Malaria News |
Malaria: passive case detection and healthcare providers' choices of chemotherapy 
Prompt diagnosis and treatment play a central role in the malaria control programme in sub Saharan Africa. However, in most cases the diagnoses are never confirmed either for lack of facility or disinterest of healthcare providers resulting in over-diagnosis. To determine the proportion of clinically diagnosed malaria cases who could be confirmed with microscopy and evaluate compliance of healthcare providers with the National treatment guidelines for malaria. Participants were patients referred for malaria microscopy after the attending physicians had made clinical diagnosis of malaria. Thick blood smears were made under strict asepsis, stained and thereafter examined under oil immersion objective lens. Of the 630 patients who were referred with clinical impression of malaria, only 224 or 35.6% were positive for malaria parasite. The slide positive patients were younger with a mean age of 10.6 +/- 13.0 years versus 17.2 +/- 18.5 years [P < 0.005] for the slide negative individuals. There were only few instances of non-compliance with the National treatment guidelines for malaria. In conclusion, there appears to be over-diagnosis of malaria considering that only about a third of the clinical malaria cases were confirmed by microscopy. There is need for large epidemiological studies and possible policy review.
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Cotrimoxazole, clinical uses and malaria chemotherapy
Microbial infections still account for considerable morbidity and mortality in sub-Saharan Africa. The importance of chemotherapeutic agents cannot be over-emphasized. Some antimicrobial agents provide broad spectrum of activity spanning different classes of bacterial and protozoan diseases. Cotrimoxazole, an antifolate antimicrobial was originally meant for treatment of bacterial diseases but has been shown to be an effective drug in the treatment of malaria amongst other conditions. This review attempted to explore the pharmacology of cotrimoxazole, its many clinical uses and adverse effects. Specific experiences of the author in the application of cotrimoxazole in the treatment of acute uncomplicated falciparum malaria were highlighted and suggestions on how to optimize the use of this drug were made.
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