NIMR Field Unit

Rourkela, India

NIMR Field Unit

Rourkela, India
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Singh R.K.,SRO | Dhiman R.C.,SRO | Das M.K.,NIMR Field Unit
Journal of Communicable Diseases | Year: 2011

The epidemiological and entomological investigations were carried out in 18 tribal villages of Godda district of Jharkhand state revealed average slide positivity rate (SPR) 9.9% and slide positivity rate for Plasmodium falciparum (SfR) 5.0%, respectively. P. falciparum was the dominant parasite accounting 51.2 per cent of the total infections. All the villages are situated in the deep forest and forest fringes. A total of 416 blood slides were collected and examined. Out of which 41 slides were found positive for malaria parasite (21 positive for P. falciparum and 20 positive for P. vivax). All the positive cases were treated with Blister Packs of anti-malarial of chloroquine and primaquine as per NBVDCP schedule to prevent further transmission of malaria, which were available. Rapid diagnostic Kits were used selectively only on the recommendation of the Physician/Medical Officer. Results of house to house fever survey indicated the presence of high percentage of symptomatic carriers of malaria parasites in the local population and in our study Pf % is more than reported data by District Malaria Office, Godda district, Jharkhand. In entomological studies, for mosquito fauna with reference to both Anopheline, 11 species belonging to one genus Anopheles were collected and identified during the survey; among them some species were most prevalent. A total of 599 mosquitoes were recorded and average density of mosquitoes recorded was 13.19 in human dwellings and 86.11 in cattle sheds.

Anvikar A.R.,National Institute of Malaria Research ICMR | Sharma B.,Drugs for Neglected Diseases initiative | Sharma S.K.,NIMR Field Unit | Ghosh S.K.,NIMR Field Unit | And 6 more authors.
Indian Journal of Medical Research | Year: 2012

Background & objectives: In vitro assays are an important tool to assess baseline sensitivity and monitor the drug response of Plasmodium falciparum over time and place and, therefore, can provide background information for the development and evaluation of drug policies. This study was aimed at determining the in vitro sensitivity of P. falciparum isolates to antimalarials. Methods: The in vitro activity of 108 P. falciparum isolates obtained from five States of India was evaluated using WHO microtest (Mark III) to chloroquine, monodesethylamodiaquine, dihydroartesunate and mefoquine. Samples were collected from the States of Orissa, Jharkhand, Karnataka, Goa and Chhattisgarh from September 2007 to August 2009. In addition, representative samples from different States of India cryopreserved and culture adapted in the Malaria Parasite Bank of National Institute of Malaria Research, New Delhi, were also evaluated. Results: The proportion of isolates resistant to chloroquine and monodesethylamodiaquine was 44.4 and 25 per cent, respectively. Of the 27 isolates resistant to monodesethylamodiaquine, 16 (59.3%) were cross-resistant to chloroquine. No isolate showed resistance to dihydroartesunate and mefoquine. Isolates from Orissa showed the highest degree of resistance to chloroquine and amodiaquine followed by Jharkhand. Forty two isolates were genotyped for pfcrt T76K chloroquine resistant mutation; mutations were seen in 38 (90.47%) isolates. Interpretation & conclusions: The Indian P. falciparum isolates showed a high degree of resistance to chloroquine followed by monodesethylamodiaquine. No resistance was recorded to mefoquine and dihydroartesunate.

Singh R.K.,National Institute of Malaria Research ICMR | Das M.K.,NIMR Field Unit | Dhiman R.C.,National Institute of Malaria Research ICMR | Mittal P.K.,National Institute of Malaria Research ICMR | And 2 more authors.
Journal of Communicable Diseases | Year: 2012

The study was carried out for evaluation of various activities of malaria control programme in five different tribal and malaria endemic Primary Health Centres of Dumka district (Jharkhand) during 2007-08. A total of 321 houses of 18 villages were surveyed on use of indoor residual spray (IRS) and insecticide-treated bed nets (ITN) and other activities as tool for vector control and interrupting the transmission of malaria. Out of 690 living rooms and 343 verandahs examined, IRS with Dichlorodiphenyl-trichloro-ethane (DDT) was done only in 16.23% living rooms and 64.72% verandahs. Refusal rate of IRS in living rooms was 81.93% due to lack of knowledge regarding the importance of IRS, no prior information to villagers, houses locked, reluctance to remove domestic articles, dislike of smell of DDT spray. Compliance rate of ITN uses was 71.66% during the night, which might be a factor for decline in malaria cases in the study area. Various important components of the programme, viz. surveillance and compliance to treatment activities, use of rapid diagnostic test kits (RDKs), involvement of accredited social health activist (ASHA's) and fever treatment depots (FTDs), laboratory activities, adult mosquito collection, other activities like constitution of village health sanitation committee, information education and communication activities, capacity building, use of larvivorous fishes, supervision of IRS etc. require much strengthening. However, 100% community acceptance was recorded for ITN in the villages surveyed. In addition, an entomological study was carried out for information on prevalence of mosquito species in this area to find out effectiveness of IRS activities. Eleven anopheline species, including three malaria vectors i.e., An. culicifacies, An. stephensi, An. fluviatilis, An. annularis, An. subpictus, An. nigerrimus, An. pallidus, An. aconitus, An. vagus, An. jamsii and An. splendidus were collected from cattle and human dwellings.

Mishra N.,National Institute of Malaria Research NIMR | Anvikar A.R.,National Institute of Malaria Research NIMR | Shah N.K.,National Institute of Malaria Research NIMR | Kamal V.,National Institute of Malaria Research NIMR | And 9 more authors.
Malaria Journal | Year: 2011

Background: The World Health Organization has urged all member states to deploy artemisinin-based combination therapy and progressively withdraw oral artemisinin monotherapies from the market due to their high recrudescence rates and to reduce the risk of drug resistance. Prescription practices by physicians and the availability of oral artemisinin monotherapies with pharmacists directly affect the pattern of their use. Thus, treatment practices for malaria, with special reference to artemisinin monotherapy prescription, in selected states of India were evaluated. Methods. Structured, tested questionnaires were used to conduct convenience surveys of physicians and pharmacists in eleven purposively selected districts across six states in 2008. In addition, exit interviews of patients with a diagnosis of uncomplicated malaria or a prescription for an anti-malarial drug were also performed. Logistic regression was used to determine patient clinical care, and institutional factors associated with artemisinin monotherapy prescription. Results: Five hundred and eleven physicians from 196 health facilities, 530 pharmacists, and 1, 832 patients were interviewed. Artemisinin monotherapy was available in 72.6% of pharmacies and was prescribed by physicians for uncomplicated malaria in all study states. Exit interviews among patients confirmed the high rate of use of artemisinin monotherapy with 14.8% receiving such a prescription. Case management, i.e. method of diagnosis and overall treatment, varied by state and public or private sector. Treatment in the private sector (OR 8.0, 95%CI: 3.8, 17) was the strongest predictor of artemisinin monotherapy prescription when accounting for other factors. Use of the combination therapy recommended by the national drug policy, artesunate + sulphadoxine-pyrimethamine, was minimal (4.9%), with the exception of one state. Conclusions: Artemisinin monotherapy use was widespread across India in 2008. The accessible sale of oral artemisinin monotherapy in retail market and an inadequate supply of recommended drugs in the public sector health facilities promoted its prescription. This study resulted in notifications to all state drug controllers in India to withdraw the oral artemisinin formulations from the market. In 2010, artesunate + sulphadoxine-pyrimethamine became the universal first-line treatment for confirmed Plasmodium falciparum malaria and was deployed at full scale. © 2011 Mishra et al; licensee BioMed Central Ltd.

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