Malaria Control

Malaria Control Program

Malaria is one of the Public health Problems in Bangladesh. Malaria is endemic in 13 eastern and north eastern border belt districts of the country with variable transmissions potentials (high moderate and low). A total of 13.25 million people are at risk of malaria inhabited in those districts. In 2013 the overall prevalence rate of malaria in 13 endemic districts was found to be 0.9/1000 (Malaria prevalence survey Report, ICDDRB). The Three Hill Tract Districts (Bandarban, Khagrachari, Rangamati) and Cox’s Bazar district reported 92 percent of the malaria cases and 80 percent of malaria deaths in 2013. Both P. falciparum and P. vivax malaria are prevalent in the country of which the proportion of reported P. falciparum infection is 96% of the total cases in the country.

In 2007, the Government of Bangladesh initiated a five year project to reduce the burden of malaria infection with financial assistance from The Global Fund to fight AIDS, Tuberculosis and Malaria (GFATM). In April 2008, SAJIDA Foundation joined theconsortium of 20 NGOs, led by BRAC, to begin implementing this project in Dharmapasha sub-district of Sunamganj district with the goal of a 50% reduction in the incidence of malaria in the district by 2015.

SAJIDA Foundation’s primaryapproach to malaria control is through awareness building. The Foundation educates people at the community level on the use of insecticidal nets, and on the importance of early diagnosis and prompt treatment. SAJIDA Foundationconducts education sessions through community level advocacy workshops with various stakeholders including local government officials, Upazila Nirbahi Officers (chief executives of the sub-district), teachers, religious leaders, village doctors, paramedics and other NGO workers. The purpose of these workshops is to make people aware of the various methods of malaria control. Stakeholders are educated on malarial symptoms and encouragedto use ofLong lasting insecticide treated nets (LLIN) or insecticide treated nets (ITN). Workshops also highlight the importance of referring symptomatic cases for diagnosis by rapid diagnostic tests or blood slide examinations to ensure prompt treatment. Other awareness raising activities include loudspeaker announcements, cultural programs, and theater events, all spreading messages containing general information, symptoms, adverse consequences, preventive measures and social stigma related to the disease.

SAJIDA Foundation carried out a complete household survey of Dharmapasha, collecting information on household members, socio-economic status and presence/conditions of bed nets.LLINs are distributed to poor households and to households with pregnant women and children under five years old based on the survey findings. Ordinary bed nets are treated with insecticides and the interiors of household sprayed with insecticide.

The role of Community Health Workers is crucial in malaria intervention at the community level, and in promoting participation by bridging the gap between communities and healthcare providers. Moreover, as the Community Health Workers are residents of their working areas, they are easily accepted and trusted, enabling them to have an impact.Each worker is responsible for managing 2,000 households on average and visits approximately 20 households a day. During their visits, Community Health Workers raise awareness about malaria, educate families about the disease impact and emphasize the necessity of using Long Lasting Insecticide Treated Nets (LLIN). They also discuss how to identify malaria symptoms. The Community Heath Workers are provided with a Rapid Diagnostic Test (RDT) kit and trained on how to use it for instant diagnosis of malaria. People who test positive on the RDT are treated immediately by anti-malarial drugs. The blood slides of symptomatic patients whose test results are negative on the RDT are sent to the SAJIDA laboratory for confirmation of diagnosis by microscopic examination of the slides. The Community Health Workers follow up on all positive cases to ensure proper intake of medication. In addition, patients with malaria during pregnancy, children under 5 years of age and severe malaria cases are immediately referred to the nearest health facility by the Community Health Workers.