591 malaria cases in Mumbai diagnosed incorrectly from 2013 to 2018, reveals RTI reply
The samples were tested at Kasturba hospital between 2013 and 2018, revealed the Brihanmumbai Municipal Corporation (BMC) in response to an application filed by Chetan Kothari.mumbai Updated: Feb 28, 2018 23:55 IST
At least 591 malaria patients were incorrectly diagnosed negative for the disease in Mumbai in the past five years, according to data accessed under the Right To Information (RTI), indicating the underreporting prevalent in the city.
The samples were tested at Kasturba hospital between 2013 and 2018, revealed the Brihanmumbai Municipal Corporation (BMC) in response to an application filed by Chetan Kothari.
Careful microscopic examination of blood droplets, known as smear test, is considered the gold standard for malaria diagnosis as it is the most reliable form of diagnosis.
According to the National Vector Borne Disease Control Programme, a section of samples of malaria smear tests are sent to a sentinel infection control facility of the government for cross verification on a routine basis.
While activists said the sampling showed the city could be underestimating the total number of malaria cases, municipal health officials said immediate training and reinforcement of doctors is done after incorrect diagnosis, and heavy penalties are imposed on testing laboratories and patients are immediately contacted to ensure they receive treatment.
According to the World Health Organization report released in November 2017, 6% of the world’s new cases of malaria and 7% deaths were reported from India.
“Only a certain section of the samples, tested from batches of thousands of tests, are sent to Kasturba Hospital for cross-verification. This means, the actual number of malaria cases could be much more than this, as there is a possibility that a large number of samples, were similarly, announced as false negative,” said Kothari.
He said the RTI response indicates positive patients don’t receive care on time. “According to the rule, BMC officials are supposed to contact patients whose smear test was false negative and ensure they receive proper treatment. What about those malaria positive patients whose samples weren’t cross-verified, but tagged negative falsely? Also the patients coming to the city from other city or states might miss out on treatment due to incorrect reporting,” Kothari said.
However, officials from public health department said all possible steps are taken to ensure patients receive proper care. “Tests only provide confirmation of a disease and even if its negative, our doctors, based on their clinical acumen continue treatment of the patient based on symptoms or perform the test again,” said Dr Santosh Revankar joint executive health officer, BMC.
“We also call the patients whose tests were incorrectly diagnosed and offer them treatment,” he said.
Dr Revankar said technicians and doctors involved in incorrect diagnosis receive training and counselling to make sure such incidents are not repeated. “We have hired private laboratories to assist the hospitals to perform tests because a pathologist is supposed to check only 70 slides a day. When they (private laboratories) make a mistake in diagnosis, we impose fine equivalent to 50-100 times the cost we pay them per slide,” said Dr Revankar.
in diagnosis, we impose fine equivalent to 50-100 times the cost we pay them per slide,” said Dr Revankar.