Advertisement

Journal of Biosciences

, Volume 33, Issue 4, pp 583–592 | Cite as

Malaria in India: Challenges and opportunities

  • A. P. DashEmail author
  • Neena Valecha
  • A. R. Anvikar
  • A. Kumar
Article

Abstract

India contributes about 70% of malaria in the South East Asian Region of WHO. Although annually India reports about two million cases and 1000 deaths attributable to malaria, there is an increasing trend in the proportion of Plasmodium falciparum as the agent. There exists heterogeneity and variability in the risk of malaria transmission between and within the states of the country as many ecotypes/paradigms of malaria have been recognized. The pattern of clinical presentation of severe malaria has also changed and while multi-organ failure is more frequently observed in falciparum malaria, there are reports of vivax malaria presenting with severe manifestations. The high burden populations are ethnic tribes living in the forested pockets of the states like Orissa, Jharkhand, Madhya Pradesh, Chhattisgarh and the North Eastern states which contribute bulk of morbidity and mortality due to malaria in the country. Drug resistance, insecticide resistance, lack of knowledge of actual disease burden along with new paradigms of malaria pose a challenge for malaria control in the country. Considering the existing gaps in reported and estimated morbidity and mortality, need for estimation of true burden of malaria has been stressed. Administrative, financial, technical and operational challenges faced by the national programme have been elucidated. Approaches and priorities that may be helpful in tackling serious issues confronting malaria programme have been outlined.

Keywords

Anophelines burden of malaria DALYs P. falciparum P. vivax 

Abbreviations used

ACT

artemisinin combination therapy

API

annual parasite incidence per thousand

DALYs

disability adjusted life years

EDPT

early case detection and prompt treatment

HRP-2

histidine rich protein-2

IRS

indoor residual spraying

ITNs

insecticide treated nets

LLINs

long lasting insecticide nets

MPO

modified plan of operation

NVBDCP

National Vector Borne Disease Control Programme

Pf

Plasmodium falciparum

RDT

rapid diagnostic test

SP

synthetic pyrethroids

SPR

slide positivity rate

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Alilio M S, Bygbjerg I and Breman J G 2004 Are multilateral malaria research and control programs the most successful? Lessons from the past 100 years; Am. J. Trop. Med. Hyg. 71 268–278PubMedGoogle Scholar
  2. Alonso P L, Lindsay S W, Armstrong S J R, Keita K, Gomez P, Shenton F C, Hill A G, David P H, Fegan G, Cham K, et al 1993 A malaria control trial using insecticide-treated bed nets and targeted chemoprophylaxis in a rural area of The Gambia, West Africa. 6 The impact of the interventions on mortality and morbidity from malaria; Trans. R. Soc. Trop. Med. Hyg. (Suppl. 2) 87 37–44CrossRefGoogle Scholar
  3. Amexo M, Tolhurst R, Barnish G and Bates I 2004 Malaria Misdiagnosis: effects on the poor and vulnerable; Lancet 364 1896–1898PubMedCrossRefGoogle Scholar
  4. Beadle C, Long G W, Weiss W R, McElroy P D, Maret S M, Oloo A J and Hoffman S L 1994 Diagnosis of malaria by detection of Plasmodium falciparum HRP-2 antigen with a rapid dipstick antigen-capture assay; Lancet 343 564–568PubMedCrossRefGoogle Scholar
  5. Curtis C F and Townson H 1998 Malaria: existing methods of vector control and molecular entomology; Br. Med. Bull. 54 311–325PubMedGoogle Scholar
  6. Dash A P, Adak T, Raghavendra K and Singh O P 2007 The biology and control of malaria vectors in India; Curr. Sci. 92 1571–1578Google Scholar
  7. Dua V K, Kar P K, Kumar S and Sharma V P 1996 Chloroquine resistant Plasmodium vivax Malaria in India; Trop. Med. Int. Health 1 816–819PubMedGoogle Scholar
  8. Garg M, Gopinathan N, Bodhe P and Kshirsagar N A 1995 Vivax malaria resistant to choloroquine, Case report from Bombay; Trans. R. Soc. Trop. Med. Hyg. 89 656–657PubMedCrossRefGoogle Scholar
  9. IPCC 2001 Projections of Future Climate Change; in Climate change 2001: The Scientific Basis. http://www.grida.no/climate/ipcc_tar/wg1/index.htm
  10. Kochar D K, Saxena V, Singh N, Kochar S K, Kumar V and Das A 2005 Plasmodium vivax malaria; Emerging Infect. Dis. 11 132–134PubMedGoogle Scholar
  11. Kondrachine A V 1992 Malaria in WHO Southeast Asia Region; Indian J. Malariol. 29 129–160Google Scholar
  12. Kshirsagar N A, Gogtay N J, Rajjgor D, Dalvi S S and Wakde M 2000 An unusual case of multidrug resistant Plasmodium vivax malaria in Mumbai (Bombay) India; Ann. Trop. Med. Parasitol. 94 189–190PubMedCrossRefGoogle Scholar
  13. Kumar A 1997 Urban Malaria and its control in India; J. Parasitic Dis. 21 83–88Google Scholar
  14. Kumar A, Sharma V P, Sumodan P K and Thavaselvam D 1998 Field trials of bio-larvicide Bacillus thuringiensis var. israelensis strain 164 and larvivorous fishes Aplocheilus blocki against Anopheles stephensi for malaria control in Goa, India; J. Am. Mosq. Cont. Assoc. 14 457–462Google Scholar
  15. Kumar A, Valecha N, Jain T and Dash A P 2007 Burden of Malaria in India: Retrospective and Prospective View; Am. J. Trop. Med. Hyg. 77 69–78PubMedGoogle Scholar
  16. Melba G 2002 Malaria in Pregnancy; Bull. WHO 80 418Google Scholar
  17. Misra S P 1996 In vivo resistance to chloroquine and sulfa-pyrimethamine combination in Plasmodium falciparum in India; Proc. Natl. Acad. Sci. 66 123–138Google Scholar
  18. Mittal P K, Adak T, Singh O P, Raghvendra K and Singh O P 2002 Reduced susceptibility to deltamethrin in Anopheles culicifacies s.l. in district Ramanathpuram in Tamil Nadu: Selection of Pyrethroid resistant strain; Curr. Sci. 82 185–188Google Scholar
  19. Murray C J L and Lopez A D 1996 Evidence-based health policy—Lessons from the Global Burden of Disease Study; Science 274 740–743PubMedCrossRefGoogle Scholar
  20. Murray C J L and Lopez A D 1997 The Global Burden of Disease 1990–2020 Alternative projections of mortality and disability by cause for eight regions; Lancet 349 1498–1504PubMedCrossRefGoogle Scholar
  21. Nanda N, Yadav R S, Subbarao S K, Joshi H and Sharma V P 2000 Studies on Anopheles fluviatilis and Anopheles culicifacies in relation with malaria in forest and deforested riverine ecosystems in northern Orissa, India; J. Am. Mosq. Contr. Assoc. 16 199–205Google Scholar
  22. Newton P N, McGready R, Fernandez F, Green M D, Sunjio M, et al 2006 Manslaughter by Fake Artesunate in Asia—Will Africa Be Next?; PLoS Med. 3 197CrossRefGoogle Scholar
  23. NMEP 1985 In-depth evaluation report of the modified plan of operation under National Malaria Eradication Programme of India (Delhi: National Malaria Eradication Programme)Google Scholar
  24. NMEP 1992 Annual Report-1991 (National Malaria Eradication Programme-India, Delhi)Google Scholar
  25. Palmer C J, Lindo J F, Kaminsky R Q, Bamm M K and Ager A L 1998 Evaluation of the OptiMAL test for rapid diagnosis of Plasmodium vivax and Plasmodium falciparum malaria; J. Clinic. Microbiol. 36 203–206Google Scholar
  26. Payne D 1987 Spread of chloroquine resistance in Plasmodium falciparum; Parasitol. Today 3 241–246PubMedCrossRefGoogle Scholar
  27. Peters D, Yazbeck A, Ramana G, Sharma R, Pritchett L and Wagstaff A 2001 Raising the sights: Better health systems for India’s poor (Washington, DC; The World Bank)Google Scholar
  28. Prothero R 1977 Population movements and problems of malaria eradication in Africa; Bull. WHO 24 405–425Google Scholar
  29. Rao T R 1984 The Anophelines of India Delhi: Malaria Research Centre)Google Scholar
  30. Richards F O Jr, Boakye B, Mauricio S and Azodoga S 2001 Control of onchocerciasis today: status and challenges; Trends Parasitol. 17 558–563PubMedCrossRefGoogle Scholar
  31. Sehgal P N, Sharma M I D and Sharma S L 1973 Resistance to chloroquine in falciparum malaria in Assam State, India; J. Commun. Dis. 5 175–180Google Scholar
  32. Sharma V P and Konrachine A V (eds) 1991 Forest malaria in South East Asia (New Delhi: Malaria Research Centre)Google Scholar
  33. Sharma R S, Sharma G K and Dhillon G P S 1996 Intervention measures for Transmission Control; in Epidemiology and control of malaria in India (New Delhi: National Malaria Eradication Programme) pp 218–224Google Scholar
  34. Sharma V P 1998 Fighting malaria in India; Curr. Sci. 75 1127–1140Google Scholar
  35. Sharma V P 1999 current scenario of malaria in India; Parassitologia 41 349–353PubMedGoogle Scholar
  36. Sharma V P 2000 Status of drug resistance in malaria in India; in Multi-drug resistance in emerging and re-emerging diseases (ed.) R C Mahajan (Delhi: Narosa Publications) pp 191–202Google Scholar
  37. Singh O P, Raghvendra K, Nanda N, Mittal P K and Subbarao S K 2002 Pyrethroid resistance in Anopheles culicifacies in Surat district of Gujarat; Curr. Sci. 82 547–550Google Scholar
  38. Singh RK 2000 Emergence of chloroquine-resistant vivax malaria in South Bihar,India; Trans. R. Soc. Trop. Med. Hyg. 94 327PubMedCrossRefGoogle Scholar
  39. Singh N, Shukla M M and Sharma V P 1999 Epidemiology of malaria in pregnancy in Central India; Bull. WHO 77 567–572PubMedGoogle Scholar
  40. Singh N, Awadhia S B, Dash A P and Shrivastava R 2005 Malaria during pregnancy: A priority area for malaria research and control in South-East Asia; WHO SEARO Reg. Health Forum 9 7–17Google Scholar
  41. Snow R W, Guerra C A, Noor A M, Myint H Y and Hay S I 2005 The global distribution of clinical episodes of Plasmodium falciparum malaria; Nature (Londona) 434 214–217CrossRefGoogle Scholar
  42. Subbarao S K 1998 Anopheles species complexes in South East Asian region (World Health Organization, South East Asia Regional Office, New Delhi. Technical Publication, SEARO 18) pp 1–82Google Scholar
  43. Valecha N 1996 Resistant Malaria; Frontiers; in Padeiatrics (eds) H P S Sachdev and Panna Chaudhry (New Delhi: Jaypee Publications) pp 116–138Google Scholar
  44. Valecha N, Singh N, Yadav R S, Dev V, Aggarwal A and Subbarao S K 2003 Field evaluation of OptiMAL rapid malaria diagnostic test in India; Acta Parasitol. 48 229–232Google Scholar
  45. World Health Organization 1998 World Health Report (Geneva, Switzerland)Google Scholar
  46. World Health Organization 2004 Global strategic framework for integrated vector management (Geneva: World Health Organization)Google Scholar
  47. World Health Organization 2006 Guidelines for the treatment of malaria; WHO/HTM/MAL/2006.1108; www.searo.who.int; www.nvbdcp.gov.inGoogle Scholar

Copyright information

© Indian Academy of Sciences 2008

Authors and Affiliations

  • A. P. Dash
    • 1
    Email author
  • Neena Valecha
    • 1
  • A. R. Anvikar
    • 1
  • A. Kumar
    • 2
  1. 1.National Institute of Malaria ResearchDelhiIndia
  2. 2.Field StationNational Institute of Malaria ResearchCampal, PanajiIndia

Personalised recommendations