Assumptions galore in malaria treatment: official

Many Bangladeshi doctors treat malaria basing their diagnosis on ‘assumptions’, a government health official said on Tuesday.

Prof Be-Nazir Ahmed, Director of Disease Control, advised the physicians to ‘test first to confirm the diagnosis’.

“Malaria tests are available in laboratories and even in some hospitals. Please don’t give treatment based on assumptions,” he told a press briefing in Dhaka.

The government will observe the World Malaria Day on Thursday.

The official made the comment as he said he had observed that many reported malaria cases were ‘not actually malaria’. “But they (patients) were given medicines (for malaria).”

“Recently a patient died in a Dhaka hospital doctors said of malaria. But when we tested the samples, it was not,” he said.

“Even in 2005 when newspapers citing doctors wrote 700 malaria patients were found in Dhaka, we tested only six positive. And they (the six patients) got it when they travelled malaria endemic zones.”

He said many doctors ‘jumped to conclusion’ when they came across a patient with ‘shivering fever’.

He said they were ‘cautious’ about the ‘judicious’ use of anti-malaria drugs amid evidence of increasing resistance to the latest choice of malaria treatment along the Thailand-Myanmar border.

The World Health Organisation recommends artemisinin-based combination therapies as the first-line of treatment that it says contributed substantially to the recent decline in malaria cases in many regions.

As malaria was a vector-borne disease, he said there must have been presence of the vector, mosquito, in the area concerned.

According to him, malaria is widespread in 13 districts of Bangladesh, with more than 80 percent cases being reported from the three hill districts of Rangamati, Khagrachhahri and Bandarban located in dense forested areas along the border with India.

The second largest number of cases are being reported from Cox's Bazar, Chittagong, Sunamganj, Moulvibazar, Sylhet, Habiganj, Netrakona, Mymensingh, Sherpur and Kurigram.

According to the government's malaria control programme, use of long-lasting special mosquito nets, indoor residual spraying, effective medicines and preventive treatment have brought down malaria fatalities in Bangladesh.

In 2012, they recorded only 11 deaths while the number was more than 500 even seven years back.

The number of cases also reduced to around 30,000 in 2012 from more than 60,000 three years ago.

Prof Be-Nazir said despite successes, they were facing challenges in hard-to-reach areas. “We are not getting skilled workforce in remote hilly areas. It is also a challenge to collaborate well with the private doctors and organisations in the remote endemic zones.”

He said they had plans to equip malaria treatment procedures with more facilities. Under the plan, they had selected 800 community clinics in 13 districts to be prepared by June with malaria treatment services.

The initiative will be launched on the World Malaria Day, to be observed with the theme ‘Invest in the Future: Defeat Malaria’.

The Ministry of Health and Family Welfare has allocated about $29.7 million until 2016 to fight malaria.

Prof Be-Nazir said there must be ‘continuation’ of investments.

“It’s not only financial but also physical and human investments to make the achievements sustainable.”