Malaria in India: Challenges and opportunities

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.

In vitroantiplasmodial and antimicrobial potential ofTagetes erectaroots

“…The plant is also useful for other conditions such as hyperkeratotic plantar lesions and parakeratosis (Khan & Evans, 1996). Phytochemical screening of various parts of the plant revealed the presence of flavonoids (Das & Tripathi, 1997;El-Emary & Ali, 1983), phenols (Tripathy & Gupta, 1991), carotenoids (Hadden et al, 1999), 5-(but-1-ol-ynyl)-2,2'-bithienyl and methyl-3,5-dihydroxy-4-methoxy benzoate (Tripathy et al, 1992).…”

Malaria Prevalence in Arunachal Pradesh—A Northeastern State of India

“…13 Persistence of malaria in this region may be caused by lack of awareness and low socioeconomic status among the populace, difficult terrain to reach, lack of proper healthcare services, and ideal climatic conditions for mosquito breeding. 18 Because of these prevailing factors, it is very difficult to monitor malaria dynamics in the northeast region. 19 To understand the pattern of disease transmission and the reasons for the high numbers of malarial cases, a detailed epidemiological study was conducted in Arunachal Pradesh from 1995 to 2012.…”

Strengthening Malaria Service Delivery through Supportive Supervision and Community Mobilization in an Endemic Indian Setting: An Evaluation of Nested Delivery Models

“…In terms of the involvement of CHW, the global evidence suggests that regular and systematic supervision with clearly defined objectives can improve the performance of community health workers involved in primary health care [13][14][15][16]. Such evidence for India, however, is lacking and insufficient community capacity, trust, and coordination may keep the new malaria control strategies from meeting expected outcomes [9,17,18]. Hence, without addressing these community level impediments, ongoing control efforts may lead to diminished outcomes and the wastage of resources.…”