India must take urgent, proactive measures to banish malaria

Health Care, Heart Care Foundation of India Comments Off

Large-scale detection and awareness are the need of the hour

New Delhi, 26th April 2018: India has the fourth highest number of malaria cases and deaths in the world as per recent reports. Malaria exists in all Indian states and about 95% of the people are at risk. Most cases are reported from Chhattisgarh, Jharkhand, Madhya Pradesh and Odisha. Arunachal Pradesh, Meghalaya, Mizoram and Tripura also have high transmission. There is an urgent need to document cases and take integrated action at the earliest.

India has set a target of being malaria-free by 2027 and eliminating the disease by 2030.However, there are many challenges before this can be achieved. What is needed is large-scale detection of cases and major awareness campaigns.

Speaking about this, Padma Shri Dr K K Aggarwal, President, Heart Care Foundation of India (HCFI), said, “Malaria is a life-threatening mosquito-borne blood disease caused by a Plasmodium parasite. It is transmitted to humans through the bite of the Anopheles mosquito. Once an infected mosquito bites a human, the parasites multiply in the host’s liver before infecting and destroying red blood cells. India still has an extremely weak malaria surveillance system. Each case of malaria has been shown to cost households at least US$ 2.67 (range US$ 0.34–7.66) in direct out-of-pocket expenses. In adults, this leads to an average of 3.4 days (range 2–6 days) of lost productivity, at a minimum additional indirect cost of US$ 10.85.Despite efforts at various levels, this disease still remains an acute public health challenge.”

Symptoms of severe malaria include the following: fever and chills; impaired consciousness, prostration, or adopting a prone position; multiple convulsions; deep breathing and respiratory distress; abnormal bleeding and signs of anemia; and clinical jaundice and evidence of vital organ dysfunction.

Adding further, Dr Aggarwal, who is also the Vice President of CMAAO, said, “India has been central to the fight against malaria since the beginning of the battle. The breakthrough discovery that malaria is transmitted by mosquitoes was made 120 years ago in Secunderabad, India. Since then, half of the world’s countries have banished malaria. It is high time that India takes urgent action to do the same.”

Some tips from HCFI for prevention.

  • Malaria mosquitoes grow in fresh water collected in the house. It is therefore important to not let water stagnate in your house and the surrounding areas. Mosquito cycle takes 7-12 days to complete. So, if any utensil or container that stores water is cleaned properly once in a week, there are no chances of mosquito breeding.
  • Mosquitoes can lay eggs in money plant pots or in water tanks on the terrace if they are not properly covered. If the water pots for birds kept on terraces are not cleaned every week, then mosquitoes can lay eggs in them.
  • Using mosquito nets/repellents in the night may not prevent malaria because these mosquitoes bite during the day time.
  • Malaria mosquitoes do not make a sound. Therefore, mosquitoes that do not produce a sound do not cause diseases.
  • Wearing full sleeves shirt and trousers can prevent mosquito bites. Mosquito repellent can be helpful during the day.

On this World Malaria Day, let us pledge to “Test. Treat. Track” every malaria case

Health Care Comments Off

India is a malaria endemic country. The reported malaria cases in the country last year have declined by 23% compared to 2016, yet India still accounts for 87% of malaria cases in the South Asia region. Also, as per the World Malaria Report, India has among the weakest malaria surveillance systems globally, with only 8% of cases detected by the surveillance system.

The World Health Organization (WHO) Global Technical Strategy for Malaria has set a target of reducing malaria case incidence by at least 90%, reducing malaria mortality rates by at least 90%, eliminating malaria in at least 35 countries and preventing a resurgence of malaria in all countries that are malaria-free.

There is still a long road ahead before the goal of elimination of malaria throughout the country by 2030 is achieved.

Malaria is entirely a preventable disease. It is also a treatable disease provided it is diagnosed and treated in time. The symptoms of malaria are non specific and can be variable. So it may be mistaken for other diseases such as viral infections, typhoid and the diagnosis of malaria may be missed as a result.

It is important to remember here that malaria is not a clinical diagnosis; the diagnosis has to be confirmed by microscopy or a rapid diagnostic test (RDT).

The ‘T3’ initiative of the WHO Global Malaria Program supports malaria-endemic countries in their efforts to achieve universal coverage with diagnostic testing and antimalarial treatment, as well as in strengthening their malaria surveillance systems

T3 stands for Test. Treat. Track., which means:

Every suspectedmalaria case should be tested
Every confirmedcase should be treated with a quality-assured antimalarial medicine
The disease should be trackedthrough a timely and accurate surveillance system.

Adopting and implementing this initiative will be a step in the right direction in the efforts to control and eliminate malaria.

Every patient of fever must be investigated for malaria to either confirm the diagnosis or exclude it as a cause of fev

IMA Policy on Antibiotics

Health Care, Medicine Comments Off

At the Antimicrobial Resistance Conference held in New Delhi yesterday to discuss the IMA Antibiotic Policy the following decisions were taken. Doctors should write the antibiotic in a box to differentiate it from other drugs in the prescription. The role of antibiotics should be discussed in an informed consent. When prescribing antibiotics clear instructions should be given to the patient about no refill of antibiotic prescription without signature of the doctor. No antibiotic cover or prophylactic antibiotic should be given without a high degree of clinical suspicion. No antibiotics should be prescribed in following conditions o Small bowel diarrhea o Fever with cough and cold o Dengue o Chikungunya o Malaria o Fever with rash Early initiation of antibiotics is the rule in suspected sepsis bacterial pneumonia meningitis and confirmed TB. Food Safety and Standards Authority of India FSSAI should make it mandatory for food companies to label all poultry and agriculture products as Antibiotic free . IMA will be writing to the Health Ministry to formulate clear guidelines about safer disposal of left over antibiotics.

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