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Malaria in India: Challenges and opportunities

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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.

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Abbreviations

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

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Authors and Affiliations

  1. National Institute of Malaria Research, 22 Sham Nath Marg, Delhi, 110 054, India

    A. P. Dash, Neena Valecha & A. R. Anvikar

  2. Field Station, National Institute of Malaria Research, DHS Building, Campal, Panaji, 403 001, India

    A. Kumar

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  1. A. P. Dash
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  2. Neena Valecha
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  3. A. R. Anvikar
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  4. A. Kumar
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Correspondence to A. P. Dash.

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Dash, A.P., Valecha, N., Anvikar, A.R. et al. Malaria in India: Challenges and opportunities. J Biosci 33, 583–592 (2008). https://doi.org/10.1007/s12038-008-0076-x

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