the treatment of malaria and filaria

Q. 49. Write down the treatment of malaria and filaria ?
 Treatment of Malaria :-
A. Chemotherapy of the acute attack :-
1. Chloroquine is the drug of choice for acute malaria caused by sensitive strains.
- usual course of treatment
- 600mg of the effective base (4 tablets) follow by 300mg base in 6 hours then 150 mg base twice daily for 2 more days.
- The initial dose for children is 5-15 mg/kg
- For semi-immune individuals, a single dose 600mg for on adult is usually adequate.

2. P. falcifarum malaria which is chloroquine resistant should be treated with.
- Quinine dihydrochloride or sulphate 600mg salt (10mg/kg) 3 times daily for 5 days by move followed by a single dose of sulphadoxine 1.5 combined with pyrimethamine 75 mg i, e, 3 tablets of Fansider.
- Alternative to quinine plus fansider are:
* Mefloquine 20mg/kg base up to maximum 1.5 gm in two divided dose 8 hours apart.
* malarone (adovaquone 250 mg plus proguanil 100 mg) 4 tablets once daily for 3 days

B. Management of cerebral malaria.
Quinine is indicated if a chloroquine- resistant is suspected.
Dose : 10mg/kg in l0 ml/kg isotonic saline given 1/v over 4 hours.

This is repeated at intervals of 8-12 hours until the patient can take drug orally.

C. Radical cure of P. vivax and p oval malaria.
This can be achieved by a course of primaquine (15mg/dey for 14 days).

 Treatment of filariasis :-
1. Diethylcarbamazine (9-12 mg/kg thrice daily orally for 14 days) is the drug of choice for filariasis the course may be repeated twice at intervals of 4-6 weeks.
2. Antihistamines or corticosteroids may be given to control allergic phenomenon.

Q. 50. What are the organism of malaria? Write down the prevention and control of malaria?
 organism of malaria :-
1. Plasmodium falciparum
2. Plaomodium vivax.
3. Plasmodium ovale.
4. Plasmodium malariae.

 Prevention and control of malaria:-
A. The individual
1. Chemoprophylaxis
a. Chloroquine – sensitive areas
(i) Chloroquine 150 mg base (2 tablets weekly) or (ii) Proguanil 100mg (1 or 2 tab) daily.
b. Chloroquine resistant areas
(i) Proguanil and chloroquine (dose as also)
c. ‘hard care’ multidrug-resistant areas.
(i) Mefloquine 25mg (one tablet0 weekly.
d. Chemoprophylaxis in pregnancy and tablet proguanil or chloroquine may be given safel

2.  Other preventive measures in addition to chemoprophylaxis
(i) the use of mosquito net
(ii) Protective clothing should be worn outside the house
(iii) Screened windows.
(iv) Use of repellent cream and spays
(v) Burning of repellent coils or tablets.
B. the vector :-
1. Control of adult mosquito by insecticides.
2. Control of larvae with larvacides on the breeding place.
- Heavy oiling with antimalarial oil.
- light spraying with kerosene.
3. Subsoil drainage.
C. The community.
1. Residual spray.
2. Larviciding
3. Mass drug ad minis tration
Q. 51. What is tuberculin test? How will you interpret the results of this test.
 Tuberculin test : It is a hypersensitivity test that depends on delayed hypersensitivity reaction which develops in individuals infected with TB bacilli.

 Interpretation :-
1. Positive result- indicates that the individual has been infected with the tubercle bacillus, but it does not say whether the infection is already healed, latent or even active at the time of the test.

2. Negative results:- indicates that the individual is free from the infection with tubercle bacilli.

3. Doubtful reaction :- Indicates that the person may be infected with other mycobacterium.