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Just because you are poor does not mean you have to live dirty. I grew up poor and my mom always said that and we were always clean and our house was clean. I learned how to clean and be clean and now my house is clean. It’s not society’s responsibility to pick up after people. How about teaching people how to take personal responsibility?
It should also be required of all full time immigrants to speak a basic level of English. Why the heck should any accepting country change its culture and language for others? I’m not against basic accommodations nor if they want to speak their native language most do the time to each other. But they should be required to know English. No way would I expect anything different from any country I might decided to move to.
For a fuller discussion of the effects of parasites and the poor I suggest this article.
That's actually a real problem for people who travel to countries with endemic malaria, They go to the doctor here with a fever, tell the doctor they've been in <name of malarial country here> and the doctor tells them they have some random virus, and doesn't refer them to a tropical disease specialist or prescribe appropriate treatment. I've heard of several deaths caused by doctors not diagnosing correctly.
Unfortunately true. The doctored ordered a simple CBC and it was fortuitous that it was flagged for slide review but not specifically for malaria simply as a regular review. There has been cases where malaria was missed on a slide review and the person responsible reprimanded on file. It was caught because the doctor actually ordered a blood parasite test a couple of hours later. Counseling and retraining ensued.
In all fairness parasite numbers can be exceedingly small and simply blood smear review is not enough. The entire procedure of a blood parasite smear review includes a thin and a thick drop of blood. The thick drop of blood is needed to see a small number of parasites. So the proper thing for doctors to do is to order that test.
It would be hopeful that a doctor would order a blood test CBC when a fever is present but there is no guarantee that a blood smear will be made.
Yes indeed that is possible. Serological tests are non-invasive. Normal people or close to normal will have very low numbers of infected red blood cells which are removed by the spleen. In essence the defective infected cells are removed by the spleen keeping the numbers really low and harder to detect visually. In contrast those with a working spleen will have high numbers in the 1-2% of the red blood cells infected. that is enough to easily see them. It also gets more difficult because the parasites cause destruction of the red blood cells they infect and so they get free and harder to see because they are so small. It is easier to see when they are inside the red blood cell. Another reason is that sometimes autoimmune destruction of the cells occurs and when that happens the cells more fragile and more likely to be destroyed are the ones infected with babesia.
They can hide in the bone marrow where all the blood cells are made and more easily assessable. I also think that the other immune organ like the liver and Kupffer cells would become infected. Don't know of anywhere else. Some malaria also hide in the liver and can be dormant for years.
Socioeconomic status impacts health outcomes in a variety of ways. It is often mentioned as a "risk" factor and leave it to others in the non-healthcare community to view it as "victims".
The MMWR letter to all healthcare professionals sent out by the CDC does two things, it states a problem so doctors won't miss it and it gives facts concerning how to identify it, transmission and risk factors. The CDC is always looking for "victims" to report on. That is their whole role, to seek victims of illness and not play politics.
People who don't have a lot of money will usually have poor housing that makes them susceptible to rodents, vermin and arthropod borne disease. That is a risk factor. Newly arrived latinos are at risk to be having the parasite and some do not speak English and so there is a language barrier there which also makes for poor outcomes as most doctors are not bilingual. One needs to spend more time in order to assess the problem.
The role of public health institutions and doctors is to treat disease.
"One needs to spend more time in order to assess the problem."
Unfortunately true. The doctored ordered a simple CBC and it was fortuitous that it was flagged for slide review but not specifically for malaria simply as a regular review. There has been cases where malaria was missed on a slide review and the person responsible reprimanded on file. It was caught because the doctor actually ordered a blood parasite test a couple of hours later. Counseling and retraining ensued.
In all fairness parasite numbers can be exceedingly small and simply blood smear review is not enough. The entire procedure of a blood parasite smear review includes a thin and a thick drop of blood. The thick drop of blood is needed to see a small number of parasites. So the proper thing for doctors to do is to order that test.
It would be hopeful that a doctor would order a blood test CBC when a fever is present but there is no guarantee that a blood smear will be made.
My employer's captive doctors will prescribe anti-malarials if you have a fever shortly after returning from a malarial country, even before blood test results are back. I know malaria is hard to diagnose sometimes, when I lived in Africa and had malaria, the tests were inconclusive, but between my symptoms and the fact that fansimef cleared them quickly, the doctor said I had a presumed case. All of them have said that there's little downside to taking the malaria treatments in any case, so it's better to err on the side of caution.
My employer's captive doctors will prescribe anti-malarials if you have a fever shortly after returning from a malarial country, even before blood test results are back. I know malaria is hard to diagnose sometimes, when I lived in Africa and had malaria, the tests were inconclusive, but between my symptoms and the fact that fansimef cleared them quickly, the doctor said I had a presumed case. All of them have said that there's little downside to taking the malaria treatments in any case, so it's better to err on the side of caution.
One needs to do appropriate tests before starting anti-malarials especially to check for enzyme deficiency called G-6PD deficiency. If one doesn't check, the medication can destroy your red cells, if one is genetically deficient in that enzyme. Blacks tend to have a higher incidence of that genetic mutation that renders them susceptible to oxidant drugs. We heard about that during the hydroxychloroquine discussions.
The geographic location of where the infection occurred is important because one wants to know if there are resistant strains present in the area. Thankfully in the case I mentioned the region they were from had no resistant strains there and there was good response to medication. The killer one is falciparum malaria and unfortunately some are now resistant to some medications. The rates of red cell infections are quite high which is why it has a severe effect. One red cell can be infected with two parasites. It can also go into the brain (cerebral malaria). One does not want to mess with that type of malaria.
Malaria can generate markers for a hemolytic anemia along with low platelet counts. The fever pattern is distinctive for the different types of malaria.
Just because you are poor does not mean you have to live dirty. I grew up poor and my mom always said that and we were always clean and our house was clean. I learned how to clean and be clean and now my house is clean. It’s not society’s responsibility to pick up after people. How about teaching people how to take personal responsibility?
Chagas has nothing to do with cleanliness and everything to do with living in places where houses have thatched roofs and no drywall, or similar quality.
Was your house like that?
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