The Delhi Government claims that it is geared to deal with any eventuality and that there is no cause for alarm. But medical professionals hold otherwise and tend to brand the governmental attitude as one of smug complacency associated with the system. "Under-reporting" is one of the major attributes of this default setting, they say.

According to Dr V K Monga, coordinator of the National Anti-Malaria Programme (NAMP), there is under-reporting of malaria cases both in Government agencies and among private practitioners. About 70 to 75 per cent of the healthcare in India is provided by private practitioners and in any given area one may find about 50 general practitioners as against only three to four dispensaries, he adds.

There is a rule that all malariacases in the city should be reported to the Municipal Corporation of Delhi. But general practitioners are reluctant to abide by it owing to the resultant hassles likely to be caused by the MCD officials.

Even doctors attached to dispensaries run by the Delhi administration shun the responsibility of reporting malaria cases on the plea that it is not their job. "If I get a suspected case I will refer it to the lab technician whose duty is to follow it up with the MCD," says Dr Malik, Chief Medical Officer of New Ranjit Nagar dispensary in west Delhi.

Doctors claim lab technicians are under-reporting cases because of the entailing follow-up exercises. Once a test is identified as positive, it is incumbent on the lab technician to go to the patient's house for five consecutive days to administer the full dose of prescribed medicine.

Also, other family members have to be tested to see if they are infected, besides conducting a survey of the surroundings and door-to-door campaigns to alert people onprecautionary measures against the disease.

Of the 200 suspected cases referred in New Rajinder Nagar dispensary for tests, only two were found positive. As a result of the tardy attitude of the lab technician, the reported incidence of malaria in west Delhi is barely one to two per cent of the actual number, says Dr Suneet Khanna, president of the Indian Medical Association, MCD's Karol Bagh branch. The picture would be more or less the same in other parts of the city, he feels.

However, MCD has a different story to tell. According to Dr P K Sharma, Deputy Medical Health Officer (Malaria), the total number of reported positive cases in the city from January 1 to 5 this year is 268. This figure is considerably less than the 456 cases reported during the same period last year, he says.

Dr Chakravarty, CMO of Patel Government Hospital, says they receive many cases of clinical malaria in which the patient displays clinical symptoms including high fever and shivering. "But, on testing if they are foundnegative, we simply call them clinical cases and discharge the subjects after administering preventive doses," he says adding, "We cannot report these cases because they are negative."

According to him, many suspected cases report negative for a variety of reasons including self medication by the patients. "We find that patients on experiencing the symptoms of malaria go to chemists who generally give them anti-malarial drug Metakelfin. As a result, when they come to us the results will not be accurate," he says.