BMC’s Kasturba Hospital, located at Jacob Circle in South Mumbai, has come across nearly 500 cases of wrong analytical tests of malaria, carried out on patients by different civic hospitals and dispensaries in the last five years.
As per the data provided by BMC’s Assistant Health Officer Dr. Santosh Revankar, vide his letter dated February 22, 2018 in response to a RTI query by Chetan Kothari, after cross-checking the samples already tested by other laboratories, the Kasturba Hospital noted that the tests carried out by BMC hospitals, dispensaries and labs outsourced by it, have not been up to the mark.
The Kasturba Hospital has come across false negative as well as positive cases of malaria. False negative cases are those in which the patients really suffered from malaria, but tested negative and were eventually not given malaria medicines. They were subjected to unnecessary other investigations and were given unwanted antibiotics, thus aggravating their ailment.
The available data of false negative malaria cases are: year 2013-165 cases, 2014-128, 2015-91, 2016-63 and 2017-48 cases. Some of the dispensaries and labs where these samples were tested include: Medilab Diagnostics, Mumbai central, L T Road dispensary, Wadala dispensary, Pant Nagar municipal Hospital, Ghatkopar, Kamala Raman Nagar Dispensary, Govandi, Worli Koliwada dispensary, Colaba dispensary, Shastri Nagar dispensary, Santacruz, West and Bharat Nagar dispensary, Bandra East.
The false positive malaria cases are those in which the patients did not suffer from malaria but were unnecessarily given Chloroquine, a medication used to prevent and to treat malaria, in areas where malaria is known to be sensitive to its effects. The chloroquine has side effects and sometimes the condition of patients can worsen. As per available data, there have been 8 cases of false diagnosis of positive malaria between 2014 and 2016.
Malaria is a parasitic disease that spreads between humans through the bite of infected female anopheles mosquitoes. Post the bite, the parasite enters the human bloodstream, invades the liver and then the red blood cells. Initial symptoms include fever, headache, sweats, chills and vomiting.
The malaria testing, by slide method (microscopy) is considered as “Gold Standard”, provided it is done by experienced person, that is at least by MD (Pathology). But in many dispensaries, technicians routinely carry out tests regardless of presence or absence of pathologists. Basically the diagnostic tests are just to support the diagnosis and the physicians should rely on actual signs and symptoms of the disease and should not totally depend upon the test results.
As part of routine exercise, the tested slides are sent to Kasturba Hospital, for verification. The Kasturba Hospital is the largest infectious diseases hospital in the South East Asia. The samples of drugs and formulations received from BMC hospitals and dispensaries are analysed in its laboratory, which is the sole central analytical laboratory of the BMC. The most advanced and state-of the-art laboratory deals with Clinical Pathology, Histopathology, Biochemistry, Hematology, Serology and Clinical Microbiology.
It may be recalled that BMC had diagnosed 2,338 people with malaria from January 1 to July 23 last year (2017) and had also advised private doctors to report the malaria cases. Mumbai also witnessed six malaria deaths last year. The rains and water logging followed by a dry spell was the reason given for the spread of infectious diseases, which was stated to have helped the vectors like mosquitoes – the vector for diseases like dengue and malaria – to breed.