Self-Assessment Questions (SAQs) for Study Session 8
Now that you have completed this study session, you can assess how well you have achieved its Learning Outcomes by answering these questions. Write your answers in your Study Diary and discuss them with your Tutor at the next Study Support Meeting. You can check your answers with the Notes on the Self-Assessment Questions at the end of this Module.
SAQ 8.1 (tests Learning Outcomes 8.1 and 8.3)
Which of the following statements about supportive treatment is false? In each case, state why it is incorrect.
A Supportive treatment is given to kill the malaria parasites in the blood circulation of the patient.
B Malaria patients with high grade fever should be given supportive treatment.
C Patients with moderate dehydration have to be immediately referred to a health centre without giving any supportive treatment.
D No supportive treatment is required for women with malaria, with normal temperature, who can breastfeed very well and with no anaemia.
E If the malaria patient has moderate anaemia, then treat with ferrous sulphate (iron tablets).
Answer
A is false. Supportive treatment is what is given to treat other conditions at the same time as the malaria treatment. It is not the supportive treatment that kills the parasites; rather it is the anti-malaria drugs that you give to the patient that kills the parasites in the blood circulation.
B is true. Malaria patients with high grade fever should be given supportive treatment such as paracetamol tablets, or cooling the body of the patient with clean pieces of cloth dipped in slightly warm water, or by fanning.
C is false. Malaria patients with moderate dehydration should be given oral rehydration salts (ORS) as supportive treatment. The patient should also be advised to drink increased amounts of clean water or other fluids.
D is true. If the temperature is normal, there is no sign of dehydration and no anaemia, you do not need to give supportive treatment to a malaria patient even if she is breastfeeding. Just treat the malaria.
E is true. Malaria patients with mild or moderate anaemia should be treated with ferrous sulphate (iron tablets) 200 mg once daily for two months, and advised to return for recheck in two months.
SAQ 8.2 (tests Learning Outcomes 8.2 and 8.3)
What anti-malaria drug would you give a patient with a clinical diagnosis of uncomplicated malaria, if you cannot do an RDT? How many times a day does the patient take this drug?
Answer
If you diagnose malaria clinically (if there is no RDT) you give the patient Coartem, unless the patient is a pregnant woman in the first trimester, or an infant under 5 kg or under four months (they get quinine tablets instead).
Coartem is given two times a day (in the morning and in the evening) for three days. The first dose is given in front of you immediately after the diagnosis of malaria. The rest of the drug is given to the patient/caregivers to take at home.
SAQ 8.3 (tests Learning Outcome 8.4)
Molamo is a 15 year-old boy who came to your Health Post. You diagnosed him with malaria and gave him Coartem. He took the medicine correctly as you ordered. Three days after his first visit he came back to your Health Post with no improvement of the fever. Describe the actions that you have to take.
Answer
Give pre-referral treatment to Malomo (one 50 mg rectal suppository of Artesunate — see Table 8.4) and immediately refer him to the nearest health centre.
SAQ 8.4 (tests Learning Outcomes 8.2 and 8.4)
Describe what you would do if you found that a patient who came to your Health Post is a suspected severe malaria case?
Answer
Severe malaria should be referred to the health centre very fast. Before referring the patient it is important to give a pre-referral treatment with rectal Artesunate (or intramuscular injection of Artemether, if available). This will help to prevent the patient’s condition from getting worse.
SAQ 8.5 (tests Learning Outcome 8.5)
What could happen if a malaria patient does not take the full course of treatment or does not adhere to the treatment?
Answer
If the patient does not adhere to the treatment he or she will not get cured completely and the disease will come back. It also leads to the development of resistance to the drug by the malaria parasites.
Read Case Study 8.1 about Beka and answer the questions that follow it.
Case Study 8.1 Is Beka sick with malaria?
Beka is a five-year-old boy. His mother brought him to you to seek treatment. Beka and his family are living in your catchment area, which is malarious. The mother says he was well until this morning when he woke up and said he was feeling tired and refused his breakfast. When the mother touched him, he felt hot and she gave him ½ a tablet of paracetamol.
When you examined Beka, you found a well-nourished 15-kg child, not pale, alert and with temperature of 38.5°C measured with the thermometer under his armpit. You could not do a RDT because you used the last kit two days ago. In the rest of the examination, Beka is normal.
SAQ 8.6 (tests Learning Outcomes 8.2, 8.3, 8.4 and 8.5)
- a.What is your diagnosis?
- b.What treatment will you give Beka? And what dose?
- c.What will you tell his mother?
Answer
- a.Uncomplicated malaria is the diagnosis you should give to Beka.
- b.Coartem is the correct treatment for a child of five years. The full dose is 12 tablets. Beka takes two tablets in the morning and two tablets in the evening for three days. You give two tablets to swallow immediately and give the remaining 10 tablets to Beka’s mother to take home.
- c.Advise Beka’s mother on the following issues:
- Tell her the reason for giving the drug.
- Demonstrate to her on how to give the correct dose.
- Tell her to watch while Beka is taking each dose of the drug.
- Explain that the drugs must be finished even if Beka feels well.
- Advise her on when to return if Beka does not improve.
Summary of Study Session 8