Impact assessment of Intensified Malaria Control Project in transitioning a high malaria-endemic district to a low-endemic district: an epidemiological aspect

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.

Current status of malaria elimination in Koraput district of Odisha, India

BACKGROUND & OBJECTIVES

After launching of NFME and NSP with wide scale implementation of effective intervention tools during 2017, Odisha State of India observed a drastic reduction of malaria cases (81%) in 2018 and 88.6% in 2019, compared to 2017. The current study analysed the different factors causative for malaria reduction in Koraput district of Odisha State, India.

METHODS

The vector density and malaria incidences were assessed from January 2016 to December 2019 and human blood index, bio-efficacy and use rate of LLINs were assessed after distribution of long-lasting insecticidal nets.

RESULTS

The use rate of LLINs by the villagers ranged from 93.8% to 100% throughout the year. The mortality of Anopheles jeyporiensis remained 100.0% in both DuraNet and PermaNet LNs. The density of An. fluviatilis after distribution of LLINs reduced from 4.7 to 0.0 whereas, the density of An. culicifacies reduced from 12.2 to 9.3. The HBI of An. fluviatilis and An. culicifacies was 0.006 and 0.005, respectively after distribution of LLINs. The malaria incidences also drop from 14.2 to zero after distribution.

INTERPRETATION & CONCLUSION

A significant reduction in malaria incidences was validated and the possible reasons for the reduction are discussed.