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Dr Hilda Ganesen

Female Family Physician

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Malaria in SA

The map below highlights the malaria areas in SA in 2017.

Malaria transmission occurs in three provinces in SA: KwaZulu Natal, Mpumalanga and Limpopo. Transmission is generally associated with higher rainfall and temperature, between September and May each year. Plasmodium falciparum infection accounts for about 90% of malaria diagnosed in South Africa.

The female Anopheles mosquitos which transmit malaria are only active and more likely to bite between dusk and dawn. Prevention of mosquito bites should be enforced between dusk and dawn.

Measures to prevent mosquito bites include:

  • Wear long pants and socks
  • Applying topical mosquito repellants to exposed skin areas that contain at least 20% DEET
  • Burning of  coils for repelling  mosquitoe
  • Sleeping under mosquito nets treated with long-lastinginsecticide when in high transmission area
  • Use of air- conditioning and fans where available
  • Staying in dwellings with screened windows and doors

Current recommended malaria prevention medication include mefloquine, doxycycline or atovaquone-proguanil. Your doctor will advise on the best option.  Even though these medications are highly effective at preventing malaria, they are not 100% effective.

Anyone returning from a high risk malaria area ( up to one month) who has flu like symptoms must be screened for malaria.

 

My child has chicken pox after taking the vaccine!!

In view of the recent outbreak in chickenpox this has been a common occurrence with the children in Durban North.  Mother's are often confused as to why the child has chickenpox if the vaccine was administered.

Although some vaccinated children (about 2%) will still get chickenpox, they generally will have a much milder form of the disease, with fewer blisters (typically fewer than 50), lower fever, and a more rapid recovery. The vaccine almost always prevents against severe disease.

Chickenpox is caused by a virus, the varicella-zoster virus. How does chickenpox spread? Chickenpox spreads from person to person by direct contact or through the air by coughing or sneezing. It is highly contagious. It can also be spread through direct contact with the fluid from a blister of a person infected with chickenpox, or from direct contact with a sore from a person with shingles. How long does it take to show signs of chickenpox after being exposed? It takes from 10 to 21 days to develop symptoms after being exposed to a person infected with chickenpox. The usual time period is 14–16 days. What are the symptoms of chickenpox? The most common symptoms of chickenpox are rash, fever, coughing, fussiness, headache, and loss of appetite. The rash usually develops on the scalp and body, and then spreads to the face, arms, and legs. The rash usually forms 200–500 itchy blisters in several successive crops. The illness lasts about 5–10 days.

Complications from Chickenpox:

The most common complication is bacterial infection of the skin or other parts of the body including the bones, lungs, joints, and blood. The virus can also lead to pneumonia or infection of the brain. These complications are rare but serious. Complications are more common in infants, adults, and people with weakened immune systems.

How long is a person with chickenpox contagious?

Patients with chickenpox are contagious for 1–2 days before the rash appears and continue to be contagious through the first 4–5 days or until all the blisters are crusted over.

How do we treat chickenpox?

Most cases of chickenpox in otherwise healthy children are treated with bed rest, fluids, and control of fever. Children with chickenpox should NOT receive aspirin because of possible subsequent risk of Reye's syndrome. Acetaminophen may be given for fever control. Chickenpox may be treated with an antiviral drug in serious cases, depending on the patient's age and health, the extent of the infection, and the timing of the treatment.

 

PLEASE REMEMBER TO AVOID CONTACT WITH PREGNANT WOMEN IF YOU HAVE CHICKENPOX!

Medicine Recall: Epipen and Epipen Junior

Mylan has recalled specific batches of Epipen and Epipen Junior.  Please read the following attachment regarding the affected batch numbers. There is a problem with the activation device of the devices. Contact your pharmacy if you are in possession of such a pen

 

Insulin and your body

Reaching your true potential

Allergies and the home

According to the Allergy society of SA, dust mite excrement in the most common household allergen in SA.  

  • More than 30% of people who have allergies react to housedust mite excrement. 
  • Pet allergies are a common household allergy. Cats or dogs can be a source of allergens through their saliva, urine, dander or dur.  The fur itself is not an allergen but hte fur can pick up other forms of household airborne allergens.  
  • Mould grows easily in damp conditions. Bathrooms are a common source of mildew and mould growth.  Durban with its subtropical climate is especially susupetible to mould growth.  

Dust mites live of the dead skin cells regularly shed by humans. House dust mites can be found in bedding

How to manage house dust mite in the home?

1  Remove carpets if possible.  If you do have carpets, vacuum  carpets regularly.

2. Remove fluffy toys, books and thick curtains.

3.  Cover pillows and mattresses with plastic or polyurethane covers.

4.  Wash bedding, pillows and mattress cover regularly in hot water and allow to dry in the sun.  Consider replacing pillows every 6 months.

5.  Ideally pets should be kept outside.  If pets are brought into the house, ensure the upholstery and carpets are regularly vacuumed.  Consider steam cleaning carpets and upholstery regularly.

6.  Treat mould by applying white vinegar to the walls of the bathrooms, leave it to dry for an hour then wipe off with hot water and dry the surfaces. Endure the bathroom is well ventilated.  Keep bathroom windows open and if possible allow direct sunlight into the bathroom.

Deworming

I often find that as a mum, it is easy to forget to deworm your children regularly.  My personal reminder is BACK TO SCHOOL.  Deworm children and the beginning of the school year.  By establishing such a routine annually you will find it less likely to overlook this task.

Remember if you have pets at home, that pets carry worms

 

PrEP

At its 75th meeting on 27-28 November 2015, South Africa’s Medicines Control Council (MCC) approved the use of the fixed-dose combination of tenofovir disoproxyl fumarate and emtricitabine to include pre-exposure prophylaxis of HIV (also referred to as PrEP).

WHAT IS PrEP? It is a drug taken daily by people who are are high risk of acquiring the HIV infection.

Interesting facts about PrEP:
1. It is not a cure for HIV.
2. It does not prevent STD's
3. It does not prevent pregnancy
4. It is not a morning after pill ie: take it the day after risky behavior to prevent HIV infection
5. It must be taken daily for effective protection
6. It is not a vaccine against HIV
7. You can only take PrEP if you are HIV negative.
8. PrEP can only be prescribed by a medical doctor following the relevant tests.

 
 
 

Have you checked your cholesterol levels?

The fingerprick cholesterol test done in doctors rooms and pharmacies detects total cholesterol. If your total cholesterol is greater than 5, be sure to get a full lipogram done. A lipogram will tell you what the LDL (bad cholesterol), HDL (good cholesterol) and triglycerides are.

 

Breastmilk Supply has decreased

New mums: do you have decreased breastmilk production.  Try a simple natural remedy as outlined in the book , Baby Sense by Megan Faure.

This is used to help promote more milk when you are breastfeeding...

1 litre of boiled water

1 litre of apple or any other juice but not acidic juice

1 sachet Blackcurrent rehydrate

60 mls schlehen berry elixier

8/10 drops of rescue remedy

You will need a 2 litre container.. This amount should be used in 24 hours

KEEP IN THE FRIDGE.

 

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