A child with malaria: the anxiety of a mother

Bolgatanga- “Nurse! Nurse! Nurse! “Faa n bia” which means save my child in the gurune language was how a visibly worried woman in tears rushed into the Paediatric ward of the Upper East Regional hospital with her child of about five years old in her hands looking very weak and ill.

Her action drew the attention of Doctors and nurses on the ward, who immediately received the child onto a bed they used for venipuncture, while some nurses tried to console the woman whose chicks were flooded with tears.

“Please all visitors should kindly leave, visiting time is over,” a nurse suddenly announced while another one moved out of the Unit, hurrying towards the laboratory with a vaccine carrier, ostensibly for blood to transfuse the child.

The then lead Doctor of the Unit at the time, Dr Odalys Batista, a Cuban Doctor who attended to the child, later expressed concern about the attitude of some patients, who unnecessarily delay at home and later visit the facility with their children in bad conditions.

Malaria Parasites

“The malaria parasites in that child are too much and that resulted in severe anaemia and the boy was brought in unconscious. The mother came straight to the ward without going through the OPD, where the child would have been received in his unconscious state and managed. But it is understandable, she is very anxious.

“We set up blood on him, passed a Nasogastric (NG) Tube for feeding, we connected a urethral catheter and also connected oxygen because the oxygen concentration level is very low. This child may not be normal after recovering, the condition may affect his brain. He had several episodes of convulsions,” she said.

Some background

Malaria is a life-threatening disease caused by Plasmodium parasites spread to people through the bites of infected female Anopheles mosquitoes, called “malaria vectors.”

There are basically five parasite species that cause malaria in humans, but two of these species, Plasmodium falciparum and Plasmodium vivax pose the greatest threat.

The symptoms of malaria usually develop within 10 days to four weeks, but in some cases, symptoms may not develop for several months. Some malarial parasites can enter the body, but will be dormant for long periods of time.

Common symptoms of the disease include; headache, chills, nausea and vomiting, profuse sweating and fever. These symptoms among others if not treated within 24 hours, the Plasmodium falciparum malaria can progress to severe illness, often leading to death.

Children with severe malaria frequently develop one or more of the following symptoms: severe anaemia, respiratory distress, cerebral malaria. Multi-organ failure is also frequent in adults.

In malaria endemic areas, people may develop partial immunity, which allows asymptomatic infections to occur.

Effects of Malaria

It has for many years been the highest cause of OPD attendance and a leading cause of death among children in the Upper East Region and Ghana as a whole.

Even though it is a year- round disease that can infect one at anytime, it is most prevalent in the rainy season, where pools of water provide breeding grounds for the mosquito.

Most health facilities in the Upper East Region usually record high malaria cases in children, especially in the rainy seasons when breeding sites for mosquitoes are many.

Paediatric Units of most District Hospitals are often filled to capacity, some facilities are often compelled to pair children on one bed, while others are nursed on mattresses on any available space on floors.

Mrs Sylvia Antwi Boasiako Frimpong, a Paediatric Nurse at the Unit, told the GNA that “When we ask about the use of mosquito nets, the mothers tell us they have the nets, and their children sleep under them.

“We however realised during our health talks and interactions with the mothers every morning that some of them, especially those in local and compound houses allow the children to play around on the compounds at night, they get the mosquito bites before they sleep under the nets,” the nurse said.

According to data from the Hospital, made available to the GNA, the OPD malaria attendance in 2018 was 5727, it increased to 6767 in 2019, but declined to 5154 in 2020 without any under- five mortality recorded in 2020 even though the facility recorded 1,984 under five malaria OPD attendance.

Mr Sydney Ageyomah Abilba, the Malaria Focal Person of the Ghana Health Service (GHS) in the Upper East Region, said the Region consistently recorded a decline in under-five mortality from 2015 to 2019.

In 2016, under-five malaria mortality was 0.51 per cent, in 2017, it reduced to 0.30 per cent, in 2018, 0.08 per cent and 0.01 per cent in 2019.

Causes of under-five reduction

He attributed the achievement to interventions carried out by the Regional Health Service.

“We are doing well as a Region, he said, and many positive gains have happened so far.

Some of the interventions in the system such as the Seasonal Malaria Chemoprevention, the Sulfadoxine-Pyrimethamine (IPTp-SP) coverage and the use of bed nets have brought some changes.”

Other measures the Regional Health Directorate undertook to achieve the good results worth emulating include,Diagnostics and Malaria Case Management.

The GHS in the Region embarked on series of training programmes for Clinicians on prompt diagnostic before treatment of suspected malaria cases, that is the 3Ts (Test, Treat and Track).

Laboratory Scientists were also trained to promptly diagnose suspected malaria cases for quick treatment interventions.

Doctors, midwives, Physician Assistants and other Clinicians across the Region had refresher training programmes on how to handle malaria cases in pregnancies in the Region.

Malaria Prevention

The Seasonal Malaria Chemoprevention (SMC): Provision of Sulfadoxine-Pyrimethamine (SP) and Amodiaquine as prophylaxis for children below five years during the high peak of malaria transmission in the rainy season.

The Health Directorate supplied the Intermittent Preventive Treatment (IPTp) to pregnant women during Antenatal visits to reduce the risk of malaria infection in pregnancy.

Expectant and nursing mothers were also provided Long Lasting Insecticide Nets (LLINs) to protect them and their children, while School children and general households in the Region were not left out. This initiative was done through the Point Mass Distribution of LLINs.

Conclusion

Malaria in children can have dire consequences, while adults lose many hours of work when suffering the disease.

Until the Country is able to find a lasting solution, either by eradicating the mosquito or disabling its ability to carry and spread the plasmodium parasite, the Upper East Health Directorate would have to continue carrying out its measures to ensure that both children and adults do not die or suffer any debilitating side effects of malaria.

Source: Ghana News Agency

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