Research Report
Treatment Confusion Due To Misjudgment between Malaria and Dengue: A Comparative Study and Differential Analysis 
,
Abeeha Malick 
,
Sameera Kaleem ,
Aniqa Malick ,
Afshan Shameem Author Correspondence author
Journal of Mosquito Research, 2016, Vol. 6, No. 24 doi: 10.5376/jmr.2016.06.0024
Received: 06 Sep., 2016 Accepted: 19 Oct., 2016 Published: 07 Nov., 2016
Somia G., Abeeha M., Sameera K., Aniqa M., and Afshan S., 2016, Treatment Confusion Due to Misjudgment between Malaria and Dengue: A Comparative Study and Differential Analysis, Journal of Mosquito Research, 6(14): 1-5 (doi: 10.5376/jmr.2016.06.0024)
Parasitic protozoa are transmitted by insect or by fecal or oral route. In human they mainly occupy the intestine or blood. Plasmodium falciparum cause severe malaria than other plasmodium species (vivax, ovale and malaria) and are transmitted by Anopheles mosquitoes, whereas dengue is transmitted by the bite of female mosquito Aedesaegypti. Infection with malaria parasites may result in a wide variety of symptoms, ranging from absent or very mild symptoms to severe disease and even death. This study is aimed to provide the awareness about two epidemic disease i.e. malaria and dengue. We have done a survey on population of Karachi (sample=200 and age group=15 to 50 years) presented at schools, colleges, universities and other professionals and common places. The survey was accomplished using common questions generally on malaria and dengue. Data analysis of current survey shows that 164 people were infected of malaria in a population of 200 which makes 82% hence here we can also conclude that catching the disease risk ratio is high. This research highlights the need for training and education about malaria and misjudgment of it with dengue. Nowadays malaria is not a life threatening disease it is curable with proper regimen by maintaining hygienic and health environment and preventions.
1 Introduction
Mosquitoes are vectors of parasitic and viral diseases of enormous importance for community health (Moss, 2008). Malaria and dengue (Duane, 1998) both are most conventional topical epidermal diseases transmitted by mosquitoes that are primordial danger for the human life span (Narayanappa and Rizwan, 2006). The first reported epidemic monitored in the French West Indies in the 17th century (Howe, 1997). On the 6th of November 1880 Charles Louis Alphonse Laveran, a French army surgeon noticed the parasites in the blood of patient suffering from malaria. For this Laveran was awarded the Nobel Prize in 1907 (Trypanosomes et al., 1907) Dengue is vector born disease mainly initiated by bite of female Aedesaegypti mosquitoes (Shamim, 2012) whereas Anopheles gambiae has predominant role in transmission of severe kind of malaria in human through plasmodium falciparum (Meigen, 1818). Due to the occurrence of protozoan parasites, Malaria can be chronic and acute infectious disease that can lead to severe as fatal to human life (CDC guidelines). Unlike dengue is a viral infection (Malavige et al., 2004) can be more severe because the patient’s condition gets aggravated in a short span of time (Hemant, 2010). Robert M. Waterhouse and its collaborators worked on acquisition of the genome sequence of dengue fever have allowed comparative study of insect immune reporter in malaria (Robert, 2007).
Clinical presentations of malaria may include headache, fever, shivering, arthralgia (joint pain), vomiting, hemolytic anemia, jaundice, hemoglobinuria, retinal damage, convulsions (Beare et. al., 2006) Nguyen ThiHoang Mai and its co-worker investigate that Neurological syndrome are abundantly seen in malaria (Mai N.T.H. et al., 1996) Clinical presentation of dengue shows four major clinical symptoms of dengue virus: 1) undifferentiated fever, 2) dengue fever, 3) dengue hemorrhagic fever (DHF), and 4) dengue shock syndrome (DSS) (CDC guidelines, 2006; 2005). Severe dengue complications include liver dysfunction, encephalitis, cardiomyopathy (usually reversible), pancreatitis, acalculouscholecystitis, peripheral neuropathy, and acute renal failure (Nguyen Thi, 1996; Malavige, 2004). Malaria has many sever complications if left untreated. Among these is the development of respiratory distress. Renal failure is a feature of black water fever, where hemoglobin from lyses red blood cells leaks into the urine (Taylor, 2012).
The objective of our explorations to articulate comparative study amongst malarial and dengue fever, to become aware of the general episode/ occurrence between the two diseases that leads to misjudge the disease the symptoms which leads to wrong drug therapy.
2 Materials and Methods
For the interpretation of misjudgment of malaria and dengue we have designed a questionnaire and performed a survey on a population of 200 people (n=200) assembled from different places like schools, colleges, universities and other professionals and other common places of Karachi, Pakistan. The survey was accomplished on different age groups from 15 years to elderly age.
Questionnaire was a setup of different questions including elemental knowledge about malaria its sign and symptoms and cause of spread. We have also interrogated basic knowledge of dengue its sign and symptoms and reason of spread further more we have added a question of differentiation between dengue and malaria and how many number of peoples are infected with either of disease.
2.1 Statistical analysis
After survey we have done statistical analysis and made Figures considering different parameters including knowledge of symptoms causes and reason of spread of both diseases, ratio of people who got infected by malaria and differential analysis of different age groups who knows the difference between malaria and dengue. The results are mentioned after calculating and determining percentage among 200 people.
3 Results
200 people of aged 15-50 years were included in our studies. Symptoms marked by population were assessed and found in dengue and malaria are redness, vomiting, headache, body pain, constipation, fever and chills as marked in Table 1 and presented in Figure 1. 82% of the tested population has claimed to get infected by malaria as shown in Figure 2. After analyzing different age groups Table 2 shows knowledge of people in comparison to malaria and dengue and presented in Figure 3 and Figure 4, Affirmation from Table 2 also shows how various age group populations differentiating between malaria and dengue is presented in Figure 5. Our survey indicates lack of citizen’s knowledge about differentiation and prevention from malaria as 164 persons were found to be infected by malaria out of 200 which makes 82%.
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Table 1 shows the symptomatic variation among the dengue and malaria |
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Figure 1 People’s Symptomatic View of Malaria & Dengue |
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Figure 2 Ratio of malaria in people |
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Table 2 Shows knowledge of people in comparison to malaria and dengue Note: According To Age, Column 1 Shows People Awareness about Malaria; Column 2 Shows People Awareness about Dengue; Column 3 Shows How Many People Can Differentiate Among Malaria and Dengue |
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Figure 3 Shows people awareness about Malaria |
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Figure 4 Shows people awareness about Dengue |
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Figure 5 Shows how many people can differentiate among Malaria and Dengue |
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4 Discussion
Malaria is a mosquito-borne disease of tropical areas for humans and other animals caused by protists (a type of microorganism protozoans) of the genus Plasmodium. It begins with a bite from an infected female Anopheles mosquito, which introduces the protists through saliva into the circulatory system. In the blood, the protists travel to the liver to mature and reproduce. The word malaria originates from the Italian language and translates literally as “malaria” or “bad air.” This came from the early belief that the disease was caused by breathing the stale, warm, humid air found around swamps. Malaria parasites belong to the genus Plasmodium. In humans, malaria is caused by P.falciparum, P.malariae, P.ovale, P.vivaxand, P.knowlesi. Among those infected, P.falciparum is the most common species followed by P.vivax. Although P.falciparum traditionally accounts for the majority of deaths, recent evidence suggests that P.vivax malaria is associated with potentially life-threatening conditions about as often as with a diagnosis of P.falciparum infection. Malaria infection develops via two phases: one that involves the liver (exo-erythrocytic phase), and one that involves red blood cells or erythrocytes (erythrocytic phase). When an infected mosquito pierces a person's skin to take a blood meal, sporozoites in the mosquito's saliva enter the bloodstream and migrate to the liver, where they affect liver cell. Medical examination may include headache, fever, shivering, Arthralgia, vomiting, hemolytic anemia, jaundice, Hemoglobinuria, retinal damage, and convulsions. The first applicable remedy for malaria comes from the bark of cinchona tree, which contains quinine
In current study, survey has been conducted on 200 people (n=200) of different schools, universities, hospitals, colleges which include men women of different age groups. Psyche behind designing of questions was to gather knowledge of people about general information of malarial disease which includes its causes symptoms and treatment. In our survey we have also included some questions about dengue because of their similar acute symptoms and cause “mosquito” some people thinks that malaria and dengue are same so we have questioned causes and symptoms of dengue as well to our survey volunteers.
According to questionnaire assessment of 200 individuals, we analyzed that 82% of population has caught malaria, and 12% people articulate that symptoms of malaria is simple fever while 20% articulate that symptom of dengue is high fever. 3% of people articulate that malaria happen by biting of any mosquito while 14% articulate that dengue is caused by female mosquito of anopheles. 9% articulate that malaria is parasitic where as 1% expressed that dengue is caused by parasite. 18% of people said that malaria is a viral disease although 23% says that dengue is caused by virus. Even though 58% of the population does not have sufficient knowledge of malaria they said that it is just a disease and 42% of the population give the opinion about dengue. 16% of individuals thought that an antibiotic such as quinines is used to treat malaria and 84% of people said that dengue can be treated by papaya juice. Differential knowledge of the “two” diseases were also checked by different age group (Table 2) population was asking numerous questions after analysis it was determined that 14% of the population said that malaria and dengue are same, 77% said that it is different and 16% said that they don’t know about it. Many people said that mosquito repellents cure against both diseases.
We have determined that people are confused about cause of malaria the falsehood is they think malaria is caused by any mosquito which is wrong it is by a special kind of mosquito that is female anopheles and dengue is also caused by a different species of mosquito that is Aedesaegypti, there is also a misconception that malaria is initiated with low fever, but it is initiated with very high fever (103-104) with chills and sweats while in case of dengue fever, it is an acute febrile infection characterized by sudden onset, fever for 3-5 days, intense headache, muscle pain, joint pain, eye pain, anorexia, gastrointestinal disturbances and rash. Hence most of the people have said that diagnostic test of the two diseases is that in malaria platelet count is not decreased while in dengue platelet count is decreased but the proper diagnostic test of malaria is such as Antigen-based Malaria Rapid Diagnostic Tests etc. Medicines such as Quinine and related agents like Chloroquine, Amodiaquine, and Pyrimethamine are used to treat malarial fever. Some people have said that malaria is spread by contaminated food, unhealthy environment, dust. But it is also a delusion in comparison to dengue; malaria is only spread by saliva of female anopheles bite while dengue is spread by contaminated water. Dengue Aedesaegypti breeds mainly in man-made containers such as earthenware jars, metal drums and concrete cisterns used for domestic water storage, but discarded plastic food containers and toys, old tyres and other items that can collect rainwater, gutters, drains, tree holes, palm fronds and leaves that gather to form "cups" and catch water, are also potential breeding sites. Prevention of malaria are Sleep in rooms that are properly screened with gauze over the windows and doors. There should be no holes in the gauze and no unscreened entry points to the room. Spray the room with an insecticide, Mosquito repellent containing diethyl toluamide (DEET) is recommended as the most effective form of bite-preventive treatment. Otherwise, one should use a mosquito net around bed to avoid malaria.
5 Conclusion
Hence we are successfully negotiate that causative specie of malaria is female anopheles while of dengue is Aedesaegypti. Malarial fever arrives with high grade fever, chills, sweat and can only spread by bite of female anopheles, but dengue fever is characterized by low persistent fever other symptoms include severe muscle pain bleeding from any body part. Treatment of malaria includes antibiotic treatment by quinines and dengue can be cured by papaya juice. Here we can also conclude that ratio and risk of getting malaria is high in Karachi, Pakistan and it can be prevented by using good mosquito repellents use of net during sleep can also protect against malaria. In general, malaria is a curable disease if diagnosed and treated promptly and correctly.
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