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Containing a malaria outbreak in Bihar through rapid deployment

© UNICEF India/2009/ Jha
Last summer, UNICEF helped coordinate distribution of 30,000 insecticide-treated bed nets to affected areas of Munger District in Bihar to help contain an outbreak of malaria.

By Dr. Jorge Caravotta

BIHAR, India, 28 October 2009 – This summer, an outbreak of approximately 3,600 cases of cerebral malaria took 22 lives along two blocks of Munger District in Bihar province.

The district had all the ingredients for an outbreak: DDT spraying had not been undertaken in these areas for about two years, and poor sanitation was prevalent. Places for mosquitos to breed were plentiful, and community awareness was low. Also, there were no insecticide-treated mosquito nets available and the local health facilities were overwhelmed.

It was a great challenge for the district administration to control the deadly outbreak. Long queues of patients waited at health centres for chloroquine drug treatment, which proved ineffective against the resistant strain.

Strong partnership

In response, the National Vector Borne Disease Control Programme, in consultation with the National Institute of Malaria Research, mobilized the powerful artemisinin-based combination therapy in the district. A strong partnership between UNICEF and government at the state and district levels helped contain the outbreak.

“Malaria is a threat, especially for the poor and disadvantaged in many parts of India,” said UNICEF India Chief of Health Dr. Henri van den Hombergh. “We need to be well prepared to act when the disease strikes like it did in Munger, where the population is now protected.”

UNICEF was asked to supply 30,000 long-lasting insecticidal nets for the two affected blocks of Munger District. These were to be distributed to 62 villages in Kharagpur and 32 villages in Dharahra, where a UNICEF-led surveillance team detected further cases.

The nets were successfully distributed in 20 days by experienced door-to-door polio vaccination teams.

Lessons learned

More than 50 per cent of the households that received the nets were from socially excluded groups such as the Musahars and Santhal Adivasi tribal groups.

A Santhali tribal woman who was three-months pregnant was the first to receive a net.

Mr. van den Hombergh said there was a need to rapidly scale up preventive strategies for malaria control. Lessons learned while combatting this outbreak will help improve government health programming for malaria control in Bihar and other affected states of India.



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