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
PF Rate (%)
NAME OF DISTRICT
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
Where EMS can Help...?
“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.
Only Malaria cases can contribute 300 Lives saved cases/ month in Meghalaya...
for EMS PF Cases with
Complications - 700
PF cases - 3500
PF cases - 34930
Malaria positive cases - 37949
Popoualtion Meghalaya (2008) - 23,06,069
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...
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
• Personal Protection
• Antilarval measures
• Vector Control EMS Can help by participating in 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 compliance as per instructions
– Dispensing the correct drugs of assured quality,( first dose be given preferably by
Can we help by simply adding Antimalarials to
“Ambulance drug formulary”...
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.
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
• 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.
• 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