MALARIA AND OSTEOPOROSISDISEASE CASE STUDY

JENNIFER YU

MALARIACause:

There are four parasite species that cause malaria in humans:

• Plasmodium falciparum• Plasmodium vivax• Plasmodium malariae• Plasmodium ovale

Plasmodium falciparum and plasmodium vivax are the most common.

Plasmodium falciparum is the most deadly.

Transmission:

Malaria is transmitted via the bites of infected Anopheles mosquitoes.

Factors impacting transmission include the climatic conditions that affect the number and survival of mosquitoes, and human immunity.

SYMPTOMS

Within 10 - 15 days of infection:

• Fever, headache, fatigue, sweating, dry cough, diorrhea enlargement of the spleen, shivering, pain in the joints, muscles and back, chills, generalised convulsions, repeated vomiting and coma.

Children with severe malaria often develop one or more of the following:

• Severe anaemia (red blood cell deficiency), respiratory distress in relation to metabolic acidosis (body accumulating too much acid), or cerebral malaria.

In malaria endemic areas, people may develop partial immunity, letting asymptomatic (producing no symptoms) diseases to occur.

TREATMENTTreatment for uncomplicated malaria:

Artemisinin-based combination therapy (ACT) – combines two active ingredients with different mechanisms of action.

• Best available and recommended treatment

• Best suited for Plasmodium falciparum

Treatment for severe malaria:

Injectable artesunate (a drug that treats malaria) followed by a course of an ACT as soon as the patient take oral medicine.

If injectable treatment cannot be given, patients are treated with intra-rectal artesunate and referred to an appropriate facility for full parenteral treatment (where the substance enters the body via a route other than the mouth or rectum).

PREVENTIONThe common way to reduce malaria transmission at a community scale is vector control. There are two forms of vector control:

Insecticide-treated mosquito nets (ITNs)

• Long-lasting insecticidal nets (LLINs) are the preferred form of ITNs for public health distribution programmes.

Indoor spraying with residual insecticides (IRS)

• Powerful way to rapidly reduce malaria transmission. • Most effective when at least 80% of houses in targeted areas are

sprayed.• Effective for 3-6 months, depending on the insecticide use and type

of surface on which it is sprayed.

PREVENTIONOther forms of prevention include:

• Personal protection against mosquito bites (e.g. applying insect repellent, cover up as much as possible, etc)

• Antimalarial medicines

• Chemoprophylaxis – recommended for travellers, supresses the blood stage of malaria infections, preventing its disease.

• Screening of dwellings to prevent mosquitoes from entering and biting people inside.

• Use of mosquito mats and coils

CASES OF MALARIA IN 2010, BY REGION AND MONTH

OSTEOPOROSIS

Osteoporosis is a disease of the bones, occurring when a person loses too much bone, makes too little bone or both.

Causes:

• Family history and genetics

• Gender - women are twice as likely to develop osteoporosis as men. This is due to the facts that women start life with a lower bone density than men and they live longer.

• Age - particularly over age 50

• Menopause - oestrogen deficiency in women

• Testosterone deficiency in men

• Other hormone imbalances such as those including the parathyroid hormone and growth hormone, which help control how well the body uses calcium.

• Lack of calcium and vitamin D

• Long-term physical inactivity

• Some medications that reduce bone density such as corticosteroids (used for asthma and other inflammatory conditions), selective serotonin reuptake inhibitors and blood thinning medications.

• Inadequate diet

SYMPTOMS Osteoporosis is often called a silent disease as bone loss occurs without symptoms until a fracture occurs.

People are not aware that they have osteoporosis until their bones become so weak that a minor strain, bump or fall causes a hip to fracture or a vertebra to collapse.

TREATMENT• Hormone replacement therapy (HRT): for women going through

menopause, HRT assists in preventing bone density loss.

• Testosterone treatment - recommended when a man has osteoporosis due to low testosterone productions.

• However, both these hormone treatments are not the first to be recommended as they can increase the risk of heart disease, breast cancer and prostate cancer.

• Bisphosphonates - help prevent bone density loss and are non-hormonal drugs. Taking one pill per month may help slow down bone loss.

• Calcitonin - inhibits the cells that break down bone.

• Calcium and vitamin D supplements - may help older patients lower their risk of hip fractures.

• Nutrition - eating a wide and proportioned range of nutritious foods with vitamins and minerals.

• Regular and healthy exercise

PREVENTION

•  Ensuring that anyone with specific risk factors for osteoporosis to be checked by their doctor.

• Adequate Calcium and vitamin D intake

• Eating foods that are good for bone health such as fruits and vegetables.

• Exercise. The best exercises to prevent osteoporosis are those in which you have to carry the weight of your body e.g. walking, dancing or jogging.

• Controlling alcohol and caffeine consumption.

Taken from an Australian website