Abstract
Early diagnosis and complete treatment are the most important components of the malaria control program, which have a direct bearing on prevention of mortality and reduction in the morbidity, therefore, follow-up of the patient treatment is an important aspect of monitoring disease in the community. Aims: To assess treatment compliance among confirmed malaria cases in Gandhinagar District and to determine the proportion of cure rate with complete treatment as per the national drug policy. Study Variables: Exploratory-rural and urban areas; outcome-compliance, cure rate. Analysis: Percentage, proportions. Results: Compliance among 192 subjects under the study conducted in 2008 i.e. confirmed that malaria cases were 88% even after the introduction of 14 day therapy for “Plasmodium vivax” cases, while 100% cure rate was observed on the follow-up till the 28th day among “P. vivax” and “P. falciparum” cases which helped in reducing malaria incidence in the rural area by 50% as compared to the preceding year of the study. Conclusion: Follow-up of the treatment given to malaria patients has enhanced compliance and cure rate, which in turn contributed towards interruption of transmission. Therefore, a better cure rate through the administration of effective antimalarial drugs as per the drug policy in combination with other containment measures is the right strategy to keep morbidity and mortality due to malaria under effective control.
Highlights
During 2008, out of 236,327 blood smears of fever patients screened for malaria 500 (88.96%) and 62 (11.03%) were positive for “P. vivax” and “P. falciparum” respectively. 409 (72.77%) of the total malaria cases detected in the district were from the urban area while 153 (27.2%) cases were from the rural area
Looking to the feasibility of collecting the information and availability of staff to undertake the work more emphasis was given to the rural areas and all the subjects included in the study were followed up, while in urban areas only 9.53% of the cases could be followed up which indicates the constraints in tracking the cases in an urban settings where the infrastructural facilities are deficient as compared to the rural area
The comparatively higher rate of non compliance among the falciparum cases studied were due to the high proportion of non compliance in urban areas as 42% of falciparum cases which have not completed the treatment were from the urban areas
Summary
Malaria continues to be a major vector borne disease and accounts for a major part of the morbidity, though there has been a significant and constant decline in total incidence of malaria in the state since 2004 [1]. Malaria in Gujarat state is unstable and contributes to only 2.9% incidence of malaria reported from India (2009). CRPF was reported in labors working at construction site, agriculture field and urban area in different districts of Gujarat [4]. Since 1990s outbreaks/epidemics of malaria occurred in many parts of the state [5], genotype investigation of “P. vivax” cases had confirmed two true chloroquine treatment failures in Anand District [6].
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