Testing Material Is Also In Short Supply

State–run health facilities are reeling under severe crunch of testing materials to detect malaria as well as anti–malarial drugs meant for children. Incidence of malarial cases closely correlates with monsoon, which is considered as high transmission season.

"There is a shortage of primaquine 2.5 mg, which is given to children in the age bracket of one to four years. The drug is especially meant for those children who are down with the P vivax strain of malaria. Besides, there is a shortage of items required for malaria detection tests such as glass slides, cotton swabs and lancets, across the state," said an official from the state’s drugs distribution cell, requesting anonymity.

Children in the one to four years age bracket constitute 10 to 15% of total malaria cases in Maharashtra.

Among other medicines, the cell also distributes antimalaria drugs and testing materials to state health facilities, including primary health centres (PHC), subcentres, rural hospitals and district hospitals for early intervention to control malaria across the state.

"The state needs 20 lakh tablets of primaquine 2.5 mg every year. We have around 50,000 tablets available with some health facilities. Besides, we need 1.5 crore lancets to carry out slide tests for malaria detection. At present, we have around 65 lakh lancets in tribal districts, which are considered sensitive for high transmission of the malaria infection. The 17 non–tribal districts are facing a shortage," the official said.

Last year, the cell had approached the state’s National Rural Health Mission (NRHM) office for its requirement of primaquine 2.5 mg tablets. The NRHM officials had approved the requirement and asked the state procurement cell to provide the required amount of the tablets. The procurement cell, through its centralised drug purchasing system, had in turn asked government drug suppliers to provide the tablets, but the suppliers failed to do so.

To tide over the crunch, the cell had to request officials of the Union health and family welfare department to provide the tablets. "The tablets were insufficient and we are again facing a shortage across the state. There are some health facilities which do have the drugs, but most are running short. This doesn’t mean that the centres have stopped treating children with malaria, however. We have asked our health staff to cut primaquine 7.5mg tablets, which are in adequate stock, into four pieces and administer them to the children," the official said.

"Our health workers and technicians, who use slide tests to detect malaria caused by P falicparum and P vivax strains are running short of testing materials," said the official.

Items required for the tests include clean glass slides, disposable lancets, and spirit or cotton swabs to clean the finger. Spirit is required to clean the finger tip, dry gauze to wipe the finger before pricking it and after the blood has been taken for the test, and lancets to prick the finger. These lancets cannot be reused.

"A few drops of blood are spread on a glass slide. A trained laboratory technician then examines the glass slide under a microscope. If the technician sees Plasmodium organisms in the smears, the slide test is reported positive. All the materials are crucial to the test," said the official.

Satish Pawar, joint director (procurement cell), state health department, said, "We did not get any response for the tender called to procure glass slides, lancets, cotton gauze, etc. We are going to recall the tender now. Besides, another tender for supply of 190 drugs, including anti–malaria drugs, has also been called. The shortage will soon be addressed."