FROM January to August 2022, more than 3.4 million suspected cases of malaria were reported in Pakistan compared to 2.6 million such cases reported in 2021. Malaria, which, according to the World Health Organisation (WHO), is one of the six priority communicable diseases that affects about 300,000 Pakistanis annually, leaving about 50,000 of them dead.

Pakistan was hit by devastating floods in June last year, which resulted in over 33 million people being affected, 81 districts being declared as calamity-hit, and the health infrastructure taking a serious hit. The flood devastated Sindh and Balochistan in particular where health facilities are poor.

A rapid upsurge in reported malaria cases was observed after the floods. In Sindh, confirmed malaria cases last August reached 69,123 compared to 19,826 cases reported in the corres-ponding month in 2021. In Balochistan, 41,368 confirmed cases were reported in August last year compared to 22,032 in August 2021.

These two provinces together account for 78 per cent of all the reported confirmed cases of malaria in Pakistan in 2022. Reports from 62 high-burden districts indicate that additional 210,715 cases were reported in September 2022, which were more than the 178,657 cases reported in the districts in August 2022.

There are five parasite species that cause malaria in humans, of which two species pose the greatest threat to public health, namely plasmodium falciparum and plasmodium vivax. Both parasite species are reported in Pakistan, with plasmodium vivax representing the most predominant parasite (80pc).

In a recent survey by a non-profit organisation in Gharo, it was found that the prevalence of plasmodium falciparum was more common compared to that of plasmodium vivax, which is contrary to the prevalence trend in Pakistan. This is probably due to the drier season across Sindh.

The government should take active action to stop the spread of malaria. Provision of nets and mosquito repellents, especially for children and the elderly, are merely baseline essentials that need to be delivered without delay.

Besides, all general physicians should be trained to diagnose and treat malaria as well as offer preventive advice in their respective communities.

Dr Asghar Naqvi
Karachi

Published in Dawn, March 28th, 2023