Experts pick holes in Pb malaria surveillance net

CHANDIGARH: An evaluation of malaria surveillance in Punjab carried out by a team of experts has found the state wanting in most parameters.
Among the seven parameters on which the system was assessed, overall score for representativeness and stability was found to be poor while the state received average scores for simplicity, acceptability, data quality, and timeliness, suggesting a moderate performance in these areas.
The existing system, however, performed well in flexibility, demonstrating an ability to adapt to changing circumstances.
Experts from the National Centre for Disease Control in Delhi, PGIMER in Chandigarh, South Asia Field Epidemiology and Technology Network at NCDC in Delhi, and the department of health and family welfare in Punjab conducted the evaluation of malaria surveillance system in Punjab with an objective to offer recommendations for reinforcing the current system and addressing the shortcomings that hindering the state’s progress towards becoming malaria free.
The assessment was carried during July and August 2020 and the trend of 2009-2019 malaria cases examined. Among the health officials and workers interviewed were two district epidemiologists, two medical officers, five assistant malaria officers, 12 multipurpose health supervisors, six multipurpose health workers, four multipurpose health workers, five lab technicians, two insect collectors and four accredited social health activists.
Two districts were selected according to the annual parasite incidence (API) — Amritsar with the lowest API and Mansa with the highest API. Two community health centres from rural areas, one primary health centre, one sub-centre and one village from each district were picked randomly
The findings have been published in the latest edition of the Indian Journal of Community Medicine. It was found that the data received at the state headquarters was of good quality in terms of reporting. However, at the district and lower levels, half of the reporting formats examined were found incomplete, especially in Amritsar. The acceptability of the surveillance system at the health facility level was found to be poor. A comparison between the out-patient department data and surveillance data revealed that 31% of fever cases — 49% in Amritsar and 14% in Mansa — were not investigated for malaria at the health facility level.
Reports received at the state and district headquarters showed that all fever cases were investigated for malaria, raising concerns about the authenticity and accuracy of these reports. Although the surveillance system was excellent at reporting malaria cases within 24 hours of blood slide examination, the epidemiological investigation in terms of active case search in the community and entomological investigation, was very poor, in Mansa.