Press Statement of Dr BS Kakkilaya

That two young siblings of a very poor family from the remote village of Shishila, Belthangady had to succumb to severe malaria in 2014 is highly shocking. There appear to be several lapses at multiple levels leading to these tragic deaths. There also appears to be a clear attempt to hush up at least 35 deaths due to malaria in the last 2 years.

According to the reports in the media and the information that we have collected, the older girl was initially taken to the Primary Health Centre at Hatyadka for fever and other related symptoms. She was diagnosed as a case of jaundice (hepatitis) and no test was done for malaria. The relatives chose to treat her jaundice with herbal remedies from a local healer. Two days later, she was taken to the same PHC again; malaria test was not done and she was referred to the district hospital with suspicions of infective hepatitis or leptospirosis. The relatives brought her to the district hospital after a delay of 2 more days and by then she had deteriorated irreversibly. Her younger brother was also brought to the district hospital under similar conditions. At the time of admission to the district hospital, both the kids had cerebral malaria, severe anemia, severe acidosis and respiratory distress and despite prompt treatment, both could not be saved.

The failure to diagnose malaria at PHC, Hatyadka, combined with the attempted herbal remedies, resulted in the delay and aggravation of the infection before reaching the district hospital. This clearly indicates the failure to adhere to the guidelines of the NVBDCP that every case of fever must be immediately tested for malaria either with a blood smear or with Rapid Diagnostic Test. This failure could have been due to non-availability of a trained microscopist or of the RDT at the PHC. Therefore, immediate measures must be taken to sensitise all the medical officers regarding early diagnosis and prompt treatment of malaria, as envisaged in the NVBDCP guidelines and measures must also be taken to strengthen laboratory/RDT supplies at all the PHCs. Strict and immediate action must be taken against the district NVBDCP officials for these lapses at PHC Hatyadka.

The claims of the two-doctor team from Directorate of Health and Family Welfare, Bangalore, as reported in the media, that the children were anaemic and could not resist the malarial attack and hence their deaths, are laughable. Anemia in these two children was the result of severe malaria, rather than being the cause of malaria. Therefore, such a statement is not only false but also a blatant attempt to divert the attention from the lapses of the health authorities.

The claims of the district NVBDCP and Epidemic Surveillance officials that there have been no reports of deaths due to malaria over the last 3 years are also totally baseless. The data that we have collected from six major hospitals of Mangalore reveal that not less than 35 cases of deaths due to malaria have been duly reported to the local health authorities in 2012 and 2013. If data from all other hospitals are collected, this number will be much more. The reasons for hushing up these reports, confirmed by relevant investigations in tertiary care hospitals and medical college hospitals, are only known to the concerned authorities. Hushing up the actual number of cases and the deaths due to malaria would adversely impact on the malaria control efforts in the district. Therefore, strict action must be initiated against all the officials responsible for this.

It is indeed worrisome that two young lives have been lost to malaria in 2014, when all the facilities are available for early diagnosis and prompt treatment. It is also worrisome that this has happened in the month of January when the transmission of malaria is expected to be the lowest. It is evident therefore that malaria transmission is high even during the lean season and the NVBDCP authorities have failed to record and contain it. Urgent investigations are needed to find out why and how the two children from a remote village could contract malaria, instead of brushing it aside as a freak incident.

I urge the Hon’ble minister of Health and Family Welfare to take immediate action against the concerned officials and to initiate an independent enquiry into the lapses that led to the delay in the diagnosis and treatment of these two children, as well as into the hushing up of reports of malarial transmission and deaths.

  ©malariasite.com ©BS Kakkilaya | Last Updated: Mar 11, 2015

 

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