scholarly journals Assessment of ASHA for knowledge, diagnosis and treatment on malaria in Mandla district of Madhya Pradesh as part of the malaria elimination demonstration project

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Harsh Rajvanshi ◽  
Kalyan B. Saha ◽  
Man Mohan Shukla ◽  
Sekh Nisar ◽  
Himanshu Jayswar ◽  
...  
Keyword(s):  
Malaria Elimination ◽  
Care Delivery ◽  
Malaria Diagnosis ◽  
Cross Sectional Study ◽  
Madhya Pradesh ◽  
Demonstration Project ◽  
Diagnosis And Treatment ◽  
Cross Sectional ◽  
Elimination Programme ◽  
Delivery Services

Abstract Background The role of Accredited Social Health Activist (ASHA) in the health care delivery services at the periphery level is crucial for achieving disease prevention, control and elimination goals. The objective of the study was to assess the knowledge, attitude, practices, priorities and capability of ASHA related to malaria diagnosis and treatment as part of the Malaria Elimination Demonstration Project in 1233 villages of district Mandla, Madhya Pradesh. Methods A cross sectional study was conducted using a fully structured, pre-tested interview schedule during June and July 2017 (before the field operations of MEDP were started). Two hundred twenty (17%) of the total ASHAs were selected for the interview from the 9 developmental blocks of Mandla district. Results Knowledge, Attitude and Practices (KAP) study revealed that most ASHAs knew that mosquitoes are the main agent for spread of malaria (97.7%). They mostly used Rapid Diagnostic Test (RDT) for diagnosis (91.8%). The majority (87.3%) correctly identified negative RDT result while only 15% and 10.5%, respectively, identified Plasmodium vivax and Plasmodium falciparum positive cases correctly. Further analysis showed that 85% ASHAs used chloroquine, 44.5% used artemisinin-based combination therapy (ACT), and 55.5% used primaquine for treatment of malaria. It was also found that only 38.2% ASHA gave PQ for 14 days in cases of P. vivax. At the time of the interview, 19.1% ASHAs did not have any RDTs for diagnosis and 47.7% reported not having ACT for treatment of P. falciparum malaria. Conclusions This study has revealed that ASHAs in the test district were not adequately trained or stocked for malaria parasite species identification and treatment, which are the major components of malaria elimination programme. This study has, therefore, revealed a need for training ASHAs on testing by RDT and proper treatment regimen for P. vivax and P. falciparum.

scholarly journals The Determinants of Delayed Diagnosis and Treatment Among Malaria Patients in Myanmar: A Cross-Sectional Study

2019 ◽  
Vol 12 (1) ◽  
pp. 78-85
Author(s):  
Myo Min Than ◽  
Myo Min ◽  
Pyae Linn Aung
Keyword(s):  
Social Support ◽  
Sex Education ◽  
Delayed Diagnosis ◽  
Malaria Diagnosis ◽  
Cross Sectional Study ◽  
Diagnosis And Treatment ◽  
Sectional Study ◽  
Health Seeking ◽  
Chi Square ◽  
Cross Sectional

Background: This cross-sectional study was conducted to assess the determining factors for delayed diagnosis and treatment among malaria patients in Myanmar. Methods: The sample comprised 220 respondents diagnosed with malaria last year, living in the upper, middle, and lower part of Myanmar. In 2017, data were collected through interviews and analyzed using percentage, mean, standard deviation, and the chi-square test. Results: The results affirmed that most of the respondents were in the working age group and of low educational level. They also had poor knowledge and perception of malaria, and more than half of the respondents visited health centers or volunteered for their first treatment of choice. Most respondents received little social support for malaria. There were significant associations between age, sex, education, marital status, occupation, and delayed diagnosis and treatment (p < 0.05). Knowledge and perceptions of malaria, health-seeking behavior, and low social support on malaria services were also significantly associated with delayed malaria diagnosis and treatment (p < 0.05). Conclusion: According to the findings, appropriate strengthening of cooperation and collaborations among different sectors upon diagnosis, coverage of treatment services, interventions to increase community awareness, effective communication, behavioral changes, and improved capability of the village health volunteers are evidently needed.

scholarly journals Occupational Risk: Needle-Stick Injuries and Its Determinants Among the Healthcare Workers

2018 ◽  
Vol 5 (1) ◽  
pp. 45-48
Author(s):  
Madhusudan Ghimire ◽  
Achala Sharma ◽  
Anuj Poudel ◽  
Moushami Ghimire
Keyword(s):  
Health Care ◽  
Healthcare Workers ◽  
Health Workers ◽  
Care Delivery ◽  
Cross Sectional Study ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Needle Stick ◽  
Delivery Services ◽  
Needle Stick Injuries

INTRODUCTION: Needle-stick injuries are common problems among the healthcare workers; it might impact significantly on workers' health and health care delivery services. Sometimes small pinch of infected needle or sharp instrument may lead to big threat in their life and it may go into mortal outcomes.OBJECTIVE: To explore prevalence of needle-stick injuries and its determinants among the healthcare workers in Banke, Pyuthan and Palpa district of Nepal.MATERIALS & METHODS: A cross-sectional study was undertaken in 2015 and that focused on needle-stick injuries and its determinants. Data were collected by using an unstructured pre tested questionnaire from 359 healthcare workers. SPSS-21 windows process was used to analyze the information. RESULTS: Three hundred fifty-nine health care workers: Doctors (23.70%), Allied health workers (37.60%), Nurses (31.80%), and Laboratory staffs (7.00%) were involved in the study. The mean age of health workers was 32.75 ± 10.478 years. 37.60% of total healthcare workers had needle stick injuries.CONCLUSION: The prevalence of needle-stick injuries was associated strongly with age of healthcare workers, depression, social problems and alcohol consumer and, practice of sleepJournal of Universal College of Medical Sciences (2017) Vol.05 No.01 Issue 15, page : 45-48

scholarly journals A model for malaria elimination based on learnings from the Malaria Elimination Demonstration Project, Mandla district, Madhya Pradesh

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Harsh Rajvanshi ◽  
Praveen K. Bharti ◽  
Sekh Nisar ◽  
Himanshu Jayswar ◽  
Ashok K. Mishra ◽  
...  
Keyword(s):  
Case Management ◽  
Vector Control ◽  
Capacity Building ◽  
Malaria Elimination ◽  
Lessons Learned ◽  
Madhya Pradesh ◽  
Demonstration Project ◽  
Bed Nets ◽  
Field Staff ◽  
Pharmaceutical Industries

Abstract Background Malaria Elimination Demonstration Project (MEDP) was started as a Public-Private-Partnership between the Indian Council of Medical Research through National Institute of Research in Tribal Health, Govt. of Madhya Pradesh and Foundation of Disease Elimination and Control of India, which is a Corporate Social Responsibility (CSR) initiative of the Sun Pharmaceutical Industries Limited. The project’s goal was to demonstrate that malaria can be eliminated from a high malaria endemic district along with prevention of re-establishment of malaria and to develop a model for malaria elimination using the lessons learned and knowledge acquired from the demonstration project. Methods The project employed tested protocols of robust surveillance, case management, vector control, and capacity building through continuous evaluation and training.  The model was developed using the learnings from the operational plan, surveillance and case management, monitoring and feedback, entomological investigations and vector control, IEC and capacity building, supply chain management, mobile application (SOCH), and independent reviews of MEDP. Results The MEDP has been operational since April 2017 with field operations from August 2017, and has observed: (1) reduction in indigenous cases of malaria by about 91 %; (2) need for training and capacity building of field staff for diagnosis and treatment of malaria; (3) need for improvement insecticide spraying and for distribution and usage of bed-nets; (4) need for robust surveillance system that captures and documents information on febrile cases, RDT positive individuals, and treatments provided; (5) need for effective supervision of field staff based on advance tour plan; (6) accountability and controls from the highest level to field workers; and (7) need for context-specific IEC. Conclusions Malaria elimination is a high-priority public health goal of the Indian Government with a committed deadline of 2030. In order to achieve this goal, built-in systems of accountability, ownership, effective management, operational, technical, and financial controls will be crucial components for malaria elimination in India. This manuscript presents a model for malaria elimination with district as an operational unit, which may be considered for malaria elimination in India and other countries with similar geography, topography, climate, endemicity, health infrastructure, and socio-economic characteristics.

scholarly journals Significance of training, monitoring and assessment of malaria workers in achieving malaria elimination goal of Malaria Elimination Demonstration Project

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Harsh Rajvanshi ◽  
Sekh Nisar ◽  
Praveen K. Bharti ◽  
Himanshu Jayswar ◽  
Ashok K. Mishra ◽  
...  
Keyword(s):  
Case Management ◽  
Vector Control ◽  
Malaria Elimination ◽  
Disease Surveillance ◽  
Training Session ◽  
Central India ◽  
Malaria Diagnosis ◽  
Demonstration Project ◽  
National Goal ◽  
Health Delivery

Abstract Background The Malaria Elimination Demonstration Project (MEDP) maintained a workforce of 235 Village Malaria Workers (VMWs) and 25 Malaria Field Coordinators (MFCs) to conduct disease surveillance, case management, IEC/BCC activities, capacity building, and monitoring of vector control activities in 1233 villages of Mandla, a high malaria endemic district of Madhya Pradesh in central India. Methods The induction training was conducted for 3 days on malaria diagnosis, treatment, prevention, and ethics. All trainings were assessed using a pre and post-training assessment questionnaire, with 70% marks as qualifying threshold. The questionnaire was divided into three thematic areas viz. general knowledge related to malaria (KAP), diagnosis and treatment (DXRX), and vector control (PVC). Results In 2017, the project trained 330 candidates, followed by 243 and 247 candidates in 2018 and 2019, respectively. 94.3% candidates passed after a single training session. Almost all (95%) candidates showed improvement in knowledge after the training with 4% showing no effect and 1% showing deterioration. Progressive improvement in scores of 2017 cohort was seen along with significant improvement in performance of candidates in 2019 after the introduction of systematic monitoring and ‘shadowing’ training exercises. Conclusion The project has successfully demonstrated the value of recruitment of workers from the study area, outcome of training, and performance evaluation of field staff in malaria elimination programme. This careful strategy of recruitment and training resulted in a work-force that was capable of independently conducting surveillance, case management, vector control, and Information Education Communication/Behaviour Change Communication (IEC/BCC). The learnings of this study, including the training modules and monitoring processes, can be used to train the health delivery staff for achieving national goal for malaria elimination by 2030. Similar training and monitoring programmes could also be used for other public health delivery programmes.

scholarly journals G6PD deficiency among malaria-infected national groups at the western part of Myanmar with implications for primaquine use in malaria elimination

2021 ◽  
Vol 49 (1) ◽  
Author(s):  
Kay Thwe Han ◽  
Zay Yar Han ◽  
Kyin Hla Aye ◽  
Khin Thet Wai ◽  
Aung Thi ◽  
...  
Keyword(s):  
Enzyme Activity ◽  
Malaria Elimination ◽  
G6pd Deficiency ◽  
Control Program ◽  
Cross Sectional Study ◽  
Diagnostic Tools ◽  
Asymptomatic Malaria ◽  
Radical Cure ◽  
Readiness Assessment ◽  
Cross Sectional

Abstract Background Glucose 6-phosphate dehydrogenase deficiency (G6PDd) plays a central role in readiness assessment for malaria elimination in Myanmar by 2030 that includes primaquine (PQ) use. The risk of hemolysis in G6PDd individuals hampers the widespread use of primaquine safely in malaria-infected patients. In the pre-elimination era, it is important to screen initially for asymptomatic malaria in combination with G6PD deficiency by applying more sensitive diagnostic tools. Therefore, this study examined the proportion of G6PDd and the distribution of G6PD genotypes among malaria-infected national groups in Myanmar before initiation of malaria elimination strategies. Methods A cross-sectional study in one township each with high malaria burden from two states in the western part of Myanmar, was conducted during 2016-2018, and 320 participants (164 Rakhine and 156 Chin National groups) were recruited. We used RDT and ultrasensitive polymerase chain reaction (us PCR) method to confirm malaria infection, and a G6PD RDT(CareStart) to detect G6PDd and PCR/restriction fragment length polymorphism (RFLP) method to confirm the variant of G6PDd for genotyping. G6PD enzyme activity was measured by G6PD Biosensor (CareStart). Results Malaria positivity rates detected by RDT were lower than those detected by us PCR in the combined samples [13% (42/320) vs. 21% (67/320)] as well as in the Rakhine samples [17% (28/164) vs. 25% (41/164)] and in Chin samples [9% (14/156) vs. 17% (26/156)]. G6PD deficiency rates were approximately 10% in both the combined samples and specific national groups. For G6PD enzyme activity in the combined samples, G6PDd (defined as < 30% of adjusted male median) was 10% (31/320) and severe G6PDd (< 10% of AMM) was 3% (9/320). Among malaria-infected patients with positive by both RDT and usPCR, G6PDd was less than 20% in each national group. G6PD genotyping showed that the G6PD Mahidol (G487A) was the major variant. Conclusions The varying degree of G6PDd detected among malaria-infected national groups by advanced diagnostic tools, strongly support the recommend G6PD testing by the National Malaria Control Program and the subsequent safe treatment of P. vivax by primaquine for radical cure. Establishing a field monitoring system to achieve timely malaria elimination is mandatory to observe the safety of patients after PQ treatment.

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