Prevention and Management Strategies for Malaria

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  • Topic: Malaria, Plasmodium falciparum, Mosquito
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  • Published : November 18, 2011
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India has had lots of hits and misses with malaria since independence. Prevention starts at home. Self determination is needed .Protective measures should be adopted; they not only help protect the individual but rather deprive the mosquito of its blood meal .self enforcement is the key, motivation and commitment from the user is needed for a fail safe outcome. A child dies from malaria every 30 seconds The Roll Back Malaria Partnership (RBM) (an alliance of WHO, UNICEF, World Bank, UN Development Programme, malaria endemic countries, donors, NGOs, private sector and academia) was established in 1998 to provide a global approach to combating malaria For any programme and its implementation an effective strategy is integral. The NVBDCP (National Vector Borne Disease Control programme) is an umbrella programme for prevention and control of vector borne diseases (VBDs) and is an integral part of the India.s National Rural Health Mission (NRHM). The Enhanced Malaria Control Project (EMCP) with World Bank assistance was implemented during 1997-2005 in 100 districts of eight high malaria incidence states. The World Bank is assisting the programme again through the National Vector Borne Disease Control Project (2008-2013) which was launched in September 2008. The Intensified Malaria Control Programme (IMCP) funded by Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) is in operation since 2005 in 106 districts of 10 states. The NVBDCP envisages a well informed and self-sustained, healthy India with equitable access to quality health care and the programme activities are in tandem with the National Health Policy (2002) and NRHM goals as well as the Millennium Development Goal of halting and reversing the incidence of malaria and other vector borne diseases by the year 2015 towards reduction of poverty. A plan of action was formed with the set objectives General Objectives;

Prevention of deaths due to malaria
Prevention of morbidity due to malaria
Maintenance of ongoing socioeconomic development
Malaria control and prevention in pregnancy
Behavior and social change communication in support of all interventions •Management of malaria at home

Specific Objectives
API 1.3 or less in the 11th Five Year Plan
At least 50% reduction in mortality due to malaria by the year 2010, as per National Health Policy (2002) •To halt and reverse the incidence of malaria by 2015 (as per Millenium Development Goals) Malaria control strategies

Surveillance and case management-

Malaria surveillance connotes the maintenance of an on-going watch/ vigil over the status of malaria in a group or community. Its main objective is to detect patterns and changes in trends or distributions in malaria in order to start investigative measures and control activities. Surveillance is directly linked to the intensity of the malarial transmission, in leu of limited recourses prevention and control is essentially related to the magnitude of the transmission Due to the failure of the previous strategy to combat malaria a new and improved strategy called “Modified Plan of Operation” (MPO) w.e.f. 1.4.1977.

Strategies under MPO
i) Fortnightly blood smear collection by domiciliary visits, from fever cases, their examination and treatment with antimalarial drugs. ii) Decentralisation of laboratory services to the PHC level. iii) Establishment of Drug Distribution Centres (DDCs)/ Fever Treatment Depots (FTDs). iv) Insecticidal spray with appropriate insecticide during the transmission period in rural areas recording Annual Parasite Incidence (API) 2 or above. In urban areas, through recurrent antilarval operations. v) Health Education and Community Participation.

Table 1: Countrywide Epidemiological Situation (1995 – 2010)

YearPopulation (in ‘000)Total Malaria Cases (million)P.falciparum cases (million)Pf %APIDeaths due to malaria 19958881432.931.1438.843.291151