Background Malaria causes significant morbidity and mortality each year. In the past few years, the global malaria cases have been declining and many endemic countries are heading towards malaria elimination. Nevertheless, reducing the number of cases seems to be easy than sustained elimination. Therefore to achieve the objective of complete elimination and maintaining the elimination status, it is necessary to assess the gains made during the recent years. Main text With inclining global support and World Health Organisation (WHO) efforts, the control programmes have been implemented effectively in many endemic countries. Given the aroused interest and investments into malaria elimination programmes at global level, the ambitious goal of elimination appears feasible. Sustainable interventions have played a pivotal role in malaria contraction, however drug and insecticide resistance, social, demographic, cultural and behavioural beliefs and practices, and unreformed health infrastructure could drift back the progress attained so far. Ignoring such impeding factors coupled with certain region specific factors may jeopardise our ability to abide righteous track to achieve global elimination of malaria parasite. Although support beyond the territories is important, but well managed integrated vector management approach at regional and country level using scrupulously selected area specific interventions targeting both vector and parasite along with the community involvement is necessary. A brief incline in malaria during 2016 has raised fresh perturbation on whether elimination could be achieved on time or not. Conclusions The intervention tools available currently can most likely reduce transmission but clearing of malaria epicentres from where the disease can flare up any time, is not possible without involving local population. Nevertheless maintaining zero malaria transmission and checks on malaria import in declared malaria free countries, and further speeding up of interventions to stop transmission in elimination countries is most desirable. Strong collaboration backed by adequate political and financial support among the countries with a common objective to eliminate malaria must be on top priority. The present review attempts to assess the progress gained in malaria elimination during the past few years and highlights some issues that could be important in successful malaria elimination. Electronic supplementary material The online version of this article (10.1186/s40249-019-0524-x) contains supplementary material, which is available to authorized users.

BackgroundMalaria is a major cause of morbidity and mortality in Northeast India. As there is limited information available on the potential influence of socio-economic variables on malaria risk, the present study was conducted to assess the influence of demographic factors, the socio-economic status, and knowledge, awareness and education on malaria occurrence.MethodsDemographics, malaria knowledge and socio-economic variables were collected in four randomly selected health sub-centres of the Orang primary health centre in the Udalguri district, Assam and the association of malaria occurrence with different variables were analysed. The trend of malaria occurrence for different income groups, proximity to health centres and number of mosquito bites per day was also determined using the chi-square test. Relative risk (RR) for gender, house type, knowledge and use of bed nets was determined using Katz approximation.ResultsOut of the 71 household heads interviewed, 70.4% (50/71) were males. About half (54.9%, 39/71) of the participants had a history of malaria in the last two years, of which 64.1% (25/39) were males, while 35.9% (14/39) were females (χ2 = 5.13; p = 0.02; RR = 1.79). Of the total population surveyed, 49.3% lived in bamboo houses and 35.2% lived at a distance of >3 km from the nearest health centre. The number of participants who had a history of malaria decreased with an increasing monthly income (p < 0.0001). Malaria occurrence was higher among the households living in bamboo houses (69.2%), as compared to Kucha houses (20.5%) and Pucca houses (10.3%). No significant association was observed between education level and malaria occurrence (p = 0.93). The participants who did not use bed nets regularly reported a high occurrence of malaria infection as compared to those who used bed nets everyday (p < 0.0001).ConclusionsLower income, house type, distance to health sub-centre, knowledge and awareness about malaria, number of mosquito bites per day and use of bed nets were positively associated with malaria occurrence. Increasing the number of health sub-centres close to rural areas, improving the economic status and increasing awareness about malaria prevention measures will thus help to reduce malaria-associated morbidities.

BackgroundThe R2 repeat region of GLURP has been reported as a good genetic marker for Plasmodium falciparum genotyping. Proper knowledge of the extent and nature of P. falciparum genetic diversity using highly immunogenic R2 repeat region in malaria-endemic areas is a crucial element to understand various aspects related to immunity acquisition and disease pathogenesis.MethodsPopulation diversity of P. falciparum GLURP and amino acid sequence repeats in GLURP R2 region was studied in malaria-endemic Assam state, northeast India and compared at an interval of five years during 2005 (Group-A) and 2011 (Group-B).ResultsOf the 66 samples, a total of 55 samples showed positive PCR bands for GLURP R2 region and altogether ten types of alleles with size ranging from 501 bp to 1,050 bp (50 bp bin) were observed and coded as genotypes I-X. In Group-A (n = 29), 24 samples were found infected with single, four with double and one with triple P. falciparum genotype, while in Group-B (n = 26), single genotype was found in 23 samples, double in two samples and triple in one sample. Genotype IV showed significant increase (p = 0.002) during 2011 (Group-B). Genotypes I to V were more common in Group-B (62%), however genotypes VI to X were more frequently distributed in Group-A. The expected heterozygosity was found slightly higher in Group-A (HE = 0.87) than Group-B (HE = 0.85), whereas multiplicity of infection (MOI) in Group-A (MOI = 1.21 ± 0.49) and Group-B (MOI = 1.12 ± 0.43) did not display significant variation. The amino acid repeat sequence unit (AAU) DKNEKGQHEIVEVEEILPE (called ‘a’) was more frequent in the well-conserved part of R2 repeat region.ConclusionThe present study is the first extensive study in India which has generated substantial data for understanding the type and distribution of naturally evolved genetic polymorphism at amino acid sequence level in GLURP R2 repeat region in P. falciparum. There was decrease in the PCR amplicon size as well as the number of AAU [amino acid repeat unit] in Group-B displaying the bottleneck effect. The present study described a new type of AAU ‘d’ which varied from the other previous known AAUs.Electronic supplementary materialThe online version of this article (doi:10.1186/1475-2875-13-450) contains supplementary material, which is available to authorized users.

Mosquito repellents play an important role in preventing man-mosquito contact. In the present study, we evaluated the synergistic mosquito-repellent activity of Curcuma longa, Pogostemon heyneanus and Zanthoxylum limonella essential oils. The mosquito repellent efficacies of three essential oils were evaluated separately and in combination under laboratory and field conditions. N,N-Diethylphenylacetamide (DEPA) and dimethylphthalate (DMP) were used for comparison of the protection time of the mixture of essential oils. At an optimum concentration of 20%, the essential oils of C. longa, Z. limonella and P. heyneanus provided complete protection times (CPTs) of 96.2, 91.4 and 123.4 min, respectively, against Aedes albopictus mosquitoes in the laboratory. The 1:1:2 mixture of the essential oils provided 329.4 and 391.0 min of CPT in the laboratory and field trials, respectively. The percent increases in CPTs for the essential oil mixture were 30 for DMP and 55 for N,N-diethylphenylacetamide (DEPA). The synergistic repellent activity of the essential oils used in the present study might be useful for developing safer alternatives to synthetic repellents for personal protection against mosquitoes.

BackgroundMalaria transmission is perennial in the Assam–Arunachal Pradesh interstate border areas in the Sonitpur district of Assam, India. A yearlong study was carried out on the incidence of symptomatic and asymptomatic malaria and the role of asymptomatic malaria carriers in persistent transmission of the disease. The relationships between malaria incidence and weather parameters were also investigated.MethodsActive and mass blood surveys were conducted on a monthly basis in Bengenajuli, Sapairaumari Pathar, and Nigam villages near the Assam–Arunachal Pradesh border. Epidemiological indices were estimated for malaria-positive cases. Multiple linear regression between monthly malaria incidence and monthly average temperature, and relative humidity along with monthly total rainfall was carried out. The known malaria vectors collected in CDC light traps were identified and recorded.ResultsSlide positivity rate (SPR) and Plasmodium falciparum percent (Pf%) for symptomatic malaria were 26.1 and 79.8, respectively. Prevalence of malaria vectors was observed throughout the year with varying density. Anopheles philippinensis/nivipes and A. annularis were predominant among the seven known vector species recorded currently. Asymptomatic parasitemia was detected throughout the year with SPR ranging from 4.8 to 5.3. Monthly rainfall with 1-month lag had the highest correlation (r=0.92) with SPR. The relationship between SPR and weather factors was established as SPR=−114.22+0.58 T min+1.38 RH+0.03 RF (R 2=0.89; p=0.00).ConclusionLow and relatively constant levels of asymptomatic parasitemia was present in the study area. High malaria vector density and presence of asymptomatic malaria parasite carriers were responsible for persistent malaria transmission in the region. This study concludes that passive detection and prompt treatment of asymptomatic carriers is essential for preventing persistent disease transmission. Rainfall along with some other weather variables may be used for predicting the malaria epidemics in the region. The predictive information could be useful to target resources more effectively.

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BackgroundDengue is rapidly expanding mosquito-borne viral infection globally facing operational challenges due to insecticide resistance in dengue vectors. We have studied the susceptibility status of potential dengue vectors St. albopicta and St. aegypti to the commonly used insecticides.MethodsStegomyia larval bioassays were carried out to determine LC10, LC50 and LC99 values and resistance ratios (RR50 and RR99) for temephos. Adult susceptibility bioassay to 4% DDT, 0.05% deltamethrin, 5% malathion was assessed following standard procedure to determine the corrected mortality. Knock-down times (KDT50 and KDT99) were estimated and the knock-down resistance ratios (KRR50 and KRR99) were calculated.ResultsSt. albopicta wild population (WP) of Sotia was resistant to temephos as the LC99 value was 0.12 mg/l and found to be 2.3 fold high than the reference population (RP). St. aegypti WP of Borgong, Kusumtola and Serajuli displayed a RR99 of 2.5, 5.4 and 4.5 respectively suggesting high level of resistance to temephos. Results suggested that both St. albopicta and St. aegypti WP were fully resistant to DDT (mortality < 90%) in all the study locations. Both the species were completely susceptible to deltamethrin and malathion (corrected mortality > 98%), except for St. albopicta at Sotia which displayed low level of resistance to malathion (corrected mortality =95.4%). The estimated KDT values for both the species indicated high level of knock-down resistance to DDT and susceptibility to deltamethrin.ConclusionWP of both the dengue vectors showed varied response to temephos, while resistant to DDT and completely susceptible to deltamethrin. Both the species were susceptible to malathion at majority of the testing sites. Current results strongly advocate that DDT is no longer effective against dengue vectors, while thorough monitoring of malathion susceptibility in geographical area at dengue risk is inexorable to ascertain whether or not the resistance to malathion is focal. Information generated herein may be useful in better planning and implementing in dengue control strategy using insecticides.

BackgroundDengue vector control programmes are facing operational challenges due to resistance against commonly used insecticides throughout the endemic countries. Recently, there has been appreciable increase in the dengue cases in India, however, no recent data are available on susceptible status of dengue vectors. We have studied the susceptibility level of St. albopicta to commonly used insecticides in India. Adult mosquitoes were tested for the presence of dengue virus.MethodsSt. albopicta larval bioassays were carried out to determine the lethal concentrations (LC10, LC50 and LC99) and the resistance ratios (RR10, RR50 and RR99) for temephos. Susceptibility to 4% DDT, 0.05% deltamethrin and 5% malathion was assessed following standard procedure. Knock-down times (KDT10, KDT50 and KDT99) were estimated and knock-down resistance ratios (KRR10, KRR50 and KRR99) were calculated. VectorTest™ dengue antigen assay was used to detect the dengue virus in the field collected mosquitoes.ResultsIn larval bioassays, the RR ranged from 1.4 (for RR99) to 1.7 (for RR50), which suggested that the tested St. albopicta were susceptible to temephos. There was no deviation among the lethal concentration data from linearity (r2 = 0.61). Adult St. albopicta mosquitoes were resistant to DDT, while fully susceptible to deltamethrin and malathion. The knock-down values (KDT10, KDT50 and KDT99) obtained for DDT displayed straight line in log-dose-probit analysis and follow linear regression model. The KRR99 for DDT was 4.9, which indicated a 4.9 folds increase in knock-down resistance to DDT. However, for malathion and deltamethrin, the KRR99 values were 1.6 and 1.5 respectively suggesting that mosquitoes were knock-down sensitive. None of the mosquito pool was dengue virus positive.ConclusionSt. albopicta showed resistance to DDT and reduced sensitivity to deltamethrin and malathion. This data on insecticide resistance could help public health authorities in India to design more effective vector control measures. More dengue vector specimens need to be scanned to identify the potential dengue vector.