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Complicated prevention and treatment of malaria for Western visitors to Africa

7 Dec

By Meredith Chait

Krista Jobst, a student at the University of Kansas, was studying in Tanzania when she began to experience sleepless nights. She was having vivid dreams of everyday activities like riding a bus and seeing family and friends. However, these dreams had so many details that she was not sure if she was dreaming or awake.

Jobst suspected her dreams were a side effect of her anti-malaria medication, Malarone. She stopped taking the medication and the dreams stopped.

Then Jobst got malaria.

“I caught it during one of three instances during that time period when I was exposed to areas with large amounts of mosquito population,” Jobst said via email.

Jobst was fortunate to have been diagnosed and treated. She was put on a three-day treatment regimen. By the second day she was feeling 50 percent better.

However, not all Westerners are as lucky at Jobst. Preventing and treating malaria in Westerners in Africa is complicated by the inconveniences of the prevention techniques, lack of awareness of the symptoms, counterfeit and spoiled medication and a dangerous treatment method. Recently, 82 million doses of fake anti-malaria medications were discovered in western Africa, according to the Botswana Gazette. The drugs were worth about $40 million, according to the newspaper.

Prevention burdens

Some Westerners see malaria prevention as a burden when traveling to Africa, according to Jobst. A person can take anti-malarial medication. However, some mosquitoes carry a strain of malaria that is resistant to anti-malarial medication, according to Patty Quinlan, head nurse at KU’s Watkins health center.

Wearing long sleeve shirts and pants also helps prevent mosquito bites and lowers the chance of getting malaria. However, it can easily be over 100 degrees in North Africa, according to goafrica.about.com

Mosquitoes in Africa are becoming more resistant to malaria prevention medications, according to the World Health Organization.

Some African visitors choose to spray DEET to deter mosquitoes. However, this is a toxin and some people are uncomfortable using it for multiple days in a row.

One of the most effective prevention methods is sleeping under mosquito netting, according to NetsforLife Africa. However, it can be annoying to sleep with.

Diagnosis complications

In addition to prevention, diagnosing malaria is also complicated for Westerners. Kathryn Rhine, a University of Kansas anthropology professor, had stomach aches, headaches, stress and fatigue, when she was doing research in Nigeria. Instead of malaria, she misidentified these symptoms as a common cold.

Because malaria is not common in First World countries, Westerners do not always recognize the symptoms of malaria when they travel to Africa.

“I suspect I had malaria anywhere from 45 days to one week before I sought out treatment,” Jobst said via email. “Sometimes malaria takes a while to devolve symptoms.”

Treatment complications

Even if individuals get diagnosed correctly and quickly, getting medication, which is not counterfeit or spoiled, is something new to watch out for.

Malaria medication seized in the raid was found to be stored at 122 degrees, when it should be stored at a maximum of 40 degrees to be effective, according to the newspaper.

For severe malaria cases, quinine can be injected intravenously. However, there is a chance the medication can kill the person it is supposed to be helping, Jobst said.

Getting treatment

Luckily for Jobst, she was in Dar es Salaam, the capital of Tanzania when she sought treatment. In urban settings, there are many hospitals and testing centers. However, a person might have to travel hours by bus if he or she lives live in some rural areas to get tested and treatment.

Medication to treat malaria in Africa costs between $15 and $20, according to Jobst. It costs the same at KU’s Watkins Memorial Health Center.

In Africa, a prescription is not needed to get medication at a pharmacy, Jobst said. Some Africans see traditional healers instead to get treated for malaria, according to Rhine.

The trade-off for Jobst was she did not have any vivid dreams, but, she did get malaria.

“[I] don’t regret stopping the meds,” Jobst said via text message.

 

Photo slideshow

Click here to see what KU students know about malaria

 

Visual 

In 2010, there were 106 countries in the world were malaria has been found. 45 of those countries are in Sub-Saharan Africa, and 27 of those countries have at least one medication-resistant malaria strain, according to the World Health Organization.

Correction to the graph, malaria has been found in 106 countries,  not 109, as stated in the graph. Therefore, out of the 106 countries in the world where malaria has been found, 42 percent are in Sub-Saharan Africa, not 41 percent, as stated in the graph.

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KU students’ knowledge of malaria

7 Dec

See what 10 University of Kansas students answered when asked, “What do you know about malaria?”  in the slideshow below.

 

Click here to go back to the story and graphic

Microsoft holding annual Partners in Learning Global Forum

4 Dec

By Meredith Chait

  • Microsoft is holding its annual Partners in Learning Global Forum. More than 250,000 participants, from more than 75 countries, will present a number of solutions to boost education and help students realize their potential in Africa and across the world. Africa has numerous entries vying for the top prize, the global Innovation Educator Award for people who bring technology to the classroom.
  • Ugandan rebel leader Joseph Kony, accused of crimes against humanity by the International Criminal Court, will not be captured without more U.S. troop involvement, according to the Enough Project. The Enough Project is urging the 100 U.S. Army Special Forces in advisory roles to become more involved in the combat roles. About 2,500 African Union troops carry-out the operational activities of finding Kony in the jungles of central Africa.
  • The Tanzanian shilling has hit a three-month conversion rate low of 1580.11 to $1, according to the Bank of Tanzania. However, commercial banks are quoting the shilling trading between 1,585 and 1,603 to $1, the lowest since January. The shilling weakened after an increase in demand for the U.S. dollar from importers for oil, gold and cash crops according to a Tanzanian securities officer and the National Microfinance Bank.

Preview of next story

30 Nov

Topic: prevention and treatment of malaria for westerners in Africa.

My audience knows malaria is not found in the U.S.

after reading: while malaria, in theory, is easy to treat, there are more and more circumstances that make it hard for westerners to get cured in Africa.

South African official worried about indigenous languages

27 Nov

-The minister of Higher Education and Training in South Africa, Blade Nzimande, is worried about the decreasing use of African languages in South African universities. Nzimande would like classes at universities to be taught in indigenous languages, to help preserve and promote the languages, and therefore, the cultures of South Africa. Nzimande has put together a committee that will provide recommendations on how to increase the use of African languages in the universities.

-African journalists, from 15 African countries, visited the United States in September as part of a program, International Visitor Leadership Program, to help people improve professionally by understanding the U.S., including the U.S.’s free press. The goal of the program is for the participants to share their new views of the U.S. with their countrymen, including the difference between the American government and U.S. citizens. Invited by the U.S. State Department, the 16 journalists came to study journalist principles and rights reporters have in the U.S.

-The £102 million ($163 million) the UK government has sent to Nigerian schools has not contributed to any major improvements in student learning, according to the Independent Commission for Aid Impact (ICAI). ICAI believes the money did not help because there is a shortage of effective teachers and a lack of local support. The money went to teacher development, school improvements, community engagement and accountability, among other things, according to the ICAI.

Former head of US Africa Command stripped of rank for misuse of funds while in command in Africa

19 Nov

-General William E. Ward, former head of U.S. Africa Command, has been demoted to a three-star General by Defense Secretary Leon Panetta. A U.S. Defense Department report found that Ward misused military aircrafts and staff, excessively spent public money on unofficial travel and was the recipient of reimbursements he was not entitled to when he was Commander of U.S. Africa Command. The Department of the Army will try to recover the $82,000 Ward misused. He is currently a special assistant to the Vice Chief of Staff of the U.S. Army. Ward is now going to retire a three-star Lieutenant-General instead of a four-star General, the highest rank in the U.S. Army.

-The Students Association of Nigeria in Diaspora (SAND) has called for the Nigerian government to help stop massive amounts of money from leaving the country in the form of tuition and fees for Nigerian students to go to foreign universities. SAND would like the money leaving Nigeria to be given to higher education institutions in Nigeria. This money would help Nigerian higher education schools become top universities in Africa and therefore less students would feel the need to leave Nigeria to receive a good education.

-Assistant U.S. Secretary of State for Democracy, Human Rights and Labor Michael Posner is urging the Nigerian military to be cautious before using force and violence against civilians. Nigerian military forces are accused by numerous organizations of mass arrests, killings, torture and detention without due process to try and fight Boko Haram. Boko Haram has killed hundreds in bomb and gun attacks since 2009. Amnesty International claims that Nigerian military tactics are driving angry teens to join Boko Haram and encouraging the northern population, who feel helpless and are impoverished, to shelter the group. Nigeria is Africa’s top energy producer, making the U.S. want to help Nigerian President Goodluck Jonathan fight the Boko Haram to get in his good graces.

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Malaria problem for visitors to Africa

16 Nov

In 2010, 80 percent of the world’s malaria cases were in Africa. Out of the 216 million world cases, 174 million were in Africa, according to malaria.com. Below is a graph showing the number of malaria cases in the world in 2010 by world region.

Kathryn Rhine, a University of Kansas anthropology professor, chalked-up her loss of appetite and fatigue to the 110-degree days she was experiencing in Nigeria.

She was in Nigeria doing anthropological research. Her Nigerian friends suspected malaria. Even though this was not her first time with malaria, she still did not think her symptoms could have been from the parasite. She protested their diagnoses but got the blood test anyway, just to check. The test showed that she, in fact, did have malaria.

The first few times she had malaria she was sicker. All the times she has had malaria, she has confused the symptoms. She had symptoms like a cold, stomach aches, headaches, stress and fatigue. Both times she was treated and recovered, Rhine said via email from sabbatical.

Few Nigerians would confuse the symptoms of malaria. It is too common, Rhine said. In 2010, 174 million Africans contracted malaria. That is 80 percent of the world’s malaria cases for that year, according to malaria.com.

Because Malaria is not as common to foreigners traveling to Africa, it is even more dangerous to them.

Krista Jobst, a senior at KU, contracted malaria when she studied abroad in Tanzania for eight months before starting college. A person can get malaria if they are bitten by a mosquito that has it. Like Rhine, Jobst also did not think she had malaria.

“I have never been so sick in my life,” Jobst said.

She had hallucinations and nausea. She was delirious, drowsy and dizzy. The dizziness was so bad she felt like she was on a boat, Jobst recalls.

Malaria in Africa

People traveling to areas where there is malaria should be extra cautious. They are less likely to know the symptoms and therefore seek treatment before the disease becomes severe.

There are 106 countries in the world that have malaria mosquitoes, 45 of which are in Africa, according to Nets for Life Africa.

Out of the 80 percent of world malaria deaths that occur in Africa, 30 percent occur in Nigeria and the Democratic Republic of the Congo, according to Rhine.

Rhine also adds that mosquitoes in Africa are becoming more resistant to common western drug treatments of malaria.

Africa and the Indian subcontinent are the only places where the malaria carrying mosquitoes can be found in rural and urban areas, said Patty Quinlan, nursing supervisor at KU’s Watkins Memorial Health Center.

Krista Jobst would meet fellow students and volunteers at a hotel in town every month for a meeting. The first thing they would do was try to  kill all the mosquitoes in the room, which they called a game.

Prevention

The two main malaria “preventative medications” are Chloroquine and Mefloquine. Both are oral medications, according to Quinlan.

These medications need to be taken from three weeks to one day before traveling to a malaria infected area and when in the area, according to Quinlan.

Quinlan explained  that there are four different types of malaria; some strains are resistant to some anti-malaria medication. A doctor will prescribe one medication over the other depending on where the person is traveling to, how long they are staying there and the time of year they are traveling, Quinlan said.

When in a malaria infected area, a person should wear light-colored long sleeve shirts and pants, limit their outside activity at dusk and dawn, use insect repellent, eliminate standing water and cover the bed with mosquito netting, Quinlan advises.

Limiting dusk and dawn activity is a popular method of prevention. Female mosquitoes, the one that bites and could carry malaria, are nocturnal and therefore most active at dusk and dawn, Quinlan said.

Some people see malaria prevention has a burden, with no good solution, according to Jobst. A person can take anti-malaria medication. However, that does not guarantee the person not contracting malaria. People could spray DEET, but that is a toxin. And, mosquito netting is annoying to sleep with.

Jobst said she had side effects from Malarone. She had vivid dreams and being tired at different times during the day.

Symptoms

All humans can contract malaria. Infants, pregnant women and people with compromised immune systems are most at-risk, according to Quinlan.

Jobst suspects she contracted malaria when she traveled to a tropical part of Tanzania. She was taking Malorone, but she stopped taking it when it became winter in her Tanzanian area.

The malaria parasite first gets into the blood stream. If not treated, it can move to the liver and become dormant for as long as seven years, Jobst said. Within those seven years, the malaria can come back at any time, Quinlan said.

Jobst is counting down the years until there is no chance of the malaria coming back.

Jobst remembers being sick with malaria vividly. It was the sickest she had ever been. She could not leave the bathroom because of vomiting and diarrhea.

“It is such a quick virus,” Jobst said, the 3-day treatment seemed like an eternity.

Treatment

The same medication to prevent malaria also treats it. A blood test is needed to confirm a person has a malaria parasite, Quinlan said.

When Jobst contracted the parasite, she was put on a 3-day treatment plan. On the first day, she already felt 50 percent better. After the 3-days there was no trace of malaria in her blood.

For severe cases of malaria, IV quinine is used to treat it. However, the treatment could also kill you, Jobst said.

In Africa, a person can get medication directly from the pharmacies, without a doctor’s prescription. Some people see a traditional healer instead, according to Rhine.

KU health center and malaria

KU’s health center offers Chloroquine and Mefloquine to prevent and treat malaria.

At the KU pharmacy at Watkins Health Center, 20 pills of Chloroquine costs $30 and 20 pills of Mefloquine costs $16.50, without insurance.

Summer study abroad students are the most common people to go to Watkins health center to get the malaria medication, Quinlan said.

The health center also educates study abroad students coming to KU about malaria, Quinlan said.

If someone is born and raised in a country with malaria, and there are 106 of them, then they are considered immune. They have either had malaria, creating antibodies, or they have not had it and know how to prevent it. However, after six months away from that environment they are no longer considered immune, Quinlan said.

Quinlan remembers treating some students with malaria.

“Oh Meredith, they are in such pain,” Quinlan said, as she cringed remembering seeing students with malaria.