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Award: Musketeer of the Year, Quiz Whiz of the Year (2011)
Joined: Tue Dec 23, 2008 5:22 am
Posts: 19262
Location: Midway between the infinite and the infinitesimal!
Award: Musketeer of the Year, Quiz Whiz of the Year (2012) |
renervr wrote: Sory but I'm going to step on some toe's  As both my wife and I being medical specialists we must then have been seriously ignorant and dof regarding risks. My son [20yrs] had his first visit at 16 days old for 2 weeks and my daughter[17yrs ] had her first visit at3 months old and ever since visiting at least 5-8 times a year.Nobody ever used malaria tablets and good old Tabard Peacefull sleep and in the rooms mozie mats protected us for all these years. I stand amazed at all the old wife tails and urban legends!? With a bit of lateral thinking you ask the qeustion how many thousands if not hundreds of thousand babies live in the eastern areas with the mozies and the heat!Yes there are many malaria cases but once again the studies tell the storie that in 98% of cases not a single type of precaution used! In 21yrs of practice [x2 including my wife's practice] I had one malaria case from Kenya referred to me because I do high risk obstetric manegment.At least once a month we hear of a fatal incident of one of our patients be it motor accident [99.9%] robbery etc
Many people are indeed ignorant, or sometimes unwise and insufficiently cautious (which usually stems from ignorance!) about the risks of malaria - and this traverses the entire range of people, from professionals to non-professionals, foreigners to locals, adults to teenagers, those in the know and those not! I've come across all types of people who prefer not to use antimalarial drug prophylaxis (known as chemoprophylaxis) for various reasons. Often, it is indeed not having sufficient knowledge about malaria, how to prevent it, the risks involved, how to suspect and diagnose it, and how to treat it. These people can then be sufficiently educated, whereupon their approach to malarial prevention (and, if necessary,
However - and this is what often amazes me - there are many people who know that malaria can kill - are sufficiently educated - yet they almost disdainfully ignore the risks!!  Many, I believe, walk with that age-old fallacy: it will not happen to me! Poppycock!!
EVERYBODY WHO ENTERS A MALARIAL AREA IS AT RISK OF CONTRACTING MALARIA!!!
Sure, people have different responses to the disease - for instance, some have partial immunity and develop milder symptoms (but that is only partial immunity and does not guarantee them safety from death at the hands of this tragic killer!), some are immunocompromised (lowered immune system) and face higher risks (including young children and babies, those on chemotherapy, etc.), and some do not get infected with the most lethal and common strain, P. falciparum, but P. vivax, P. malariae, or P. ovale. Some people are even lucky enough not to get bitten by a single mosquito during their stay, and different people are bitten more than others in general.
However, everybody is at risk of contracting malaria when entering malarial area, and that is an important point to keep in mind. You may think you are protected because of your religious beliefs, or family history of no-one ever having contracted malaria, or whatever, but the bottom line is that malaria is still a rife killer in the world, and especially in children 5-years and younger! It is not about bravado, but caution and wisdom, that is essential!
Renervr, I understand that you and your wife, from a clinical perspective, have not seen cases of malaria (bar one referred) in over 40 combined years of practice. You are fortunate, but your two medical practices by no means determine the statistics of your province, let alone South Africa or the world! As medical professionals, you must know that malaria is lethal and that millions of people die from it annually! Lateral thinking does not even enter into the equations, as the only thing that must be of concern to all people is the tragic loss of life - the statistics - due to malarial infection. Many people who die of the disease are indigent and in remote areas of Africa, and so have little or no access to medical prophylaxis and/or treatment when they do get the disease! Relatively affluent people mostly do not live in high malaria risk areas, have access to knowledge and information, and can obtain treatment for the disease if needed! I have no idea where your practices are (were), but there seems little doubt that they were not in high-risk malarial areas and that you did not see many indigent, or poor, people who have come from high-risk areas.
You don't specify which malarial areas you took your infants to, but it is well to remember certain points pertaining thereto: there are low risk areas, there are high risk areas, and there are very high risk areas; many seasonal risk areas in South Africa had a lower incidence of (reported) malaria cases twenty or more years ago, and recent evidence suggests that the amount of people contracting malaria in seasonal risk areas in Southern Africa (e.g. Kruger) has increased of late - therefore, higher risk now than then; and, if anyone of you (especially the children) had been unlucky enough to contract malaria, your attitudes towards the disease would almost definitely have been different.
One final, and very important, point that needs to be made, and which is unequivocal, Renervr: you have declared yourselves to be medical professionals - specialists at that; remember that people then will look up to you as authorities on medical conditions and their treatments.
Quote: I stand amazed at all the old wife tails and urban legends!?
Not quite sure what you mean by this? If you're saying that you "stand amazed at all the old wife tails (sic) and urban legends!?" because malaria is not a serious disease, then this would have no founding in research and fact! Many people contract malaria and/or die from the disease because their knowledge base is insufficient or they choose to be irresponsible in the face of the risks. This is no exaggeration either as millions of people do die from a combination of insufficient information, insufficient knowledge, insufficient caution, insufficient awareness, insufficient diagnosis, and insufficient treatment!
Quote: With a bit of lateral thinking you ask the qeustion how many thousands if not hundreds of thousand babies live in the eastern areas with the mozies and the heat!Yes there are many malaria cases but once again the studies tell the storie that in 98% of cases not a single type of precaution used!
I'm not sure what areas you are referring to when you say the "eastern areas"? If you are talking about the eastern areas of South Africa, then yes, there is a relatively low risk of anyone, including babies, contracting malaria - relative to high risk areas like Mozambique or tropical Africa! Still, these facts mean that babies and adults alike nevertheless do get malaria - which may be increasing in infection-frequency and fatalities - and this does not warrant suggesting that the disease is not as serious as it is known to be! Every exposure to a mosquito in a malarial area is a potential risk of contracting malaria - for everybody!
Please do not make unfounded statements unless you have researched the topic sufficiently! Opinions are one thing, and personal clinical "evidence" another. However, malaria is not about opinions, but facts, and people's awareness of the serious, and often fatal, consequences of the disease must not be diluted by inaccurate observations and insufficient research and clinical evidence!Disclaimer: My recommendations here - though based on some experience and some drug, and other, knowledge - are not absolute, and further consultation with suitable health-care professionals is suggested before a final decision is taken on whether to enter a malarial area, what prophylaxis to use, and any general factors and limitations that need to be taken into account. Furthermore, I only advise based on what information is given by the person(s) entering the malarial area, but I have no control on the information given to me, and so such information could possibly be incomplete or misleading. Moreover, people vary subjectively as to how they metabolise, and react to, drugs and other substances, which further accentuates that my suggestions here are only general suggestions, and therefore not to be taken as pertaining to every person alike.
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EVERYBODY'S TR!TR: A NEW DAY IS S-OWNTR: NECTAREAN NICETIES OF THE NORTHTR: PRIMEVAL PLEASURE"Outside of a dog, a book is a man's best friend. Inside of a dog, it's too dark to read." (Groucho Marx)
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The area discussed is west of Kruger, which place nothern Kruger in the same risk area. Another point is that the government protects people by spraying their houses with pesticides in malaria epidemic areas, but I am not sure if Kruger practice the same during summer season. 
The news clip is from Jan 2010; the last rainy season I could get info on. This news article points out the real risk of malaria in Kruger, allthough not mention but all areas in the article borders on Kruger or is very close.
