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Lecture 9

Lecture 9 notes: Malaria and AIDS orphans in Africa LECTURE NOTES AND SUPPLEMENTARY READING NOTES

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Health Studies
Jason Ramsay

Lecture 9 Malaria and AIDS orphans in Africa July 16 2012most dangerous animals in perspectivevenomous snakes250000 fatalitiesyearscorpions2000 fatalitiesyearbig cats800 fatalitiesyearcrocodiles800 fatalitiesyearmosquitos13 million fatalitiesyear plasmodium falciparumstrain of malaria that is particularly virulentappears to directly affect the central nervous systemcan cause neurological sequelae and epilepsy sequelaea condition that is the consequence of a previous disease or injurymost common form of malariaoccurs 85 in subSaharan Africa malaria in context350500 million infections in humansone to three million deaths annuallyhas killed more people than all wars and other plagues combinedtransmitted by Anopheles mosquitosvaccination efforts have failed famous author Wilbur Smith I WAS BORN OF BRITISH STOCK ON JANUARY 9 1933 IN NORTHERN RHODESIA NOW ZAMBIA IN CENTRAL AFRICA As an infant of eighteen months I was struck down by cerebral malaria delirious for ten days The doctors told my parents that it was probably better if I died because if I survived I would be brain damaged Despite the primitive medical facilities available in Africa in those days their prognosis proved correct I survived and am now only mildly crazy pathogenesis the Protozoan parasites live inside cells where they are largely hidden from the immune response infection has a profound effect on the immune system and can cause immune suppression dendritic cells suffer a maturation defect following interaction with infected erythrocytes and become unable to induce protective liverstage immunityendemic areas for malaria found esp around equatortreatmentmalaria is now tolerant of older treatments quininebased gin and tonic sulfadoxinepyrimetharineartimisinin China is now widely used7day course is recommended and followup and monitoring recommended malaria in kidsCNS manifestations severe infectioncerebral malaria severe infectionhypoglycemia hypoglycemia is induced by quinine severe anemia high fever drug induced behavioural changes neurocognitive morbidity of malaria previously malaria was considered mainly in terms of mortalityor how many people it killed each year now research shows that besides mortality it also has a high rate of morbidity
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