Malaria in India: Challenges and opportunities |
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Authors: | A P Dash Neena Valecha A R Anvikar A Kumar |
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Institution: | (1) National Institute of Malaria Research, 22 Sham Nath Marg, Delhi, 110 054, India;(2) Field Station, National Institute of Malaria Research, DHS Building, Campal, Panaji, 403 001, India |
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Abstract: | India contributes about 70% of malaria in the South East Asian Region of WHO. Although annually India reports about two million
cases and 1000 deaths attributable to malaria, there is an increasing trend in the proportion of Plasmodium falciparum as the agent. There exists heterogeneity and variability in the risk of malaria transmission between and within the states
of the country as many ecotypes/paradigms of malaria have been recognized. The pattern of clinical presentation of severe
malaria has also changed and while multi-organ failure is more frequently observed in falciparum malaria, there are reports
of vivax malaria presenting with severe manifestations. The high burden populations are ethnic tribes living in the forested
pockets of the states like Orissa, Jharkhand, Madhya Pradesh, Chhattisgarh and the North Eastern states which contribute bulk
of morbidity and mortality due to malaria in the country. Drug resistance, insecticide resistance, lack of knowledge of actual
disease burden along with new paradigms of malaria pose a challenge for malaria control in the country. Considering the existing
gaps in reported and estimated morbidity and mortality, need for estimation of true burden of malaria has been stressed. Administrative,
financial, technical and operational challenges faced by the national programme have been elucidated. Approaches and priorities
that may be helpful in tackling serious issues confronting malaria programme have been outlined. |
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Keywords: | Anophelines burden of malaria DALYs P falciparum P vivax |
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