Malaria is an everyday tragedy. Since the rains began a few months ago almost children admitted to Queens have been diagnosed with malaria.
More children arrive each day. For many of these children malaria is a short illness, not much worse than the flu, part of growing up here. Others are not so lucky.
My first patient on the ward round is a boy admitted two days before with severe malarial anaemia. His father greets me with a huge smile — his son had a blood transfusion yesterday, he is much better today. They go home happy. As the ward round continues, I see another four children with severe malarial anaemia waiting, pale and breathless, for blood. The excellent Malawi Blood Transfusion Service simply cannot keep up with demand at this time of year.
Clinical topic — Malaria prophylaxis — Evidence on insect repellents for the prevention of mosquito bites. Field-selected pyrethroid resistance in Anopheles has been well studied in only one case — that of An. To preserve susceptibility, selection for resistance should be minimized.
There are too many children who need blood. Some of them die waiting. He was admitted a few days before with cerebral malaria, a severe complication where the infection spreads to the brain causing seizures and coma.
As a team we try our best to resuscitate him while his family watch. He is well-grown, he is well-loved, he is five years old. I tell his mother he is dead. As we close his eyes and cover him with a chitenje a piece of Malawian fabric his mother and relatives are crying and shouting something in Chichewa that I do not understand. I ask the Malawian intern to translate.
We still do not understand why some children with malaria develop life threatening complications. More research is needed to understand the disease, and find better treatments.
Even more important are strategies to prevent malaria. Global efforts continue to develop a vaccine, but the malaria parasite is complex and effective vaccine development is challenging.
We know that simple insecticide-treated bednets to protect sleeping children from the mosquitoes which spread malaria are extremely effective, but not always available or accepted in local communities. As I have learned from the families and staff at Queens, every day there are challenges, and every day there is hope. An insecticide treated mosquito net offers protection against mosquitos and the malaria that they carry.
Every cot and bed in our homes has to have one, and each child who goes home takes one with them too.
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