A major scourge of
healthcare in India is the presence of preventable diseases. The incidence of
malaria has definitely been on the decrease. However, I’ve few friends who
believe that there is not much of a decrease in incidence, rather, it is a
failure of reporting that has sort of given across the message that the
incidence has decreased.
At Kachhwa, we see quite
a few cases of malaria every week. Most of them are Plasmodium Vivax cases.
Yesterday, we had a very
interesting patient. A young man working in a town in North Bihar, he had come
with fever of quite a long duration – almost couple of months. We had seen him
about a month back and had treated him as Enteric Fever. And he had responded
well to treatment.
However, he came back
within couple of weeks of stopping treatment. We did a malaria smear and this
is what we got.
The smear was full of
gametocytes. In fact, almost every field had at least one gametocyte and
surprisingly we could not find any ring forms. It is not very common that we
got a field with 3 gametocytes.
The scenario of having Falciparum Malaria cases in
the community is frightening. It exposes the population to a chance of morbidity
and mortality from severe forms of malaria. And it is a harsh reminder of the
infantile public health scenario of the country.
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