January 19, 2012

Intensive and persistent larval and parasite survey is needed to keep malaria at bay

The World Malaria Report 2011 says there is a significant decrease in malaria deaths in our South-east Asia. That is good news to all.
I wonder how many of our youth in Maldives know we had a disease called malaria afflicting us for centuries. Yes, it was, and it took many a life and left families bereaved. Ibn Batuta the famous traveller of old, (who visited Maldives too--and incidentally, was also the chief Ghazee here for sometime, I believe, during the reign of Queen Rehendhi Khadija) even mentioned this disease as the Maldives fever. But due to the good effort of the energetic health workers of Maldives and the support of WHO, this disease is now history in our country. By the Grace of Allah, we achieved this way back in 1986, but we need to constantly keep up the larval surveys in our islands, and the active case detection at our entry ports to keep vigil of visitors from malarious countries. Hopefully this is being carried out with no less vigor. I say this because, given the new decentralized health structure in Maldives, and the role of being active mover in this now being the city councils, the control processes need to be well clarified and established as operational policy in the Councils. A lapse may leave us vulnerable again to the risk of this devastating disease, and having to re-enact the hardships of decades ago; and I can tell you personally, it's an understatement to say that it was not easy. Concerted supervision and surveillance is the way to keep the disease at bay and keep the tourists flowing in.

The world report 2011 goes on to say that "With an estimated 28 million cases and 38 000 deaths in 2011, malaria remains a significant public health problem in South-East Asia. However, malaria incidence and deaths have decreased significantly in the last decade, according to the World Malaria Report 2011. Globally, the estimated incidence of malaria has reduced 17% between 2000 and 2010, and malaria-specific mortality rates by 26%. This is attributed to increased availability of long-lasting insecticidal nets, indoor- residual spraying, better access to diagnostic testing, and effective treatment with artemisinin-based combination therapies (ACTs). Increasing drug resistance however, is a challenge. Resistance to artemisinins – a vital component of drugs used in the treatment of the most dangerous types of malaria – has been reported in a growing number of countries in South-East Asia".

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