WHO Malaria Mass Drug Administration -
Ans. is 'b' i.e., >2 o First you should know what does mass prophylaxis mean in malaria.o In areas with high malaria prevalence, presumptive treatment is given to all people. This is know as mass treatment,o Presumptive treatment is given when API is >2.o Under The modified plan of operation, the endemic areas were reclassified according to annual parasite incidence (API) with different strategy for control measures.o The report of the consultative committee of experts indicated that in order to stabilize the malaria situation in the country', areas with API 2 and above should be taken up for regular spray operations.Areas with API < 2Areas with API >2Focal spraying is undertaken (Not regular spraying)Regular insecticidal sprayingTwo Rounds of DDT (if sensitive to DDT)Three Rounds of HCH (if refractory to DDT)Three rounds of Malathion (if refractory to HCH & DDT)Active and passive surveillance to be carried out every fortnightActive and passive surveillance is carried out every fortnightAll detected cases should receive radical treatmentAlt detected cases should receive radical treatment. Presumptive treatment is also considered.Epidemiglojgical .i instigationAll malaria positive cases are to be investigated.# Mass surveys -# Follow up blood smears to be collected from all positive cases on completion of radical treatment and thereafter at monthly intervals for 12 monthsEntomological assessmentThis is done by entomological teams.# They carry' out susceptibility tests and suggest appropriate insecticides to be used in particular areaso The technical advisory committee on Malaria (2002 ) has prioritized the criteria for undertaking indoor residual spray (IRS). These criteria are as follows.To spray priority basis with suitable insecticide all areas with > 5 API where ABER is 10% or more, taking subcentre as a unit.To spray on priority' basis with suitable insecticide all areas reporting > 5% SPR, if the ABER < 10%.Due priority' be accorded for spray if Pf proportion is > 50%.To accord priority for IRS in areas with API < 5/SPR < 5% in case of drug resistant foci, project areas with population migration & aggregation or other vulnerable areas.To make provision for insecticidal spraying in epidemic situations.Other parameters (entomological, ecological etc) may also be considered while prioritizing areas for sparying.o The population living in areas with API > 5 is planned to be covered by Long lasting insecticidal nets (LLINs) and in endemic areas registering API 2 to 5 is covered with conventional net treated with insecticides (Isecticide treated bed nets-ITNs) and IRS.
API >5
> 2
15
25
Health Programmes in India