Doctor's Column: Why do I get malaria whenever it rains?

Dear doctor, Why do I get malaria whenever it rains? I start shivering the moment it starts raining on me and after this, I find out that it’s malaria. Unfortunately, I am a student and have to go to school even when it rains.
Starford Nsereko

Dear Starford, to many Ugandans, fever, general weakness, headache and even loss of appetite are symptoms that warrant one to self-prescribe drugs for malaria.

The classic symptoms of malaria are a sudden coldness followed by shivering, then fever and sweating.

However, following the shivering which naturally comes because the body is being chilled by the early morning drizzle, Ugandans usually take this as fool proof for malaria. It is not true that these symptoms (although they occur in malaria) mean one has the disease.

Many diseases may masquerade as malaria and as one wastes time treating malaria, the causative germs are establishing themselves or even spreading for their own survival.

That said, malaria in Ugandan affects children and pregnant women more than other people. Therefore, children may more easily be found with malaria by sheer coincidence whether it has rained on them or not.

Also, a child is more likely to be incubating malaria at any one time. Chilling of the body by the morning rain during the incubation is likely to immediately make the body lose the fight against malaria parasites and suffer the fever.

Many people may habour malaria parasites, without having fever symptoms. It is envisaged that these people are also more likely to develop symptoms when their bodies are chilled by a drizzle.

Chilling of the body may trigger or worsen allergies (hay fever) which will also give malaria-like symptoms.

Dear doctor, I have had cough since I was a baby. I was often treated for asthma. Of late, the asthma is intense; I even get fever at night. X-Ray results showed that I have T.B. How can this be possible? I thought it was asthma cough.
Damalie Ajok

Dear Damalie, people with asthma just as any other person when they are exposed to TB germs through inhaling infected mucus droplets from an infected person who is especially coughing, sneezing, singing or talking close to them, are likely to get tuberculosis of the lungs (PTB).

Thinking it is the usual cough of asthma when one has actually been invaded by TB germs may delay diagnosis and treatment of TB leading to prolonged suffering and complications. This is not helped by taking steroid treatment for asthma which makes tuberculosis show differently, or show up more seriously with the likelihood of dangerous outcomes even when using the best drugs.

Anybody with asthma and especially taking steroids (in Uganda mainly Prednisone or Dexamethasone) should be evaluated by a doctor often, for related complications including risking infections or making those already existing severe. Unfortunately in Uganda, steroids are self-prescribed.

Today asthma is treated more with inhalation which helps to minimise the drug side effects. Many Ugandans say that they fear using inhalers lest they get “used” to them which is a fallacy!

Dear doctor, I am now pregnant but bothered by pain in my breasts which makes it difficult for me to sleep on them. Please advise me on the best painkiller to take.
Comfort Turinawe