The health experts have set the alarm bells ringing regarding the drug–resistant malaria. Incidentally, no authentic study on anti–malarial drug resistance is available currently.
The period between June to October is identified as the breeding season of malaria vector– Plasmodium vivax (Pv) and Plamodium falciparum (Pf). Traditionally, chloroquine is the cheapest and widely used anti–malarial drug. However, incomplete and improper use results into ineffectiveness.
The first case of resistance of Pf to chloroquine was reported in the India in 1973 from Assam. To combat the drug resistance in malaria, the national drug policy on malaria in 2010 recommended the use of combination therapy including Artesunate plus Sulfadoxine Pyrimethamine for treatment.
As per the National Vector Borne Disease Control Programme, the anti–malarial drug resistance is negligible, around 3–4 percent of total malaria cases.
However, according to general physician and former president of Indian Medical Association Pune Dr Avinash Bhondwe, who frequently reports drug–resistant malaria cases, combination therapy is not cost effective and resistance to them is also observed.
"Overall unhygienic conditions in public places, lack of adequate knowledge about anti–malarial treatment by the physicians and lack of eradication treatment are responsible for the failure of the Malaria Control Programme in the country," he said.
"The dosage of chloroquine differs from age–to–age. In case of an adult, four tablets are administered on the first day of treatment, followed by two tablets after six hours. Then two tablets are given for two days each," Bhondwe said.
He pointed out that this curative treatment should be followed by eradicative treatment, which often is neglected. "Even after the curative treatment, the protozoa (Plasmodium) remains in the liver. It may relapse, whenever favourable conditions are available. During the eradication treatment, drug namely primaquine is administered for 14 days for complete eradication of the vector from the body."
He mentioned that in the government healthcare set up, only chloroquine is given and not the eradication therapy. The district malaria officer Dr ST Pardeshi admitted the risk of anti–malarial drug resistance, but said that no such case has been reported in the district so far.
The State vigilance officer Dr Pradip Awate said that the as per the national drug policy on malaria, use of chloroquine was stopped in 2010 for the treatment of Pf malaria. "Only combination therapy is administered for Pf malaria. We also conduct workshops for general physicians on the national guidelines for the malaria treatment. The department also conducts random surveys on the drug–resistance malaria," he said.
5 Aug 2013, Pune