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Malaria

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Malaria A major public health problem-Namibia. Seasonal (Rainy season) Mean incidence: 255/1000 population. Mortality: 61 96/100,000 population. – PowerPoint PPT presentation

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Title: Malaria


1
Malaria
  • A major public health problem-Namibia.
  • Seasonal (Rainy season)
  • Mean incidence 255/1000 population.
  • Mortality 61 96/100,000 population.
  • About 26.4 OPD 21.6 of all
  • admissions.

2
Malaria Cont
  • Maria Risk areas Namibia
  • High Risk areas North East Kavango-
  • Caprivi region
  • North the 4 O- regions
  • North West region (Opuwo, Khorixas)
  • Low Risk Area Erongo-, Otjozondjupa-, Khomas-
    Omaheke region
  • No-Risk Area Hardap- Karas region

3
Malaria
  • Definition An acute, infectious blood borne
    disease.
  • Cause Malaria parasites hosted by female
    mosquito Anopheles mosquito.

4
Malaria (Continued)
  • Mode of transmission Bite by female anopheles
    mosquito.
  • Types of mosquitoes that transmit malaria
  • - Plasmodium Falcifarum in Namibia
  • Plasmodium Malaria
  • -Plasmodium Vivae
  • Target for the parasites Red blood cells and
    platelets

5
Path physiology/ Disease process of Malaria
  • The female anopheles mosquito carries the malaria
    parasites in its saliva
  • Bite by the female anopheles mosquito
  • Injection of malaria parasites in the blood
  • Malaria parasites invade red blood cells
    platelets
  • Malaria parasites feeds on the hemoglobin of red
    blood cells ? Hemolysis of red blood cells and
    platelets ? results into Anemia and bleeding
    tendency.

6
Path physiology/ Disease process of Malaria
  • Hemolysis of RBC and Platelets produces the
    bilirubin--- creates jaundice (yellow
    discoloration of skin and mucus).
  • Bilirubin may obstruct the tubules of the
    glomeruro apparatus of the kidneys resulting
    into renal failure.
  • Malaria pathophysiology (cont)
  • Bilirubin affects the liver nausea and
    vomiting and result into dehydration.

7
Malaria pathophysiology (cont)
  • In response to the parasites invasion, the bodys
    immune system releases white blood cells
    (leucocytes) result into (leucocytosis) to fight
    infection, heat production pyrexia.
  • Malaria parasites can affect the brain, causing
    cerebral malaria
  • edema of the brain cells
  • suppression of vital centers in the brain
    (cardiac- respiratory, vomiting center).
  • Resultant unconsciousness and death

8
Potential complications of malaria
  • Acute complications dehydration from vomiting,
    anemia from hemolysis of red blood cells, and
    cerebral malaria and death
  • Chronic complications anemia,
  • renal failure due to damage of glomerulo
    apparatus by the bilirubin..

9
Management of Malaria
  • Medical Management
  • Investigations and potential findings
  • history of malaria e.g. epidemic area season
    and clinical manifestations
  • a positive blood smear for malaria.

10
Malaria RX Continued
  • Medications Uncomplicated malaria
  • 1st Line AdultsArtemether/Lumefantrine. BD
    for 3 days. Exemption Pregnancy gt 5kg
  • Children 2-6 months and gt 5kg Sulphadoxine/Pyrimet
    hadine
  • 2nd Line Quinine (Quinine also for complicated
    malaria, IVI and p/o.
  • (See National Malaria Policy on Malaria)

11
Malaria Nursing Management
  • According to the nursing process
  • Assessment ( actual, and potential nursing
    diagnosis)
  • (based on S S and pathophysiology)
  • Planning of nursing interventions and expected
    outcome.
  • Implementation of nursing interventions
  • Evaluation of outcome.
  • (brainstorm on the black board)

12
Nursing care Plan for Malaria
  • Nursing Diagnosis
  • High body metabolism due to immune response
    (interaction of antigen wbc) as evidenced by
    Pyrexia shivering
  • Nursing Intervention
  • Tepid spongy
  • Ventilation
  • Temp monitoring
  • Anti-Malaria Rx to reverse the pathophysiology of
    the disease.

13
Nursing care Plan for Malaria
  • Nursing Diagnosis
  • Nausea, vomiting due to cerebral malaria, effect
    of
  • ? bilirubin on the liver
  • Nursing Intervention
  • Anti emetic per prescription
  • Measure volume of vomitus as output record

14
Nursing care Plan for Malaria
  • Nursing Diagnosis
  • Potential dehydration due to vomiting fever
  • Nursing Intervention
  • Adjust fluid intake to output.
  • More fluid orally, if no vomiting
  • Urine output to watch oliguria.

15
Nursing care Plan for Malaria
  • Nursing Diagnosis
  • Potential oliguria, signifying renal failure due
    to bilirubin
  • Nursing Intervention
  • Urine output to watch oliguria.
  • (Normal30ml/hour
  • Urine dipstic for proteinuria hematuria

16
Nursing care Plan for Malaria
  • Nursing DX
  • Potential anemia due to hemolysis of RBC
    Platelets, as evidenced by heamturia
  • Nurse Interventions
  • Hb monitoring
  • Iron preparates e.g. Pregamol
  • HP diet, Vitamines Minerals
  • Avoid injuries

17
Nursing care Plan for Malaria
  • Nursing DX
  • Potential cerebral Malaria (swelling of brain
    cells, suppression of vital centres e.g.
    cardiac-, respiratory centres as evidenced by
    headache, confusion
  • Nurse Interventions
  • Monitoring of consciousness level
  • Quite environment
  • Vital signs monitoring if not ?
  • Observe consciousness level.
  • Safety measures
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