“Skeeters”
You bring a lot of stuff to Kenya
and I specifically needed to bring a hat that protects me from the sun and also
insect repellent. I have many hats, but
my latest and favorite, is a gift from my family. It is an advertisement hat for a restaurant
at Atlantic Beach, NC. The mosquito insignia means something very different
here in Tenwek. Hold that thought!
Without the boring details, a
young woman presents to “casualty” (Emergency Room) in the early evening from
another hospital with an infection in the first part of her pregnancy. Neither the source nor site of the infection had
been identified. The most remarkable
finding noted at the other hospital was a very low platelet count and very low
white blood cell count.
In the United States, we have a
whole series of causes that we have learned are associated with the low
platelet counts and what to do about it!
It is a “teaching moment” to have residents share their understanding of
this finding when found during pregnancy.
Early in the morning following
admission, I was phoned by the intern who reported a “positive malaria
smear”. The diagnosis was made and now
specific treatment for severe malaria in pregnancy could be started.
Yesterday was a learning
opportunity that escapes most of the experiences of our residents in the United
States. As teachers we need to share
this knowledge of marlaria and its impact on women and children. We
need to teach globally and act locally!
When you see a mosquito, you need
to at least think of malaria!
Marvin
References:
Lacerda MV; Mourao MP; Coelho HC; Santos
JB. Thrombocytopenia in malaria: who cares?.
Memorias do Instituto Oswaldo Cruz. 106 Suppl 1:52-63, 2011 Aug
Herbinger KH; Schunk M; Nothdurft HD; von
Sonnenburg F; Loscher T; Bretzel G. Comparative study on
infection-induced thrombocytopenia among returned travellers. Infection.
40(4):373-9, 2012 Aug.
Our son Jacob, not pregnant but in his early 20's, contracted malaria while in the CAR working with a Kenyan film maker recording scenes of the rain forest for the Museum of Natural History in NY. He was given all the UN shots for prevention and yet contracted malaria once he returned to the US. I found THE HAT fun but hard to look at!!! So glad you and Mick are taking precautions. Malaria as we witnessed it was pretty awful.Cannot imagine having it and being pregnant.
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