BMC is underreporting malaria deaths, say doctors

Even as politicians, corporators and civic health authorities play the blame game over malaria, deaths due to the disease are being underreported, according to doctors.

In July alone, 17,138 people in the city tested positive for malaria. So virulent is the current strain, that over 4,000 of the people had to be hospitalised, many in ICU, after developing complications like acute respiratory distress syndrome (ARDS), septicaemia and multi-organ failure.

Yet, according to the Brihanmumbai Municipal Corporation (BMC), there were just 18 deaths, “seven confirmed malarial deaths, 11 unconfirmed”.

“This figure,” a doctor said, “simply cannot be correct. The current strain of malaria has a mortality rate of 0.5% to 1%. So, the number of deaths should be 10 times the number reported.”
“About 5% of my malaria patients suffer from complications,” said an ICU specialist from Hinduja hospital.

Calls to three major hospitals — Fortis, Mulund; Hinduja, Mahim; Jaslok, south Mumbai — revealed that the ICUs are filled to capacity with malaria patients.

According to the BMC’s health department, 98 of 26,021 malaria patients died in 2008. In 2009, the corresponding figures were 198 and 44,034. This year, 48,000 people have been diagnosed with malaria, of whom 52 have died.

According to forensic doctors at civic-run hospitals, malarial deaths are being reported as “death caused by unknown fever”.    

“Confirmation of malaria as a causative factor in these deaths would take at least two months, due to the sheer backlog of the number of deaths awaiting such confirmation. For now, we are reporting it as ‘unknown fever’,” said a forensic doctor at Sion Hospital. “Incidentally, deaths could be caused by any of the diseases such as malaria, dengue, etc, which results in viral hemorrhagic fever. It would be difficult to pinpoint the cause of death without adequate tests, which would take time.”

Not only deaths, but also the number of malaria cases are being underreported, claimed sources in the BMC.

“The BMC has shut down its labs at Mulund and Bhardawadi, Andheri. The only functioning laboratory is at Kasturba hospital, where blood samples can be tested for malaria. There is lot of pressure on the lab,” said Sunil Prabhu, group leader, Shiv Sena, BMC.

The sources said that while 163,000 blood samples have been tested in July — out of which 17,200 tested positive — 45,000 samples are yet to be tested due to the resource crunch.

“The malaria department requires 85 technicians, but the civicadministration has approved only 28 posts,” Prabhu said. The Kasturba lab is manned by 47 technicians.

Another reason why cases are being underreported is that malaria becomes harder to confirm once a patient is put on anti-malarial medication as a preventive measure.

Also, clinicians say that laboratory tests are not entirely reliable as they need to be co-related clinically by a doctor treating a patient.