PART I EXTRAORDINARY
HEALTH, MEDICAL & FAMILY WELFARE
DEPARTMENT
(B2)
MALARIA ELIMINATION - NOTIFICATION OF MALARIA CASES.
[G.O.Ms.No. 36, Health, Medical & Family Welfare (B2), 11th April, 2018.]
NOTIFICATION
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.
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.
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.
[ 1 ]
Registered No. HSE-49/2016
No.296
AMARAVATI, MONDAY , APRIL 16, 2018
G.55
NOTIFICATIONS BY GOVERNMENT
--x--
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.
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.
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.
2
ANDHRA PRADESH GAZETTE EXTRAORDINARY
[Part-I
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.
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.
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.
April 16, 2018]
ANDHRA PRADESH GAZETTE EXTRAORDINARY
3
•
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.
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.
A patient can be declared positive for malaria by prompt quality assured
diagnostic testing through quality assured bRDTs or quality microscopy.
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.
POONAM MALAKONDAIAH,
Principal Secretary to Government.
---x---
Published and Uploaded by the Commissioner of Printing, Government of Andhra Pradesh at
Government Regional Press, Vijayawada, www.apegazette.cgg.gov.in
4
ANDHRA PRADESH GAZETTE EXTRAORDINARY
[Part-I