About 90% of the estimated malaria cases in the Southeast region are from India

About 90% of the estimated malaria cases in the Southeast region are from India

India also needs a stronger malaria surveillance system to combat the disease

New Delhi, 02 December 2017: As per recent reports, India accounts for about 6% of the world’s new cases of malaria and 7% of deaths caused by the disease. India accounts for about 90% of the estimated number of malaria cases followed by Indonesia (9%) and Myanmar (1%) in the Southeast Asia region. The country has also been found to be one of the weakest in terms of malaria surveillance systems. Despite efforts at various levels, malaria remains an acute public health challenge in India.

Malaria is a life-threatening mosquito-borne blood disease caused by a Plasmodium parasite. It is transmitted to humans through the bite of the Anopheles mosquito. Once an infected mosquito bites a human, the parasites multiply in the host's liver before infecting and destroying red blood cells.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, National President Indian Medical Association (IMA) and President Heart Care Foundation of India (HCFI) and Dr RN Tandon – Honorary Secretary General IMA in a joint statement, said, "Malaria is transmitted by the bite of a female anopheles mosquito. The mosquito bite occurs mainly between dusk and dawn. Five types of Plasmodium parasite can infect humans. They are found in different parts of the world. Some cause a more severe type of malaria than others. Malaria can also be transmitted through blood transfusion, or via sharing of contaminated needles. The behavior of the mosquitoes may differ. Some may prefer to rest indoors and feed indoors in the night. Some may prefer to rest and feed outdoors earlier in the day. Preventive therapy of malaria can be instituted during pregnancy in high risk areas. The malarial mosquito feeds every third day compared to the dengue mosquito, which feeds three times in a day.”

Symptoms of severe malaria include the following: fever and chills; impaired consciousness, prostration, or adopting a prone position; multiple convulsions; deep breathing and respiratory distress; abnormal bleeding and signs of anemia; and clinical jaundice and evidence of vital organ dysfunction.

Adding further, Dr Aggarwal, said, “Pregnant travelers should defer travel to areas where risk of malaria is high until after delivery. For non-immune pregnant women who cannot defer travel, chemoprophylaxis with chloroquine and mefloquine depending on travel to areas with chloroquine-sensitive or resistant malaria is recommended. Pregnant women from endemic areas, who due to prolonged exposure to malaria, have developed natural immunity benefit from chemoprophylaxis.”

Here are some tips to prevent malaria.

• Malaria mosquitoes grow in fresh water collected in the house. It is therefore important to not let water stagnate in your house and the surrounding areas. Mosquito cycle takes 7-12 days to complete. So, if any utensil or container that stores water is cleaned properly once in a week, there are no chances of mosquito breeding.
• Mosquitoes can lay eggs in money plant pots or in water tanks on the terrace if they are not properly covered. If the water pots for birds kept on terraces are not cleaned every week, then mosquitoes can lay eggs in them.
• Using mosquito nets/repellents in the night may not prevent malaria because these mosquitoes bite during the day time.
• Malaria mosquitoes do not make a sound. Therefore, mosquitoes that do not produce a sound do not cause diseases.
•  Wearing full sleeves shirt and trousers can prevent mosquito bites. Mosquito repellent can be helpful during the day. 

Points every medical professional should know about Malaria

Points every medical professional should know about Malaria

Dr K K Aggarwal, National President IMA

·         No one should die of malaria in India.

·         Vivax malaria cases to be treated with chloroquine for 3 days and 14 days primaquine as radical treatment after doing G6PD testing, if possible. 

·         Primaquine is contraindicated in pregnant women.

·         Uncomplicated falciparum malaria to be treated with artemisinin-based combination therapy (ACT)
for 3 days and single day primaquine on second day.

·         All severe malaria cases (both vivax and falciparum) to be treated with injection artesunate followed by complete course of oral antimalarial.

·         Artesunate monotherapy is banned in India. 

·         Don't treat malaria cases with injection artesunate only.

·         Antigen-based Bivalent (Pv & Pf) Rapid Diagnostic Kit or microscopy is the recommended method of confirmation of malaria and available free of cost in Govt. Health Facility.

·         Current Malaria Treatment Guidelines are available on   http://www.mrcindia.org/Diagnosis%20of%20Malaria%20pdf/Guidelines%202014.pdf

(Contributions from Dr AC Dhariwal)

Sri Lanka malaria free and Delhi sees two deaths because of Malaria in just over two months: The need for mass awareness about prevention

Sri Lanka malaria free and Delhi sees two deaths because of Malaria in just over two months: The need for mass awareness about prevention

Malaria is a preventable disease, and it is imperative that awareness is raised about reducing the rising disease incidence around the Globe. Estimates indicate that over 3.2 billion people live at risk of contracting malaria. In 2015, there were an estimated 214 million malaria cases and some 438 000 malaria-related deaths. For a preventable disease, these numbers are alarming.

In India too malaria is a major public health concern. Over 561 people died due to the disease in 2014, 440 in 2013 and 519 in 2012.

Malaria is caused by Plasmodium parasites that are transmitted to people through the bites of infected Anopheles mosquito vectors. Of the five parasite species that cause malaria in humans, Plasmodium falciparum is the most deadly.

About 95% of India's population resides in malaria endemic areas, and 80% of the malaria cases reported in the country are confined to areas consisting of 20% of the population residing in tribal, hilly, difficult and inaccessible areas.

Young children, pregnant women are most vulnerable. Those under 5 are particularly susceptible to infection, illness and death. Globally more than two-thirds (70%) of all malaria deaths occur in this age group.

"Comprehensive malaria prevention and control measures can play a key role in dramatically reducing the malaria burden in the country. Sri Lanka, for instance, has successfully won the battle against malaria. Early diagnosis and treatment of malaria reduces disease and prevents deaths. It also contributes to reducing malaria transmission. ICMR and IMA should be allowed to do a post-mortem analysis of all 561 cases to learn lessons and come up with comprehensive strategies to fight malaria in the country",said Padma Shri Awardee Dr KK Aggarwal - President Elect & Honorary Secretary General IMA & President Heart Care Foundation of India.

Access to diagnostic testing and treatment should be seen not only as a component of malaria control but as a fundamental right of all populations at risk. Artemisinin-based combination therapies remain effective in almost all settings, as long as the partner drug in the combination is locally effective.

Long-lasting insecticidal nets provide personal protection against mosquito bites. They can be used as protection for people most at risk of malaria, such as young children and pregnant women. The nets are effective for 2-3 years, depending on the model and conditions of use.

The full potential of indoor residual spraying is obtained when at least 80% of houses in targeted areas are sprayed. Indoor spraying with insecticides kills the mosquito vector and is effective for 3–6 months, depending on the insecticide used and the type of surface on which it is sprayed.

For pregnant women WHO recommends intermittent preventive treatment at each scheduled antenatal visit after the first trimester.

The mosquito bites between dusk and dawn. It is thus important that protection for all people at risk of malaria with effective malaria vector control is considered. Two forms of vector control – insecticide-treated mosquito nets and indoor residual spraying – are effective in a wide range of circumstances

As per the WHO recommendation, all cases of suspected malaria should be confirmed using parasite-based diagnostic testing (either microscopy or rapid diagnostic test) before administering treatment. Results of parasitological confirmation can be available in 30 minutes or less.

Urgent need to create social awareness on mosquito borne diseases!

Urgent need to create social awareness on mosquito borne diseases! Prevention measures essential to curb the ongoing dengue and chikungunya menace in the city Despite the best efforts from doctors, the illnesses will continue to exist over the next one month New Delhi, August 28, 2016: Dengue and chikungunya cases are rampant in Delhi and raising preventive awareness crucial. Chikungunya is not life-threatning and symptoms typically exist for 7-10 days. Dengue on the other hand can be easily managed and does not always require hospitilization. Mass public awareness campaigns are essential. Speaking about this issue, Padma Shri Awardee Dr. KK Aggarwal Honorary Secretary General IMA and President Heart Care Foundation of India said, “The misconceptions that people have about the mosquito-borne tropical disease has contributed towards making India the ‘Dengue capital’ of the world. Nowadays, individuals ignore the fact that the disease is manageable and preventable. Also, it can be effectively treated with the right kind of first aid, medication, and precautions. In addition to this, people forget that surviving dengue the first time doesn’t make us immune to reinfection with another strain, so one should always take precautions after recovering from the infection. The need of the hour is to raise awareness about prevention, treatment options and busy common myths about the disease. Instead of panicking and spreading panic, we must all work together towards solving the problem and preventing as many cases as possible.“ It is extremely important to note that platelet transfusion is only needed in dengue cases where the platelet count is less than 10,000, and there is active bleeding. Unnecessary platelet count can cause more harm than good. Adequate hydration is the best management approach to dengue while monitoring crucial signs. In most cases, hospitalization is not required, and families must not insist towards this as it deprives seriously ill patients from getting hospital beds. Only severe dengue cases must be admitted basis the treating physicians discretion. One must always remember that 70% of the dengue fever cases can be cured just through the proper administration of oral fluids. Patients must be given 100-150 ml of safe water every hour and it must be ensured that they must pass urine every 4-6 hours. What are symptoms of severe dengue fever? • Abdominal pain or tenderness • Persistent vomiting • Clinical fluid accumulation (pleural effusion/ascites) • Active mucosal bleeding • Severe restlessness or lethargy • Tender enlarged liver How to identify dengue fever by applying the Formula of 20: • If there is rise in pulse by 20 • If there is fall in upper BP by 20 • If the difference between upper and lower blood pressure is less than 20 • If there is rise in hematocrit by 20 percent • If the platelet counts are less than 20,000 • If the petechial count in one inch of the arm is more than 20 after tourniquet test • If all of this happens then it is essential to take 20 ml of fluid per kg body weight in a span of 20 minutes and then approach the doctor. First aid for Dengue patients: • If a person has warning signs of dengue with normal blood pressure 10ml of fluid per kg body weight must be administered in the next 20 minutes (oral or IV). Then the dose should be reduced by 50% in the next hour. If they have low blood pressure than the quantity should be 20ml per body weight • A patient should drink as much fluids as he can • Best oral fluid is one litre of safe water added with six spoons sugar and half spoon salt • Anyone who is ill with dengue shouldn’t cut down on food. Consuming nutritious food in sufficient quantities is important. • Best treatment for dengue is 100 ml of fluids per hour for 48 hours from when the symptoms are noted in patients with normal BP patients and 150 ml per hour in patients with a low BP Dangerous Parameters: When you should be worried? • While first aid will help you control the situation so that it doesn’t reach the extreme. But a patient is advised to consult a doctor in situations like: • When there is an absence of baseline hematocrit value. If hematocrit value is less than 40 percent in adult female and less than 46 percent in the adult male, then a doctor should be consulted, as it might be a case of plasma leakage. • When the platelet counts are rapidly falling. • When the difference between the upper and lower blood pressure is falling. • When liver enzymes SGOT levels are more than SGPT levels. Liver enzyme levels more than 1000 can lead to severe plasma leakage and less than 400 can cause moderate plasma leakage. • When there is a progressive increase in hematocrit with a progressive reduction of platelet count

Take special care of your health during the upcoming monsoon season

Take special care of your health during the upcoming monsoon season

During the Monsoon season, the body’s immunity levels dip

New Delhi: 15 June 2016: Monsoon is a season which brings respite from the dreaded summer months and helps revive the dying crops. However the season also brings with itself a host of diseases. The immunity levels of a person are found to be at its lowest during this season making people vulnurable to illness.

 “The most common diseases associated with the monsoon season are malaria, dengue, Chikungunya, jaundice and gastrointestinal infections like typhoid and cholera. Apart from these, viral infections like cold and cough are also common”, said Padma Shri Awardee, Dr KK Aggarwal, President Heart Care Foundation of India and Honorary Secretary General IMA.

Patients with Chikungunya, typically complain of joint pains and can get relief from the pain by flexing their limbs. Chikungunya, though not fatal, can cause chronic debilitating joint pains lasting for years and adequate prevention must be taken against it.

Dengue, most commonly caused by the breeding of the aedes mosquite if not adequately managed, can be fatal in 1-4% of cases. Management of dengue involves fluid resuscitation and not platelet resuscitation. If enough fluids are given, mortality rates are negligable. Inappropriate misuse of anti fever medicines can precipitate bleeding in dengue patients. Awareness must be raised about how the aedes mosquito breeds in clean collected water and people must ensure that they wear full-sleeves clothing during the monsoon season, do not let water collect outside their house and that they use mosquito repellents.

One of the most common occurances in the monsoon season is the contamination of drinking water making people prone to diarrhea and gastrointestinal infections. People must ensure that they only drink safe and clean drinking water during these months and avoid eating at places where the water has been left out in the open for hours.

Walking in dirty water during the rainy season leads to numerous fungal infections. Diabetic patients must take special care to keep their feet clean and dry. They must walking in dirty water. 

During the monsoons, precautions have to be taken to prevent dampness and growth of fungus (mold) on and around the house were asthmatic patients are living. Avoid fumigation for mosquitos in case of asthmatic patients as it can aggrevate their condition.

Underground works come to the surface and contaminate surface vegetables during the rainy season. This can cause gastric disturbances in people with low immunity. It is because of this reason that community lunches and marriages are usually not held during this season.

Overall, one must enjoy the weather and the respite of the rains, while taking necessary precautions against diseases which might dampen the celebrations.