Malaria Situation & Drug Policy Malaysia. Infectious Disease Consultant/Physician MOH Malaysia. Malaria incidence 1961-2004. Incidence and Incidence Rate Malaria in Malaysia 1995-2004. 6154. MALARIA CASES AND INCIDENCE RATE BY GEOGRAPHICAL AREA (STATE) 2004.
Infectious Disease Consultant/Physician
BY GEOGRAPHICAL AREA (STATE) 2004
Malaysian: 18/4145 (0.43%)
Foreigners: 17/2008 (0.84%)
PROPHYLAXIS: 1. FANSIDAR & CHLOROQUINE
2. PROGUANIL & CHLOROQUINE
1. VISITORS TO HIGH RISK AREA IN SABAH,SARAWAK
2. ARMY : WORKING OR FIELD TRAINING IN
HIGH RISK AREA
3. LOCAL PEOPLE WHO WORK OR ENTER HIGH RISK
AREA-surveyors,loggers or jungle related occ.
-TO ALL CONFIRMED CASES
-ALL CASES WILL BE HOSPITALISED EXCEPT THOSE FROM REMOTE
(i) QUININE & DOXYCLINE- physician approval
(ii) MEFLOQUINE – requires Health State Director Approval
2. SEVERE MALARIA
(i) QUININE at 10mg/kg with 5% Dextrose over 4 hours then 8hourly
(ICU or HDW Management)
28.5% CQ resistance (1963 by Montgomery & Eyles)
> 60% by the mid-90's (Hakim et al, 1996) in Peninsular Malaysia.
47.4% SP resistance for the first time in Malaysia.
2000-2001, two 28-day in vivo studies on the CQ+SP combination reported
51.4% (19/37) resistance in Kemaman, Terengganu state,
62.5% (15/24) in Air Bah, Perak state.
Sentinel surveillance was started early 2003 in 10 sites
looking at treatment response (unpublished Report, 2003. VBDC, MoH)
1.CROSS BORDER MIGRATION
- Sarawak & Indonesia
- Northern part of Pen Malaysia & Thailand
2.Foreign workers from endemic areas- urban malaria outbreaks
& emergence of resistance
3.Geographical inaccessibility : Remote settlement/interior area-
4.As the number of malaria cases comes down
- delay in diagnosis/ management
5. Inadequate drug efficacy monitoring & resistance surveillance
6. Lack in number of experienced personnel in malaria management
7. Unavailability of anti-malaria drug policy