Andhra Pradesh – Malaria Elimination


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GOVERNMENT OF ANDHRA PRADESH
ABSTRACT

APM&HS – NVBDCP – Andhra Pradesh – Malaria Elimination - Notification of Malaria
cases - Orders – Issued.
HEALTH, MEDICAL & FAMILY WELFARE (B2) DEPARTMENT
G.O.MS.No. 36 Dated: 11-04-2018


 Read the following:
1. From Director, National Vector Borne Disease Control Programme, GOI, Miny. of
H&FW, New Delhi, D.O.No.14-4/2016-17/NVBDCP/MTD/Malaria
Elimination/Pt.file, dt.17-10-2017.
2. From the DPH&FW, A.P., Lr.Rc.No.715/Notificaiton of Malaria/MPHEO.2/2018,
dt.08-02-2018.

                                                 ***
ORDER:

In the letter 1st read above, Govt., of India, Ministry of Health & Family Welfare,
New Delhi have requested to declare Malaria as a “Notifiable Disease” in the State.

2. Accordingly, the following Notification will be published in an Extra Ordinary
Issue of the Andhra Pradesh Gazette dated 16-04-2018.

NOTIFICATION

3. In exercise of the powers conferred by section 62 (1) of the Andhra Pradesh
(Andhra Area) Public Health Act, 1939 the Government hereby declare that Malaria is
a notified disease in the State for the purpose of the said Act.

4. Malaria continues to be major public health concern in India accounting for
substantial morbidity and mortality, intense transmission is still going on in the
underserved rural, tribal and forested areas. In Andhra Pradesh also considerable
number of Malaria cases reported every year and the incidence is more in the tribal/
agency areas of Srikakulam, Vizianagaram, Visakhapatnam, East Godavari and West
Godavari Districts. In other districts the cases are reporting moderately in particular
areas.

5. In the last decade interest in Malaria Elimination has rejuvenated because of
evidence generated from our country and several other countries based on availability
and strategic deployment of the cost effective interventions in the form of bivalent
rapid diagnostic tests (bRDT), Artemisinin - based combination therapy (ACT) and
Long Lasting Insecticidal nets (LLINs) and new tools for improved programme
management.

6. Malaria in India reduced significantly over the years with an overall decline in
Malaria related morbidity and mortality. In A.P., state also the Malaria cases reduced
considerably. India has a vision of a Malaria free country by 2027 and Elimination by
2030 with the support of different interventions. However, the country still faces
daunting challenges, as Malaria epidemiology exhibits enormous heterogeneity and
complexity. The disease is mainly concentrate in tribal and remote areas.

7. The objectives of strategic plan are:-

• Achieve universal coverage of case detection and treatment services in endemic
districts to ensure 100% parasitological diagnosis of all suspected Malaria cases
and complete treatment of all confirmed Malaria cases.
• Strengthen the surveillance system to detect, notify, investigate, classify and
respond to all cases and foci in all districts to move towards Malaria Elimination.
• Achieve near universal coverage of populations at risk of Malaria with an
appropriate vector control interventions.
• Achieve near universal coverage by appropriate behaviour change
communication (BCC) activities to improve knowledge, awareness and
responsive behaviour regarding effective preventive and curative interventions
for Malaria Elimination.
• Provide effective programme management and coordination at all levels to
deliver a combination of target interventions for Malaria Elimination.

8. The following guiding principles will determine the direction and pace of Malaria
Elimination in the Districts and State.
• Political commitment, leader ship and owner ship by state/districts.
• Equitable access to services, especially for the most vulnerable and
underserved geographical areas and populations at risk of Malaria.
• Quality health care service delivery.
• Community mobilization and participation.
• Intersectoral approach involving all stakeholders.
• Promotion of innovative tools and newer approaches by having operational
research.
• Delegation of responsibility and fixing accountability.

9. Diagnosis of Malaria:-

Malaria treatment is recommended only after parasitological confirmation of
suspected malaria cases is done through prompt quality assured diagnostic testing
(Quality microscopy or Quality assured bRDTs) in all settings.
Use of bRDTs for diagnosis is recommended at community level especially in
the hard-to-reach remote areas were microscopy services not well within reach and
easily accessible. This is to ensure early diagnosis and treatment initiations within 24
hours.

10. Case Management:-

Early detection and complete treatment is the policy for the case management.
Once the diagnosis has been made, appropriate anti-Malarial treatment must be
initiated immediately to ensure radical cure as per the latest National Malaria Drug
Policy.
Plasmodium falciparum (Pf) infections can cause rapidly progressive severe
illness or death. Therefore, the urgent initiation of appropriate anti-Malarial treatment
therapy is especially critical.
In Plasmodium vivax (Pv) infections, patients having recovered from the first
episode of illness may suffer several additional attacks (relapses) after months or
even years with or without symptoms.
Artesunate/Quinine injection is a drug of choice for treatment for severe
malaria, followed by a complete dose of ACT.
Quinine remains the treatment of choice for pregnant mothers during the first
trimester of pregnancy, children under 5Kg body weight, and for treatment failures.
Chloroquine remains the drug of choice along with Primaquine for treatment of
uncomplicated Pv Malaria.
Mixed infection (Pv and Pf) should be treated as a case of Pf and treated with
ACT and 14 days radical treatment as prescribed for Pv cases.
Diagnosis and case management of un- complicated and sever malaria at public
sector health facilities is free of charge.

11. OBJECTIVES:-

Ensure early case detection and prompt treatment by test, treat and track (the
3Ts) of every case of Malaria.

• To achieve 100% parasitological diagnosis of Malaria cases using bRDTs and /
or microscopy within 24 hours onset of fever.
• To ensure treatment of malaria cases (100%) in accordance with the National
Malaria Drug Policy and treatment guidelines within 24 hours of onset of fever.
• To manage 100% of sever malaria cases according to national guidelines.
• Toensure that all private practitioners follow the national policy for diagnosis
and treatment of uncomplicated and sever malaria.
• To ensure that each and every district has adequate infrastructure, facilities and
capacity to treat severe cases of malaria without any charge, and such facilities
are notified both in the public and private sectors.

12. The Doctors in health institutions and registered medical private practitioners of
private hospitals/ nursing homes/clinics are required to immediately inform the office
of the district health authority of concerned district if a malaria positive case reported
at their health institution duly furnishing the complete details of patients for
administering the radical treatment and initiating further necessary action.

13. A patient can be declared positive for malaria by prompt quality assured
diagnostic testing through quality assured bRDTs or quality microscopy.

14. The information of malaria positive case should be sent to the office of the
district health authority immediately after the diagnosis for administering complete
radical treatment and for necessary actions as malaria is a notifiable disease.

(BY ORDER AND IN THE NAME OF THE GOVERNOR OF ANDHRA PRADESH)
POONAM MALAKONDAIAH
PRINCIPAL SECRETARY TO GOVERNMENT

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