Malaria

General aspects:

• Travellers to all tropical countries are at some risk.

• Malaria is endemic in 102 countries; 4 2.3 billion people are at risk.

• The risk is very low in the major cities of Central and Southern America and South-East Asia but can be high in some African cities.

• Malaria is either benign (vax, ovale) or malignant (falciparum).

• Resistance to many drugs is increasing:

o The lethal Plasmodium falciparum is developing resistance to chloroquine and the antifolate malarials (Fansidar and Maloprim). 4 o Resistance is now reported to mefloquine.

o CRFM is common in South-East Asia, Papua New Guinea, northern South America and parts of Africa.

• Chloroquine is still effective against P. ovale and P. vivax (the most common forms).

• The long-awaited vaccine will make all the complex drug management much simpler. However, it still appears to be many years away despite considerable research.

• Patients who have had splenectomies are at grave risk from P. falciparum malaria.

• People die from malaria because of delayed diagnosis, delayed therapy, inappropriate therapy and parasite-host factors.

• Practitioners should follow updated recommended guidelines, e.g. NH&MRC, WHO.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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