Summarize in a systamatic way - NATIONAL MALARIA PREVENTION
PROGRAM
9.2.1. Introduction
In the year 1982, the National Drug Policy on Malaria was first formulated, and
then subsequently reviewed and revised. Current National Drug Policy for
Malaria (2010) has been formulated with the aim to provide more effective
antimalarial drugs and drug resistance status in the country.
The main objectives of an antimalarial treatment include:
1) To ensure rapid clinical and parasitological cure of malaria.
2) To reduce morbidity and mortality.
3) To reduce cases of malaria-related anaemia.
4) To prevent progression of infection into severe and potentially fatal disease.
5) To reduce the impact of malaria infection on the foetus during pregnancy.
6) To prevent the emergence and spread of drug resistance.
9.2.2. Objectives
There are two major objectives of this programme:
1) To prevent deaths and morbidity due to malaria.
2) To maintain on-going socioeconomic development.
Some other objectives are:
1) To reduce API up to 1.3 or less in the 11th Five Year Plan.
2) Minimum 50% reduction in mortality due to malaria.
3) To halt and reverse the incidence of malaria (as per Millennium
Development Goals).
9.2.3. Functioning and Outcome
Behaviour Change Communication (BCC)
BCC is a process of learning that empowers people to take rational and informed
decisions using correct knowledge and information. As a supportive strategy,
BCC should be an integral part of malaria control program and should be
designed to enhance awareness on reducing transmission risk, treatment and
availability of services at different levels.
Monitoring and Evaluation of the Program
Monitoring is an on-going follow-up procedure of the planned program
activities/processes to examine whether the program is being implemented as per
the planning. It also gives feedback information for corrective action.
Evaluation includes the extent of achievement of the stated objectives in specific
time-periods, and reason of its success or failure. The results obtained after
evaluations are used to modify program design and policies.
182 Social and Preventive Pharmacy
9.2.3.1. Surveillance and Case Detection
It includes surveillance of fever cases in the community by means of active
case detection on the basis of slide results conducted by the multi-purpose
worker or other health officials. Following are different approaches to search
for cases:
1 ) Passive Case Detection: For the detection of malarial cases, blood slides are
collected from all fever cases in all medical or health units and then followed
by appropriate treatment. It also includes notification about all confirmed or
suspected cases of malaria.
2) Active Case Detection: Under this, malarial cases are detected by
domiciliary visits. The anti-mass blood survey carried by examining the
blood collected from all persons in a community and such detection program
is mainly carried out during epidemiological investigation around positive
cases.
This detection program is done to detect asymptomatic parasitemia malarial
program under which the health workers collect blood slide from all fever
cases by fortnight visits in community (in case secondary cases occur within
two weeks after primary cases).
3) Mass Blood Survey: In this survey, blood is collected from all person of the
community and then examined for malaria infection. This is carried out
during epidemiological investigation around positive cases and also done to
detect asymptomatic parasitemia.
9.2.3.2. Sentinel Surv eillance
Sentinel surveillance is conducted for events which are not being captured by the
regular system of reporting (severe cases of malaria), their management and on
malaria deaths and effectiveness of the antimalarial drugs being used. The
purpose of carrying sentinel surveillance is to observe the trends on in-patient
malaria, severe malaria, and malaria deaths.
9.2.3.3. Diagnosis and Treatment of Malaria
Microscopy of blood for malarial parasites and/or rapid diagnostic test should be
performed, if any fever is suspected as malaria; and antimalarial treatment should
only be started, if results are positive. In an endemic area, a person suffering
from fever during transmission season, or a person who recently visited an
endemic area, should be considered suspicious of malaria, if he/she has fever
without any other obvious causes as stated below:
1) Cough and other signs of respiratory infection
2) Running nose and other signs of cold
3) Pelvic inflammation, severe low backache, with or without vaginal
discharge, and urinary symptoms
4) Burning micturition
5) Skin infections, e.g.. rash, boils, abscess, infected wounds
6) Painful swelling of joints
7) Diarrhoea
8) Ear discharge