Background: The main objective of this study is to assess knowledge and attitude of parents & extended relatives of children diagnosed with Thalassemia major and to evaluate feasibility of screening of extended families for thalassemia trait by correlating their willingness to get screened with actual screening.Methods: This was a cross sectional type of descriptive analytical study, conducted at the thalassemia day care center at a tertiary care teaching hospital in western India among 230 study population using a pre-designed and pre-validated structured questionnaire.Results: We found the overall knowledge score of parents about thalassemia was significantly better than relatives. About 95.83% of parents and only 31.86% of the relatives amongst the study population had adequate knowledge. Majority of study population (84.61% relatives and 100% parents) had positive attitude. The significant contributing factors for knowledge and attitude towards thalassemia were age, marital status, education level, religion and per capita monthly income. 2% relatives agreed to get themselves screened for thalassemia status out of which only 20% got themselves screened.Conclusions: This study has identified key areas which need to be highlighted and emphasized in public awareness campaigns for thalassemia screening in India.
Background: High incidence of chloroquine-resistant vivax malaria has led to increasing case fatality and incidence of complicated malaria with Plasmodium vivax contributing to morbidity and mortality. Current guidelines recommend the use of chloroquine along with tissue schizontcides like primaquine for the treatment of Plasmodium vivax malaria. There were reports of increasing resistance to chloroquine in Plasmodium vivax species especially from Asia during the period when this study was taken up. Methods: Present study is a one arm, 28 day follow up, hospital based prospective observational study including 150 children aged 1 to 12 years with smear positive isolated Plasmodium vivax infections. Chloroquine was administered at the standard dose of 25 mg base/kg body weight over three days. Recurrence of parasitaemia and clinical conditions of patients were assessed on days 1, 2, 3, 7, 14, and 28 during the 28-day follow-up period. Results: All 150 children included in the study, completed their 28 day follow up. Mean age for enrolment was 5.96±2.38 years. The mean parasite index (%) on enrolment was 1.22±0.46. Based on the per protocol analysis, chloroquine efficacy (adequate clinical and parasitological response) was 92.7%. Treatment was well tolerated. Early treatment failure was seen in 2.7% of study population, late clinical failure in 2% and late parasitological failure in 2.7% of study population, suggesting that response to chloroquine was good in the study population. Conclusions: In the present study the chloroquine therapy showed high therapeutic efficacy (92.7%) in the treatment of uncomplicated vivax malaria. It was also well tolerated and equally safe when used in therapeutic doses. Regular monitoring of the pattern of resistance to chloroquine is needed in vivax malaria endemic areas of the country and measures are taken rapidly and effectively to control spread of resistance.
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