Malaria epidemics in India: Role of climatic condition and control measures

Assessing the impact of ecological, climatic, and socioeconomic factors on age-specific malaria incidence in India: a mixed-model approach using the Global Burden of Disease Study (2010-2019)

BACKGROUND

Malaria continues to be a critical public health concern in India, predominantly driven by complex interplays of ecological, climatic, and socioeconomic factors.

METHODS

This study aimed to assess the association between climatic variables (temperature and precipitation) and malaria incidence across India from 2010 to 2019, utilizing data from the Global Historical Weather and Climate Data for climate metrics and the Global Burden of Disease Study for malaria incidence rates. Generalized Linear Mixed Models (GLMMs) with a Poisson distribution were employed to analyze the data, adjusting for socio-economic status, as indexed by the Human Development Index (HDI).

RESULTS

The results indicated a declining trend in both the number of malaria cases and age-specific incidence rates (ASIR) over the study period. In 2010, India reported approximately 20.7 million cases with an ASIR of 1688.86 per 100,000 population, which significantly reduced to 9.8 million cases and an ASIR of 700.80 by 2019. High malaria incidence was consistently observed in the states of Jharkhand and Odisha, whereas Sikkim reported the lowest numbers. Statistical analysis identified significant associations between malaria incidence and both temperature deviations and precipitation levels, with variations also linked to HDI, suggesting better detection and reporting capabilities in more developed areas.

CONCLUSION

The study underscores the critical interactions between climatic variables and socio-economic factors in shaping the trends of malaria incidence across India. These findings highlight the necessity for adaptive, localized public health strategies that integrate environmental monitoring with socio-economic data to efficiently predict and manage malaria outbreaks.

Spatial patterns of malaria case burden and seasonal precipitation in India during 1995-2013

The majority of malaria cases in Southeast Asia occur in India. It is a major public health problem in India, which accounts for substantial morbidity, mortality, and economic loss. The spatial distribution of malaria widely varies due to geo-ecological diversity, multi-ethnicity, and wide distribution of the different anopheline vectors. The predominant malaria parasites in India for malaria are P. Falciparum (Pf) and P. Vivax (Pv). This study analyzes the spatial patterns of malaria cases, specifically the two dominant malaria vectors, at the regional level and its relation to seasonal precipitation. The results of our study revealed an overall decline in malaria cases in the later years. The spatial spread of malaria cases was more widespread during the normal monsoon years vs drought years, which can be attributed to more conducive environment for mosquitos to breed. The correlation analysis revealed a stronger correlation between malaria case burden and monsoon precipitation. Spatially, the strongest correlation between seasonal and annual precipitation, and malaria case burden were located across the northern plains and northeast India. The results of this research further our understanding of the relationship between seasonal precipitation and malaria case burden at the regional level across India.

Malaria Elimination in Two Endemic Coastal Environments of Southern India: An Eco-Epidemiological Analysis from 2004 to 2019

PURPOSE

Presently, India is heading towards malaria elimination. In this context, analysing malaria epidemiological data of endemic pockets is important. In the present investigation, malaria prevalence in two endemic coastal localities of India viz., Besant Nagar (Chennai district) and Pamban (Ramanathapuram district) was analysed from 2004 to 2019 and correlated with the highest maximum temperature.

METHODS

Malaria surveillance data and entomological data from the malaria clinics were used to investigate epidemiological parameters. The annual malaria cases were correlated with the highest maximum temperature.

RESULTS

The analysis showed that the malaria case (P.v. and P.f.) reports were directly proportional to the temperature increase. Malaria cases were remarkably increased from 2004 to 2011 and subsequently, both Plasmodium vivax and Plasmodium falciparum cases were drastically reduced till 2019. P. vivax was higher than P. falciparum and the male population was found to be more affected. Mixed infection of P. vivax and P. falciparum was observed only in the Besant Nagar site (0.3%). The most affected age group was the adult age group (15 years and above) in both Besant Nagar (76.1%) and Pamban (69.5%).

CONCLUSION

Improved surveillance, complete treatment and integrated vector control activities correlated with a declining trend of malaria cases in both the coastal sites towards malaria elimination.

Current Epidemiological Characteristics of Imported Malaria, Vector Control Status and Malaria Elimination Prospects in the Gulf Cooperation Council (GCC) Countries

Malaria is the most common vector-borne parasitic infection causing significant human morbidity and mortality in nearly 90 tropical/sub-tropical countries worldwide. Significant differences exist in the incidence of malaria cases, dominant Plasmodium species, drug-resistant strains and mortality rates in different countries. Six Gulf Cooperation Council (GCC) countries (Bahrain, Kuwait, Qatar, Oman, Saudi Arabia and United Arab Emirates, UAE) in the Middle East region with similar climates, population demographics and economic prosperity are aiming to achieve malaria elimination. In this narrative review, all studies indexed in PubMed describing epidemiological characteristics of indigenous and imported malaria cases, vector control status and how malaria infections can be controlled to achieve malaria elimination in GCC countries were reviewed and discussed. These studies have shown that indigenous malaria cases are absent in Bahrain, Kuwait, Qatar and UAE and have progressively declined in Oman and Saudi Arabia. However, imported malaria cases continue to occur as GCC countries have large expatriate populations originating from malaria-endemic countries. Various malaria control and prevention strategies adopted by GCC countries including more stringent measures to reduce the likelihood of importing malaria cases by prior screening of newly arriving expatriates and vector elimination programs are likely to lead to malaria elimination in this region.

Intention-Based Critical Factors Affecting Willingness to Adopt Novel Coronavirus Prevention in Pakistan: Implications for Future Pandemics

Since human beings have a long tradition of coexistence with pandemics, which may profoundly impact them, adopting preventive measures is crucial for humankind's survival. This study explores the intention-based critical factors affecting the willingness of individuals to adopt pandemic prevention. To this end, a representative sample of 931 Pakistanis filled in an online questionnaire. However, only 828 questionnaires were found to be complete and valid for path modeling analysis. The core findings are as follows: Firstly, peer groups' beliefs, self-efficacy, perceived risk, pandemic knowledge, ease of pandemic prevention adoption, and risk-averse behavior are revealed as driving forces of the individuals' willingness to adopt pandemic prevention. Contrastingly, a lack of trust in political will and mythical attitude towards pandemics are uncovered as inhibitors. Nevertheless, moral values depict a neutral role. Secondly, the peer groups' beliefs are highest ranked, followed by the lack of trust in political will and a mythical attitude towards pandemic prevention. Finally, moral values are determined as the lowest-ranked critical factor. Based on these results, the government should promote awareness campaigns on lethality and fatality of the pandemic at both centralized and decentralized levels to win people's trust at the grass-roots level and overcome the mythical attitude of individuals at all societal levels. Besides, access to personal protective gears should be made feasible since an easier pandemic prevention adoption would increase the individuals' willingness to adopt such preventative measures.

Current Status and the Epidemiology of Malaria in the Middle East Region and Beyond

Vector-borne parasitic infectious diseases are important causes of morbidity and mortality globally. Malaria is one of the most common vector-borne parasitic infection and is caused by five Plasmodium species, namely P. falciparum, P. vivax, P. ovale, P. malariae, and P. knowlesi. Epidemiologically, differences in the patterns of malaria cases, causative agent, disease severity, antimicrobial resistance, and mortality exist across diverse geographical regions. The world witnessed 229 million malaria cases which resulted in 409,000 deaths in 2019 alone. Although malaria cases are reported from 87 countries globally, Africa bears the brunt of these infections and deaths as nearly 94% of total malaria cases and deaths occur in this continent, particularly in sub-Saharan Africa. Most of the Middle East Region countries are malaria-free as no indigenous cases of infection have been described in recent years. However, imported cases of malaria continue to occur as some of these countries. Indeed, the six Gulf Cooperation Council (GCC) countries have large expatriate population originating from malaria endemic countries. In this review, the current status and epidemiology of malaria in the Middle East Region countries and other malaria-endemic countries that are home to a large migrant workforce being employed in Middle East Region countries are discussed.

Perception-based influence factors of intention to adopt COVID-19 epidemic prevention in China

BACKGROUND

The researches investigating the influence factors of epidemic prevention are not only scarce, but also provide a gap in the domain of perception-based influence factors of intention to adopt COVID-19 epidemic prevention.

OBJECTIVE

This work has attempted to examine the perception-based influence factors of individuals' intention to adopt COVID-19 epidemic prevention in a modified behavioral framework.

THEORETICAL FRAMEWORK

A behavioral framework composed of the theory of reasoned action and the theory of planned behavior is developed to incorporate some additional perception-based influence factors.

METHODS

A partial least square-based path analysis has been employed to estimate the path coefficients of those factors in terms of drivers, barriers, and neutral factors based on questionnaire data of 302 respondents from six universities and two hospitals in China.

RESULTS

Among the perception-based influence factors, governments' guidelines on epidemic prevention is found to be the most important and influential factor, which was followed by risk perception. Finally, attitude towards epidemic prevention exhibited the least degree of impact on individuals' intention to adopt epidemic prevention. Moral norms did not show any contribution to individuals' intention to adopt epidemic prevention.

CONCLUSION

Concerning importance ranking, the governments' guidelines on epidemic prevention, risk perception, and epidemic knowledge are revealed as the top three drivers of individuals' intention to adopt epidemic prevention, while the perceived feasibility to adopt epidemic prevention is found to be a barrier. Moreover, moral norms is identified to have an insignificant influence on individuals' intention to adopt epidemic prevention. Given the empirical results, dissemination of Governments' guidelines on epidemic prevention, proper risk perception, and knowledge about epidemic would help prevent the COVID-19 pandemic outbreak within China and worldwide.

Development of a probabilistic early health warning system based on meteorological parameters

Among the other diseases, malaria and diarrhoea have a large disease burden in India, especially among children. Changes in rainfall and temperature patterns likely play a major role in the increased incidence of these diseases across geographical locations. This study proposes a method for probabilistic forecasting of the disease incidences in extended range time scale (2–3 weeks in advance) over India based on an unsupervised pattern recognition technique that uses meteorological parameters as inputs and which can be applied to any geographical location over India. To verify the robustness of this newly developed early warning system, detailed analysis has been made in the incidence of malaria and diarrhoea over two districts of the State of Maharashtra. It is found that the increased probabilities of high (less) rainfall, high (low) minimum temperature and low (moderate) maximum temperature are more (less) conducive for both diseases over these locations, but have different thresholds. With the categorical probabilistic forecasts of disease incidences, this early health warning system is found to be a useful tool with reasonable skill to provide the climate-health outlook about possible disease incidence at least 2 weeks in advance for any location or grid over India.

Electrophilic Chlorine from Chlorosulfonium Salts: A Highly Chemoselective Reduction of Sulfoxides

Herein, we describe a selective late-stage deoxygenation of sulfoxides based on a novel application of chlorosulfonium salts and demonstrate a new process using these species generated in situ from sulfoxides as the source of electrophilic chlorine. The use of highly nucleophilic 1,3,5-trimethoxybenzene (TMB) as the reducing agent is described for the first time and applied in the deoxygenation of simple and functionalized sulfoxides. The method is easy to handle, economic, suitable for gram-scale operations, and readily applied for poly-functionalized molecules, as demonstrated with more than 45 examples, including commercial medicines and analogues. We also report the results of competition experiments that define the more reactive sulfoxide and we present a mechanistic proposal based on substrate and product observations.