrile convulsion. She progressed from drowsy through a delirious state to an unrousable coma shortly after arrival, and remained in that state despite treatment and died after three days. The malaria parasite penetrated her brain and through its vicious mechanisms, caused her death. On the other hand, survivors from similar ordeals may have to battle with life-challenging conditions such as psychosis, paralysis, childhood developmental challenges, blindness, deafness, impaired cognition and learning.

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Repercussions

One of the commonest repercussions of malaria which has claimed many lives is severe anaemia and in some instances patients lose blood through their urine in the form of black, dark brown or red urine. Though blood transfusions are highly safe in our health facilities today, many patients still suffer from its complications to varying degrees. To complicate matters further, severely anaemic patients have a high risk developing a highly fatal “lung defect” (pulmonary oedema) which manifests as breathlessness. 

A friend once narrated bitterly how he had lost his pregnant wife through malaria. His wife had complained of lethargy and occasional chills a few days earlier but they had assumed that those were signs of early pregnancy. His wife was pronounced dead from low blood glucose attributable to malaria few minutes after he had rushed his unconscious wife to the hospital. Pregnant women are hard hit by the effects of malaria and sadly,  a good number of miscarriages can still be traced to it in our country today. 

Malaria and blood pressure

In another instance, a middle-aged woman was brought to the hospital with dizziness and general body weakness after countless episodes of diarrhoea and vomiting. It was later evident from clinical work-up that she had developed a low blood pressure as a result of malaria. She was resuscitated and fortunately she gained full recovery. 

However, for some others who find themselves in similar conditions, the end result is not always a pleasant one; often resulting in death from shock.

The essence of at least a single, healthy kidney in a person cannot be over emphasised. Regrettably, however, the activities of the malaria parasite can lead to extensive injuries to the integral parts of both kidneys leading to their malfunction. In a worst case scenario, a patient would require dialysis to restore the functions of the kidney and this comes at no mean cost to say the least.  

Thankfully through clinical practice, I have learnt not to exclude malaria as a probable cause of liver dysfunction as it can result in an increased risk of viral hepatitis infection and even liver failure. 

Action

Suffice to say, the malaria parasite deploys its ammunitions geared purposely towards destruction to almost every part of the body. Ruefully, the most vulnerable in society: pregnant women and children are hardest hit; not forgetting the immunocompromised folks among us. 

The question is: “Why are we still battling with this menace in our country when a lot of resources have been invested into its control?” 

It’s time to tailor educational and prevention campaigns on malaria towards addressing socio-cultural community challenges. We need effective intersectoral collaboration to drum home the importance of maintaining a well-balanced diet and demystifying the misconceptions surrounding the use of mosquito nets. It’s high time we rid every nook and cranny of filth and puddles to make our dear motherland an unfavourable breeding ground for mosquitoes. Real life experiences from survivors of malaria-related complications would enrich our educational campaigns.

Early detection

Early detection and treatment of malaria more often than not prevents the development of associated complications. As a malaria endemic country, we need to ensure consistent free accessibility of malaria test kits to even the remotest of communities to help curb the incidence of malaria-related complications. 

Chloroquine used to be the drug of choice in the treatment of malaria but because of the evolution of drug-resistant malaria parasites, this once precious gem is resting in the archives. Currently, our main hope of malaria cure - artemisinin-based medications is slowly losing its grounds in the fight against malaria as more fierce mutating malaria parasites evolve. To curb this trend, let’s endeavour to complete every course of anti-malaria medication we start and stamp out substandard medications.  

Mother Ghana’s boat is still not afloat on the “malaria waters.” We are losing our loved ones, disposable income and valuable productivity to malaria. We all need to harmoniously and consistently paddle our only boat ashore. 

 

The writer is a medical officer at the St John of God Hospital, 

Duayaw Nkwanta.