KARACHI, March 25: Speakers at a seminar on Thursday stressed the need for strengthening the health sector to check the high incidence of malaria in cities and remote areas of the country.

Speakers maintained that it was high time to join hands to contain malaria, which ranked third among major infectious diseases, mainly afflicting children and pregnant women.

The seminar on "Malaria" was organized by the Dow University of Health Sciences at its auditorium. The vice-chancellor of the university, Prof Masood Hameed Khan, said that education of people and doctors and promotion of research activities could play an effective role in eradicating malaria.

WHO's operation officer for Sindh, Dr Ghulam Nabi Kazi, said malaria kills over one million people globally each year and a majority of the victims are children. With acute diseases, a child may die within 24 hours without promote and effective treatment.

Referring to the data available till 2002, he said that a maximum of 33,994 malaria cases were reported in Balochistan, followed by Sindh (22,011), NWFP (20,534) and Punjab (9,468).

Under the WHO's Roll-Back Malaria initiative, introduced in 1998, it is likely that malaria burden would be reduced by 50 per cent by 2010, he added. Talking about the targets of RBM initiative for Pakistan, he said that 43 high-risk districts had been selected on the basis of annual parasite incidence report of 2002 and the falciparum malaria cases ranged from 60 to 70 per cent. Sindh has also prepared a PC-1 of Rs 60 million in which all 16 districts of the province would be covered.

Prof Khalid Mahmood of DUHS said that malaria eradication programme was in full swing in 1958 and early success were observed in many countries of Europe, Asia and Latin America, but things could not move in right direction in tropical countries of Asia, South America and overall Africa.

He maintained that complacency and laxity in anti-malarial campaigns, conflicts and wars, migrations, deteriorating health systems and poverty, vector resistance to insecticides, parasite resistance to drugs, global warming were the main reasons behind the failure of malarial programme or resurgence of malaria.

He recalled a study undertaken during a period from August 2003 to December 2003 at Civil Hospital and said that multi-stage sampling and analysis of 154 patients resulted in 84 positive cases, including 74 of Falciparum malaria and vivax malaria cases.

He remarked that a complicated falciparum malaria should be diagnosed in time to reduce modalities and mortality. Dr Abdul Rauf Memon of DUHS discussed the efficacy of different drugs and also highlighted the combination treatment of two types of Malaria, ie the Vivax and Falciparum. He said cost of treatment and availability of medicines were factors posing hindrance in the treatment of severe malaria in Sindh.

He said that chloroquine was still the first line treatment for vivax malaria, followed by full course of primaquine to achieve radical cure. He expressed the view that presumptive treatment needed to be started immediately on clinical suspicion.

Dr Shaheen Bhatti, the senior registrar of the Department of Medicine, DUHS, discussed the methods of prevention and control of malaria and stressed for promotion of personal protection measures against mosquito-bite, including maintenance houses in good and hygienic condition, prevention of stagnation of water, netting of house and use of insecticide treated bed-nets, use of mosquito repellent lotion, creams, mats and coils.

She also suggested administration of anti-malarial medicines to persons visiting from non-endemic areas, persons from Pakistan visiting hyper endemic Africa. Relevant medicines could also be given in intermittent doses to pregnant women in the second and third trimester, she remarked.

The speakers, however, could not update the participants, mostly medical professionals and medicos, about the number of malaria cases reported in the country or Sindh province every year.

At the outset of the seminar, government was urged to ensure measures to increase public awareness through print and electronic media, specially during out-breaks. It was also proposed that government should promote research activities by adequate funding.

The seminar also took notice of non-availability of relevant drugs and recommended to the government for easy availability of drugs, like Primaquine, Quinine, Mefloquine and Malarone at all health care facilities across the country.

Provision of microscopic diagnostic facilities at all levels and measures to control vector by insecticide spray in targeted areas on regular basis were also proposed by the seminar.