Malaria And Meghalaya Viz Ems(RE-UPLOADED)

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Malaria And Meghalaya Viz Ems(RE-UPLOADED)

  1. 1. Meghalaya: INDIA
  2. 2. Meghalaya is really in trouble: Simple measures can’t help much! 6 May 2008 ... Meningococcal meningitis has become the biggest killer, replacing malaria in Meghalaya this year. DISTRICT ANNUAL COMPARATIVE STATEMENT OF EPIDEMIOLOGICAL DATA of Malaria FOR THE YEAR 2008 (UPTO DECEMBER), MEGHALAYA POSITIVE CASES POPULATION Rate/million Pf POSITIVE PF Rate (%) population NAME OF DISTRICT OTHERS SPR (%) DEATH Death EAST KHASI HILLS(EKH) 853789 1883 0.20% 1281 68% 602 13 15 WEST KHASI HILLS(WKH) 294115 1075 0.40% 712 66% 363 14 48 JAINTIA HILLS(JH) 295692 1369 0.50% 243 18% 1126 1 3 WEST GARO HILLS(WGH) 614918 27135 4.40% 27034 100% 101 35 57 EAST GARO HILLS(EGH) 247555 6487 2.60% 5660 87% 827 10 40 TOTAL 2306069 37949 1.60% 34930 92% 3019 73 33 National average** 1000000000 2000000 0.20% 900000 45% 1100000 6000 6 **Simplified estimation based on information available in National Malaria Drug Policy 2007
  3. 3. Where EMS can Help...? Simple Answer: “EMS can help by transporting the Severely ill patients to suitable Centers to Prevent the progression of uncomplicated disease into severe and potentially fatal disease and thereby reduce malaria mortality.” • An effective treatment policy should aim to: – Reduce morbidity – Prevent the progression of uncomplicated disease into severe and potentially fatal disease and thereby reduce malaria mortality – Reduce the impact of placental malaria infection and maternal malaria-associated anaemia through chemoprophylaxis or preventive intermittent therapy – Prevent or delay the development of antimalarial drug resistance by correct diagnosis and rational treatment of all malaria positive cases.
  4. 4. Only Malaria cases can contribute 300 Lives saved cases/ month in Meghalaya... 73 Deaths Target Cases for EMS PF Cases with Complications - 700 Severely ill PF cases - 3500 PF cases - 34930 Malaria positive cases - 37949 Popoualtion Meghalaya (2008) - 23,06,069
  5. 5. Can EMS Help...? Tough option (Answer): Of course Meghalaya is in “crisis”. We can help in different ways. We can sit with the State health system and plan to support in Curative & preventive aspects to control the disease as a whole and of course preventing deaths by transporting the Severely ill patients to suitable Centers. It is necessary to understand the strategy of Mass prevention and control of malaria before deciding to move forward...
  6. 6. Strategic Control of Malaria • EDPT (early diagnosis and prompt treatment) is the Key Component. – Presumptive treatment and collection of blood smear by Active & Passive agencies (If a patient is suspected of having malaria which cannot be immediately confirmed, full treatment with recommended drugs should be given). – Diagnosis with rapid diagnostic kits and full radical treatment to confirmed malaria cases (in inaccessible areas). – Collected slides (blood smears) undergo microscopic examination for diagnosis of Malaria. • Personal Protection • Antilarval measures • Vector Control EMS Can help by participating in EDPT
  7. 7. EDPT • Management of malaria case: – Clinical diagnosis of malaria on the basis of sign and symptoms. – Confirmation of malaria by Laboratory diagnosis/RDK. – Referral to secondary/tertiary level of care, if necessary. – Education of patient or family on : • administration of the drugs • when to report to health facility EMS Can help in • danger symptoms • prevention of malaria Patient education • Patient compliance as per instructions – Dispensing the correct drugs of assured quality,( first dose be given preferably by dispenser);
  8. 8. Can we help by simply adding Antimalarials to “Ambulance drug formulary”... DEBATABLE BENEFITS Unless we decide to work in sync with the State Health system & Train our EMTs it is futile and even dangerous to add antimalarials to our “Ambulance drug formulary” as” • Knowledge of “NATIONAL DRUG POLICY ON MALARIA” is mandatory to participate in the Program. • Familiarity with RDK, Blood Smear preparation, designated lab. network is essential.
  9. 9. 37 dead, Meghalaya rushes team to handle meningitis menace: • 6 May 2008 ... Meningococcal meningitis has become the biggest killer, replacing malaria in Meghalaya this year. Health and Family Welfare Minister Advisor ... • As 37 persons died of meningococcal meningitis between January and May, the state Government has rushed Rapid Response Team (RRT) from East Khasi hills and Jaintia Hills districts to the affected areas. Meningococcal meningitis has become the biggest killer, replacing malaria in Meghalaya this year. • Health and Family Welfare Minister Advisor Pariong told the state Assembly on Monday that 226 cases of meningococcal meningitis had been detected in five districts of the state, and 37 had succumbed to the disease. • Pariong said most of the cases were detected in East Khasi and Jaintia Hills districts and a few cases were reported from East Garo Hills, West Khasi Hills and Ri-Bhoi district of the state. • Pariong told the Assembly thatmost of the patients who were diagnosed with meningococcal meningitis were provided with free treatment in Government hospitals. But there were patients who preferred to be treated in private hospitals and nursing homes. Pariong said RRTs would make necessary investigations and make a case study with an intention of providing preventive treatment. • Dr Mihir Goswami, from department of general medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Science, had earlier told reporters that the institute was fully equipped to treat patients of meningococcal meningitis. • He said meningococcal meningitis was a communicable disease and, if detected early, could be cured. Dr Goswami said, medical and paramedical staff in the institute were also taking preventive measures by taking antibiotics after contact with the patients.
  10. 10. REFERENCES • http://www.indianexpress.com/news/37-dead-meghalaya-rushes-team-to-handle-m • NATIONAL DRUG POLICY ON MALARIA 2007 • Indian Society of Health Administrators, Strengthening Health Systems in North Eastern States,1995-96 • International Institute of Population Sciences, National Family Welfare Survey, 1998-99, Mumbai, India, October 2000
  11. 11. Thanks

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