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Ahmed RA, Kumar A, Swargiary A, Suri HS, Shankar H, Hussain SSA, Kumar G, Singh K, Kalita D, begum A. Impact assessment of Intensified Malaria Control Project in transitioning a high malaria-endemic district to a low-endemic district: an epidemiological aspect. Pathog Glob Health 2023; 117:493-504. [PMID: 36960929 PMCID: PMC10262807 DOI: 10.1080/20477724.2023.2194498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2023] Open
Abstract
Intensified Malaria Control Project (IMCP) was implemented in 2005 to control malaria in all North-Eastern and Odisha states of India. The present study aimed to investigate the impact of IMCP in reducing the malaria burden in Udalguri district, Assam state of North-East India. Malaria epidemiological data were obtained for IMCP intervention (Udalguri) and nonintervention district (West Singhbhumi, Jharkhand state). IMCP activities include introducing bi-valent rapid diagnostic kits (RDTs), Artemether-Lumefantrine drug in North-East India, long-lasting insecticidal nets (LLINs) distribution, and creating awareness programs about malaria in an intensified mode. The data revealed a significant decline in annual parasite incidence (API) from 14.94 (2005) to 2.61 (2018), -37% (95%CI: -57%, -19%, p = 001) after using LLINs in 2009 and -64% (95%CI: -116%, -14%, p = 013) after the introduction of RDTs in district Udalguri. Whereas control district showed a -28% (95%CI: -63%, 6.3%, p = 0.051) decrease in API using LLINs and a 10% (95%CI: -7.6%, 28%, p = 0.122) increase after the introduction of RDTs. Plasmodium falciparum (Pf) and P. vivax (Pv) were the major malarial parasites in Udalguri. Pv-malaria was much higher (71%) than Pf-malaria (29%) during the study period. An increasing trend of Pf cases was observed in Udalguri. Udalguri and Khoirabari BPHCs showed an overall reduction of 94% (95%CI: -143%, -45%, p = 0.001) and 84% (95%CI: -126%, -39%, p = 0.003), respectively; however, only a 10% (95%CI: -65%, -41%, p = 0.360) reduction in API was observed in Orang BPHC. An overall decrease in malaria indicates the effective implementation of vector and disease control strategies in the Udalguri district.
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Affiliation(s)
- Rahim Ali Ahmed
- National Vector Borne Disease Control Programme, Udalguri, Darrang, Assam, India
- Department of Parasite – Host Biology, ICMR – National Institute of Malaria Research, Dwarka, New Delhi, India
- Academy of Scientific & Innovative Research, Ghaziabad, Uttar Pradesh, India
| | - Avdhesh Kumar
- National Vector Borne Disease Control Programme, Ministry of Health & Family Welfare, Government of India, New Delhi, India
| | - Ananta Swargiary
- Department of Zoology, Bodoland University, Kokrajhar, Assam, India
| | - Harpal Singh Suri
- National Vector Borne Disease Control Programme, Udalguri, Darrang, Assam, India
| | - Hari Shankar
- Department of Parasite – Host Biology, ICMR – National Institute of Malaria Research, Dwarka, New Delhi, India
- Indian Council of Medical Research, Ansari Nagar, New Delhi, India
| | - Syed Shah Areeb Hussain
- Department of Parasite – Host Biology, ICMR – National Institute of Malaria Research, Dwarka, New Delhi, India
| | - Gaurav Kumar
- Department of Parasite – Host Biology, ICMR – National Institute of Malaria Research, Dwarka, New Delhi, India
| | - Kuldeep Singh
- Department of Parasite – Host Biology, ICMR – National Institute of Malaria Research, Dwarka, New Delhi, India
- Academy of Scientific & Innovative Research, Ghaziabad, Uttar Pradesh, India
| | - Dipika Kalita
- Department of Zoology, Bhattadev University, Pathshala, Assam, India
| | - Afluza begum
- Department of Chemistry, Bhattadev University, Pathshala, Assam, India
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Ahmed RA, Shankar H, Hussain SSA, Swargiary A, Kumar A, Tarique M, Prabhakar P, Suri HS, Singh K, Chakma JK, Singh J, Begum A. Moderate Rainfall and High Humidity During the Monsoon Season, Negligence in Using Malaria Protection Methods and High Proportion of Mild Symptomatic Patients Were the Driving Forces for Upsurge of Malaria Cases in 2018 Among Tea Tribe Populations in Endemic Dolonibasti Health Sub-center, Udalguri District, Assam State, North-East India. Front Med (Lausanne) 2022; 9:913848. [PMID: 35847777 PMCID: PMC9280886 DOI: 10.3389/fmed.2022.913848] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 05/30/2022] [Indexed: 12/04/2022] Open
Abstract
Malaria elimination is a global priority, which India has also adopted as a target. Despite the malaria control efforts like long-lasting insecticidal nets distribution, rounds of indoor residual spray, the introduction of bi-valent rapid diagnostic tests and artemisinin combination therapy, malaria remained consistent in Dolonibasti sub-center of Orang block primary health center (BPHC) under the district Udalguri, Assam state followed by abrupt rise in cases in 2018. Therefore, we aimed to investigate the factors driving the malaria transmission in the outbreak area of Dolonibasti sub-center. Malaria epidemiological data (2008–2018) of Udalguri district and Orang BPHC was collected. The annual (2011-2018) and monthly (2013–2018) malaria and meteorological data of Dolonibasti sub-center was collected. An entomological survey, Knowledge, Attitude and Practices study among malaria cases (n = 120) from Dolonibasti was conducted. In 2018, 26.1 % (2136/ 8188) of the population of Dolonibasti were found to be malaria positive, of which 55% were adults (n = 1176). Majority of cases were from tea tribe populations (90%), either asymptomatic or with fever only, 67.5 % (81/120) had experienced malaria infection during past years. The outbreak was characterized by a strong increase in cases in June 2018, high proportion of slide falciparum rate of 26.1% (other years average, 15.8%) and high proportion of P. falciparum of 81.2 % (other years average, 84.3%). Anopheles minimus s.l. was the major vector with 28.6% positivity and high larval density in paddy fields/ drainage area. Annual relative humidity was associated with rise in malaria cases, annual parasite incidence (rs = 0.69, 90%CI; p = 0.06) and slide positivity rate (rs = 0.83, 95%CI; p = 0.01). Older people were less educated (rs = −0.66; p < 0.001), had lesser knowledge about malaria cause (rs = −0.42; χ2=21.80; p < 0.001) and prevention (rs = −0.18; p = 0.04). Malaria control practices were followed by those having knowledge about cause of malaria (rs = 0.36; χ2 = 13.50; p < 0.001) and prevention (rs = 0.40; χ2 = 17.71; p < 0.001). Altogether, 84.6% (44/52) of the respondents did not use protective measures. We described a sudden increase in malaria incidence in a rural, predominantly tea tribe population group with high illiteracy rate and ignorance on protective measures against malaria. More efforts that are concerted needed to educate the community about malaria control practices.
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Affiliation(s)
- Rahim Ali Ahmed
- National Vector Borne Disease Control Programme, Guwahati, India
- Parasite-Host Biology Group, ICMR – National Institute of Malaria Research, New Delhi, India
- Rahim Ali Ahmed
| | - Hari Shankar
- Indian Council of Medical Research, New Delhi, India
- *Correspondence: Hari Shankar
| | - Syed Shah Areeb Hussain
- Parasite-Host Biology Group, ICMR – National Institute of Malaria Research, New Delhi, India
| | | | - Avdhesh Kumar
- National Vector Borne Disease Control Programme, Ministry of Health & FW, Government of India, New Delhi, India
| | - Mohammad Tarique
- Department of Child Health, University of Missouri, Columbia, MO, United States
| | - Pankaj Prabhakar
- Department of Pharmacology, Indira Gandhi Institute of Medical Sciences, Sheikhpura, India
| | | | - Kuldeep Singh
- Epidemiology & Environmental Biology Group, ICMR—National Institute of Malaria Research Field Station, Guwahati, India
- Kuldeep Singh
| | | | - Jyoti Singh
- Department of Zoology, Maitreyi College, University of Delhi, New Delhi, India
| | - Afluza Begum
- Department of Chemistry, Bhattadev University, Guwahati, India
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