Football Sport

Problem of malaria in soccer players

DOCTOR’S CORNER with JOSEPH KABUNGO
TWO Sundays ago, I looked at the issue surrounding the Ebola outbreak in West Africa and how it has affected soccer in general.
All African countries have intensified on screening of people entering their countries and finding posters with Ebola messages is the norm.
This week, I want to review malaria as one problem which can affect sports men and soccer players in particular as they travel to play in different places.
Just before the start of the 2015 Africa Cup of Nations in Equatorial Guinea, I had a chat with my colleague from Tunisia who wanted to take one of his players for malaria screening.
We joked about the surroundings and the huge presence of mosquitoes in Ebebiyin which was the host town for preliminary Group B matches.
I explained to him how a few days ago one of the players under my care had to miss training for almost five days as he was down with malaria.
Malaria still remains a problem in many African countries, especially in southern, central, east and West Africa.
Just like the current campaigns against Ebola, there are also campaigns against malaria.
Although malaria is treatable, it still remains one of the leading causes of morbidity and mortality. Soccer players need prompt diagnosis and treatment whenever they are suspected to have malaria.
Not only can players lose training and game time, but untreated malaria is a serious issue because of the potential it has of causing death.
My discussion will bring out some of the things needed to identify and treat simple malaria.
Malaria is one of the commonest infections which Zambia has tried to deal with for a long time.
It is also interesting to note that numbers of people recorded as suffering from malaria has drastically reduced in our country.
This does not mean that the numbers of malaria cases being recorded in our health facilities are no longer significant, but the general picture has really improved.
I want to state that malaria is a serious infection and whoever is treating a case of malaria has to exactly know what they are talking about.
Sometime back, I had a case of three reported malaria cases from one club based in our neighbouring country which had problems in releasing our players for national assignment on the pretext that they all had malaria at the same time.
This development had so many twists and turns on how it was handled and left a great deal to be desired.
However it is not the controversy on the club versus country which I want to talk about but just to remind the players, coaches and other sports administrators on the diagnosis and treatment of simple malaria.
Almost a year and half ago, the Football Association of Zambia organised a selection tournament for players who came from all the provinces, including Muchinga.
However, one thing which struck me most was that I had to attend to four players on the first day of the tournament with signs and symptoms of malaria.
The other interesting thing was that, all of them had a history of being treated with fansidar or sulphadoxine pyrimethamine (SP) as it is called in medical terms, nearly a week before the tournament.
I have to make a clear statement to the sports men, including various team managements, that when you have a player with complaints which are suggestive of malaria, it is very important that the correct things are done.
You must not take the complaints lightly and give the fansidar which you have been keeping in your bag or shelves for as long as you can remember.
The best thing is to refer the affected sports man or athlete to appropriate medical facilities were a thorough check-up is done and a correct diagnosis given.
In some cases, you might find that it is not actually malaria which a player is suffering from.
It has to be appreciated that there are a lot of conditions which will actually mimic a malaria infection and the worst thing is to start giving drugs for a condition which is not well understood.
I have come across coaches who have assumed the role of team doctors, which is a very sad development.
I would humbly request those who are tasked with the responsibility of looking after young sportsmen and women, to exhibit high standards of professionalism and refer all the medical problems to appropriate competences.
Despite the number of malaria cases being recorded in the country showing a downward trend, this condition still remains a killer.
Malaria is basically divided or classified into two categories. The commonest one which we see and treat patients for even at home is called the uncomplicated type of malaria or simple malaria.
For a diagnosis of simple malaria to be made, a blood slide, which still remains as the gold standard in the diagnosis of malaria, has to be used.
The other test used for getting a diagnosis of malaria is the rapid diagnostic test (RDT) which is simple to do and the results are almost instant.
Once a diagnosis has been made or the malaria parasite has been seen in a blood sample, it is important that the correct medical treatment is given.
The Ministry of Health first drug of choice is the Artemether-Lumefantrine combination which is commonly known as Coartem.
For simple malaria Coartem is the drug of choice and fansidar is no longer in use as the treatment for malaria.
The use of fansidar in our medical facilities has only been confined as an option to antenatal mothers for prophylactic reasons.
This simply means that no one in Zambia must use fansidar as the drug of choice when treating malaria and fansidar must only be left as a choice for its role in pregnant women.
In short, fansidar has been replaced by Coartem in the treatment of simple malaria.
The other type of malaria whose treatment has not changed is the complicated malaria.
The term complicated amplifies the fact that the person is very sick and will need hospital admission in most cases.
An example of the complicated malaria is the cerebral malaria, which is dreadful and the treatment has to be vigorous.
The drug of choice which is recommended in this case is Quinine, which can be taken in as tablets or it can be given through the veins (intravenous route).
The worst thing is to blindly treat a sportsman with fansidar and three days later he gets worse with complicated malaria which is potentially fatal.
This is the reason why Coartem has been chosen to be the first line of treatment because it has shown to be very effective in eliminating the malaria parasite.
Fansidar through the years has shown that it’s effectiveness against malaria has reduced because of what we refer to as drug resistance.
It is because of this resistance that prompted Government through the Ministry of Health to change protocols from using fansidar to Coartem when treating simple malaria.
For questions and comments write To Dr kabungo Joseph
Email: zengajk@yahoo.com or Kateulejk@gmail.com


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