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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 only Wednesday was reportedly due to Malaria Falciparum which she developed followed a blood transfusion is definitely a cause of serious alarm.
It makes necessary an urgent reassessment of the scenario across the country, stressed the physicians interviewed by APP on Thursday.
They not only regretted failure of concerned civic agencies to combat malaria, despite easy availability of simple and cost effective measures, but also drew attention towards blatant neglect on part of major health care institutions themselves.
It was mentioned that vast majority of blood banks operating, within public as well as private sectors, while boosting the provision for HIV and Hepatitis screening facilities available with them are found to have little consideration towards malaria screening kits.
This is despite the fact that country is placed among Malaria Endemic Zone and concerned departments appear to be simply helpless to prevent the scenario. On the contrary pools of standing and stagnant water, a safe sanctuary for mosquitoes, even in a metropolitan city is of common sight.
Dr Imtiaz A Siddiqui regretted indifference of the citizens themselves towards poor civic conditions. "Instead of waiting for anti-malarial campaign or aerial spray citizens themselves can at least sprinkle kerosene or even discarded Mobil oil over these pools," he observed.
However, what appeared to be the most alarming aspect of the ailment was the growing resistance among locals against the WHO recommended first line of drugs comprising chloroquine phosphate, bezoquine and pyramithaminine/sulphadoxine, a compound drug commonly known as Fansidar.
33 percent resistance to chloroquine and 31 percent to sulpha doxine/pyremethamine has been registered in Pakistan during recent years.
Physicians attribute 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.
It is owing to the very deviation that resistance is witnessed against conventional drugs further leading to sudden surge in the incidence of Falciparum Malaria against Yivax commonly witnessed till some time back.
Malaria is also observed to be predisposing individuals to severe malnutrition. Meanwhile, non-availability of diagnostic kits also continue to restrict large majority of local doctors to conventional methods often delaying in time diagnosis.
Dr Mobina Agboatwala, Paediatrics Department, Civil Hospital Karachi, mentioning that 'the data can not be considered generalised as no reliable community based study is available also referred to the fact that only serious cases are referred to hospitals.
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.
Paediatricians associated with Civil Hospital, Karachi seconded him and reminded of cases referred to them from Balochistan as well as other parts of Sindh.
The main presentations were fever, anaemia, etc. These were followed with congestive cardiac failure, jaundice, acute renal failure, febrile fits, gastroenteritis, etc.
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.

Copyright Associated Press of Pakistan, 2004

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