Situation of P. vivax malaria in Ahmedabad city: A study in purview of national guidelines

Abstract

Introduction: Malaria is still the most important cause of morbidity-mortality in India. National vector borne disease control program (NVBDCP) in urban areas is implemented through UHCs. In Gujarat, 89,764 malaria cases were reported in 2011 with 127 deaths, with 17.9% of them being the vivax cases. Ahmedabad is at the receiving end of malaria menace due to its rapid growth. Compared to 2011, significant rise in number of Plasmodium vivax (Pv) cases has been observed in Ahmedabad in 2012. Aims and Objectives: The study was carried out to assess the Pv malaria detection modalities, relevant indices, existing radical treatment strategies, and adherence to national guidelines in the urban areas of Ahmedabad. Materials and Methods: Data of all 9 UHCs of south zone, catering total population of approximately 1 million and showing significant rise in Pv cases, were verified clubbed with field analysis, for the corresponding quarters of March, April, and May of two consecutive years-2011-2012. Concerned healthcare staff was interviewed. Guidelines and definitions of national anti-malarial guidelines and operational manual were followed. Process indicators for surveillance, case finding, and disease burden were considered. Results: Out of total blood smears examined, Pv cases raised from 97 (2011) to 382 (2012). Statistically significant rise of Pv% was 0.35% and 2.79% in active and passive slide collection, respectively. 71% slides were actively collected in both years. Quarterly Blood Examination Rate (QBER) rose from 1.50% to 2.41%. Quarterly Parasite Index (QPI) rose from 0.12 to 0.39. Successful Radical Treatment of Pv Malaria (RT) completion decreased from 59.8% to 29.1%. Knowledge regarding national-anti-malarial-guidelines was satisfactory in more than 70% of healthcare functionaries. Interpretations: Number of cases significantly increased in two years, Pv-positivity rise being 1.04%. Active slide collection is static. Rise in Pv-positivity should trigger improvement in the same. Average QBER and QPI rose in two years. QBER never reached prescribed levels. Successful RT-completion is the key towards drug-resistance and relapse prevention. Adherence to national-anti-malarial-guideline is imperative.

Babesia ovis secreted antigen-1 is a diagnostic marker during the active Babesia ovis infections in sheep

“…In addition, there was a significantly positive correlation between OD values and parasitemia levels (r: 0.980, p : 0.000 for blood, r: 0.990, p : 0.000 for serum) in the present study ( Figure 4 ). Similar findings were reported by Joshi et al. (2004) in Plasmodium vivax infections of humans, and by Luo et al.…”

“…In addition, there was a significantly positive correlation between OD values and parasitemia levels (r: 0.980, p: 0.000 for blood, r: 0.990, p: 0.000 for serum) in the present study (Figure 4). Similar findings were reported by Joshi et al (2004) in Plasmodium vivax infections of humans, and by Luo et al (2012) in B. microti infections of hamsters. Luo et al (2012) revealed that circulating Babesia microti-secreted antigen 1 (BmSA1) overlaps with the parasitemia profile during active infections in a hamster model.…”

Progress towards Malaria Elimination in India: Achievements till Now & Way Forward

“…A complex health system of public and private providers adds to the socioeconomic and environmental factors to increase the complexities of malaria control and elimination in India 24 . In India, the National Vector Borne Disease Control Programme is a vertically implemented nationwide programme 25 . Health is the responsibility of the state; therefore, malaria controlis primarily carried out by the states under the overall guidance of the programme 26 The true burden of malaria in India isunder-reported as a result of poor surveillance, inadequate collaboration between the private health sector and the government, and the inability to make accurate estimates of populations at risk 27 .…”

Clinical and epidemiological characterization of severe Plasmodium vivax malaria in Gujarat, India

“…Gujarat is one of the major states contributing to the Pv burden in India, with a Pv / Pf ratio around 80:20 [ 12 ]. Remarkably, about one in five malaria-associated deaths reported in that state has been attributed to Pv [ 12 , 13 ]. This is in line with the mounting evidence for the ability of Pv to induce a wide spectrum of severe malaria, with a risk of death similar to that observed for Pf infection [ 3 , 7 , 8 , 10 , 11 ].…”