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New Diagnostic Kits to Help Combat Malaria

Control of malaria in coastal Andhra region would be easier with the introduction of rapid (bivalent) diagnostic kits (RDK) under the national vector-borne disease control programme (NVBDCP) this year, said health officials on the occasion of World Health Day. This is because the kits would help test both kinds of malaria strains, which require different modes of treatment, explained the officials.

Further, with the implementation of the new drug policy using a combination of drugs (instead of the traditional mono-therapy to which resistance had developed), malaria could be controlled successfully in the vulnerable districts of Andhra Pradesh, the health officials said.

WHO, which is this year focusing on vector-borne diseases such as malaria, dengue, chikungunya, fileria and Japanese encephalitis, has as its theme for World Health Day 2014 'Small Bite, Big Threat'. In keeping with the theme, the state government is focusing on control of malaria, which is mostly prevalent in coastal Andhra.

There has been around 25% decrease in instances of malaria in the state in 2013 compared to 2012, according to statistics provided by the State Epidemic Cell (SEC) and the Vizag district malaria control office. In Vizag district alone, malaria instances have come down by around 20%.

"There's around 25% decrease in malaria cases in 2013 as compared to 2012," said Dr Champa Naik, additional director (malaria and filaria), SEC.

Dr NRV Somaraju, regional director, medical and health services (north coastal Andhra), attributed the success in malaria control to the multi-pronged approach of NVBDCP. Since WHO research had found that the plasmodium or malarial parasite had developed resistance to chloroquine that was used in malaria treatment since decades, a combo drug therapy is used with artesunate, sulfadoxine and pyremethamin combination treatment (ACT) for all the positive cases under the new drug policy.

"Moreover, from this malaria season, we are using rapid (bivalent) diagnostic kits (RDK) instead of the monovalent ones. With monovalent RDKs, only plasmodium falciparum (a species of protozoan parasite) can be detected in the blood drop but now bivalent RDKs can detect even plasmodium vivax (pv) (another species), which requires treatment with primaquine for two weeks whereas ACT for plasmodium falciparum (pf) lasts for three days," said Somaraju.

"If left without treatment for 48 hours, pf malaria can be fatal and 90% of malaria cases in tribal and rural areas are those of pf, while pv is mostly seen in plains," he said.

"Under NVBDCP, intensive surveillance activities are being carried out and health staff has been trained to detect the presence of the parasite in blood using the RDK and blood smear test even in remote areas and accordingly commence treatment," said Vizag district malaria control officer and entomologist KVS Prasad Rao.

"Besides, under the integrated vector control approach, weekly anti-larval operations have been taken up by municipalities either through releasing the gambusia fish in water bodies that eats up larvae or through spraying of bio-larvicides. There is indoor residual spraying in tribal and rural pockets and fogging operations in urban areas and insistence on personal protection measures such as use of long lasting insecticidal nets (LLIN), lakhs of which has been distributed in tribal areas," he said.

As for the other vector borne diseases, dengue, which usually affects urban dwellers, can be controlled by observing weekly dry day and not allowing water accumulation inside the house. Fileria, which is not alarming in the state, is controlled through annual mass drug administration, while vaccines are available for Japanese encephalitis.

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