KARACHI, Sept 5: Pakistan being an endemic zone for malaria registers 50,000 deaths every year with victims from all age groups.

The situation is turning grave with the growing resistance among the locals against the WHO-recommended first line of drugs comprising chloroquine phosphate, bezoquine and pyramithaminine/sulphadoxine, a compound drug commonly known as Fansidar.

Thirty-three per cent resistance to chloroquine and 31 per cent to sulpha doxine/pyremethamine has been registered in Pakistan during the recent years. Physicians attribute the situation to non-compliance to recommended drug therapy and its due course on the part of patients. The first line drugs must necessarily be taken for at least three days.

Malaria is also observed to be causing severe malnutrition. Meanwhile, non-availability of diagnostic kits also continues to restrict a large majority of local doctors to conventional methods often delaying in-time diagnosis.

Hospital-based data of Sindh reveals children to be generally inflicted with falciparum malaria. Paediatricians say the data cannot be considered generalised as no reliable and community- based study is available. They also point out that only serious cases are referred to hospitals.

Fever, anaemia, hepatosplenomegaly, cerebral malaria, jaundice and acute renal failure are the common manifestations of severe falciparum malaria reported at paediatric wards of government hospitals spread across the province.

The most commonly affected age group falls between one to six years of age. Many of them are below one year of age and above six months. The main syptoms are fever and anaemia. These are followed by congestive cardiac failure, jaundice, acute renal failure, febrile fits and gastroenteritis.

Dr S.M Afaq, talking to APP, said any fever extending beyond one week and not responding to conventional anti-malarial medicines must be suspected for resistant malaria. According to him, timely referral to hospitals saves many lives. Around 50 malarial deaths (mainly presumed to be cerebral malaria) are registered every year in Karachi only and 15,000 to 20,000 in Pakistan every year.

Mentioning that there were more cases of malaria today than any time in history as about 40 per cent of the population was at risk, Dr Afaq said that 300 to 500 million got inflicted every year and most of them were children.

Of the one million deaths occurring every year around the world, 40 per cent are of children below five years. Dr Afaq attributed the situation to resistance to conventional drugs because of their misuse, treatment with low doses and improper duration.—APP