Malaria, also known as pendulum, is a contagious disease transmitted by the bite of Anopheles mosquitoes. It is characterized clinically by periodic periodic episodes of chills, high fever, sweating and fever withdrawal, as well as anemia and splenomegaly. The clinical symptoms and attack pattern vary depending on the differences in protozoan strain, degree of infection, immune status and organism reactivity.
Etiology
(a) Source of infection: Malaria patients and carriers are the source of malaria infection.
(B) Transmission: The natural vector of malaria is Anopheles mosquito.
(C) Population susceptibility: People are generally susceptible to malaria.
Symptoms
Incubation period: From human infection with Plasmodium to the onset of disease (oral temperature over 37, 8 ℃), called the incubation period.
(a) Inter-day malaria: Mostly acute, especially in recurrent cases. First-time infections often have prodromal symptoms, such as weakness, lethargy, yawning; headache, aching limbs; loss of appetite, abdominal discomfort or diarrhea; irregular low-grade fever. It usually lasts 2 to 3 days, or a week in long cases. It then turns into a typical attack. It is divided into three phases.
1, chills phase: sudden chills, first cold at the end of the extremities, quickly feel the back, the whole body chills. Goose bumps on the skin, blue lips and nails, pale face, muscle and joint pains all over the body.
2, the fever period: after the cold disappears, the face turns red, cyanosis disappears, the body temperature rises rapidly, usually the more significant the chills, the higher the body temperature, up to 40 ℃ or more.
3, sweating period: the late stage of hyperthermia, face and palms sweating slightly, then throughout the body, sweating profusely, wet clothes, about 2 to 3 hours to reduce the body temperature, often to 35, 5 ℃. Patients feel comfortable, but very sleepy and often fall asleep peacefully.
(B) Three day malaria: The attack is similar to inter-day malaria, but it occurs once every three days, mostly in the morning and lasts for 4-6 hours. Anemia is lighter with splenomegaly, but the recurrence rate is high, and there is often proteinuria, especially in children, and malaria nephropathy can be formed. Three day malaria is easy to mix infection, and it is very difficult to cure itself at this moment.
Examination
1.Blood picture: red blood cells and hemoglobin drop after several episodes, especially in falciparum malaria; total white blood cell count can be slightly increased at the beginning, and then normal or slightly low, and white blood cell classification mononuclear cells often increase, and see phagocytosis with malaria pigment particles.
2.Plasmodium examination.
(1) Blood smear (pry film can be thick film) staining to detect malaria parasites.
(2) Bone marrow smear staining to detect Plasmodium, the positive rate is higher than the blood film.
(3) Serological examination, the positive rate can reach 90%.
Treatment
(A) Basic treatment.
(ii) Pathogenic treatment. The purpose of pathogenic treatment is to kill Plasmodium in the intra-red stage to control the attack, and to kill Plasmodium in the infrared stage to prevent recurrence, and to kill gametophytes to prevent transmission.
1.Control the attack.
(1) Chloroquine, which is currently the drug of choice for attack control.
(2) Other new drugs: clozaril phosphate, clozaril phosphate.
2, resistance of Plasmodium falciparum.
Chloroquine. Mefloquine, artemisinin or a combination of drugs should be used for those with resistance.
3, to prevent recurrence and transmission.
Primaquine phosphate (referred to as Primaquine): This product can kill extra-erythrocytic stage protozoa and gametophytes, so it can prevent recurrence and transmission.