Evaluation of training programme.

Resurgence of malaria in the country during seventies and subsequent implementation of Modified Plan of Operation (MPO) through Primary Health Care (PHC) system highlighted the urgent need for short term courses for PHC medical officers and clinicians at the periphery. In pursuance of these objectives. Dte. of National Malaria Eradication Programme (NMEP) laid down series of "Orientation Courses" for medical officers of PHCs and "Workshops" in management of severe and complicated malaria for physicians, paediatricians and pathologists in hospitals/teaching institutions. While there exist standard methods for evaluation of institutional courses, for peripheral short term courses, a new method i.e. "Retrospective assessment at the work sites of the participants" was followed for evaluation of the above mentioned two types of courses. The findings were revealing in as much as, besides being highly successful, medical officers of PHCs who so far did not consider them as part of the programme, then onward aligned themselves as an integral part of the campaign. These courses helped them in updating with knowledge viz. concept of malaria control, passive case detection, dosages and choice of drugs, treatment schedules particularly in pregnancy and significance of quinine and primaquine therapy. Assessment of workshops for clinicians, provided the forum for first ever interaction between clinicians and the programme in the country. The workshops provided an update with current advances/researches in the treatment of severe and complicated cases of malaria. These were considered highly beneficial, as it cleared many doubts about pathological processes and clinical manifestations including induced by drugs. The study also highlighted the deficiencies in the delivery process by the faculty.

PIP: A large-scale resurgence of malaria took place in the 1970s following major reductions in the 1960s. This turnaround prompted the National Malaria Eradication Programme (NMEP) to develop and hold a series of orientation courses for primary health center medical officers and workshops in the management of severe and complicated malaria for physicians, pediatricians, and pathologists in hospital/teaching institutions. The 4-5 day orientation courses covered parasitology in terms of laboratory services, epidemiology, clinical manifestation of malaria, chemotherapy and treatment of malaria, and prevention and control. 838 participants were trained over the period 1985-89. 340 were trained in the 2-3 day workshops of group educational activities conducted over the period 1988-90. Courses were evaluated retrospectively at work sites in discussions with participants. The programs were generally successful and held the added bonus of garnering closer medical officer participation with the campaign. The courses helped participants to increase their knowledge on the concept of malarial control, passive case detection, dosages and choice of drugs, treatment schedules especially in pregnancy, and the significance of quinine and primaquine therapy. The workshop assessment was the first ever interaction in the country between clinicians and the program. It was found that the workshop updated current advances in treating severe and complicated malaria cases; cleared many doubts about pathological processes and clinical manifestations; and highlighted deficiencies in the delivery process by the faculty.

Experimental studies of the potentiation of proguanil and pyrimethamine by dapsone using Plasmodium berghei in white mice.

An accurate system with stringent criteria has been established to test antimalarial drugs and drug combinations against Plasmodium berghei in mice. Minimum effective doses for a number of antimalarial drugs have been determined when used in this system. Considerable potentiation of the activity of pyrimethamine and to a somewhat less extent of proguanil by dapsone has been demonstrated. The need to extend studies of these combinations to the parasites of human malaria is discussed in terms of establishing a safe chemoprophylactic regime in the presence of drug-resistant strains of parasites.