Battling the malaria iceberg with chloroquine in India

The National Vector Borne Disease Control Programme (NVBDCP) of the Ministry of Health, Government of India is reporting about 2 million parasite positive cases each year, although case incidence is 30-fold or more under-estimated. Forty five to fifty percent of Plasmodium infections are caused by P...

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Bibliographic Details
Published inMalaria journal Vol. 6; no. 1; p. 105
Main Author Sharma, Vinod P
Format Journal Article
LanguageEnglish
Published England BioMed Central Ltd 07.08.2007
BioMed Central
BMC
Subjects
Antimalarials - therapeutic use
Artemisinins - therapeutic use
Chloroquine
Chloroquine - therapeutic use
Delivery of Health Care
Dosage and administration
Drug Combinations
Drug Resistance
Evaluation
Humans
India - epidemiology
Malaria
Malaria - diagnosis
Malaria - drug therapy
Malaria - economics
Malaria - epidemiology
Prevention
Preventive Health Services
Pyrimethamine - therapeutic use
Sesquiterpenes - therapeutic use
Socioeconomic Factors
Sulfadoxine - therapeutic use
Time Factors
India
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Summary:The National Vector Borne Disease Control Programme (NVBDCP) of the Ministry of Health, Government of India is reporting about 2 million parasite positive cases each year, although case incidence is 30-fold or more under-estimated. Forty five to fifty percent of Plasmodium infections are caused by Plasmodium falciparum, the killer parasite. Anti-malaria drug policy (2007) of the NVBDC recommends chloroquine (CQ) as the first line of drug for the treatment of all malarias. In a Primary Health Centre (PHC) reporting 10% or more cases of CQ resistance in P. falciparum, ACT blister pack is recommended and, so far, the policy has been adopted in 261 PHCs of 71 districts. The NVBDCP still depends on CQ to combat malaria and, as a result, P. falciparum has taken deep roots in malaria-endemic regions, causing unacceptable levels of morbidity and mortality. This policy was a subject of criticism in recent Nature and Lancet articles questioning the World Bank's decision to supply CQ to the NVBDCP. Continuation of an outdated drug in the treatment of P. falciparum is counterproductive in fighting drug resistant malaria and in the containment of P. falciparum. Switchover to Artemisinin-based Combination Therapy (ACT) in the treatment of all P. falciparum cases, ban on artemisinin monotherapy and effective vector control (treated nets/efficient insecticide spraying) would be a rational approach to malaria control in India.
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ISSN:1475-2875
1475-2875
DOI:10.1186/1475-2875-6-105