KARACHI, March 18: Pakistan being an endemic zone for malaria registers an estimated 50,000 deaths every year with victims pertaining to all age groups. The unfortunate demise of a senior medical researcher, Dr Sarwar Jehan Zubeiri, on Wednesday was reportedly due to malaria falciparum, which she had developed.
Health experts while talking to APP on Thursday said that there was an urgent need on part of the government to reassess the growing incidence of the disease across the country.
They regretted that the concerned civic agencies had been failed to combat malaria despite easy availability of simple and cost-effective measures. Pools of standing and stagnant water, a safe sanctuary for mosquitoes, even in the metropolis was of common sight, they said.
The doctors also drew attention towards blatant neglect on part of major health care institutions. It was mentioned that a vast majority of blood banks operating within public as well as private sectors while boosting the provision for HIV and hepatitis screening facilities was found to have little consideration towards malaria screening kits.
Dr Imtiaz A. Siddiqui regretted indifference of the citizens themselves towards the poor civic conditions. "Instead of waiting for anti-malarial campaign, citizens can sprinkle kerosene or even discarded mobil oil over the pools of stagnant water," he said.
He said that the growing resistance among locals against the WHO recommended drugs commonly known as Fansidar was the most alarming aspect of the ailment. Around 33 per cent resistance to chloroquine and 31 per cent to sulphadoxine or pyremethamine had been registered in the country during the last few years, he added.
Physicians also attributed the situation to non-compliance to recommended drug therapy and its due course on part of patients. The first line drugs must necessarily be taken for at least three days, they said.
It was owing to the very deviation that resistance was witnessed against conventional drugs further leading to sudden surge in the incidence of falciparum malaria against vivax, they pointed out. The physicians said that malaria was also observed to be predisposing individuals to severe malnutrition.
Non-availability of diagnostic kits used to restrict a large majority of local doctors to conventional methods often delaying diagnosis. The situation commonly affected children suffering from malaria being brought to hospital often in serious condition, said Dr Jamal Raza of the National Institute of Child Health.
Hospital-based data reveals that children were generally inflicted with falciparum malaria against the vivax, commonly observed some time back. Fever, anaemia, hepatosplenomegaly, cerebral malaria, jaundice and acute renal failure were the common presentations of severe falciparum malaria cases reported at paediatric wards of the government hospitals in Sindh.
Dr Mobina Agboatwala of paediatrics department, Civil Hospital, mentioned that the data could not be considered generalized, as only the serious cases were referred to hospitals and no community-based study was available.
Dr Jamal Raza drew attention towards consistent surge in the incidence of cerebral malaria among children being brought from Thatta belt in particular as well as from other areas.
The paediatricians associated with the Civil Hospital seconded him and reminded of the cases referred to them from various parts of Sindh and Balochistan. They said that the most commonly affected age group fell between one and six years.
Dr Imtiaz A. Siddiqui stressed that any fever extending beyond one week and not responding to conventional anti-malarial must be suspected for resistant malaria. According to him, timely referral to large hospitals could save many lives. - APP