Treatment of malaria by Dr. Jay Sarkar

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Bengaluru, Karnataka, India, Republic of (Free-Press-Release.com) November 26, 2011 -- Treatment of malaria by Dr. Jay Sarkar

Let me introduce Dr. Jay Sarkar, who is a renowned general physician from Delhi. After lot of coaxing he finally agreed to give his opinion on growing cases of malaria in India. Ratan and I, Sunil were very happy and exited to meet him at his hospital. Firstly, he greeted us by a warm coffee then we started our interview. He went on to deliberate on the prevailing condition of malaria in India. He said that although malaria is not a lethal disease but still he is having so many cases of ill treatment and non-diagnosis. He said that he usually gets 5-7 cases every week which could have been averted had proper care been taken at right time.
Present scenario of malaria

Well, you would be surprised t know that almost half of the world’s population is at a risk of malaria. malaria affects more than five hundred million people per year and kills more than one million. Malaria is one of the major public health problems in India. Around 1.5 million confirmed cases are reported annually by the National Vector Borne Disease Control Programme (NVBDCP), Directorate General of Health Services, Ministry of Health & Family Welfare, New Delhi, of which 40–50% occur due to parasite Plasmodium falciparum and plasmodium vivax.
He further went on to caution that the old age technique of DDT spray by government is not giving expected result due to the resistance developed by them.
Treatment

He went on to say that treatment of malaria is no more a secret practice rather government has published detail guideline on treatment of malaria. For instance the second edition of The World Health Organization ‘Guidelines for the Treatment of Malaria’ brought out in 2010, provides evidence-based and current recommendations for countries on malaria diagnosis and treatment. Guidelines cover the subject in exhaustive manner and really good and enriching resource for regular practitioners. I would recommend all practitioners to keep their medical knowledge updated and enriched by referring to latest guidelines and development.
Effective diagnosis
Upon being asked about its treatment Dr. Jay Sarkar went on to cite WHO report and guideline on effective diagnosis. According to Dr. Sarkar WHO recommends diagnostic testing even in cases of suspected malaria. Also, the treatment should not be based on clinical symptoms alone, clinical test should be reserved for settings only where diagnostic tests are not available.

Dr. Sarkar further went on to say that “If diagnosis is based simply on clinical symptoms, malaria can be confused with any other disease. For this matter, microscopy of stained thick and thin blood smears remains the gold standard for confirmation of diagnosis of malaria. But the recent development of rapid diagnostic tests (RDTs), although expensive, can reliably demonstrate the presence or absence of malaria parasites in the blood.” Upon this he agreed with the view of doctors in Lilavati hospital.
RDTs are based on detection of circulating parasite antigens in the blood. The test is performed using a dip stick and a drop of blood. Several types of RDTs are available, produced by different companies, of which some can detect the presence of P Falciparum while others can detect other parasite species.

RDTs can be performed at all levels of the health system, including community settings. Recently, there is a move towards universal diagnostic testing to fight against malaria. At present NVBDCP supplies RDT kits for detection of P Falciparum at locations where microscopy results are not obtainable within 24 hours of sample collection.
Malaria treatment
According to Dr. Jay Sarkar affected individuals diagnosed with malaria by RDT or microscopy requires prompt and effective treatment. P Vivax cases are treated with Chloroquine but there occurs a relapse at times. In India, the relapse rate is around 30%. For its prevention Primaquine is given for 14 days. The medications need to be taken only under doctor’s supervision.

Dr Sarkar further went on to say that although Chloroquine is used for treating malaria, for treating P Falciparum malaria, Artemisinin Combination Therapy (ACT) is prescribed. P Falciparum malaria is the deadliest form of the disease. Fixed dose combination drugs are now available. WHO recommends that oral Artemisinin-based Monotherapy should be removed from the market because their use will hasten the development of parasite resistance and countries need to ensure that patients are diagnosed properly and take the full dose of ACTs to prevent the development of drug resistance.