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HOSPITAL AND COMMUNITY PHARMACY
ROLE OF COMMUNITY PHARMACIST IN MALARIALCONTROL
PROGRAM
12/12/22
1
PREPARED BY:-
MALINI.R
M.PHARMACY -1st year
PHARMACY PRACTICE
WHAT IS MALARIA
• Malaria is a serious or fatal disease caused by plasmodium parasite transmitted by the bite of infective
female mosquitoes.
• The term MALARIA is derived two italian words i.e mal means bad aria means air.
• MALARIA is most important parasitic disease of the world.
• Malaria in humans is caused by four Plasmodium species:
 Plasmodium falciparum,
 Plasmodium vivax,
 Plasmodium malariae, and
 Plasmodium ovale.
• This (April to novemember) period is quite favourable for mosquito
breeding and female mosquitoes bite human beings for sucking blood.
12/12/22 2
• Malaria is one of the most prominent public health problems in India.
• At the time of independence there were approximately 75 million malaria cases and 0.8
million deaths every year.
• In 1953, the central government launched a National Malaria Control Programme with the
objective of decreasing malaria transmission.
• Later, the National Malaria Eradication Programme (NMEP) was launched
• in 1958, with the objective of eradicating malaria. About 2 million cases were reported.
• in 2000, of which 1.04 million were due to Plasmodium falciparum; there were 972 deaths.
• WHO has launched a project called Roll Back Malaria (RBM) on worldwide partnership basis
to coordinate malaria control activities in various countries.
12/12/22 3
MALARIA IN INDIA
CONDITION OF MALARIA IN INDIA
• Malaria is an acute parasitic illness caused by Plasmodium falciparum or Plasmodium vivax in
India.
• The main clinical presentation is fever with chills; however, nausea and headache can also
occur.
• The diagnosis is confirmed by microscopic examination of a blood smear and Rapid
Diagnostic Tests.
• Majority of the patients recover from the acute episode within a week.
12/12/22 4
• b) In India, the major vector for rural malaria is Anopheles culicifacies, found all over the
country and breeds in clean ground water collections.
• Malaria caused due to Plasmodium falciparum may cause fatality, if not treated early.
C). In urban areas, malaria mainly transmitted by Anopheles stephensi which breeds in man-
made water containers in domestic such as tanks, and malaria transmission lasts throughout the
year.
• Increasing human activities, such as urbanization, industrialization and construction projects and
indiscriminate disposal of articles (tyres, containers, junk materials, cups, etc.) creates
mosquitogenic conditions and thus contribute to the spread of vector borne diseases.
12/12/22 5
NATIONAL HELATH PROGRAM IN INDIA
• The MINISTRY OF HEALTH, GOVERNMENT OF INDIA ,CENTRAL HEALTH COUNCIL
launch programs aimed at controlling or eradicating diseases which cause considerable
MORBIDITY and MORTALITY in India.
• Since India became independent, several measures have been taken under National
Government to improve the health of people.
• Program among these measures are the NATIONAL HEALTH PROGRAMS, which has
been launched by central government of control and eradication of communicable disease,
improvement of environmental sanitation, raising the standard of nutrition,
control of population and improving rural health.
12/12/22 6
• Various international agencies like WHO(world health organization),UNICEF(United Nations
International Children Emergency Fund),UNFPA(United Nations Population Fund
),WORLD BANK
• and also a number of foreign agencies like SIDA(Swedish International Development
Cooperation Agency), DANIDA(Danish International Development Agency), and
USAID( United Nations Agency International
Development) have been providing technical and material assistance in the
implementation of these programs.
12/12/22 7
MEASURES TO IMPROVE NATIONAL HEALTH
PROGRAMS IN INDIA
Improving the quality of services.
Improving the implementation of programs.
Arranging appropriate training for the workers to increase their capabilities & skill.
 Ensuring the supply of required resources for the implementation of program.
Increasing the awareness about NHPs through IEC(information, education,
communication strategy) activities.
12/12/22 8
12/12/22 9
MILESTONES OF MALARIAL CONTROL
PROGRAMME
MAIN ACTIVITIES
Formulating policies and guidelines
Technical guidance
Planning
Logistics
Monitoring and evaluation
Coordination of activities through state and in consultation with National centre of
disease control (NCDC),National institute of malarial research(NIMR).
Collaboration with international organizations like the WHO, WORLD BANK, AND
OTHER DONOR AGENCIES.
Training
Facilitating research through NCDC(national centre for disease control),
Regional medical research centres.
Coordinating control activities in the inter-state and inter country border areas.
12/12/22 10
NATIONAL VECTOR BORNE DISEASE CONTROL
PROGRAMME
• The National Vector Borne Diseases Control Programme (NVBDCP) is an umbrella
programme for prevention and control of vector borne diseases viz. Malaria, Japanese
Encephalitis (JE), Dengue, Chikungunya, Kala-azar and Lymphatic Filariasis.
• Malaria, Filaria, Japanese Encephalitis, Dengue and Chikungunya are transmitted
by mosquitoes.
• The transmission of vector borne diseases depends on prevalence of infective vectors and
human-vector contact, which is further influenced by various factors such as climate, sleeping
habits of human, density and biting of vectors etc.
12/12/22 11
STRATEGIES FOR PREVENTION AND CONTROL
OF VECTOR BORNE DISEASES
1. Integrated Vector Management including Indoor Residual Spraying (IRS) in
selected high risk areas, Long Lasting Insecticidal Nets (LLINs), use
of larvivorous fish, anti - larval measures in urban areas including bio-larvicides and
source reduction.
2. Disease Management including early case detection with active,
passive and sentinel surveillance and complete effective treatment, strengthening
of referral services.
3. Supportive Interventions including Behaviour Change Communication (BCC), Inter-sectoral
Convergence, Human Resource Development through capacity building.
4. Vaccination only against J.E.(Japanese Encephalitis)
5. Annual Mass Drugs Administration (only against Lymphatic Filariasis)
12/12/22 12
Control Strategy for Malaria
1. Parasite Control: Treatment is done through passive agencies hospitals, dispensaries both in
private & public sectors.
 In mega cities malaria clinics are established by each health sector/malaria control
agencies via Municipal Corporations, Railways, Defence services.
2.Vector Control: Source reduction, use of larvicides, use of larvivorous fish, space spray.
12/12/22 13
ROLE OF COMMUNITY PHARMCIST IN MALARIAL CONTROL
PROGRAM
• Community pharmacists appear to be the most accessible health care professionals, for the
prevention, control, and treatment of malaria.
• Pharmacists are experts in the use of medications.
• They possess the knowledge and skills required to ensure the safe and effective use of
medicines.
• Also, community pharmacists are becoming increasingly involved in health promotion and
education.
• Community pharmacists are responsible for the supply of medicines and the counselling of
patients and caregivers with regards to the rational use of drugs.
• The Community Pharmacists (CPs) are the third largest health professionals after the
physicians and nurses and are most accessible to the public
12/12/22 14
PHARMACIST COUNSELLING POINTS FOR MALARIA
PREVENTION
• Offer advice, particularly around prevention, to patients through effective
communication.
• Identify complicated malaria in patients by being aware of the signs and symptoms to
ensure timely and appropriate care.
• Supply treatment and prophylaxis to patients, according to guidelines, in hospitals or
community pharmacies.
• Adhere to treatment guidelines by staying aware of local policies and developing action
plans to implement.
• Monitor response to treatment in patients by being aware of signs and symptoms and
reactions to antimalarials.
• Raise awareness in patient communities by using your knowledge.
12/12/22 15
PREVENTION OF MALARIA
• 1) improvements in environmental sanitation, the use of preventive interventions like indoor
residual spraying and insecticide treated bed nets (ITN) to avoid human contacts with
mosquitoes.
• 2). administering IPT (Intermitent Preventive Treatment) with adequate doses of
sulfadoxine/pyrimethamine (S/P) to prevent malaria illness in pregnancy.
• 3) promptly diagnosing and effectively managing uncomplicated malaria with adequate doses of
artemisinin-based combination products.
• 4). with regards to severe malaria and malaria infection in pregnancy, the policy initiative
recommends immediate referral to the appropriate institutions.
12/12/22 16
To prevent mosquito breeding and spread of malaria fever following measures should be
taken
• (i) Do not allow to collect water around the house and the locality.
• (ii) The water meter as well as overhead tanks should not leak or over flow.
• (ii) Do not allow to collect the refuse in the dust bins. They should be cleaned regularly and
refuse disposed of in a sanitary manner.
• (iv) Do not throw the broken earthen pots and other discarded containers/tins/tyres etc. on
your roof top because water may collect there which will act as breeding place for
mosquitoes.
• (v) Do not store water in open containers.
• (vi) All water containers, coolers, flowerpots etc. should be emptied once a week, cleaned and
dried and then used again.
• (vii) All weeds and wild growth should be removed from the locality as well as-banks of small
drains and canals so as to eliminate breeding place for mosquitoes.
• (viii) All drains should be regularly cleaned and sprayed with D.D.T., B.H.C. or slaked lime.
• (ix) Kerosene oil or any other larvicide oil should be sprayed over stagnant water so as to kill
mosquito larvae
12/12/22 17
• (x) Larvicidal fish 'Gambusia fish' should be grown in ponds which will eat mosquito larvae.
• (xi) While sleeping in the open, mosquito net should be used.
• (xii) Mosquito repellants should be used.
• (xiii) Mosquito-proof clothes should be used to prevent bite of mosquitoes.
• (xiv) Adult mosquitoes should be destroyed by spraying the insecticides like:
• ( (a) D.D.T. (Dichloro-Dipheny1-Trichloroethane).
Mosquitos have a tendency that after sucking blood they rest out on walls and roof of the room, when they
rest on the these surfaces for some time they absorb some of the D.D.T. through their legs and get
themselves after poisoned and die sometime.
• (b) 50% D.D.T., kerosene oil solution.
• (c) Pyrethrum, D.D.T., kerosene oil mixture (Flit).
• (xv) Various which types of mosquito traps are available in the market should be used. The mosquitoes
are caught in the and subsequently killed.
• (xvi) Health education should be given to the public.
12/12/22 18
REFERENCES
• Hand Book of Health Education and Community Pharmacy BY Ashok K. Gupta
• Practice of HOSPITAL, CLINICAL AND COMMUNITY PHARMACY
• https://www.slideshare.net/pateldharmendra4/national-health-programme
• https://www.slideshare.net/drpriyankaclre/national-health-programs-of-india
• https://slideplayer.com/slide/6084384/
• https://commonwealthpharmacycpd.org/courses/malaria-an-overview-for-pharmacists/
• NATIONAL PROGRAMMES UNDER NHM- CHAPTER 6
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8364789/
• https://www.pharmacytimes.com/view/pharmacist-counseling-points-for-malaria-prevention
12/12/22 19

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ROLE OF COMMUNITY PHARMACIST IN MALARIAL CONTROL PROGRAM

  • 1. HOSPITAL AND COMMUNITY PHARMACY ROLE OF COMMUNITY PHARMACIST IN MALARIALCONTROL PROGRAM 12/12/22 1 PREPARED BY:- MALINI.R M.PHARMACY -1st year PHARMACY PRACTICE
  • 2. WHAT IS MALARIA • Malaria is a serious or fatal disease caused by plasmodium parasite transmitted by the bite of infective female mosquitoes. • The term MALARIA is derived two italian words i.e mal means bad aria means air. • MALARIA is most important parasitic disease of the world. • Malaria in humans is caused by four Plasmodium species:  Plasmodium falciparum,  Plasmodium vivax,  Plasmodium malariae, and  Plasmodium ovale. • This (April to novemember) period is quite favourable for mosquito breeding and female mosquitoes bite human beings for sucking blood. 12/12/22 2
  • 3. • Malaria is one of the most prominent public health problems in India. • At the time of independence there were approximately 75 million malaria cases and 0.8 million deaths every year. • In 1953, the central government launched a National Malaria Control Programme with the objective of decreasing malaria transmission. • Later, the National Malaria Eradication Programme (NMEP) was launched • in 1958, with the objective of eradicating malaria. About 2 million cases were reported. • in 2000, of which 1.04 million were due to Plasmodium falciparum; there were 972 deaths. • WHO has launched a project called Roll Back Malaria (RBM) on worldwide partnership basis to coordinate malaria control activities in various countries. 12/12/22 3 MALARIA IN INDIA
  • 4. CONDITION OF MALARIA IN INDIA • Malaria is an acute parasitic illness caused by Plasmodium falciparum or Plasmodium vivax in India. • The main clinical presentation is fever with chills; however, nausea and headache can also occur. • The diagnosis is confirmed by microscopic examination of a blood smear and Rapid Diagnostic Tests. • Majority of the patients recover from the acute episode within a week. 12/12/22 4
  • 5. • b) In India, the major vector for rural malaria is Anopheles culicifacies, found all over the country and breeds in clean ground water collections. • Malaria caused due to Plasmodium falciparum may cause fatality, if not treated early. C). In urban areas, malaria mainly transmitted by Anopheles stephensi which breeds in man- made water containers in domestic such as tanks, and malaria transmission lasts throughout the year. • Increasing human activities, such as urbanization, industrialization and construction projects and indiscriminate disposal of articles (tyres, containers, junk materials, cups, etc.) creates mosquitogenic conditions and thus contribute to the spread of vector borne diseases. 12/12/22 5
  • 6. NATIONAL HELATH PROGRAM IN INDIA • The MINISTRY OF HEALTH, GOVERNMENT OF INDIA ,CENTRAL HEALTH COUNCIL launch programs aimed at controlling or eradicating diseases which cause considerable MORBIDITY and MORTALITY in India. • Since India became independent, several measures have been taken under National Government to improve the health of people. • Program among these measures are the NATIONAL HEALTH PROGRAMS, which has been launched by central government of control and eradication of communicable disease, improvement of environmental sanitation, raising the standard of nutrition, control of population and improving rural health. 12/12/22 6
  • 7. • Various international agencies like WHO(world health organization),UNICEF(United Nations International Children Emergency Fund),UNFPA(United Nations Population Fund ),WORLD BANK • and also a number of foreign agencies like SIDA(Swedish International Development Cooperation Agency), DANIDA(Danish International Development Agency), and USAID( United Nations Agency International Development) have been providing technical and material assistance in the implementation of these programs. 12/12/22 7
  • 8. MEASURES TO IMPROVE NATIONAL HEALTH PROGRAMS IN INDIA Improving the quality of services. Improving the implementation of programs. Arranging appropriate training for the workers to increase their capabilities & skill.  Ensuring the supply of required resources for the implementation of program. Increasing the awareness about NHPs through IEC(information, education, communication strategy) activities. 12/12/22 8
  • 9. 12/12/22 9 MILESTONES OF MALARIAL CONTROL PROGRAMME
  • 10. MAIN ACTIVITIES Formulating policies and guidelines Technical guidance Planning Logistics Monitoring and evaluation Coordination of activities through state and in consultation with National centre of disease control (NCDC),National institute of malarial research(NIMR). Collaboration with international organizations like the WHO, WORLD BANK, AND OTHER DONOR AGENCIES. Training Facilitating research through NCDC(national centre for disease control), Regional medical research centres. Coordinating control activities in the inter-state and inter country border areas. 12/12/22 10
  • 11. NATIONAL VECTOR BORNE DISEASE CONTROL PROGRAMME • The National Vector Borne Diseases Control Programme (NVBDCP) is an umbrella programme for prevention and control of vector borne diseases viz. Malaria, Japanese Encephalitis (JE), Dengue, Chikungunya, Kala-azar and Lymphatic Filariasis. • Malaria, Filaria, Japanese Encephalitis, Dengue and Chikungunya are transmitted by mosquitoes. • The transmission of vector borne diseases depends on prevalence of infective vectors and human-vector contact, which is further influenced by various factors such as climate, sleeping habits of human, density and biting of vectors etc. 12/12/22 11
  • 12. STRATEGIES FOR PREVENTION AND CONTROL OF VECTOR BORNE DISEASES 1. Integrated Vector Management including Indoor Residual Spraying (IRS) in selected high risk areas, Long Lasting Insecticidal Nets (LLINs), use of larvivorous fish, anti - larval measures in urban areas including bio-larvicides and source reduction. 2. Disease Management including early case detection with active, passive and sentinel surveillance and complete effective treatment, strengthening of referral services. 3. Supportive Interventions including Behaviour Change Communication (BCC), Inter-sectoral Convergence, Human Resource Development through capacity building. 4. Vaccination only against J.E.(Japanese Encephalitis) 5. Annual Mass Drugs Administration (only against Lymphatic Filariasis) 12/12/22 12
  • 13. Control Strategy for Malaria 1. Parasite Control: Treatment is done through passive agencies hospitals, dispensaries both in private & public sectors.  In mega cities malaria clinics are established by each health sector/malaria control agencies via Municipal Corporations, Railways, Defence services. 2.Vector Control: Source reduction, use of larvicides, use of larvivorous fish, space spray. 12/12/22 13
  • 14. ROLE OF COMMUNITY PHARMCIST IN MALARIAL CONTROL PROGRAM • Community pharmacists appear to be the most accessible health care professionals, for the prevention, control, and treatment of malaria. • Pharmacists are experts in the use of medications. • They possess the knowledge and skills required to ensure the safe and effective use of medicines. • Also, community pharmacists are becoming increasingly involved in health promotion and education. • Community pharmacists are responsible for the supply of medicines and the counselling of patients and caregivers with regards to the rational use of drugs. • The Community Pharmacists (CPs) are the third largest health professionals after the physicians and nurses and are most accessible to the public 12/12/22 14
  • 15. PHARMACIST COUNSELLING POINTS FOR MALARIA PREVENTION • Offer advice, particularly around prevention, to patients through effective communication. • Identify complicated malaria in patients by being aware of the signs and symptoms to ensure timely and appropriate care. • Supply treatment and prophylaxis to patients, according to guidelines, in hospitals or community pharmacies. • Adhere to treatment guidelines by staying aware of local policies and developing action plans to implement. • Monitor response to treatment in patients by being aware of signs and symptoms and reactions to antimalarials. • Raise awareness in patient communities by using your knowledge. 12/12/22 15
  • 16. PREVENTION OF MALARIA • 1) improvements in environmental sanitation, the use of preventive interventions like indoor residual spraying and insecticide treated bed nets (ITN) to avoid human contacts with mosquitoes. • 2). administering IPT (Intermitent Preventive Treatment) with adequate doses of sulfadoxine/pyrimethamine (S/P) to prevent malaria illness in pregnancy. • 3) promptly diagnosing and effectively managing uncomplicated malaria with adequate doses of artemisinin-based combination products. • 4). with regards to severe malaria and malaria infection in pregnancy, the policy initiative recommends immediate referral to the appropriate institutions. 12/12/22 16
  • 17. To prevent mosquito breeding and spread of malaria fever following measures should be taken • (i) Do not allow to collect water around the house and the locality. • (ii) The water meter as well as overhead tanks should not leak or over flow. • (ii) Do not allow to collect the refuse in the dust bins. They should be cleaned regularly and refuse disposed of in a sanitary manner. • (iv) Do not throw the broken earthen pots and other discarded containers/tins/tyres etc. on your roof top because water may collect there which will act as breeding place for mosquitoes. • (v) Do not store water in open containers. • (vi) All water containers, coolers, flowerpots etc. should be emptied once a week, cleaned and dried and then used again. • (vii) All weeds and wild growth should be removed from the locality as well as-banks of small drains and canals so as to eliminate breeding place for mosquitoes. • (viii) All drains should be regularly cleaned and sprayed with D.D.T., B.H.C. or slaked lime. • (ix) Kerosene oil or any other larvicide oil should be sprayed over stagnant water so as to kill mosquito larvae 12/12/22 17
  • 18. • (x) Larvicidal fish 'Gambusia fish' should be grown in ponds which will eat mosquito larvae. • (xi) While sleeping in the open, mosquito net should be used. • (xii) Mosquito repellants should be used. • (xiii) Mosquito-proof clothes should be used to prevent bite of mosquitoes. • (xiv) Adult mosquitoes should be destroyed by spraying the insecticides like: • ( (a) D.D.T. (Dichloro-Dipheny1-Trichloroethane). Mosquitos have a tendency that after sucking blood they rest out on walls and roof of the room, when they rest on the these surfaces for some time they absorb some of the D.D.T. through their legs and get themselves after poisoned and die sometime. • (b) 50% D.D.T., kerosene oil solution. • (c) Pyrethrum, D.D.T., kerosene oil mixture (Flit). • (xv) Various which types of mosquito traps are available in the market should be used. The mosquitoes are caught in the and subsequently killed. • (xvi) Health education should be given to the public. 12/12/22 18
  • 19. REFERENCES • Hand Book of Health Education and Community Pharmacy BY Ashok K. Gupta • Practice of HOSPITAL, CLINICAL AND COMMUNITY PHARMACY • https://www.slideshare.net/pateldharmendra4/national-health-programme • https://www.slideshare.net/drpriyankaclre/national-health-programs-of-india • https://slideplayer.com/slide/6084384/ • https://commonwealthpharmacycpd.org/courses/malaria-an-overview-for-pharmacists/ • NATIONAL PROGRAMMES UNDER NHM- CHAPTER 6 • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8364789/ • https://www.pharmacytimes.com/view/pharmacist-counseling-points-for-malaria-prevention 12/12/22 19