Question : TREATMENT OF MALARIA

(a) the objectives and salient features of the National Drug Policy on Malaria;

(b) whether the Government has conducted any study to ascertain the therapeutic efficiency of the Artemisininbased Combination Therapies (ACTs) for treatment of malaria in the country, if so,the details and the outcome thereof;

(c) the extent to which the said treatment has been effective and successful in treatment of malaria caused by plasmodium falciparum in the country;

(d) whether any case of development of resistance to the said drug has been reported in the country and, if so, the details thereof; and

(e) the fresh measures being taken by the Government to prevent the spread of malaria in the country?

THE MINISTER OF HEALTH AND FAMILY WELFARE (DR. HARSH VARDHAN)

(a): The National Drug Policy for Malaria (2013) has been formulated with following objectives:
# Reducing morbidity by prompt and complete treatment of suspected/confirmed malaria cases # Prevention of progression of uncomplicated malaria into severe malaria and thereby reduce malaria mortality # Prevention of relapses by administration of radical treatment # Preventing transmission of malaria by use of gametocytocidal drugs # Preventing development of drug resistance by rational treatment of malaria cases
Salient features of National Drug Policy for malaria are as under:
1. Treatment of uncomplicated P. falciparum cases :Complete course of three days Artemisinin based Combination Therapy (ACT) along with single dose of primaquine 0.75 mg/kg body weight on day 2.
2. Treatment of uncomplicated P. vivaxcases: Chloroquine – 10 mg/kg body weight on day 1 and day 2 and 5 mg/kg body weight on day 3. Primaquine- 0.25 mg/kg body weight for 14 days.
3. For severe malaria cases (both Pv and Pf) injectableartemisinin derivatives followed by full course of ACT.

(b) to (d): 15 sentinel sites have been identified for monitoring of therapeutic efficacy of anti malarials in the country for all anti malarials including ACT in collaboration with National Institute of Malaria Research. Three studies conducted in North Eastern States during 2012-13 and 2013-14 have shown late parasite clearance to ACT- Artesunate + Sulphadoxinepyrimethamine. Accordingly, the ACT- Artemether + Lumefantrineis being used in seven North Eastern States in place of ACT- Artemether + Sulphadoxinepyremethamine. At remaining 12 centres, ACT(Artesunate+ Sulphadoxinepyremethamine) in Pf cases as well as Chloroquine in Pvcases were found effective (cure rate nearly 100%).

(e): Recent measures taken by the Government of India to prevent the spread of malaria are as following :
1. Introduction of Bivalent rapid diagnostic kit for Malaria.
2. New artimisinin combination therapy for malaria in the North East Region.
3. Strengthening Inter sectoral coordination.
4. Incentives for ASHA for preparing blood slides, performing RDT test, providing complete treatment for RDT positive Pf cases and providing complete radical treatment to positive Pf and Pv case detected by blood slide has been revised.