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Singh MP, Bharti PK, Rajvanshi H, Sahu RS, Jayswar H, Anvikar AR, Lal AA. Malaria elimination: situation analysis of cases in India, the state of Madhya Pradesh in central India, and district Mandla of Madhya Pradesh. Front Public Health 2024; 12:1363736. [PMID: 38655519 PMCID: PMC11035778 DOI: 10.3389/fpubh.2024.1363736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Accepted: 03/11/2024] [Indexed: 04/26/2024] Open
Abstract
India contributed approximately 66% of the malaria cases in the WHO South-East Asia region in 2022. In India, approximately 44% of cases have been reported to be disproportionately contributed by approximately 27 districts. A comparative analysis of reported malaria cases between January 2017 and December 2022 was performed in Mandla district, which is the site of a model malaria elimination demonstration project (MEDP) in Madhya Pradesh (MP), India. Compared to 2017, the decrease in malaria cases in Mandla from 2018 to 2022 was higher than MP and the rest of the country. The reduction of cases was significant in 2018, 2019, and 2021 (p < 0.01) (Mandla vs. MP) and was highly significant during 2018-2022 (p < 0.001) (Mandla vs. India). Robust surveillance and real-time data-based decisions accompanied by appropriate management, operational controls, and independent reviews, all designed for resource optimisation, were the reasons for eliminating indigenous malaria in Mandla district. The increase in infection rates during the months immediately following rains suggests that surveillance, vector control, and case management efforts should be specifically intensified for eliminating imported and indigenous cases in the near-elimination districts to work towards achieving the national elimination goal of 2030.
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Affiliation(s)
- Mrigendra P. Singh
- Malaria Elimination Demonstration Project, Mandla, Madhya Pradesh, India
| | - Praveen K. Bharti
- Indian Council of Medical Research, National Institute of Malaria Research, New Delhi, India
| | - Harsh Rajvanshi
- Malaria Elimination Demonstration Project, Mandla, Madhya Pradesh, India
| | - Ram S. Sahu
- Department of Health Services, Government of Madhya Pradesh, Mandla, Madhya Pradesh, India
| | - Himanshu Jayswar
- Directorate General of Health Services, Government of Madhya Pradesh, Bhopal, Madhya Pradesh, India
| | - Anup R. Anvikar
- Indian Council of Medical Research, National Institute of Malaria Research, New Delhi, India
| | - Altaf A. Lal
- Foundation for Disease Elimination and Control of India (FDEC India), Mumbai, Maharashtra, India
- Sun Pharmaceutical Industries Ltd., Mumbai, India
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Rajvanshi H, Singh MP, Bharti PK, Sahu RS, Jayswar H, Govil PJ, Anvikar A, Chan XX, Chebbi A, Das S, Lal AA. Science of malaria elimination: using knowledge of bottlenecks and enablers from the Malaria Elimination Demonstration Project in Central India for eliminating malaria in the Asia Pacific region. Front Public Health 2024; 11:1303095. [PMID: 38303961 PMCID: PMC10830794 DOI: 10.3389/fpubh.2023.1303095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 11/27/2023] [Indexed: 02/03/2024] Open
Abstract
Malaria poses a major public health challenge in the Asia Pacific. Malaria Elimination Demonstration Project was conducted as a public-private partnership initiative in Mandla between State government, ICMR, and FDEC India. The project employed controls for efficient operational and management decisions. IEC campaigns found crucial in schools and communities. Capacity building of local workers emphasized for better diagnosis and treatment. SOCH mobile app launched for complete digitalization. Better supervision for Indoor Residual Sprays and optimized Long Lasting Insecticidal Nets distribution. Significant malaria cases reduction in Mandla. Insights from MEDP crucial for malaria elimination strategies in other endemic regions of the Asia Pacific.
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Affiliation(s)
- Harsh Rajvanshi
- Asia Pacific Leaders' Malaria Alliance, Singapore, Singapore
| | - Mrigendra P. Singh
- Foundation for Disease Elimination and Control of India, Mumbai, Maharashtra, India
| | - Praveen K. Bharti
- Indian Council of Medical Research – National Institute of Malaria Research, New Delhi, India
| | | | - Himanshu Jayswar
- Directorate of Health Services, Government of Madhya Pradesh, Bhopal, India
| | - Pallavi Jain Govil
- Department of Tribal Welfare, Government of Madhya Pradesh, Bhopal, India
| | - Anup Anvikar
- Indian Council of Medical Research – National Institute of Malaria Research, New Delhi, India
| | | | - Amita Chebbi
- Asia Pacific Leaders' Malaria Alliance, Singapore, Singapore
| | - Sarthak Das
- Asia Pacific Leaders' Malaria Alliance, Singapore, Singapore
| | - Altaf A. Lal
- Foundation for Disease Elimination and Control of India, Mumbai, Maharashtra, India
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Ompad DC, Padhan TK, Kessler A, Tozan Y, Jones AM, van Eijk AM, Sullivan SA, Haque MA, Pradhan MM, Mohanty S, Carlton JM, Sahu PK. The effectiveness of malaria camps as part of the malaria control program in Odisha, India. Sci Rep 2023; 13:22998. [PMID: 38155156 PMCID: PMC10754896 DOI: 10.1038/s41598-023-46220-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 10/30/2023] [Indexed: 12/30/2023] Open
Abstract
Durgama Anchalare Malaria Nirakaran (DAMaN) is a multi-component malaria intervention for hard-to-reach villages in Odisha, India. The main component, malaria camps (MCs), consists of mass screening, treatment, education, and intensified vector control. We evaluated MC effectiveness using a quasi-experimental cluster-assigned stepped-wedge study with a pretest-posttest control group in 15 villages: six immediate (Arm A), six delayed (Arm B), and three previous interventions (Arm C). The primary outcome was PCR + Plasmodium infection prevalence. The time (i.e., baseline vs. follow-up 3) x study arm interaction term shows that there were statistically significant lower odds of PCR + Plasmodium infection in Arm A (AOR = 0.36, 95% CI = 0.17, 0.74) but not Arm C as compared to Arm B at the third follow-up. The cost per person ranged between US$3-8, the cost per tested US$4-9, and the cost per treated US$82-1,614, per camp round. These results suggest that the DAMaN intervention is a promising and financially feasible approach for malaria control.
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Affiliation(s)
- Danielle C Ompad
- School of Global Public Health, New York University, New York, NY, 10003, USA.
| | - Timir K Padhan
- Department of Molecular Biology and Infectious Diseases, Community Welfare Society Hospital, Rourkela, Odisha, 769042, India
| | - Anne Kessler
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA
| | - Yesim Tozan
- School of Global Public Health, New York University, New York, NY, 10003, USA
| | - Abbey M Jones
- School of Global Public Health, New York University, New York, NY, 10003, USA
| | - Anna Maria van Eijk
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Steven A Sullivan
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA
| | - Mohammed A Haque
- Department of Molecular Biology and Infectious Diseases, Community Welfare Society Hospital, Rourkela, Odisha, 769042, India
| | - Madan Mohan Pradhan
- Department of Health and Family Welfare, State Vector Borne Disease Control Programme, Bhubaneswar, Odisha, 751001, India
| | - Sanjib Mohanty
- Department of Molecular Biology and Infectious Diseases, Community Welfare Society Hospital, Rourkela, Odisha, 769042, India
| | - Jane M Carlton
- School of Global Public Health, New York University, New York, NY, 10003, USA
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA
- Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Global Public Health, Baltimore, MD, 21205, USA
| | - Praveen K Sahu
- Department of Molecular Biology and Infectious Diseases, Community Welfare Society Hospital, Rourkela, Odisha, 769042, India
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Khan N, Awasthi G, Das A. How can the complex epidemiology of malaria in India impact its elimination? Trends Parasitol 2023; 39:432-444. [PMID: 37031071 PMCID: PMC10175201 DOI: 10.1016/j.pt.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 03/04/2023] [Accepted: 03/10/2023] [Indexed: 04/10/2023]
Abstract
Malaria is a human health hazard in the tropical and subtropical zones of the globe and is poised to be eliminated by the year 2030. Despite a decrease in incidence in the past two decades, many endemic countries, including India, report cases regularly. The epidemiology of malaria in India is unique owing to several features of the Plasmodium parasites, Anopheles vectors, ecoepidemiological situations conducive to disease transmission, and susceptible humans living in rural and forested areas. Limitations in public health reach, and poor health-seeking behaviour of vulnerable populations living in hard-to-reach areas, add to the problem. We bring all of these factors together in a comprehensive framework and opine that, in spite of complexities, targeted elimination of malaria in India is achievable with planned programmatic approaches.
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Affiliation(s)
- Nikhat Khan
- Molecular Epidemiology Laboratory, ICMR-National Institute of Research in Tribal Health, Jabalpur, India
| | | | - Aparup Das
- Molecular Epidemiology Laboratory, ICMR-National Institute of Research in Tribal Health, Jabalpur, India.
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Ompad DC, Padhan TK, Kessler A, Mohanty S, Tozan Y, Jones AM, van Eijk AM, Sullivan SA, Haque MA, Pradhan MM, Mohanty S, Carlton JM, Sahu PK. The effectiveness of malaria camps as part of the malaria control program in Odisha, India. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.01.18.23284743. [PMID: 36711482 PMCID: PMC9882634 DOI: 10.1101/2023.01.18.23284743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Durgama Anchalare Malaria Nirakaran (DAMaN) is a multi-component malaria intervention for hard-to-reach villages in Odisha, India. The main component, Malaria Camps (MCs), consists of mass screening, treatment, education, and intensified vector control. We evaluated MC effectiveness using a quasi-experimental cluster-assigned stepped-wedge study with a pretest-posttest control group in 15 villages: six immediate (Arm A), six delayed (Arm B), and three previous interventions (Arm C). The primary outcome was PCR+ Plasmodium infection prevalence. Across all arms, the odds of PCR+ malaria were 54% lower at the third follow-up compared to baseline. A time (i.e., visit) x study arm interaction revealed significantly lower odds of PCR+ malaria in Arm A versus B at the third follow-up. The cost per person ranged between US$3-8, the cost per tested US$4-7, and the cost per treated US$82-1,614, per camp round. These results suggest that the DAMaN intervention is a promising, financially feasible approach for malaria control.
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Affiliation(s)
- Danielle C Ompad
- School of Global Public Health, New York University, New York, NY, 10003, USA
| | - Timir K Padhan
- Department of Molecular Biology & Infectious Diseases, Community Welfare Society Hospital, Rourkela, Odisha, 769042, India
| | - Anne Kessler
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA
| | - Stuti Mohanty
- Department of Molecular Biology & Infectious Diseases, Community Welfare Society Hospital, Rourkela, Odisha, 769042, India
| | - Yesim Tozan
- School of Global Public Health, New York University, New York, NY, 10003, USA
| | - Abbey M Jones
- School of Global Public Health, New York University, New York, NY, 10003, USA
| | - Anna Maria van Eijk
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA
| | - Steven A Sullivan
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA
| | - Mohammed A Haque
- Department of Molecular Biology & Infectious Diseases, Community Welfare Society Hospital, Rourkela, Odisha, 769042, India
| | - Madan Mohan Pradhan
- Department of Health & Family Welfare, State Vector Borne Disease Control Programme, Bhubaneswar, Odisha, 751001, India
| | - Sanjib Mohanty
- Department of Molecular Biology & Infectious Diseases, Community Welfare Society Hospital, Rourkela, Odisha, 769042, India
| | - Jane M Carlton
- School of Global Public Health, New York University, New York, NY, 10003, USA
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10003, USA
| | - Praveen K Sahu
- Department of Molecular Biology & Infectious Diseases, Community Welfare Society Hospital, Rourkela, Odisha, 769042, India
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Singh A, Rajvanshi H, Singh MP, Bhandari S, Nisar S, Poriya R, Telasey V, Jayswar H, Mishra AK, Das A, Kaur H, Lal AA, Bharti PK. Mass screening and treatment (MSaT) for identifying and treating asymptomatic cases of malaria-malaria elimination demonstration project (MEDP), Mandla, Madhya Pradesh. Malar J 2022; 21:395. [PMID: 36575544 PMCID: PMC9793628 DOI: 10.1186/s12936-022-04423-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 12/19/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Mass screening and treatment (MSaT) aims at reducing the spread of malaria in communities by identifying and treating infected persons regardless of the symptoms. This study was conducted to identify and treat asymptomatic cases using MSaT approaches in the community. METHODS Three rounds of MSaT using cluster combination approaches were carried out during September 2018 to December 2019 to identify and treat asymptomatic malaria cases in the community. All individuals who were present in the household were screened using RDT irrespective of malaria related symptoms. Simultaneously thick and thin blood smear and blood spot were collected for further analysis using microscopy and diagnostic PCR done in a subset of the samples. RESULTS Logistic regression analysis revealed that asymptomatic malaria cases significantly less among the older age groups compared with < 5 years children (OR ranged between 0.52 and 0.61; p < 0.05), lowest in cluster 4 (OR = 0.01; p < 0.0001); during third round of MSaT survey (OR = 0.11; p < 0.0001) and significantly higher in moderate to high endemic areas (OR = 88.30; p < 0.0001). CONCLUSION Over the three rounds of MSaT, the number of asymptomatic cases were significantly less in the older age groups, and during third round. Similarly, the asymptomatic cases were significantly less in the low endemic area with API < 1 (cluster four). Therefore, the malaria elimination programme may consider the MSaT strategy to identify asymptomatic cases that would be otherwise missed by routine fever based surveillance. This MSaT strategy would help accomplish the malaria elimination goal in an expedited manner.
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Affiliation(s)
- Akansha Singh
- Indian Council of Medical Research - National Institute of Research in Tribal Health (ICMR-NIRTH), Jabalpur, Madhya Pradesh India
- Indian Council of Medical Research - National Institute of Malaria Research (ICMR-NIMR), New Delhi, India
| | - Harsh Rajvanshi
- Malaria Elimination Demonstration Project, Mandla, Madhya Pradesh India
- Present Address: Asia Pacific Leaders Malaria Alliance (APLMA), Singapore, Singapore
| | | | - Sneha Bhandari
- Indian Council of Medical Research - National Institute of Research in Environment Health (ICMR-NIREH), Bhopal, Madhya Pradesh India
| | - Sekh Nisar
- Malaria Elimination Demonstration Project, Mandla, Madhya Pradesh India
- Present Address: Department of Health and Family Welfare, NHM Raigarh, Raigarh, Chattisgarh India
| | - Rajan Poriya
- Indian Council of Medical Research - National Institute of Research in Tribal Health (ICMR-NIRTH), Jabalpur, Madhya Pradesh India
| | - Vinay Telasey
- Malaria Elimination Demonstration Project, Mandla, Madhya Pradesh India
| | - Himanshu Jayswar
- Directorate of Health Services, Government of Madhya Pradesh, Bhopal, India
| | - Ashok K. Mishra
- Indian Council of Medical Research - National Institute of Research in Tribal Health (ICMR-NIRTH), Jabalpur, Madhya Pradesh India
| | - Aparup Das
- Indian Council of Medical Research - National Institute of Research in Tribal Health (ICMR-NIRTH), Jabalpur, Madhya Pradesh India
| | - Harpreet Kaur
- Department of Health Research, Ministry of Health and Family Welfare, Indian Council of Medical Research, New Delhi, India
| | - Altaf A. Lal
- Malaria Elimination Demonstration Project, Mandla, Madhya Pradesh India
- Foundation for Disease Elimination and Control of India, Mumbai, 482003 Maharashtra India
| | - Praveen K. Bharti
- Indian Council of Medical Research - National Institute of Research in Tribal Health (ICMR-NIRTH), Jabalpur, Madhya Pradesh India
- Indian Council of Medical Research - National Institute of Malaria Research (ICMR-NIMR), New Delhi, India
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Singh MP, Rajvanshi H, Bharti PK, Das A, Thakre V, Jayswar H, Sahu RS, Telasey VK, Lal AA. A qualitative study on community perceptions on quality of healthcare services they received in the Malaria Elimination Demonstration Project in district Mandla, India. Malar J 2022; 21:368. [PMID: 36463136 PMCID: PMC9719226 DOI: 10.1186/s12936-022-04400-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 11/24/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND The utilization and impact of the healthcare services depend on the perceived quality, appropriateness, ease of availability, and cost of the services. This study aimed to understand the community's perception of the quality of healthcare services delivered as part of the Malaria Elimination Demonstration Project (MEDP), Mandla, Madhya Pradesh, India. METHODS The study used qualitative techniques to analyze the community perceptions that emerged from the participants' narratives during the Focus Group Discussions (FGDs) and in-depth Interviews with Key Informants (IKIs) on the promptness and quality of healthcare service delivery, the behaviour of MEDP staff, Information, Education and Communication, and Behavioural Change Communication activities, coordination with community members and other health personnel, and capacity building of healthcare workers and the community. RESULTS 36 FGDs and 63 IKIs with 419 respondents were conducted in nine blocks of district Mandla. Overall, 97% to 100% of beneficiaries associated MEDP with regularity and prompt service delivery, availability of diagnostics and drugs, friendly behaviour, good coordination, and community mobilization to enhance treatment-seeking behaviour. CONCLUSIONS The study's findings highlighted the importance of building and maintaining the community's participation and promoting the demand for optimal utilization of healthcare services inside the village to promptly achieve the malaria elimination goal.
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Affiliation(s)
| | - Harsh Rajvanshi
- Malaria Elimination Demonstration Project, Mandla, Madhya Pradesh India ,Present Address: Asia Pacific Leaders Malaria Alliance (APLMA), Singapore, Singapore
| | - Praveen K. Bharti
- grid.452686.b0000 0004 1767 2217Indian Council of Medical Research – National Institute of Research in Tribal Health (ICMR-NIRTH), Jabalpur, Madhya Pradesh India ,grid.419641.f0000 0000 9285 6594Present Address: Indian Council of Medical Research – National Institute of Malaria Research (ICMR-NIMR), New Delhi, India
| | - Aparup Das
- grid.452686.b0000 0004 1767 2217Indian Council of Medical Research – National Institute of Research in Tribal Health (ICMR-NIRTH), Jabalpur, Madhya Pradesh India
| | - Vikesh Thakre
- Malaria Elimination Demonstration Project, Mandla, Madhya Pradesh India
| | - Himanshu Jayswar
- Directorate General of Health Services, Government of Madhya Pradesh, Bhopal, Madhya Pradesh India
| | - Ram Shankar Sahu
- Department of Health Services, Government of Madhya Pradesh, Mandla, Madhya Pradesh India
| | - Vinay K. Telasey
- Malaria Elimination Demonstration Project, Mandla, Madhya Pradesh India
| | - Altaf A. Lal
- Foundation for Disease Elimination and Control of India (FDEC India), Mumbai, Maharashtra India
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Rahi M, Sharma A. India could harness public-private partnerships to achieve malaria elimination. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2022; 5:100059. [PMID: 37383669 PMCID: PMC10305908 DOI: 10.1016/j.lansea.2022.100059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Public-private partnerships (PPP) have been beneficial in different sectors like infrastructure development and service sector across the world, including in India. Such partnerships in the healthcare sector have also been successful in providing access to affordable medical attention to all sections of society. These partnerships between public and private entities have proven to be beneficial in controlling malaria in high burden districts of India and taking these areas to the brink of elimination, thus setting examples to follow. The two successful ones are the Comprehensive Case Management Project (CCMP) in Odisha which is now adopted by the state, and the Malaria Elimination Demonstration Project (MEDP) which has nearly eliminated malaria from the highly endemic district of Mandla in Madhya Pradesh. Here we propose that non-government and semi-government actors may be given vital roles in the malaria elimination efforts till 2030 and beyond. These partners will add value to the national programme and may have the potential to develop and test different models of malaria elimination in real-life settings that the government programme can absorb sustainably.
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Affiliation(s)
- Manju Rahi
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research (ICMR), New Delhi, India
- Academy of Scientific and Innovative Research, Ghaziabad, India
| | - Amit Sharma
- Academy of Scientific and Innovative Research, Ghaziabad, India
- ICMR-National Institute of Malaria Research, New Delhi, India
- Molecular Medicine, International Centre for Genetic Engineering and Biotechnology, New Delhi, India
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Pradhan MM, Pradhan S, Dutta A, Shah NK, Valecha N, Joshi PL, Pradhan K, Grewal Daumerie P, Banerji J, Duparc S, Mendis K, Sharma SK, Murugasampillay S, Anvikar AR. Impact of the malaria comprehensive case management programme in Odisha, India. PLoS One 2022; 17:e0265352. [PMID: 35324920 PMCID: PMC8947122 DOI: 10.1371/journal.pone.0265352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 02/28/2022] [Indexed: 11/19/2022] Open
Abstract
Background
The Comprehensive Case Management Project (CCMP), was a collaborative implementation research initiative to strengthen malaria early detection and complete treatment in Odisha State, India.
Methods
A two-arm quasi-experimental design was deployed across four districts in Odisha, representing a range of malaria endemicity: Bolangir (low), Dhenkanal (moderate), Angul (high), and Kandhamal (hyper). In each district, a control block received routine malaria control measures, whereas a CCMP block received a range of interventions to intensify surveillance, diagnosis, and case management. Impact was evaluated by difference-in-difference (DID) analysis and interrupted time-series (ITS) analysis of monthly blood examination rate (MBER) and monthly parasite index (MPI) over three phases: phase 1 pre-CCMP (2009–2012) phase 2 CCMP intervention (2013–2015), and phase 3 post-CCMP (2016–2017).
Results
During CCMP implementation, adjusting for control blocks, DID and ITS analysis indicated a 25% increase in MBER and a 96% increase in MPI, followed by a –47% decline in MPI post-CCMP, though MBER was maintained. Level changes in MPI between phases 1 and 2 were most marked in Dhenkanal and Angul with increases of 976% and 287%, respectively, but declines in Bolangir (−57%) and Kandhamal (−22%). Between phase 2 and phase 3, despite the MBER remaining relatively constant, substantial decreases in MPI were observed in Dhenkanal (−78%), and Angul (−59%), with a more modest decline in Bolangir (−13%), and an increase in Kandhamal (14%).
Conclusions
Overall, CCMP improved malaria early detection and treatment through the enhancement of the existing network of malaria services which positively impacted case incidence in three districts. In Kandhamal, which is hyperendemic, the impact was not evident. However, in Dhenkanal and Angul, areas of moderate-to-high malaria endemicity, CCMP interventions precipitated a dramatic increase in case detection and a subsequent decline in malaria incidence, particularly in previously difficult-to-reach communities.
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Affiliation(s)
- Madan M. Pradhan
- National Vector Borne Disease Control Programme, Government of Odisha, Bhubaneswar, India
- * E-mail:
| | - Sreya Pradhan
- National Vector Borne Disease Control Programme, Government of Odisha, Bhubaneswar, India
| | - Ambarish Dutta
- Indian Institute of Public Health, Bhubaneswar, India
- Kalinga Institute of Industrial Technology, Deemed to be University, Bhubaneswar, India
| | - Naman K. Shah
- University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Neena Valecha
- National Institute of Malaria Research, New Delhi, India
| | - Pyare L. Joshi
- Independent Malariologist, Gallup, Washington, D.C., United States of America
| | | | | | - Jaya Banerji
- Medicines for Malaria Venture, Geneva, Switzerland
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