Slide 1

Dr. Irshad Ali Jokhio 1

Bismillahir Rahmanir Raheem

REVIEW OF SECONDARY DATA 2009, 2010,2011,20122REVIEW OF SECONDARY DATA Goal of GFATM Round-10

3To reduce malaria burden by 60% in 38 highly endemic districts.

These 38 districts also include 19 districts of the Global Fund Round 10

4Disease burden

True indicator

API - Annual Parasite Incidence. API = (confirmed cases during 1 year/population under surveillance) x 1000. Malaria

5ABER - Annual Blood Examination Rate. Calculated as (number of slides examined/population) x 100. WHO recommendation for malarious areas is that the number of slides examined per month should equal at least 1% of the populationINTERVENTION IMPACTS (SPR+RDT)

LLIN Distribution impacts IRS impacts Months wise trends Treatments impacts

SINDH District DaduYEAR Total population LLIN Distributed Slide Examine Slide Positive casesRDT used RDT Positive cases Total casesAPI20092142269--------------18420.8520102194948150509

1296(0.86%)

923357(0.6%)1353+1519=2872(Flood camp)1.32011224104199809462811596(3.4%)8545175(2%)17710.7920122288103489091600(3.2%) 6443136(2%)17360.75Total2459994492(1.8%)24221368(1.5%)6379DISTRICT KHAIRPURTotal population LLINSlide Examine Slide Positive casesRDT used RDT Positive casesTotal casesAPI20091918671------------------------168398.7201019658516798913369(19.6%) 472407949(16.8%)21318+4231( Flood camp cases )=2554912.9201120492831228257597614352(18%) 6971913304(19%)2765613.420122067133

6935313205(19%) 606648108(13%)2131310.3Total 800093821331840926 (19%)17762329361 (16.5%)74018District ThattaTotal population LLINSlide Examine Slide Positive casesRDT used RDT Positive casesTotal casesAPI20091339209------------49453.620101372140536144626 (8.6%)

149961345 (8.9%)5971+1405(flood camp)=73765.320111400954106017377103258(8%)

13680842(6%)41002.920121430374410074805(11%) 148192098(14%)68734.8Total 554267713233112689(9.5%)434954285(9%)183798DISTRICT THARPARKARTotal population LLINSlide Examine Slide Positive casesRDT used RDT Positive casesTotal casesAPI20091167123---------------------21141.820101195823416515452 (13%)13115379 (2.8%)58314.82011122093578014459519096(19.7%)

17291676(3.9%)97728.020121246574

5535413882(25%)

13879253(1.8%)1413511.3Total 483045514295628430(19.8%)442851308 (2.9%)132575KPK DISTRICT MARDANTotal population LLINSlide Examine Slide Positive casesRDT used RDT Positive casesTotal casesAPI20091751138------------39562.220101794199465445481 (11.7%)6467142(2.1%)56233.1201118318771205356888611200(16%) 7544190(2.5%)113906.220121870346

671046824(10%) 4850234(4%)70583.7Total 7247560

18253423505(12.8%)18861566(3%)24071DISTRICT BANUTotal population LLINSlide Examine Slide Positive casesRDT used RDT Positive casesTotal casesAPI2009768431-----------------34654.52010787327404917483 (18.4%) 5465650 (11.8%)813310.32011803860559415242816895(32%) 333812094(6.2%)1898923.620128207416999616731(23.9) 255122630(10%)1936123.5Total 78732716291541109 (25.2%)64358 5374(8%)46483DISTRICT LakiTotal population LLINSlide Examine Slide Positive casesRDT used RDT Positive casesTotal casesAPI2009626808-------25504.02010642221220673562(16.1%7038197 (2.7%)37595.8201165570770487270856719(24%) 35706949(2.6%)766811.62012669477300546360(21%) 20304535(2.6%)689510.2Total25942137920616641(21%)630481681 (2.6%)18322FATA KHYBER AGENCY Total population LLINSlide Examine Slide Positive casesRDT used RDT Positive casesTotal casesAPI20097318608762

11.92010749857204485,853 (28%) 2811170 (6.0%)60238.0201176560354729209777599(36%) 434974(1.7%)767310.02012781681297556357(21%) 4815340(7%)66978.5Total 2370327

7118019809 (27%)11975584(4.8%)20393FATA KURAM AGENCY Total population LLINSlide Examine Slide Positive casesRDT used RDT Positive casesTotal casesAPI2009541008----------------46578.6201055431122695 6116 (26.9%) 4,647388 (6.3%)650411.7201156595143262170793442(20%) 9200130(1.4%)

35726.32012577836

140232998(21%) 414086(2%)30846.4Total22391065379712556(23%)17987604(3.3%)33553 SUMMARY API WISEDistricts2009201020112012ZHOB 61.329.332.39.9GAWADAR34.427.525.726.2SIBI4.411.623.917.5NASERABAD11.710.225.516.9KECH21.39.816.28.9LAKKI4.05.811.81.5BANU4.510.324.124.5KHAIRPUR8.712.71410.81516In 2012 the case load is deceased in KPK,FATA and Baluchistan because of Increase in screen of suspected ones The effective training in microscopy leads to quality diagnosis. In time provision of treatment on national guidelines especially the ACTs. Development of community trust in public sector laboratories. 17Preventive measures taken in target districts by providing LLINs Change in behaviour of people by mobilizing them to contact centres for malaria diagnosis & treatment. While in Banu, where case load are slightly increase because of in Bannu District where heavy rain fall and most of Rice cultivation Area in KPK.18The case load is visibly increased in 2012 in Sindh because, The heavy anddevastated rains .post flood affects. There was onslaught of population from other. adjacent province during rainy season which caused increase in the cases. Intensive & harsh season of malaria in the districts. Lack of coordination between public & private. sector for malaria control interventions.

HOW TO IMPROVEMENTS THE SERVICES?

19DIAGNOSIS+CLINCALBlood examination centers RDT CentersMortalityFalciparum proportion

20 Thank

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