Abstract:Worldwide and in India, malaria elimination efforts are being ramped up to eradicate the disease by 2030. Malaria elimination efforts in North-East (NE) India will have a great bearing on the overall efforts to eradicate malaria in the rest of India. The first cases of chloroquine and sulfadoxine-pyrimethamine resistance were reported in NE India, and the source of these drug resistant parasites are most likely from South East Asia (SEA). NE India is the only land route through which the parasites from SEA can… Show more
“…Plasmodium falciparum is responsible for the majority of the cases, and accounts for >90% of the malaria cases [22]. Based on the cumulative cases from 2008-2018, and population density, 1.1% of the total population is estimated to be affected by malaria on an average per year, and is the second most malarious state in NE India after Meghalaya [24]. Over the last decade, there has been a steep fall in malaria cases throughout India, mainly attributed to the public health measures and greatly hinder malaria control efforts in this region [24].…”
Section: Discussionmentioning
confidence: 99%
“…Based on the cumulative cases from 2008-2018, and population density, 1.1% of the total population is estimated to be affected by malaria on an average per year, and is the second most malarious state in NE India after Meghalaya [24]. Over the last decade, there has been a steep fall in malaria cases throughout India, mainly attributed to the public health measures and greatly hinder malaria control efforts in this region [24]. In addition, significant deforestation in Mizorama net decline in forest cover (1079 sq.km) from 1987-2019, the highest among all states could be an important factor in malaria transmission.…”
Section: Discussionmentioning
confidence: 99%
“…The tribal population of the State is 94.43% [23]. Malaria is endemic in Mizoram for many decades, and is one of the highly malarious states in India [24]. While the malaria cases have continued to steeply decline in other states, Mizoram continues to have a stable malaria transmission.…”
Section: Introductionmentioning
confidence: 99%
“…Compared to 2018 (3937 cases), the malaria cases more than doubled in 2019 (8543 cases) (Source: SVBDCP). Mizoram is also a key entry route for the drug resistant malaria parasites from Myanmar to mainland India [24]. Until the emergence of dengue in 2012 [25], malaria remained the major vector-borne disease in the state.…”
Background
Malaria and dengue are the two major vector-borne diseases in Mizoram. Malaria is endemic in Mizoram, and dengue was first reported only in 2012. It is well documented that climate change has a direct influence on the incidence and spread of vector-borne diseases. The study was designed to study the trends and impact of climate variables (temperature, rainfall and humidity) in the monsoon period (May to September) and deforestation on the incidence of dengue and malaria in Mizoram.
Methods
Temperature, rainfall and humidity data of Mizoram from 1979–2013 were obtained from the National Centers for Environmental Prediction Climate Forecast System Reanalysis and analyzed. Forest cover data of Mizoram was extracted from India State of Forest Report (IFSR) and Land Processes Distributed Active Archive Centre. Percent tree cover datasets of Advanced Very High Resolution Radiometer and Moderate Resolution Imaging Spectroradiometer missions were also used to study the association between deforestation and incidence of vector-borne diseases. The study used non-parametric tests to estimate long-term trends in the climate (temperature, rainfall, humidity) and forest cover variables. The trend and its magnitude are estimated through Mann-Kendall test and Sen's slope method. Year-wise dengue and malaria data were obtained from the State Vector Borne Disease Control Program, Mizoram.
Results
The Mann-Kendall test indicates that compared to maximum temperature, minimum temperature during the monsoon period is increasing (p < 0.001). The Sen’s slope estimation also shows an average annual 0.020C (0.01–0.03 at 95% CI) monotonic increasing trend of minimum temperature. The residuals of Sen’s estimate show that temperature is increasing at an average of about 0.10C/year after 2007.Trends indicate that both rainfall and humidity are increasing (p <. 0.001); on an average, there is a 20.45 mm increase in monsoon rainfall per year (5.90–34.37 at 95% CI), while there is a 0.08% (0.02–0.18 at 95% CI) increase in relative humidity annually. IFSR data shows that there is an annual average decrease of 162 sq.km (272.81–37.53 at 95% CI, p < 0.001) in the dense forest cover. Mizoram in 2012 was the last state in India to report the incidence of dengue. Malaria transmission continues to be stable in Mizoram; compared to 2007, the cases have increased in 2019.
Conclusion
Over the study period, there is an ~ 0.80C rise in the minimum temperature in the monsoon season which could have facilitated the establishment of Aedes aegypti, the major dengue vector in Mizoram. In addition, the increase in rainfall and humidity may have also helped the biology of Ae. aegypti. Deforestation could be one of the major factors responsible for the consistently high number of malaria cases in Mizoram.
“…Plasmodium falciparum is responsible for the majority of the cases, and accounts for >90% of the malaria cases [22]. Based on the cumulative cases from 2008-2018, and population density, 1.1% of the total population is estimated to be affected by malaria on an average per year, and is the second most malarious state in NE India after Meghalaya [24]. Over the last decade, there has been a steep fall in malaria cases throughout India, mainly attributed to the public health measures and greatly hinder malaria control efforts in this region [24].…”
Section: Discussionmentioning
confidence: 99%
“…Based on the cumulative cases from 2008-2018, and population density, 1.1% of the total population is estimated to be affected by malaria on an average per year, and is the second most malarious state in NE India after Meghalaya [24]. Over the last decade, there has been a steep fall in malaria cases throughout India, mainly attributed to the public health measures and greatly hinder malaria control efforts in this region [24]. In addition, significant deforestation in Mizorama net decline in forest cover (1079 sq.km) from 1987-2019, the highest among all states could be an important factor in malaria transmission.…”
Section: Discussionmentioning
confidence: 99%
“…The tribal population of the State is 94.43% [23]. Malaria is endemic in Mizoram for many decades, and is one of the highly malarious states in India [24]. While the malaria cases have continued to steeply decline in other states, Mizoram continues to have a stable malaria transmission.…”
Section: Introductionmentioning
confidence: 99%
“…Compared to 2018 (3937 cases), the malaria cases more than doubled in 2019 (8543 cases) (Source: SVBDCP). Mizoram is also a key entry route for the drug resistant malaria parasites from Myanmar to mainland India [24]. Until the emergence of dengue in 2012 [25], malaria remained the major vector-borne disease in the state.…”
Background
Malaria and dengue are the two major vector-borne diseases in Mizoram. Malaria is endemic in Mizoram, and dengue was first reported only in 2012. It is well documented that climate change has a direct influence on the incidence and spread of vector-borne diseases. The study was designed to study the trends and impact of climate variables (temperature, rainfall and humidity) in the monsoon period (May to September) and deforestation on the incidence of dengue and malaria in Mizoram.
Methods
Temperature, rainfall and humidity data of Mizoram from 1979–2013 were obtained from the National Centers for Environmental Prediction Climate Forecast System Reanalysis and analyzed. Forest cover data of Mizoram was extracted from India State of Forest Report (IFSR) and Land Processes Distributed Active Archive Centre. Percent tree cover datasets of Advanced Very High Resolution Radiometer and Moderate Resolution Imaging Spectroradiometer missions were also used to study the association between deforestation and incidence of vector-borne diseases. The study used non-parametric tests to estimate long-term trends in the climate (temperature, rainfall, humidity) and forest cover variables. The trend and its magnitude are estimated through Mann-Kendall test and Sen's slope method. Year-wise dengue and malaria data were obtained from the State Vector Borne Disease Control Program, Mizoram.
Results
The Mann-Kendall test indicates that compared to maximum temperature, minimum temperature during the monsoon period is increasing (p < 0.001). The Sen’s slope estimation also shows an average annual 0.020C (0.01–0.03 at 95% CI) monotonic increasing trend of minimum temperature. The residuals of Sen’s estimate show that temperature is increasing at an average of about 0.10C/year after 2007.Trends indicate that both rainfall and humidity are increasing (p <. 0.001); on an average, there is a 20.45 mm increase in monsoon rainfall per year (5.90–34.37 at 95% CI), while there is a 0.08% (0.02–0.18 at 95% CI) increase in relative humidity annually. IFSR data shows that there is an annual average decrease of 162 sq.km (272.81–37.53 at 95% CI, p < 0.001) in the dense forest cover. Mizoram in 2012 was the last state in India to report the incidence of dengue. Malaria transmission continues to be stable in Mizoram; compared to 2007, the cases have increased in 2019.
Conclusion
Over the study period, there is an ~ 0.80C rise in the minimum temperature in the monsoon season which could have facilitated the establishment of Aedes aegypti, the major dengue vector in Mizoram. In addition, the increase in rainfall and humidity may have also helped the biology of Ae. aegypti. Deforestation could be one of the major factors responsible for the consistently high number of malaria cases in Mizoram.
“…North East India bears a large case burden of malaria in India and is co-endemic for both P. falciparum and P. vivax malaria [17][18][19][20]. Vivax malaria has been reported in almost all states of North East India, attributing up to 60-80% of all malaria cases in some states [17].…”
Introduction
Glucose-6-phosphate dehydrogenase (G6PD) enzyme deficiency is the most common enzymopathy in humans, and its distribution has been historically described to be closely associated with that of malaria. North East India provides optimal conditions for transmission of malaria and bears a considerable burden of
Plasmodium vivax
(
P. vivax
) malaria. Primaquine, a mainstay in the treatment of vivax malaria, may trigger episodes of acute hemolysis in patients with G6PD deficiency. The present study sought to delineate the frequency and genotypes of G6PD deficiency among patients suffering from vivax malaria infections.
Methods
Blood specimens from 80 individuals diagnosed with vivax malaria underwent enzyme assay for G6PD deficiency. Samples with deficient phenotype underwent isolation of DNA using a genomic DNA isolation kit (Qiagen India Pvt. Ltd., New Delhi, India). The genomic DNA underwent amplification, serial denaturation, annealing, extension, final extension followed by digestion with restriction endonucleases Nla III and Fok I. The digested products were subjected to horizontal agarose electrophoresis for the separation of digested fragments. Samples without nucleotide 376 adenine→guanine (A→G) mutation were classified as G6PD B. Those with the mutation were further classified into G6PD A(+) and G6PD A(-) based on the presence of Nla III site.
Results
Twenty-seven out of 80 individuals (33.75%) with
P. vivax
malaria were found to have G6PD deficiency, of which a majority (n=24) had G6PD B genotype. Three individuals had Asparagine→Aspartic Acid mutation at position 376 (A→G), of which G6PD A(+) and G6PD A(-) were present in two and one cases, respectively.
Conclusion
G6PD deficiency was noted in about a third of patients with vivax malaria. Since primaquine therapy is contraindicated in this group of patients, there is a rationale for looking into screening patients with vivax malaria from the region prior to primaquine therapy. Further large scale studies may substantiate this and help in better genotypic and geographic characterization of G6PD deficiency in the region.
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