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TOPIC: General studies 2 and 3
- Public Health issues
- Science and technology: medical research
In News: With the monsoon setting in after delay of a fortnight from the expected date, there has been a spurt in vector-borne diseases such as malaria, dengue, and chikungunya, which could be life-threatening in some cases and entails huge expenses for treatment.
Vector borne diseases (VBDs) form a major part of the communicable diseases in India. Ignorance and impoverished conditions of people contribute in creating source and spread of vector borne diseases and hinder disease control strategy. Slums are more vulnerable to vector borne diseases because of poor environmental condition, standard of living, poverty and ignorance of the people.
What are Vectors: Living organisms that can transmit infectious diseases between humans or from animals to humans (ticks, flies, sandflies, fleas, triatomine bugs and some freshwater aquatic snails)
Methods for controlling mosquito breeding
Disease management
Case Study: Odisha
From 4,36,850 malaria cases reported in 2015, Odisha had 66,301 cases reported in 2018, an 85-per cent reduction, giving the eastern coastal state the honour of reporting the highest reduction in malaria cases across the country, according to data from the Health Ministry’s National Vector Borne Disease Control Programme.
Surveying the period between March 2015 and March 2019, this year’s Economic Survey also stated that “malaria cases improved significantly…after implementation of Swachh Bharat Mission (SBM)” – Odisha brought about the highest reduction in malaria cases among children below five years but also notes that “major focus of SBM has been on making villages Open Defecation Free (ODF)”.
How it was achieved
Flip side of success: While successful test helps an ASHA get Rs 75, just testing, and achieving a negative result, fetches her only Rs 15 per case. As negative cases rise, malaria supervisors in Odisha worry whether the lower pay will demotivate ASHAs to work with equal fervour — or, worse, whether false cases will be reported to game the payment structure. Nine ASHAs in different low-endemic districts admitted that as negative tests keep increasing, the associated lower payment is a disincentive for them to continue testing each case of fever for potential malaria.
The new malaria vaccine
The vaccine (in Malawi) has taken three decades to come to fruition, and is the first one ever against a disease that kills 4,35,000 people a year, most of them children. India ranks high in the list of countries worst affected by the mosquito-borne disease.
The vaccine has been developed by GSK — the company is donating about 10 million doses of the product for the pilot. It was created in 1987 by GSK, and was subsequently developed with support from the Bill and Melinda Gates Foundation. In 2014, the vaccine cleared phase III clinical trials which certified that it was both effective and safe for use in humans. According to a description from PATH’s Malaria Vaccine Initiative (MVI), “RTS,S aims to trigger the immune system to defend against the first stages of malaria when the Plasmodium falciparum parasite enters the human host’s bloodstream through a mosquito bite and infects liver cells. The vaccine is designed to prevent the parasite from infecting the liver, where it can mature, multiply, re-enter the bloodstream, and infect red blood cells, which can lead to disease symptoms”.
PATH is an international nonprofit team of innovators which advises and partners with public institutions, businesses, grassroots groups, and investors to tackle the world’s toughest global health problems, including malaria. MVI works with various stakeholders towards the development of a malaria vaccine.
In Phase 3 trials conducted in Africa between 2009 and 2014, children received four doses of RTS,S. The vaccine prevented four in 10 cases of clinical malaria; three in 10 cases of severe malaria; and six in 10 cases of severe malaria anaemia, the most common reason children die from malaria. There were reductions in overall hospital admissions and the need for blood transfusions.
The Way Forward
Synergy: In high-burden regions, there is a need for Government’s ASHA or community health workers, who are equipped with rapid diagnostic kits, to quickly test and facilitate treatment.
Negating drug resistance: The above is important to ensure that medicines are given only to those who need it. Resistance to a drug develops when people are treated randomly or when those taking the drug do not complete its full course.
Tackling under-reporting: data about people being treated in private hospitals may not be getting captured. If the Government mandated that the private sector report its malaria cases to them (as is with TB), that would be “powerful”.
Proactive surveillance system: There is a need to keep looking as to where the first cases emerge from and report them immediately. All clinics and hospitals, both government and private, should be able to inform the authorities immediately, when there are suspected cases of dengue or chikungunya.
Rapid response emergency vector control: With a focus on eradicating breeding places, prompt action should be taken to spray and fog suspected breeding grounds.
An awareness campaign to ensure that patients seek early hospitalization during an epidemic: When dengue and chikungunya cases start appearing, people need to be aware of what they should do at the first signs, such as seeking treatment from proper hospitals with facilities for blood tests.
Health personnel training: Health personnel should be given continuous training in the management and monitoring of dengue patients.
There is a greater need to tailoring strategies not just State by State but in some cases district by district to end the disease. It is also high time that a collective demand for timely provision of amenities is made at the community level and a sense of shared responsibility by the citizenry to ensure that the gains from government’s efforts to reduce the incidence of vector-borne diseases bear fruit.
Note:
Why is malaria such a major global public health challenge?
Rift Valley fever: Rift Valley fever (RVF) is an acute, fever-causing viral disease most commonly observed in domesticated animals (such as cattle, buffalo, sheep, goats, and camels), with the ability to infect and cause illness in humans.
‘MERA India’ to eliminate malaria by 2030: By The Indian Council of Medical Research – – a conglomeration of partners working on malaria control – in order to prioritise, plan and scale up research to eliminate the disease from India by 2030.
New paper-based test kit for Malaria Detection: A group of researchers from IIT Guwahati has developed a simple detection method that uses an instrument when in the lab or a piece of chromatographic paper when in the field.
Paper Test Kit for Malaria
Working mechanism
Connecting the Dots:
Which of the above options is/are correct?
Figure out:
Solution of qn 2: d. All of the above