Assessment of preparedness of the health sector for an outbreak of malaria Sri Lanka-Dr. B.A.M.P. Bulathsinghe


Introduction: Sri Lanka has entered into period of prevention of reintroduction phase following elimination of malaria in 2016. However, annually around 50 imported malaria cases are being recorded. In the current phase, even one locally acquired case of malaria of any species is defined as an outbreak. Until global eradication is achieved, health sector should be more vigilant of the disease.

Objectives: The aim of the study was to assess the preparedness of the health sector for an outbreak of malaria.

Methodology: A descriptive cross-sectional study was conducted at four hospitals in Badulla district from 11th March to 31st March 2021. A sample of 303 Medical Officers were recruited. A self-administered questionnaire was used to collect data. In addition, checklist assessment was carried out at PGH Badulla, Regional Malaria Office of Badulla and Anti Malaria Campaign Headquarters to assess the preparedness. For categorical data percentages were calculated. 

Results: The majority of the sample (n = 187, 61.7%) was from PGH Badulla. Nearly two third of the responders were Medical officers/Senior House Officers (59.4%) and 59.4% (n = 180) have been in service for 1-10 years. A small percentage (8.9%) had public health experience. Majority (n = 229, 75.6%) had no experience in treating malaria. Most respondents (70.0%) did not have prior training on malaria. Around 44.0% Medical Officers were confident in diagnosing a patient with malaria but 59.7% did not consider malaria as differential diagnosis in febrile patients. Around half of the study population (n = 148, 48.8%) did not know malaria could be transmitted by blood transfusion and only 33.1% knew treatment cannot be started without confirming the diagnosis. However, majority had poor knowledge on malaria (56.1%). A significant association was seen between the knowledge on malaria and receipt of training (p <0.05). Overall preparedness of hospital sector and Regional Malaria office of Badulla were unsatisfactory. But Anti Malaria Campaign headquarters had a satisfactory preparedness.

Conclusions and recommendation: This study demonstrated considerable gaps in preparedness in hospitals and malaria control program in district level. Proper training of Medical Officers and adequate buffer stock maintenance along with proper infrastructure is recommended.

Key words: Malaria, outbreak, preparedness, health sector,