MALARIA KILLER: Should pesticide DDT be used to kill the mosquitoes that spread malaria?
Image: ©ISTOCKPHOTO.COM/CHRISTOPHER BADZIOCH
-
The Best Science Writing Online 2012
Showcasing more than fifty of the most provocative, original, and significant online essays from 2011, The Best Science Writing Online 2012 will change the way...
Read More »
A panel of scientists recommended today that the spraying of DDT in malaria-plagued Africa and Asia should be greatly reduced because people are exposed in their homes to high levels that may cause serious health effects.
The scientists from the United States and South Africa said the insecticide, banned decades ago in most of the world, should only be used as a last resort in combating malaria.
The stance of the panel, led by a University of California epidemiologist, is likely to be controversial with public health officials. Use of DDT to fight malaria has been increasing since it was endorsed in 2006 by the World Health Organization and the President's Malaria Initiative, a U.S. aid program launched by former President Bush.
In many African countries, as well as India and North Korea, the pesticide is sprayed inside homes and buildings to kill mosquitoes that carry malaria.
Malaria is one of the world's most deadly diseases, each year killing about 880,000 people, mostly children in sub-Saharan Africa, according to the World Health Organization.
The 15 environmental health experts, who reviewed almost 500 health studies, concluded that DDT "should be used with caution, only when needed, and when no other effective, safe and affordable alternatives are locally available."
We cannot allow people to die from malaria, but we also cannot continue using DDT if we know about the health risks," said Tiaan de Jager, a member of the panel who is a professor at the School of Health Systems & Public Health at the University of Pretoria in South Africa. "Safer alternatives should be tested first and if successful, DDT should be phased out without putting people at risk."
The scientists reported that DDT may have a variety of human health effects, including reduced fertility, genital birth defects, breast cancer, diabetes and damage to developing brains. Its metabolite, DDE, can block male hormones.
"Based on recent studies, we conclude that humans are exposed to DDT and DDE, that indoor residual spraying can result in substantial exposure and that DDT may pose a risk for human populations," the scientists wrote in their consensus statement, published online today in the journal Environmental Health Perspectives.
"We are concerned about the health of children and adults given the persistence of DDT and its active metabolites in the environment and in the body, and we are particularly concerned about the potential effects of continued DDT use on future generations."
In 2007, at least 3,950 tons of DDT were sprayed for mosquito control in Africa and Asia, according to a report by the United Nations Environment Programme.
"The volume is increasing slowly," said Hindrik Bouwman, a professor in the School of Environmental Sciences and Development at North-West University in Potchesfstroom, South Africa, who also served on the panel.
In South Africa, about 60 to 80 grams is sprayed in each household per year, Bouwman said.
Brenda Eskenazi, a University of California at Berkeley School of Public Health professor and lead author of the consensus statement, is concerned because the health of people inside the homes is not being monitored.
A 2007 study on male fertility is the only published research so far. Conducted in Limpopo, South Africa by de Jager and his colleagues, the study found men in the sprayed homes had extremely high levels of DDT in their blood and that their semen volume and sperm counts were low.
"Clearly, more research is needed…but in the meantime, DDT should really be the last resort against malaria, rather than the first line of defense," Eskenazi said.
The pesticide accumulates in body tissues, particularly breast milk, and lingers in the environment for decades.
In the United States, beginning in the1940s, large volumes of DDT were sprayed outdoors to kill mosquitoes and pests on crops. It was banned in 1972, after it built up in food chains, nearly wiping out bald eagles, pelicans and other birds.
Today's use differs greatly. In Africa, it is sprayed in much smaller quantities but people are directly exposed because it is sprayed on walls inside homes and other buildings.
Many health studies have been conducted in the United States, but on people who carry small traces of DDT in their bodies, not the high levels found in people in Africa.
"DDT is now used in countries where many of the people are malnourished, extremely poor and possibly suffering from immune-compromising diseases such as AIDS, which may increase their susceptibility to chemical exposures," said panel member Jonathan Chevrier, a University of California at Berkeley post-doctoral researcher in epidemiology and in environmental health sciences.
In 2001, more than 100 countries signed the Stockholm Convention, a United Nations treaty which sought to eliminate use of 12 persistent, toxic compounds, including DDT. Under the pact, use of the pesticide is allowed only for controlling malaria.
Since then, nine nations—Ethiopia, South Africa, India, Mauritius, Myanmar, Yemen, Uganda, Mozambique and Swaziland—notified the treaty's secretariat that they are using DDT. Five others—Zimbabwe, North Korea, Eritrea, Gambia, Namibia and Zambia--also reportedly are using it, and six others, including China, have reserved the right to begin using it, according to a January Stockholm Convention report.
"This is a global issue," Eskenazi said. "We need to enforce the Stockholm Convention and to have a plan for each country to phase out DDT, and if they feel they can't, good reason why other options cannot work."
Mexico, the rest of Central America and parts of Africa have combated malaria without DDT by using alternative methods, such as controlling stagnant ponds where mosquitoes breed and using bed nets treated with pyrethroid insecticides. But such efforts have been less successful in other places, particularly South Africa.
"We have a whole host of mosquito species and more than one parasite. The biology of the vectors is different and there is therefore no one-method-fits-all strategy, as is the case in Central America," Bouwman said.
For example, he said, some types of mosquitoes in South Africa breed in running water, which cannot be easily controlled.
"The area to be covered is also vast, and infrastructure in most areas is too little to allow environmental management on a sustainable basis," he said.
When a mosquito strain that had previously been eliminated returned to South Africa, it was resistant to the pyrethroid insecticides that had replaced DDT.
"The resulting increase in malaria cases and deaths was epidemic," Bouwman said. Cases soared from 4,117 in 1995 to 64,622 in 2000. "South Africa had to fall back on DDT, and still uses it in areas where other chemicals would have a risk of failure," he said.
The scientists also recommended study of possible health effects of pyrethroids and other alternatives for DDT.
"The general thoughts are that if chemicals have a shorter half-life, like pyrethroids, they are less dangerous," Eskenazi said. "This may be true, but there are virtually no studies on the health effects in humans of the alternatives."
The panel convened in March, 2008, at Alma College in Michigan, near a Superfund site where DDT was produced at a chemical plant. Their goal was "to address the current and legacy implications of DDT production and use," according to their report.
Acknowledging that some areas remain dependent on DDT, they recommended monitoring of the spraying to ensure that usage guidelines are followed and improved application techniques.
"It is definitely not a matter of letting people die from malaria," de Jager said.
This article originally ran at Environmental Health News, a news source published by Environmental Health Sciences, a nonprofit media company.
See what we're tweeting about
25 Comments
Add CommentThe pure hypocrisy of these American eco-colonialists makes me livid. Imagine these western elites telling Africans how to deal with malaria! One-million or more Africans--mainly women and infants--die of malaria each and every year--and this "panel's" advice: don't use DDT! Why? Because of "reduced fertility" and "breast cancer." Hello--the alleged linkage of breast (or any other cancer) and DDT/DDE has been sought and NOT FOUND for over a decade. DDT was banned by the EPA administrator in 1972 against the advice of his scientific advisory panel--there remains NO EVIDENCE of significant adverse human health effects, which was true even at the massive overuse levels of the 1960s. Their "concern" over the "potential effects of DDT use on future generations" would be obviated by the loss of these generations to malaria without DDT. Their meeting at a "Superfund" site in Michigan where DDT was made would be laughable if it weren't so deadly serious: it's a Superfund site BECAUSE DDT was made there--however, DDT is not hazardous to humans, so MAYBE it shouldn't be a Superfund site! The "lead author" Eskenazi demands "we" enforce the Stockholm Convention--so impoverished Africans should have to apply to Brenda to use DDT to save their children's lives and health--because she fears that the health of the folks who live there "is not being monitored." How pompous and arrogant can anyone get!
Reply | Report Abuse | Link to thisLeave Africa to the Africans, and let's reduce the frightful toll of malaria in Africa with indoor spraying of DDT--why did we ban DDT AFTER we wiped out malaria in the US and Europe?
I am really shocked and enraged to find that ddt is back - of course it is harmful to humans, and everyone else.
Reply | Report Abuse | Link to this(talk about pompous/arrogant, it's personified above)
What happened to the coming innoculations? and where on the Earth are there people alive who cannot take the Proper precautions?
Let's see... 880,000 people, mostly children, a year suffering and dying vs. a possible increased risk of low sperm count? The list of possible side effects is not unlike bis-phenol A. The most effective solution to prevent over half a million child deaths a year should be denied for fear of a statistically questionable group of non-acute symptoms?
Reply | Report Abuse | Link to thisMalnutrition kills, so does starvation. But obesity greatly increases ones chances for diabetes and heart disease. By the same rational applied to malaria we should only send vitamins and not food.
Jim Humble, http://www.jimhumble.com, has already helped manythousands in Africa and elsewhere in eliminating Malaria from the body. Using a simple and inexpensive solution of 28%Sodium Chlorite (NaClO2) and organic acids such as lemon or lime juice, or 5% acid vinnegar (15 drops NaClO2 to 1/2 teaspoon acid), he creates Chlorine Dioxide to which he adds 4 ounces of apple juice or water. The concoction is then ingested. With just one dose blood tests have proven the total elimination of Malaria from the body. After eliminating the Malaria, the Chlorine Dioxide breaks down to a minute amount of salt and water, no harmful side effects, no poisons, no toxins. So why isn't this being promoted more by world health agencies. Uh, lets see, maybe its more profitable to do endless research to produce vaccines. I wonder who has the monopoly on DDT?
Reply | Report Abuse | Link to this@Carlton22: you are seriously advocating the next snakeoil here?! I know SciAm has an open reply section and anybody who wants can read and reply, but the "Sci" part is there for a reason. ClO2 is a powerful oxidant. Yes, it'll oxidize the malaria, however it is entirely indiscriminate and will happily oxidize healthy human cells as well. Didn't any alarm bells go off when you read this miracle medicine cures malaria, cancer, aids and all other diseases you can think of? And if they didn't, didn't you even think of searching PubMed for any actual medical research done using ClO2 as a cure for all those diseases?
Reply | Report Abuse | Link to this@Gilros: I agree completely. The original research about DDT causing a number of health problems has been shown to be greatly exaggerated, if not downright wrong. Once again an example of politics running away with science they don't understand.
It's been documented that DDT has been the most affective way to control the mosquito that spreads malaria. I second the opinion that DDT's environmental damage has been overblown and poorly documented.
Reply | Report Abuse | Link to thisSnake oil? Oh, you mean the stuff like Vioxx, Thalidomide, Baycol, Zelnorm, Phenylpropanolamine.... the list would take more room than allowed here. All of these and more were approved by our wonderful Food and Drug Administration after supposedly strenuous and expensive "scientific" tests and studies. The companies that produced them made megabucks while killing or injuring untold numbers of people. None of them were raided and ransacked, their files destroyed, their computers confiscated, none of them were closed down and none of their owners were imprisioned for murder. I know of no drug that restores the body to health so that the drug is no longer needed. Once they get you "hooked" on their drug you are "hooked" for life or until death do you part. Most of their "stuff" only masks the symptoms while the body gets worse and worse and then the side effects cause other problems which get masked over by other medications, etc., etc., ad nauseum. No wonder many doctors are leaving the profession, they came into it to heal people not to prolong suffering and certainly not to kill people.
Reply | Report Abuse | Link to thisChlorine Dioxide gets rid of the pathogen period. The body recovers, health is restored, people get on with their lives as normal human beings. Hundreds of thousands have used it to no ill effect. It does not harm healthy cells. Why don't you do your PhD thesis on it? I know of another man who did his thesis on the so called "Conspiracy". He was determined to prove that there was no conspiracy. His name is Gary Allen and he wrote the book "None Dare Call it Conspiracy" because he found that there was indeed a conspiracy of powerful people seeking to dominate and control every aspect of our lives. Maybe you will have such a revelation as well.
Snake oil? Oh, you mean the stuff like Vioxx, Thalidomide, Baycol, Zelnorm, Phenylpropanolamine.... the list would take more room than allowed here. All of these and more were approved by our wonderful Food and Drug Administration after supposedly strenuous and expensive "scientific" tests and studies. The companies that produced them made megabucks while killing or injuring untold numbers of people. None of them were raided and ransacked, their files destroyed, their computers confiscated, none of them were closed down and none of their owners were imprisioned for murder. I know of no drug that restores the body to health so that the drug is no longer needed. Once they get you "hooked" on their drug you are "hooked" for life or until death do you part. Most of their "stuff" only masks the symptoms while the body gets worse and worse and then the side effects cause other problems which get masked over by other medications, etc., etc., ad nauseum. No wonder many doctors are leaving the profession, they came into it to heal people not to prolong suffering and certainly not to kill people.
Reply | Report Abuse | Link to thisChlorine Dioxide gets rid of the pathogen period. The body recovers, health is restored, people get on with their lives as normal human beings. Hundreds of thousands have used it to no ill effect. It does not harm healthy cells. Why don't you do your PhD thesis on it? I know of another man who did his thesis on the so called "Conspiracy". He was determined to prove that there was no conspiracy. His name is Gary Allen and he wrote the book "None Dare Call it Conspiracy" because he found that there was indeed a conspiracy of powerful people seeking to dominate and control every aspect of our lives. Maybe you will have such a revelation as well.
Africa is a vast continent. Even if DDT has little adverse effect on humans, it would need to be sprayed in colossal quantities which could have significant effects on biodiversity. Perhaps the best solution is to improve the quality of life of Africans, so that they could afford repellents and mosquito nets. Eat less meat and there will be enough cereals to feed the entire world. Feed people and they will build up their immunity naturally.
Reply | Report Abuse | Link to thiswow it nice
Reply | Report Abuse | Link to thisOffered to help out and donate their time <a rel="follow" href="http://www.lisem.net">
Reply | Report Abuse | Link to thischat</a> ?
The Open Architecture Network is the
<a href="http://www.filmizliyoruz.com">film izle</a> frustration in sharing
ideas and trying to work together
<a href="http://www.lisem.net">sohbet</a> to address.Far from replacing the
<a href="http://www.alakasiz.net">müzik indir</a> traditional architect, the
goal of the network is to allow designers to work together in a whole new way, a
expertise. The network
<a href="http://www.turk-sohbet.net">sohbet</a> has a simple.
Technology partners,
<a href="http://www.turk-sohbet.net">türksohbet</a> healthcare
<a href="http://www.turkarkadas.de">turkarkadas</a> we'll need (a lot of) help <a href="http://www.komiktir.com">
komik yazılar</a>
work together in a idea but the <a href="http://www.turk-sohbet.net">turkchat</a> <a href="http://www.proxylisteleri.com">proxy</a>
hundreds.
Thanks,
<a href="http://twitter.com/Jordan_Dunn/status/2034309853">Jordan's</a>
I'd like to see documentation that DDT is the best way to control malaria. I cannot find such a study -- and in fact, from what I've read in the research journals, it appears that bed nets and better medical care are essential -- DDT can add a hand here and there, but it's among the least effective means of control.
Reply | Report Abuse | Link to thisI'd like to see documentation that DDT is the best way to control malaria. I cannot find such a study -- and in fact, from what I've read in the research journals, it appears that bed nets and better medical care are essential -- DDT can add a hand here and there, but it's among the least effective means of control.
Reply | Report Abuse | Link to thisI'd like to see documentation that DDT is the best way to control malaria. I cannot find such a study -- and in fact, from what I've read in the research journals, it appears that bed nets and better medical care are essential -- DDT can add a hand here and there, but it's among the least effective means of control.
Reply | Report Abuse | Link to thisI'd like to see documentation that DDT is "most effective" way to fight malaria. I can't find such a document anywhere.
Reply | Report Abuse | Link to thisAll the research I see says better medical care, bed nets, draining breeding pools and education are essential to fight the disease. DDT can be useful in a few, limited situations -- but DDT is no panacea, and is not necessary at all.
I'd like to see documentation that DDT is the best way to control malaria. I cannot find such a study -- and in fact, from what I've read in the research journals, it appears that bed nets and better medical care are essential -- DDT can add a hand here and there, but it's among the least effective means of control.
Reply | Report Abuse | Link to this</blockquote>"DDT was banned by the EPA administrator in 1972 against the advice of his scientific advisory panel--there remains NO EVIDENCE of significant adverse human health effects, which was true even at the massive overuse levels of the 1960s."</blockquote>
Reply | Report Abuse | Link to thisThere were the toxicity studies, which showed relatively low toxicity to humans when correctly used, but toxicity that could kill (and had already killed); and there were the carcinogen tests, which showed DDT to be a likely human carcinogen, but weak. Research since then has verified the toxicity and probable carcinogenicity, and added endocrine disruption to the list of human problems.
But of course, DDT wasn't banned because it hurts humans. It was banned because it's uncontrollable in the wild, killing virtually any animal in a food chain where the stuff is used, lasting perhaps hundreds of years, and taking a huge toll in out years on predators.
No study has ever shown that the harms to wildlife were overestimated. Studies have repeatedly shown that the harms were underestimated instead.
So, since the harms that caused the banning of DDT use in the U.S. were found to be more favorable to DDT than they should have been, why shouldn't the ban be continued?
Sorry about the duplicates. One click did it -- go figure.
Reply | Report Abuse | Link to thisDDT is sprayed on inner house walls to control malaria. Once sprayed, it will provide many months of protection and all people living within the house will be protected, not just those under a bed net. The primary chemical action of DDT is as a repellent. When present on house walls, it stops most mosquitoes from entering the house and biting people while they sleep. No other insecticide recommended for malaria control replicates DDT's chemical actions. Additionally, no other insecticide can be produced as easily or as cheaply as DDT.
Reply | Report Abuse | Link to thisEco-steve suggests that use of DDT for malaria control will reduce biodiversity in Africa. There is no scientific evidence or background information proving that DDT on house walls will adversely impact biodiversity.
Not a single claim of environmental exposures to DDT harming human health fulfills the epidemiological criteria for a cause-effect relationship. Specifically, no claim fulfills the criteria for concluding that exposure to DDT on house walls is a cause of significant human health harm. Hundreds of millions of people lived in houses treated with DDT, to include millions in the United States. The results for those who lived in DDT-sprayed houses were improved health, increased fertility, and greater childhood survival.
Love de Jager's final comment. He knows the truth so he asserts the opposite. We can sit here in the U.S., enjoy our bald eagle comeback, and debate what to do about malaria while third world people die. Yes, clean up stagnant water, fine other things to spray, spray only on the outside of houses, install screens in windows, and allow ddt until something better comes along.
Reply | Report Abuse | Link to thisNot to mention DDT was losing it's effectiveness against insects by the time it was banned. (Evolution in action, yet again)
Reply | Report Abuse | Link to thiseco-steve at 11:19 AM on 05/13/09
Reply | Report Abuse | Link to thisAfrica is a vast continent. Even if DDT has little adverse effect on humans, it would need to be sprayed in colossal quantities which could have significant effects on biodiversity. Perhaps the best solution is to improve the quality of life of Africans, so that they could afford repellents and mosquito nets. Eat less meat and there will be enough cereals to feed the entire world. Feed people and they will build up their immunity naturally.### i fully support.
: " CLINICAL MALARIA: a sensible approach to control Malaria", [part 2 ].
Reply | Report Abuse | Link to this- [ part 1 was about my experiences with malaria and how it is NOT a killer per se.
- -
- Now this part 2 is my sensible way to recognize entity “Clinical Malaria” to deal with the world wide ancient scourge with CQ.]
- -
-
- In any City Town Village Jungle Bush Roadside OUT-PATIENT CLINIC set up: when a person arrives with any one or more of the symptoms : fever,= rigors, chills, shivering, =feeling cold, or feeling hyper-hot, with daily fever, with alternate day fever, with sweats or without, with temperature touching down or not, With previous history of Malaria slide positive or with no previous slide exam, with treatment or without meds, with icteric yellow eye, well built or wasted, with a small spleen, just a spleen tip,or a very huge spleen, a PROVISIONAL DIAGNOSIS OF : “CLINICAL MALARIA” is made,
-
= a blood slide [thick and thin smears] is taken for the lab.
=and without waiting for the result:
-
=and the first dose of CQ: Chloroquin is given, BUT ONLY AFTER SOME SEMI SOLID FOOD like a porridge, and NOT ON AN EMPTY STOMACH [= CQ retching and severe vomiting, and rejection of later CQ ]. The dose CQ tab. [ each 150 mg base CQ.]… is calculated at 2 tablets per 10 kg body weight for full course given over 4 days.
,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
The success of control / treatment depends on the prophylactic CQ suppression for at least an year or two for each person, to recover health, anemia, body weight,and work/ school ….
Coexistant disorders are taken care of:Anemia, poor nourishment, worms, Bilharzia, bleeding diseases, sickle cell…vitamin deficits,……
-
Preventive measures are continued….Impregnated nets, larvicidal fish, malaria surveillance,
-
-The entity “Clinical Malaria “ has to be recognized for all practical even statistical purposes.
-
The dosage schedule: shd be adhered to, no drop out, no half bake.
-
. This for a 60 kg adult works out to 12 tabs, [ cf. the WHO dose of 10 tabs over 3 days.] Half the dose 6 tabs [ 4 and 2] given on the first day, and the rest half 6 tabs divided as 2 tabs per day over the next 3 days.
A 70 kg person -= 14 tabs = 4-3……..3------2-----2………………
A 60 kg……………….12 tabs= 4-2……2……2…..2……
a. 50 kg……………..10 tabs = 3-2…….2…..2…..1…..
a 40kg………………8 tabs = 2-2…….2…..1……1…..
a 30kg………………6tabs..= 2 -1……1…..1……1….
a 20kg…5year old=.4tabs = 2………1……1……..
a 10kg..1 year old = 2 tablets = 300 mg base = 6 teaspoonfuls CQ SYRUP…over 4 days
a 5kg ..6month.= 1 tab …=150mg base = 3 teaspoonfuls..=over 3 days
.even a month old baby 3 kg. can be infected !!!!........
. The Doctor [or any health care provider at hand on duty ,medical assistant, medic, nurse, compounder, experienced local ‘medical’ man, quack, even the druggist,] will first look him over head to foot to eliminate any infected wound or gland or abscess, tonsil, ear & nasal sinus, eruptive fever, jaundice, joints, rapid chest action [pneumonia], a furred tongue [ typhoid group], stiff neck for brain fevers, paralyses, heat hyper fever,
AND arrives at a PROVISIONAL DIAGNOSIS OF : “CLINICAL MALARIA”, all this takes a minute. A helper is wet sponging the super hot body and feeding spoons or gulps of water for thirst dehydration, [fluids with salt and sugar, lime juice, barley water, rice water, kanjee, gruel,]
=============================================================================================
=
Malaria.[part 1 ]
Reply | Report Abuse | Link to this=Malaria IS NOT A KILLER per se;
=
=YES people die of malaria, BUT only due to : its repeat attacks causing debility, untreated anemia ; sickle cell disease; G6PDDeficit; co-existing bilharzia ; poverty malnutrition;and the confusing number of Chloroquin tablets in the market with various strengths; the OTC Rx of inadequate dosages; the self medication; the 3 day DELAY in starting the 4 day course; the quacks with improper dosages; the cost disparity of Branded makes; vomit of tablets taken on empty stomach; AND THE NON-CONTINUATION OF CQ AS WEEKLY SUPPRESSION DOSES FOR AN YEAR !!!!.
#. There is Total immunity and semiImmunity in 60% of inhabitants. They work even w huge spleens.# BlackWaterFever is rare , # and fatal Cerebral Malaria is NOT that common.
# I’ve treated Vietnam -Malaria 1969-74 so called resistant to CQ , with just CQ.
=I have Rx in Zambia 1979-88 with CQ. The few persistant cases respond to Rx with amodiaquin.
=and in the hyperendemic forest tribal areas of Sileru AP- Dasapalla Orissa...only w CQ-
=
=
# 1. YES, WHO! keep artemethers for the few obstinate cases, but NOT for the routine Rx.
=...# Impregnated Mosquito Nets, LarvaEating Fish, Fogging, Alethrin spray gutters, are NOT practical on mass scale in the huge field.
=
= 2. I myself took prophylactic CQ weekly for 5 yrs in Vietnam.=The pseudo scientific are crazy jumping hastily away as a general policy from simple good old cheap CQ .
3.=My CQ dosage calculation is easy, 12 tabs,[ not 10 tablets] x 150mg base, per course,[4,2,....2.....2.....2.] over 4 days for a 60 kg person.....@ 2 tab per 10kg body wt. [ 1 yr age =10kg =50mg per 5cc spoonful syrup=6 teaspoonfuls over 4 days.].
4=Recognise the entity “Clinical Malaria” and don’t insist on Slide Positive to start treatment. Take the slides 8 hourly for a day. If once a day slide , then take well before a chill rigor.
=Give the full course for 4 days, @ 2 tab x 150mg base per 10kg body weight. Supervise compliance.
=give the tabs after some food or porridge with sugar and plenty fluids.
5= treat and correct co-existent disease factors. Esply Nutrition. Dehydration, and high fever. [Ignore the hemolytic jaundice; urine is clear].
6=Give the weekly dose malaria–suppressing (2-4 CQ) tablets for an year or till good health recovered.
7= Look into Public Health measures available.
8= Be a simple general all round family doctor, and not only a ‘malaria doctor’.
=
=
Dont panic !!! …Dr.George Pradhan, MBBS/1950/MadrasMedical/ind
The people in developed countries don't see the suffering going on the poorer countries. This may sound bad but if malaria was a problem in a developed country, I have no doubt that the amount of effort to eradicate the disease would be increased a hundredfold.You cannot blame a country for being in the economic state that it is in... It's a cycle.The children (and if they survive) are born into a cycle of poor health and poverty.
Reply | Report Abuse | Link to thisWhen DDT was banned, it was being used in vast quantities and its use was also unchecked I assume. DDT was also used to spray crops to get rid of pests...
Maybe overpopulation is the main problem here....