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Evaluation of malaria control programme in three selected districts of Assam, India

Keywords: ASHA , evaluvation , IEC , IRS , insecticide coverage , RDKs

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Abstract:

Background & objectives: To ensure that the activities of Malaria Control Programme were takingplace in effective and judicious manner, an intensive monitoring and supervision of various activitiesof the programme were carried out in Karbi-Anglong, Cachar and Nagaon districts of Assam,India during July–October 2007.Methods: Questionnaire-based protocol prepared by the National Vector Borne Disease ControlProgramme was used to evaluate the activities. Sixteen villages belonging to five different PrimaryHealth Centres (PHCs) of three districts were selected for investigations.Results: Results of monitoring of indoor residual spraying (IRS) revealed inadequate sprayingcoverage. Although recorded to be about 69–99%, but apparently it was 17–43% in the districtsinvestigated. Cross-examination of 180 blood smears (90 positive and negative each) in thelaboratories of the study PHCs, revealed discrepancy in the results of 67 blood smears. Maximum(44%) discrepancy was observed in positive blood smears and 30% in negative blood smears. Outof 22 Accredited Social Health Activists (ASHA) interrogated, none was found involved inantimalaria activities. However, out of 13 fever treatment depots monitored, one was found partiallyfunctional. Criteria laid down for preparation of micro action plan were not followed properly inany of the districts sruveyed. Various important components of the programme like constitution ofVillage Health Sanitation Committee, information education communication (IEC) activities,capacity building, use of larvivorous fishes, supervision, etc. were not exercised properly. However,100% community acceptance was recorded for insecticide-treated bed nets in the villages surveyed.Indiscriminate use of rapid diagnostic test kits yielded poor and unsatisfactory response. Decliningtrend of malaria was observed during 2002–06 in Districts Nagaon and Karbi-Anglong (up to2005). In District Cachar, however, a little increasing trend was observed during 2002–04.Conclusion: The results of this investigation revealed that the malaria control programme hadbeen jeopardized seriously due to improper implementation of vector control measures, lack ofadequate professional support and varied commitment on the part of the State Government. It canbe concluded that long-term malaria control strategy should be based on generation of increasedawareness on the disease and various methods of its control, health care access and administrativecommitment for increased prosperity in resource-poor settings. The observation also necessitatesfurther in-depth evaluation with ap

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