Time to implement tailored interventions in Chhattisgarh, east-central India to reach malaria elimination

Abstract

Background & objectives: Despite significant progress in malaria control throughout India, Chhattisgarh continues to be a significant contributor to both malaria morbidity and mortality. This study aims to identify key factors associated with malaria endemicity, with the goal of focusing on these factors for malaria elimination by 2030. Methods: We employed an analysis and narrative review methodology to summarize the existing evidence on malaria epidemiology in Chhattisgarh. Data, encompassing environmental conditions, dominant malaria vectors and their distribution, and the impact of previous interventions on malaria control, were extracted from published literature using PubMed and Google Scholar. This information was subsequently correlated with malaria incidence data using appropriate statistical and geographical methods. Results: Much of the malaria burden in the states is concentrated in a few specific districts. The primary malaria vectors in these regions are Anopheles culicifacies and Anopheles fluviatilis. High transmission areas are found in tribal belts that are challenging to access, characterized by densely forested areas that provide a conducive habitat for malaria vectors. Interpretation & conclusion: Conducive environmental conditions, characterized by high forest cover, community behavior, and insurgency, contribute to the high malaria endemicity in the area. Challenges include insecticide resistance in malaria vectors and asymptomatic malaria. Allocating additional resources to high-endemic districts is crucial. Innovative and focused malaria control programs, such as DAMAN and Malaria Mukt Abhiyan, hold immense importance.