Application for diagnosing malaria now available as an app

By the day technology keeps growing and expanding to explore possibilities in previously unchartered waters.

This is the case with the xRAPID-Lab app , an application on the apple store that automatically counts the number of malaria parasites and red blood cells on plasmodium falciparum culture mediums.

xRAPID-Lab application is a product of the UK based Medtech company xRapid.The application initially designed for laboratories where malaria parasites are being cultured and researched was released after successful trials in tropical disease institutes in Europe.

Using an iphone connected to a microscope, the application analyses images taken from thin smear blood slides.

In less than two minutes the app gives information about:
• The number of malaria parasites on the slide
• The stage of development of the malaria parasites
• The number of red blood cells on the slide
This revolutionary tool for malaria research and diagnosis is considered cheaper, faster and just as accurate as the conventional tests for malaria.

Tests sold in 12 countries:
Over 16000 units of the test has been sold in 12 countries including Benin, Niger, Malawi, South Africa, Botswana, India, Philippines, Thailand and Indonesia.The UK and France already use xRapid’s solutions on a regular basis.

How to prepare oral rehydration solution (ORS) for children-Part 1

Preparing and administering oral rehydration
Preparing and administering oral rehydration

Introduction to hydration/dehydration
Dehydration occurs when you use or lose more fluid than you take in, and your body doesn’t have enough water and other fluids to carry out its normal functions. Anyone may become dehydrated, but the condition is especially dangerous for young children and older adults.

What is the normal level of hydration?
Water is the most abundant body constituent. It accounts for 75 – 80% of the birth weight in neonates (babies less than 30 days) and even higher in preterm babies, however this percentage decreases as the child grows such that by age one, water accounts for 60% of the total body weight – and this remains till adulthood. However, Total Body Water (TBW) decreases with increase in body fat, consequently obese children have reduced body water than slim children.

The simplest calculation for body water is to multiply 0.6 by the body weight (in kilograms) since water accounts for about 2/3rd of the body weight.

There are several methods for calculating the amount of water in the body ,the Watson and the Hume formular can be used, other methods specifically designed for children like the Mellits – Cheek formula are also very useful.

Hydration status can also be checked by comparing urine colour against a chart; normal urine is amber yellow in colour. Once a child’s hydration status reduces, urine becomes concentrated and the colour deepens to dark yellow or brown.

Specific gravity of urine and sweat analysis can also be used to determine hydration status.

What level of dehydration can warrant ORT (oral rehydration therapy)?
Dehydration can be classified into three;
· Mild dehydration
· Moderate dehydration
· Severe dehydration

These levels have their distinct features with the severe form being potentially fatal.

Mild dehydration can be managed at home, usually resolving with administration of Oral Rehydration Solution (ORS) and treatment of the cause.

However, moderate and severe forms of dehydration require hospital admission and monitoring as in these cases, dehydration might kill the child if care is not taken.

The following are tell tale signs of the degrees of dehydration;

CRITERIA MILD MODERATE SEVERE
Consciousness Alert Irritable Comatose
Eyes No change Sunken Very sunken
Tear No change Reduced Absent
Skin Normal Cold & pale Cold & muffled
Pulse Normal/high Weak&fast Very weak & fast
Urine Reduced Very little None
Breathing Normal Fast Very fast
Fontanelle No change Sunken Very sunken

NOTE: The fontanelle is the space between the bones of your baby’s skull. They are usually two soft and depressible spots. The fontanelle at the back of the baby’s head (posterior fontanelle) closes often by 6 weeks while the fontanelle at the front of your baby’s head (anterior fontanelle) closes by 18 months.

What could cause a child to be dehydrated
1. Diarrhoeal diseases are the commonest causes of dehydration in children especially in African countries.
2. Vomiting
3. Not drinking enough fluids
4. Too much sweating due to hot weather
5. Excessive urination probably due to undiagnosed or poorly treated diabetes mellitus or diabetes insipidus
6. Fever from bacteria, viral or parasitic infections
7. Burns
8. Conditions like cystic fibrosis
9. Cancers and their treatment.

How to prepare Oral Rehydration Solution (ORS) for children- Part2

Preparing Oral Rehydration Solution
Preparing Oral Rehydration Solution

Early recognition and prompt treatment of dehydration is key to halting the progression of dehydration to the severe form and preventing the fatalities associated with increased severity.

As stated before, oral rehydration solution is essential to managing a child with mild dehydration. Consequently, after you as a parent has recognised that your child is dehydrated from the signs highlighted earlier, the next step is administering oral rehydration solution to your child before taking him/her to the nearest health centre for diagnosis and treatment of the cause of dehydration.

You can prepare your own oral rehydration solution at home or buy already prepared form at a pharmaceutical store.

To make the solution at home,
· In one litre of water
· Add 6 level teaspoon of sugar and
· 1/2 level teaspoon of salt
· Wait for the particles of sugar and salt to dissolve completely
· The ORS solution is ready for drinking

You can get 1 litre of bottled water, be sure to use clean, recently boiled and cooled water. Too much salt or sugar may be harmful, make sure you use the right amounts.

Using Prepared ORS
Already prepared Oral Rehydration Hydration Salt is a special combination of dry salts that is mixed with safe water. It can help replace the fluids lost due to diarrhoea.
· Put the contents of the ORS packet in a clean container
· Check the packet for directions and add the correct amount of clean water.
· Add water only.
· Stir well, and feed it to the child from a clean cup.
· Do not add ORS to milk, soup, fruit juice or soft drinks.

Other alternatives to salt- sugar solution home remedy for dehydration are; breast milk, coconut water, rice water. However make sure, these sources are hygienic and properly prepared.

Administering oral rehydration solution
– Before preparation or administration of ORS for your child, wash your hand properly with soap and water.

– When a child has three or more loose stools in a day, begin to give ORS.

– A child under the age of 2 years needs at least 1/4 to 1/2 of a large 250-millilitre cup of the ORS drink after each watery stool.

– A child aged 2 years or older needs at least 1/2 to 1 whole large 250-millilitre cup of the ORS drink after each watery stool.

– You can keep the ORS in a refrigerator but not for more than 24 hrs. If your child needs ORS after 24 hrs, prepare fresh one. Do not keep the ORS for more than 24 hrs.

– Continue to give the child his/ her normal food alongside ORS.

– In addition, for 10–14 days, give children over 6 months of age 20 milligrams of zinc per day (tablet or syrup), give children under 6 months of age 10 milligrams per day (tablet or syrup).

– The best treatment for diarrhoea is to drink lots of liquids and oral rehydration salts (ORS), properly mixed with clean water from a safe source, and take zinc tablets or syrup for 10–14 days.

Signs of improved hydration
You should see symptoms of dehydration disappearing within hours of administering ORS.
· Your child should start urinating more
· The urine will start to look light yellow or almost clear.
· Skin goes back normally when pinched
· Thirst subsides
· Urine has been passed
· Pulse is strong

Danger signs/ when to go to the hospital
Having noted that as a parent, you can manage only the mild form of dehydration, what are the signs that your care is not yielding result or that you need to go to the hospital?
· Presence of blood in diarrhoea or black, tarry stools
· Persistent vomiting
· High fever
· Very dehydrated (feeling dizzy, lethargic, sunken eyes, no urination in the past 12 hours)

A child with diarrhoea should not be given any tablets, antibiotics or other medicines unless prescribed by a trained health worker. Diarrhoea usually stops within three or four days. If diarrhoea persists, consult a trained health worker.

Hospitalization due to dehydration can be avoided if as a parent, you recognise early when your child is dehydrated and promptly begin administration of ORS. Fatalities due to dehydration can be prevented if parents and care givers are well informed about what to do.