Tropical splenomegaly; the neglected condition
Sunday, June 24, 2018
Indoor residual spraying to fight mosquitos.

Did you know that recurring bouts of malaria could lead to another condition? Health experts say this condition is known as tropical splenomegaly.

WHAT IS IT?

Cyprien Ntiringanya, a specialist in internal medicine at University Teaching Hospital (CHUK), says many people are not aware of the condition, and some even end up living with it unmindful.

He says that tropical splenomegaly is the abnormal enlargement of the spleen located in the upper quadrant of the abdomen.

He explains that this is caused by a chronic antigenic stimulation derived from the malaria parasite.

"It comes about following several episodes of malaria, and it’s more common in tropical regions which are prevalent to malaria like Africa and India, among others,” he says.

Ntiringanya says when it comes to the condition; anyone can be affected regardless of age, especially if one has had numerous episodes of malaria.

He says it’s not easy to know if you have the condition, as sometimes there are no symptoms at all. This is because it takes time to develop, thus making it hard to realise early enough.

However, he notes that signs such as discomfort on the left side of the abdomen or swelling, pain and fullness in the upper abdomen, fatigue and frequent infections, are some of the signs of the condition.

TREATMENT AND PREVENTION

When it comes to treatment, Janvier Rusizina, a general practitioner at La Nouvelle Clinic in Remera, says it is difficult, and requires time to heal, and in some cases, it can lead to further complications.

He says that studies suggest that treatment of malaria is given, followed by preventive treatment of malaria.

The patient can as well be given medicine known as troxiciline, where it is taken over a long period of time.

"It’s very hard for the condition to go away with no trouble, and in most cases, the swellings are the ones that reduce in size instead. For it to be cured completely, it requires patience,” he says.

He says that it’s better to work towards prevention of malaria, and, if one has had habitual episodes of malaria, consultation is important.

The main complications, he says, include decrease in components of the blood, especially haemoglobin, which can lead to anaemia.

Dr Ntiringanya further explains that when this happens, the patient can suffer from anaemia or low platelets, which can result in abnormal bleeding, leading to death.

He adds that the swelling of the spleen can also rapture, because it’s an emission due to its size, which is large and fragile at the same time.

Another complication, Dr Ntiringanya says, is that if the affected place is injured, it is easy to rapture in case of a slight accident; and this may lead to complications if there are no interventions made promptly to rectify the condition.

In Rwanda, Dr Ntiringanya says, tropical splenomegaly is at 80 per cent, adding that this is because Rwanda is in a tropical region, and there are many cases of malaria in such regions.

Also, going for check-ups more often is vital, especially if one has been exposed to frequent episodes of malaria, says Rusizina.

He explains that this can help diagnose the condition early, which can ease treatment and avoid complications that come with the condition.

Rusizina points out that the idea is that if one has malaria, they should make sure they get treated well and then have frequent consultation with experts.

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