Yesterday I cared for three young people with rapid onset coma and hemiplegia. They were also all malaria test positive. Malaria can cause a plethora of neurological signs, and no confirmatory brain imaging is available out here. So I started IV quinine and today – miraculously- all three patients resolved their deficits and woke up. Astounding! But next I was suddenly struck with extreme fatigue and chills. Sure enough, though it has not rained here in four months and I’ve seen not one mosquito, I too was malaria positive. Coartem is the first-line drug of choice. Tragically, our hospital Coartem supply has entirely run out. I drove to a private South African pharmacy and paid $13 for this drug, reflecting how few Angolans enjoy to such lifesaving privilege as I.
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