Page 376 - 2021 IDMT Digital
P. 376
MALARIA
Introduction:
• 0DODULD LV WKH PRVW LPSRUWDQW SDUDVLWLF GLVHDVH RI KXPDQV FDXVLQJ KXQGUHGV RI PLOOLRQV
RI LOOQHVVHV DQG QHDUO\ D PLOOLRQ GHDWKV HDFK \HDU HQGHPLF LQ PRVW RI WKH WURSLFV 6outh
DQG &HQWUDO $PHULFD $IULFD WKH 0LGGOH (DVW ,QGLDQ VXEFRQWLQHQW 6( $VLD DQG 2FHDQLD
• )RXU VSHFLHV RI WKH JHQXV 3ODVPRGLXP FDXVH KXPDQ PDODULD
o P falciparum LV UHVSRQVLEOH IRU QHDUO\ DOO VHYHUH GLVHDVH SUHGRPLQDQW VSHFLHV LQ
$IULFD
o P vivax LV DV FRPPRQ DV falciparum H[FHSW LQ $IULFD XQFRPPRQO\ FDXVHV
VHYHUH GLVHDVH
o P ovale DQG 3 malariae DUH OHVV FRPPRQ DQG GR QRW FDXVH VHYHUH LOOQHVV
• )HYHU 7UDYHO 0DODULD XQWLO SURYHQ RWKHUZLVH
Subjective:
• 6LJQV DQG 6\PSWRPV
o &\FOLFDO IHYHU
o +HDGDFKH LQWHUPLWWHQW DWWDFNV RI FKLOOV IHYHU DQG VZHDWLQJ
o 0\DOJLDV DEGRPLQDO SDLQ GLDUUKHD DQG YRPLWLQJ
o 3DWLHQWV PD\ DSSHDU WR EH UHPDUNDEO\ ZHOO EHWZHHQ IHEULOH HSLVRGHV
Objective:
• 3K\VLFDO ([DP
o )HYHU RIWHQ ! ) ZKLFK F\FOHV HYHU\ RWKHU GD\
o +HSDWRVSOHQRPHJDO\ DQG MDXQGLFH
o 0D\ ZLWQHVV VZHDWV DQG ULJRUV
• 7RROV
o 3HULSKHUDO EORRG VPHDU VKRZV LQWUDHU\WKURF\WLF SDUDVLWHV
o 1HZ GLSVWLFN PDODULD UDSLG GLDJQRVWLF DVVD\ QRZ DYDLODEOH
Assessment:
• 'LIIHUHQWLDO
o 5LFNHWWVLDO IHYHUV PDFXORSDSXODU UDVK WKDW EHJLQV DW WKH ZULVWV DQG DQNOHV DQG
VSUHDGV WR WUXQN
o /HSWRVSLURVLV FRQMXQFWLYDO VXIIXVLRQ SHUPHDWHG ZLWK EORRG QRQ SURGXFWLYH
FRXJK
o <HOORZ fHYHU H[SRVXUH WR PRVTXLWRV XQYDFFLQDWHG
o 9LUDO KHSDWLWLV 584 SDLQ SUHGRPLQDWHV ZLWKRXW VLJQV RI EOHHGLQJ
Plan:
• 6XSSRUWLYH FDUH
• 3UHSDUH IRU $&/6 LQWHUYHQWLRQ LI IDOFLSDUXP LV VXVSHFWHG
• 3UHSDUH IRU (9$& RU WUDQVIHU
• &RQWDFW 3XEOLF +HDOWK &'&
• Treatment will be dependent on local resistance to chloroquine.
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