Malaria And Typhoid Drugs In Nigeria

Both typhoid and malaria share social circumstances which are imperative to their transmission. They are treatable with many drugs available for both young and old, men and women including pregnant women. People living in Nigeria are at risk of contracting both these diseases, either concurrently or an acute infection superimposed on a chronic one. A high index of suspicion is necessary to diagnose a co-infection as most clinicians are used to linking every symptom and sign to a single pathology.

Mosquito

Typhoid Fever

Typhoid fever is a life-threatening infection caused by the bacterium Salmonella Typhi. It is usually spread through contaminated food or water. Once Salmonella Typhi bacteria are eaten or drunk, they multiply and spread into the bloodstream.

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Symptoms include prolonged high fever, fatigue, headache, nausea, abdominal pain, and constipation or diarrhoea. Some patients may have a rash. Severe cases may lead to serious complications or even death. Typhoid fever can be confirmed through blood testing.

Most people who have typhoid fever feel better a few days after they start antibiotic treatment, but a small number of them may die of complications. Vaccines against typhoid fever are only partially effective. Vaccines usually are reserved for those who may be exposed to the disease or who are traveling to areas where typhoid fever is common.

Malaria

Malaria is an acute febrile illness caused by Plasmodium parasites, which are spread to people through the bites of infected female Anopheles mosquitoes. There are 5 parasite species that cause malaria in humans, and 2 of these species – P. falciparum and P. vivax – pose the greatest threat. P. falciparum is the deadliest malaria parasite and the most prevalent on the African continent. P. vivax is the dominant malaria parasite in most countries outside of sub-Saharan Africa.

P. knowlesi, a type of malaria that naturally infects macaques in Southeast Asia, also infects humans, causing malaria that is transmitted from animal to human (“zoonotic” malaria).

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The first symptoms – fever, headache and chills – usually appear 10–15 days after the infective mosquito bite and may be mild and difficult to recognize as malaria. Left untreated, P. falciparum malaria can progress to severe illness and death within a period of 24 hours.

Typhoid And Malaria Drugs

In the tropics, malaria and typhoid fever are among the common infectious diseases, with both being endemic in Nigeria.

Malaria Drugs

Malaria drugs are chosen based on causative agents. Artemisinin-based combination therapies (ACTs) are the recommended treatments for uncomplicated falciparum malaria. The following ACTs are recommended: Artemether + lumefantrine, artesunate + amodiaquine, artesunate + mefloquine, artesunate + sulfadoxine-pyrimethamine, dihydroartemisinin + piperaquine.

Second-line antimalarial treatment which can also be given to children and given for 7 days are:

1. Artesunate plus tetracycline or doxycycline or clindamycin.

2. Quinine plus tetracycline or doxycycline or clindamycin.

Severe malaria is best treated with – artesunate i.v. or i.m., quinine (i.v. infusion or divided i.m. injection) and artemether i.m. 

Complete treatment by giving a complete course of an ACT, artesunate + clindamycin or doxycycline, quinine + clindamycin or doxycycline.

P vivax is treated with Chloroquine combined with primaquine is the treatment of choice for chloroquine-sensitive infections. ACT is used when chloroquine is not sensitive.

Pregnant women can use Quinine + clindamycin in the first trimester. An ACT is indicated only if this is the only treatment immediately available, or if treatment with quinine + clindamycin fails or compliance issues with a 7-day treatment. In second and third trimesters ACTs are known to be effective or artesunate + clindamycin or quinine + clindamycin.

Second and third trimesters can use any of the ACT drugs except for dapsone, primaquine and tetracyclines.

There is a fifth ACT drug currently in commercial use but with little information. Combination of 150 mg of arterolane maleate and 750 mg of piperaquine phosphate (AM-PQP) in the treatment of uncomplicated p falciparum. It 8s not yet part 9f any treatment guidelines. However, random use and few clinical trials have shown it's efficacy although not superior. Artemisinin and Piperaquine is another not in world health organisation (WHO) guidelines but have shown some level of efficacy against p falciparum.

Read Also: Treatment of malaria

Popular brands of artemether/lumefantrine are Lonart, amatem, coartem, etc. Artesunate plus amodiaquine is camosunate. Artesunate plus mefloquine come as artequine. Dihydroartemisinin plus piperaquine come as p alaxin. Artemisinin and Piperaquine is called artequick.

Typhoid Fever Drugs

There are so many drugs for treating typhoid in Nigeria. They are all antibiotics. The most common is amoxicillin/clavulanic acid. This is used by children and adults including pregnant women. Another is ciprofloxacin which is restricted to non pregnant adults. Others are erythromycin, azithromycin, levofloxacin, etc.

Severe typhoid can be treated with IV or infusion with amoixicllin, ceftriaxone, gentamicin, etc.

Popular brands are amoxicillin/clavulanic acid as augmentin. Ciprofloxacin as ciprotab. Azithromycin is popular as zithromax. Rocephine is ceftriaxone.