Prevention and therapy of malaria = Preprečevanje in zdravljenje malarije
Stürchler, Matius P.
Worldwide, about 500 million people are infected annually with malaria and up to 2.5 million deaths are caused by this disease. In 1998 a total of 9 cases of malaria were treated at the University ...Hospital in Ljubljana but the actualnumber of cases in Slovenia may be as high as 30 annually. The data for 1999 are not yet available, but are expected to look similar (personal communication A. Trampuž). The case fatality rate in non-immune persons in industrialized countries ranges between 0 and 3.6% with an average of 1.1% in Europe as a whole - one malaria death per year can be expected in Slovenia. Prevention of malaria is an important public health issue for almost all countries in the world, and some simple precautions like the protection from mosquito bites with DEET-containing repellents and the spraying of clothing and bed nets with permethrin can markedly reduce the risk for travellers. Depending on the region of travel, chemosuppression or stand-by emergency self-treatment has to be discussed with the traveler. Paramount when dealing with an acutely ill person is to consider malaria by taking an exposure history (travel, residence close to airport, i. v. drug use, recent blood transfusion, parasitemia in pregnancy) and to be aware that falciparum malariais a life-threatening emergency. Therefore, when in doubt, the patient should either be hospitalized immediately or receive prompt treatment. In thissituation fast acting asexual schizonticides such as quinine and artemisinines are preferred over slow acting compounds such as mefloquine, chloroquine or sulfadoxine plus pyrimethamine.
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