BY GEOFFREY MULINDWA RWABAINGI
Most people who visit the Allan Galpin Health Centre when sick usually have a high suspicion of having malaria. Paradoxically, after the relevant tests are done, the patients are told that they are free from malaria. These people express disappointment instead of relief yet malaria is serious and can cause death.
Malaria is one of the causes of feeling unwell. However, in the tropical environment, there are several causes of such a feeling. Examples of these are flu or non-flu causing viruses like influenza, rhino and respiratory syncythial viral infections.
Patients with such infections complain of headache, hotness or coldness, general body pain and weakness. These symptoms are similar to those experienced by patients with malaria. Malaria is however caused by a parasite of the protozoa class and plasmodia species that can easily be detected in peripheral blood of the patient using simple laboratory techniques.
At Allan Galpin, patients with symptoms similar to those of malaria are physically examined and laboratory tests are carried out.
In such case, two tests could be done; the Rapid Diagnostic test (RDT) that tests for presence of malaria antigens released into blood; and the direct microscopy where the technician looks for the parasites in the patient’s blood using a microscope.
This i s the gold standard test according to the World Health Organisation. The findings from Allan Galpin Laboratory and the Mukono HC IV have shown that cases of malaria in the first quarter of 2016 were between seven percent and 11 percent.
This is much lower than the average malaria slide positivity rates in the highly endemic areas of Northern Uganda. of 37.2 percent quoted in UDHS 2011. Laboratory results at Allan Galpin and Mukono Health center IV are cross checked in a process known as external quality control (EQC) by superior laboratories.
This suggests that malaria infection is not as common as is thought. Health workers are counselors by training and they should assure patients that if they do not feel better from the symptomatic treatment prescribed they should return for a repeat assessment.
Patients should not be tempted to walk from one clinic or laboratory to another looking for a positive malaria diagnosis, which may easily be got in the for profit clinics.
Always return to the clinic that last attended to you, sleep under a mosquito net, and explore the other causes of feeling unwell, which may be physical, psychological or spiritual.
Clinicians therefore need to take a thorough history just as patients need to volunteer all the history. The vital parameters of temperature, weight, blood pressure, respiration and a thorough medical examination followed by relevant investigations go a long way in achieving a correct diagnosis.