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Ann Clin Trials Vaccines Res. 2017 | Volume 1 Issue 2
Global Vaccines & Vaccination Summit & B2B
November 01-02, 2017 | Toronto, Canada
Introduction:
Black water fever malaria, an acute hemolytic
disease syndrome, associated with Plasmodium falciparum
infection, occurring only in non – immune children and adults
could, be a disorder of the Zinc finger gene and tumor necrosis
factor alfa. It is characterized by haemoglobinuria, fever,
jaundice and anemia. We now report that their immunity
can be boosted with a combination of antihistamine and Zinc
Sulphate to the effect of preventing further malaria attack
for over a year.
Case History:
120 children aged three months to twelve
years, were followed for hemoglobinuria without a known
haemoglobinopathy, with symptoms of fever, vomiting,
abdominal pain, passage of dark red urine, and loose
stools, epistaxis and body weakness, after treatment with
chlorpheniramine and zinc sulphate in addition to anti
malarials. There was a positive family history of leprosy
one case and congenital malformations, ranging from
cervico-facial-ano genital sinuses and tags, in 96 cases,
polydactyly, in one case, to Einhoms disease, in one case and
or dactylitis, in one case. All the 120 had consumed silver
fish contaminated with organophosphate poison. Physical
examination revealed fever, pallor, jaundice, dehydration,
renal angle tenderness, hepatosplenomegaly and congestive
cardiac failure in all of them.
Method:
Blood andurine sampleswere taken for examination
and abdominal ultrasonography was requested.
Result & Treatment:
Full haemogramme showed low
haemoglobin, suggestive of severe anaemia, monocytosis,
high total white and low red blood cell counts; positive
rapid test for plasmodium falciparum and unspecified
mixed species of plasmodium, and random blood glucose
of varying degrees of hypoglycaemia. Urinalysis report
revealed a positive Haem-test without the presence of Red
blood cells. Renal parenchymal disease was detected on
Ultrasonography in all of them. Black water fever malaria
with severe anaemia and congenital pre-auricular sinus with
renal disorder was diagnosed. In addition to general and
specific care, oral chlorpheniramine, 0.35 mg/kg/day in three
divided doses for five days, and oral Zinkid (zincsulphate),
0.4mg/kg twice daily for 14 days, were administered. They
were discharged between November 2012 and April 2013,
and 114 of them have not had recurrence of the disease
to date with exception of six, four of whom turned up at 8
months of follow up, nine at 9 months, and the other, at 10
months, with Black water Fever Malaria syndrome.
Conclusion:
Black water fever Malaria syndrome patients
developed ample immunity to the disease to the extent of
protecting 95% of them for more than a year against Malaria.
e:
shepherd_ad@yahoo.co.ukA potent candidate black water fever malaria vaccine in the offing, Ugandan case
Akusa Darlington
Arua Regional Referral Hospital, Uganda