【Move to another page】
Quote
https://ift.tt/2OvLwZh
Malaria in India
Wikisanchez: /* Vectors */
India has been historically endemic for both ''[[Plasmodium vivax]]'' and ''[[Plasmodium falciparum]]'' malaria and has history of successes and resurgences.<ref name="Dhiman"></ref> India contributes over 75% of the total malaria in ,<ref name="Burden of Malaria in India: Retrospective and Prospective View"/>.<ref name="This year's World malaria report at a glance"/> In 2016 more than half of the population (698 million) was at risk of malaria according to the World Malaria Report, which also reported India accounting for 6% of all malaria cases in the world, 6% of the deaths, and 51% of the global ''[[Plasmodium vivax]]'' malaria cases.<ref name="Malaria in Indiav"/>
== Vectors ==
Nine [[Anopheles|Anopheline]] vectors are involved in transmitting malaria in diverse geo-ecological paradigms across the country.<ref name="Burden of Malaria in India: Retrospective and Prospective View"></ref> Three Plasmodial species are involved: ''[[Plasmodium falciparum]]'', ''[[P. vivax]]'', and ''[[P. malariae]]''. The principal vector of rural malaria, ''[[Anopheles culicifacies]]'', is widely distributed. The primary urban vector is ''[[Anopheles stephensi]]'', while ''[[Anopheles fluviatilis]]'' is a vector in the hills and foothills. ''[[Anopheles minimus]]'', ''[[Anopheles nivipes]]'', ''[[Anopheles philippinensis]]'', and ''[[Anopheles dirus]]'' are vectors in the northeast. ''[[Anopheles sundaicus]]'' is restricted to [[Andaman Islands|Andaman]] and [[Car Nicobar]] islands. [[Anopheles annularis]] and [[Anopheles varuna]] are secondary vectors with wide distribution.<ref name="Burden of Malaria in India: Retrospective and Prospective View"/>
== Epidemiology ==
Malaria has been controlled in most parts of the country.<ref name="Kumar"></ref> The epidemiology of malaria in India is complex because of geo-ecological diversity, multi-ethnicity, and wide distribution of the transmitting vectors.<ref name="Burden of Malaria in India: Retrospective and Prospective View"/>
The high endemic areas contribute to 80% of the burden of disease in the country. Although approximately 95% of the population lives in malaria-endemic areas, 80% of malaria occurs among 20% of those classified as 'high-risk populations', who reside in [[Andhra Pradesh]], [[Chhatisgarh]], [[Gujarat]], [[Jharkhand]], [[Madhya Pradesh]], [[Maharashtra]], [[Orissa]], and [[Rajasthan]] – the seven north-eastern states – and [[Sikkim]].<ref name="Kumar"/> The state of [[Orissa]], although constituing only 4% of the total population of India, contributes the highest number of malaria cases at 22%; 43% of total ''Plasmodium falciparum'' cases and about 50% of all reported deaths due to malaria in the country.<ref name="Kumar"/> At a national level, about 2 million malaria cases and 1,000 deaths are reported annually, although estimates by WHO South East Asia Regional Office put the figures at 15 million cases and 20,000 deaths. India contributes over 75% of the total malaria in .<ref name="Burden of Malaria in India: Retrospective and Prospective View"/> When India became independent in 1947, 75 million malaria cases were estimated in a population of 330 million. A spectacular achievement would be witnessed during the eradication era in the late 1950s and early 1960s, reducing malaria cases to just 100,000 in 1964. However, a reversal would be experienced. By 1976, malaria cases reached the 6.4 million mark. A continued rise in ''[[Plasmodium falciparum]]'' was reported, and its proportion has gradually risen to nearly 50% in recent years.<ref name="Burden of Malaria in India: Retrospective and Prospective View"/>
== Healthcare and control programs ==
State governments implement a number of well-structured National Disease Control/Elimination Programs following national policies.<ref name="Burden of Malaria in India: Retrospective and Prospective View"/> Technical and operational guidelines are provided by an organized National Vector Borne Disease Control Program (NVBDCP) to the state governments besides sharing one half the costs for the control of malaria, among other diseases.<ref name="Burden of Malaria in India: Retrospective and Prospective View"/> A cost–benefit analysis suggests that each [[Indian rupee]] invested by the National Malaria Control Program pays a rich dividend of 19.7 rupees.<ref name="Burden of Malaria in India: Retrospective and Prospective View"/>
In April 1953, the Government of India launched the National Malaria Control Program, which proved highly successful and significantly reduced the number of malaria cases to about 2 million by 1958.<ref name="Malaria in Indiav"></ref> A more ambitious National Malaria Eradication Program was launched in 1958. By 1961 the incidence dropped to a mere 49,151 cases, with no deaths.<ref name="Malaria in Indiav"/> However, a malaria resurgence was experienced in the 1960s and 1970s, as the result of technical, financial and operational problems.<ref name="Malaria in Indiav"/> Malaria cases in urban areas started to multiply in the late 1960s, and a widespread upsurge of the disease rose. In 1976, 6.45 million cases were recorded by the National Malaria Eradication Program (NMEP), the highest since resurgence.<ref name="Malaria in Indiav"/> In 1971-72 an urban malaria scheme (UMS) was implemented and a modified plan of operation (MPO) followed in 1977, improving the malaria situation for 5-6 years, providing easy availability of drugs, reducing [[morbidity]] and preventing deaths. A reduction to about 2 million cases was achieved. The impact was mainly on ''[[Plasmodium vivax]]'' malaria. In 1977 the ''[[Plasmodium falciparum]]'' containment program (PfCP) launched helping reduce ''falciparum'' malaria. However, the general spread of this parasite could not be contained. ''P. falciparum'' showed a steady upward trend during the 1970s and thereafter.<ref name="Malaria in Indiav"/>
The Enhanced Malaria Control Project (EMCP) was launched in April 1997<ref name="Kumar"/> and implemented in 181 selected districts of the country, with the assistance of the [[World Bank]].<ref name="Burden of Malaria in India: Retrospective and Prospective View"/> It consisted in five components: early diagnosis and prompt treatment, selective vector control, [[mosquito net|insecticide-treated bed nets]], epidemic response and inter-sectoral collaboration, and institutional strengthening.<ref name="Kumar"/> This program directly benefited the tribal population of eight peninsular states covering 100 districts and 19 urban areas, as well as the population living in other malaria endemic areas.<ref name="Kumar"/> In 2003, it expanded to cover 200 tribal blocks, and added two states, [[Karnataka]] and [[West Bengal]].<ref name="Kumar"/> India reported 3 million fewer cases in 2017 compared with 2016, a 24% decrease, being a unique case reporting progress in reducing its malaria cases in the period.<ref name="This year's World malaria report at a glance"></ref>
== See also ==
* [[Malaria and the Caribbean]]
== References ==
== Vectors ==
Nine [[Anopheles|Anopheline]] vectors are involved in transmitting malaria in diverse geo-ecological paradigms across the country.<ref name="Burden of Malaria in India: Retrospective and Prospective View"></ref> Three Plasmodial species are involved: ''[[Plasmodium falciparum]]'', ''[[P. vivax]]'', and ''[[P. malariae]]''. The principal vector of rural malaria, ''[[Anopheles culicifacies]]'', is widely distributed. The primary urban vector is ''[[Anopheles stephensi]]'', while ''[[Anopheles fluviatilis]]'' is a vector in the hills and foothills. ''[[Anopheles minimus]]'', ''[[Anopheles nivipes]]'', ''[[Anopheles philippinensis]]'', and ''[[Anopheles dirus]]'' are vectors in the northeast. ''[[Anopheles sundaicus]]'' is restricted to [[Andaman Islands|Andaman]] and [[Car Nicobar]] islands. [[Anopheles annularis]] and [[Anopheles varuna]] are secondary vectors with wide distribution.<ref name="Burden of Malaria in India: Retrospective and Prospective View"/>
== Epidemiology ==
Malaria has been controlled in most parts of the country.<ref name="Kumar"></ref> The epidemiology of malaria in India is complex because of geo-ecological diversity, multi-ethnicity, and wide distribution of the transmitting vectors.<ref name="Burden of Malaria in India: Retrospective and Prospective View"/>
The high endemic areas contribute to 80% of the burden of disease in the country. Although approximately 95% of the population lives in malaria-endemic areas, 80% of malaria occurs among 20% of those classified as 'high-risk populations', who reside in [[Andhra Pradesh]], [[Chhatisgarh]], [[Gujarat]], [[Jharkhand]], [[Madhya Pradesh]], [[Maharashtra]], [[Orissa]], and [[Rajasthan]] – the seven north-eastern states – and [[Sikkim]].<ref name="Kumar"/> The state of [[Orissa]], although constituing only 4% of the total population of India, contributes the highest number of malaria cases at 22%; 43% of total ''Plasmodium falciparum'' cases and about 50% of all reported deaths due to malaria in the country.<ref name="Kumar"/> At a national level, about 2 million malaria cases and 1,000 deaths are reported annually, although estimates by WHO South East Asia Regional Office put the figures at 15 million cases and 20,000 deaths. India contributes over 75% of the total malaria in .<ref name="Burden of Malaria in India: Retrospective and Prospective View"/> When India became independent in 1947, 75 million malaria cases were estimated in a population of 330 million. A spectacular achievement would be witnessed during the eradication era in the late 1950s and early 1960s, reducing malaria cases to just 100,000 in 1964. However, a reversal would be experienced. By 1976, malaria cases reached the 6.4 million mark. A continued rise in ''[[Plasmodium falciparum]]'' was reported, and its proportion has gradually risen to nearly 50% in recent years.<ref name="Burden of Malaria in India: Retrospective and Prospective View"/>
== Healthcare and control programs ==
State governments implement a number of well-structured National Disease Control/Elimination Programs following national policies.<ref name="Burden of Malaria in India: Retrospective and Prospective View"/> Technical and operational guidelines are provided by an organized National Vector Borne Disease Control Program (NVBDCP) to the state governments besides sharing one half the costs for the control of malaria, among other diseases.<ref name="Burden of Malaria in India: Retrospective and Prospective View"/> A cost–benefit analysis suggests that each [[Indian rupee]] invested by the National Malaria Control Program pays a rich dividend of 19.7 rupees.<ref name="Burden of Malaria in India: Retrospective and Prospective View"/>
In April 1953, the Government of India launched the National Malaria Control Program, which proved highly successful and significantly reduced the number of malaria cases to about 2 million by 1958.<ref name="Malaria in Indiav"></ref> A more ambitious National Malaria Eradication Program was launched in 1958. By 1961 the incidence dropped to a mere 49,151 cases, with no deaths.<ref name="Malaria in Indiav"/> However, a malaria resurgence was experienced in the 1960s and 1970s, as the result of technical, financial and operational problems.<ref name="Malaria in Indiav"/> Malaria cases in urban areas started to multiply in the late 1960s, and a widespread upsurge of the disease rose. In 1976, 6.45 million cases were recorded by the National Malaria Eradication Program (NMEP), the highest since resurgence.<ref name="Malaria in Indiav"/> In 1971-72 an urban malaria scheme (UMS) was implemented and a modified plan of operation (MPO) followed in 1977, improving the malaria situation for 5-6 years, providing easy availability of drugs, reducing [[morbidity]] and preventing deaths. A reduction to about 2 million cases was achieved. The impact was mainly on ''[[Plasmodium vivax]]'' malaria. In 1977 the ''[[Plasmodium falciparum]]'' containment program (PfCP) launched helping reduce ''falciparum'' malaria. However, the general spread of this parasite could not be contained. ''P. falciparum'' showed a steady upward trend during the 1970s and thereafter.<ref name="Malaria in Indiav"/>
The Enhanced Malaria Control Project (EMCP) was launched in April 1997<ref name="Kumar"/> and implemented in 181 selected districts of the country, with the assistance of the [[World Bank]].<ref name="Burden of Malaria in India: Retrospective and Prospective View"/> It consisted in five components: early diagnosis and prompt treatment, selective vector control, [[mosquito net|insecticide-treated bed nets]], epidemic response and inter-sectoral collaboration, and institutional strengthening.<ref name="Kumar"/> This program directly benefited the tribal population of eight peninsular states covering 100 districts and 19 urban areas, as well as the population living in other malaria endemic areas.<ref name="Kumar"/> In 2003, it expanded to cover 200 tribal blocks, and added two states, [[Karnataka]] and [[West Bengal]].<ref name="Kumar"/> India reported 3 million fewer cases in 2017 compared with 2016, a 24% decrease, being a unique case reporting progress in reducing its malaria cases in the period.<ref name="This year's World malaria report at a glance"></ref>
== See also ==
* [[Malaria and the Caribbean]]
== References ==
November 30, 2019 at 07:13AM
