感染症と治療ジャーナル

抽象的な

Operational Efficiency of Urban Malaria Scheme in a District of Central Gujarat, India: An Evaluation Study

Shobha Misra, Kalpita Shringarpure, Parag Chavda and Dipak Solanki

Background: Improving the efficiency of the Malaria control program can help combat malaria in urban areas, which still remains a major public health problem in India, affecting all spheres of human life.

Methodology: Assessment of the overall functioning of Urban Malaria Scheme run by Municipal Corporation (MC) in a district of Central Gujarat, India, was carried out over 8 months (November 2011 to June 2012) using a semi-structured instrument by observation, inspection, record review of blood smear examination and target examination rates and interviews of laboratory technicians (LT) and pharmacists. Two slide-positive individuals from each clinic and one community leader from each ward was interviewed regarding the functioning of malaria clinics.

Results: Diagnosis and treatment facilities for malaria provided in 13 corporation dispensaries were observed. Though manpower was adequate, there was lack of active surveillance in the urban areas. The basic infrastructure facilities were inadequate in half of the dispensaries and facilities for Blood Slide Collection (BSC) and staining were found to be very poor. Majority of the dispensaries did not have any idea about the blood examination rate targets and the new treatment guidelines for malaria had not reached the clinics till the time of visits. Radical treatment (RT) was found to be inadequate and unsupervised. Half of the community leaders were unaware about the availability of diagnostic facility for malaria at these dispensaries and had inadequate information about availability RT.

Recommendations: The vacant posts of LT need to be filled up at the earliest; the laboratory dispensaries to be equipped with adequate space, basic infrastructure facilities, adequate logistics and supplies for Blood Slide Examination (BSE) need to be looked into. Attention needs to be paid to follow the active surveillance activities in cities, following monthly targets distributing new malaria treatment guidelines and ensuring adequate and supervised RT.