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Kotepui M, Kotepui KU, Masangkay FR, Mahittikorn A, Wilairatana P. Prevalence and proportion estimate of asymptomatic Plasmodium infection in Asia: a systematic review and meta-analysis. Sci Rep 2023; 13:10379. [PMID: 37369862 DOI: 10.1038/s41598-023-37439-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 06/21/2023] [Indexed: 06/29/2023] Open
Abstract
Asymptomatic Plasmodium infection raises a problem for the persistent transmission of malaria in low-endemic areas such as Asia. This systematic review was undertaken to estimate the prevalence and proportion of asymptomatic Plasmodium infection in Asia. The systematic review was registered at PROSPERO (ID: CRD42022373664). The research followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. A comprehensive search of five databases, Ovid, Scopus, MEDLINE, PubMed, and Embase, was conducted to identify studies of asymptomatic Plasmodium infection in Asian countries. The pooled prevalence of asymptomatic Plasmodium infection, the pooled proportion of asymptomatic Plasmodium infection among all parasitised individuals, and the associated 95% confidence intervals were estimated using a random-effects model. A total of 916 articles were retrieved, and 87 articles that met the criteria were included in the systematic review. The pooled prevalence of asymptomatic Plasmodium infection among enrolled participants in Southeast Asia, South Asia, and Western Asia was 5.8%, 9.4%, and 8.4%, respectively. The pooled proportion of asymptomatic Plasmodium infection among all parasitised individuals in Southeast Asia, South Asia, and Western Asia was 89.3%, 87.2%, and 64.8%, respectively. There was a low prevalence of asymptomatic Plasmodium infection, but there was a high proportion of asymptomatic Plasmodium infection per all parasitised individuals in different parts of Asia. These results may support and facilitate elimination and control programs for asymptomatic Plasmodium infection in Asia.
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Affiliation(s)
- Manas Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand.
| | - Kwuntida Uthaisar Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Tha Sala, Nakhon Si Thammarat, Thailand
| | | | - Aongart Mahittikorn
- Department of Protozoology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
| | - Polrat Wilairatana
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
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Hosseini Z, Azizi K, Moghadami M, Hassaniazad M, Shafiei R, Rezaee E, Turki H. Absence of Asymptomatic Malaria Reservoirs in an Area with a Previous History of Local Malaria Transmission: A Successful Experience in Line with the Malaria Elimination Program in Iran. J Arthropod Borne Dis 2023; 17:128-137. [PMID: 37822760 PMCID: PMC10562199 DOI: 10.18502/jad.v17i2.13618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 05/17/2023] [Indexed: 10/13/2023] Open
Abstract
Background Asymptomatic malaria is a major challenge to be addressed in the implementation of the malaria elimination program. The main goal of the malaria surveillance system in the elimination phase is to identify reliably all the positive cases of malaria reliably (symptomatic and asymptomatic) in the shortest possible time. This study focused on the monitoring of asymptomatic malaria reservoirs in areas where local transmission had been previously established. Methods It was a case-study approach that was conducted in the Anarestan area. A total of 246 residents and immigrants living in the area at the age range of 4-60 years old were randomly selected to be tested for malaria by microscope, RDT, and nested-PCR techniques. The inclusion criterion for participants to be entered into the study was the absence of specific symptoms of malaria. Moreover, participants who have been taking antimalarials for the last month were excluded from the study. Results The results indicated no positive cases of asymptomatic malaria among the participants tested by all methods. Conclusion The results of this study have shown that, without concerns for asymptomatic parasitic patients, a malaria elimination program has been successfully implemented within the studies area. In addition, the findings emphasized the existence of a strong malaria surveillance system in this area.
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Affiliation(s)
- Zainab Hosseini
- Molecular Medicine Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
- Student Research Committee, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Kourosh Azizi
- Research Center for Health Sciences, Institute of Health, Department of Medical Entomology and Vector Control, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohsen Moghadami
- Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehdi Hassaniazad
- Infectious and Tropical Diseases Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Reza Shafiei
- Vector-Borne Diseases Research Center, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Elham Rezaee
- Department of Medical Parasitology and Mycology, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Habibollah Turki
- Molecular Medicine Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
- Infectious and Tropical Diseases Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Bhattarai S, Blackburn JK, Ryan SJ. Analyzing Spatial and Temporal Patterns of Designated Malaria Risk Areas in Nepal from 2018 to 2021. Vector Borne Zoonotic Dis 2023. [PMID: 37015081 DOI: 10.1089/vbz.2022.0097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2023] Open
Abstract
Background: Nepal is preparing to eliminate malaria by 2026. To evaluate the progress of vector control and prioritize areas for targeted intervention, understanding the recent changing distribution of high and moderate malaria risk areas is vital. Methods: Patterns of designated high and moderate malaria risk wards in Nepal between 2018 and 2021 were analyzed to identify stable and newly generated high- and moderate-risk (HaMR) wards, using the Spatial Temporal Analysis of Moving Polygons (STAMP) method. Results and Conclusions: High-risk and moderate-risk wards decreased by about 55% and the number of districts containing these wards also decreased from 20 to 14. However, several stable and new HaMR wards, mostly in the northwest and the southwest of the country, are apparent, despite intervention efforts. Public health officials should prioritize those wards for malaria surveillance and vector control, and future studies should explore the underlying reasons for persistent risk wards.
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Affiliation(s)
- Shreejana Bhattarai
- Quantitative Disease Ecology and Conservation (QDEC) Lab, Department of Geography, University of Florida, Gainesville, Florida, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, USA
| | - Jason K Blackburn
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, USA
- Spatial Epidemiology and Ecology Research (SEER) Laboratory, Department of Geography, University of Florida, Gainesville, Florida, USA
| | - Sadie J Ryan
- Quantitative Disease Ecology and Conservation (QDEC) Lab, Department of Geography, University of Florida, Gainesville, Florida, USA
- Emerging Pathogens Institute, University of Florida, Gainesville, Florida, USA
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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: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [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
- 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 6594Indian 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
- grid.19096.370000 0004 1767 225XIndian 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
- grid.452686.b0000 0004 1767 2217Indian 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
- grid.452686.b0000 0004 1767 2217Indian Council of Medical Research - National Institute of Research in Tribal Health (ICMR-NIRTH), Jabalpur, Madhya Pradesh 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
| | - Harpreet Kaur
- grid.19096.370000 0004 1767 225XDepartment 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
- 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 6594Indian Council of Medical Research - National Institute of Malaria Research (ICMR-NIMR), New Delhi, India
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Gupta SK, Saroha P, Singh K, Saxena R, Barman K, Kumar A, Sharma A. Malaria Epidemiology Along the Indian Districts Bordering Bhutan and Implications for Malaria Elimination in the Region. Am J Trop Med Hyg 2022; 106:655-660. [PMID: 34749312 PMCID: PMC8832941 DOI: 10.4269/ajtmh.21-0513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 09/02/2021] [Indexed: 02/03/2023] Open
Abstract
It is important for malaria-endemic countries to address malaria control across international borders, and in particular to prioritize appropriate rapid diagnosis, treatment and surveillance. Bhutan and India aim to achieve malaria elimination by 2023 and 2030 respectively. Malaria elimination along the Indo-Bhutan border is of common concern. We delineated malaria epidemiology along the border to provide a blueprint for focusing malaria control efforts in key foci within this region. Epidemiological data from 2015 to 2019 were analyzed, as the most drastic reductions in malaria burden across most parts of India were witnessed in this time frame. Several areas of concern include low surveillance in most border districts, favorable climatic conditions for perennial malaria transmission, and movement of potential parasite carriers because of the porous borders. India and Bhutan need to control the importation/exportation of malaria cases. We highlight the foci of concern for which implementing tailor-made malaria control strategies may benefit both countries.
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Affiliation(s)
| | - Poonam Saroha
- National Institute of Malaria Research, New Delhi, India
| | - Kuldeep Singh
- National Institute of Malaria Research, New Delhi, India
| | - Rekha Saxena
- National Institute of Malaria Research, New Delhi, India
| | - Keshab Barman
- National Vector Borne Diseases Control Programme, Guwahati, India
| | - Avdhesh Kumar
- National Vector Borne Diseases Control Programme, Delhi, India
| | - Amit Sharma
- National Institute of Malaria Research, New Delhi, India;,Molecular Medicine Group, International Centre for Genetic Engineering and Biotechnology, New Delhi, India,Address correspondence to Amit Sharma, ICMR-National Institute of Malaria Research, Sector 8, Dwarka, New Delhi, 110 077, India. E-mail:
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A Comprehensive Survey of Asymptomatic Malaria Cases in an Endemic Focus in Iran: A Successful Experience on the Road to Eliminate Malaria. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2021. [DOI: 10.5812/archcid.103728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Malaria is one of the important infectious blood diseases caused by the protozoan parasite of the genus Plasmodium and transmitted by female Anopheles mosquito bites. A malaria elimination plan is currently being followed in Hormozgan Province. The robust malaria surveillance system with appropriate active case findings, especially asymptomatic cases, plays an important role in the malaria elimination program. Objectives: The main objectives of this research were to determine the presence and prevalence of asymptomatic malaria cases and monitor asymptomatic parasitic reservoirs in Jask District, Hormozgan Province. Methods: This cross-sectional study aimed to evaluate and monitor asymptomatic cases in the Jask District. The purpose and stages of the study were explained to all participants/parents, and written informed consent was obtained. A total of 230 asymptomatic residents (124 females and 86 males) were randomly selected, and their blood samples (3 mL) were taken to assess Plasmodium infection using microscopic, RDT, and molecular (18ssrRNA) methods. Results: Of the 230 studied cases, 54.8% were females, and 454.2% were males. The age range was four to 65 years old, and the mean age was 24.5. None of the diagnostic methods, including the microscopic, serological, and molecular techniques, could find asymptomatic malaria cases in the study area. Conclusions: It can be concluded that Malaria Elimination Program is feasible in the Jask Region irrespective of asymptomatic parasitic reservoirs. The results also emphasize a robust and efficient malaria surveillance system to diagnose and treat positive cases and monitor treated cases successfully. Ongoing and continuous studies are recommended in the high-risk malarious area of Hormozgan Province to monitor asymptomatic cases of malaria.
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Penjor K, Tobgyal, Zangpo T, Clements ACA, Gray DJ, Wangdi K. Has COVID19 derailed Bhutan's national malaria elimination goal? A commentary. Malar J 2021; 20:20. [PMID: 33407471 PMCID: PMC7787406 DOI: 10.1186/s12936-020-03562-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 12/19/2020] [Indexed: 11/17/2022] Open
Abstract
The COVID-19 pandemic has resulted in massive global disruptions with considerable impact on the delivery of health services and national health programmes. Since the detection of the first COVID-19 case on 5th March 2020, the Royal Government of Bhutan implemented a number of containment measures including border closure and national lockdowns. Against the backdrop of this global COVID-19 pandemic response, there was a sudden surge of locally-transmitted malaria cases between June to August 2020. There were 20 indigenous cases (zero Plasmodium falciparum and 20 Plasmodium vivax) from a total of 49 cases (seven P. falciparum and 42 P. vivax) in 2020 compared to just two from a total of 42 in 2019. Over 80% of the cases were clustered in malaria endemic district of Sarpang. This spike of malaria cases was attributed to the delay in the delivery of routine malaria preventive interventions due to the COVID-19 pandemic. As a result, Bhutan is unlikely to achieve the national goal of malaria elimination by 2020.
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Affiliation(s)
- Kinley Penjor
- Vector-Borne Disease Control Programme, Department of Public Health, Ministry of Health, Gelephu, Bhutan.
| | - Tobgyal
- Vector-Borne Disease Control Programme, Department of Public Health, Ministry of Health, Gelephu, Bhutan
| | - Tandin Zangpo
- Department of Public Health, Communicable Disease Division, Ministry of Health, Thimphu, Bhutan
| | - Archie C A Clements
- Faculty of Health Sciences, Curtin University, Perth, Australia.,Telethon Kids Institute, Nedlands, Perth, Australia
| | - Darren J Gray
- Department of Global Health, College of Health and Medicine, Research School of Population Health, Australian National University, Acton, ACT, 2601, Australia
| | - Kinley Wangdi
- Department of Global Health, College of Health and Medicine, Research School of Population Health, Australian National University, Acton, ACT, 2601, Australia
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Marasinghe MM, Karunasena VM, Seneratne AS, Herath HDB, Fernando D, Wickremasinghe R, Mendis KN, Ranaweera D. Mass radical treatment of a group of foreign workers to mitigate the risk of re-establishment of malaria in Sri Lanka. Malar J 2020; 19:346. [PMID: 32977809 PMCID: PMC7517794 DOI: 10.1186/s12936-020-03419-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 09/17/2020] [Indexed: 11/29/2022] Open
Abstract
Background Following malaria elimination, Sri Lanka was free from indigenous transmission for six consecutive years, until the first introduced case was reported in December 2018. The source of transmission (index case) was a member of a group of 32 migrant workers from India and the location of transmission was their residence reporting a high prevalence of the primary vector for malaria. Despite extensive vector control the situation was highly susceptible to onward transmission if another of the group developed malaria. Therefore, Mass Radical Treatment (MRT) of the group of workers for Plasmodium vivax malaria was undertaken to mitigate this risk. Method The workers were screened for malaria by microscopy and RDT, their haemoglobin level assessed, and tested for Glucose 6 phosphate dehydrogenase deficiency (G6PD) using the Care Start RDT and Brewers test prior to treatment with chloroquine (CQ) 25 mg/kg body weight (over three days) and primaquine (PQ) (0.25 mg/kg/day bodyweight for 14 days) following informed consent. All were monitored for adverse events. Results None of the foreign workers were parasitaemic at baseline screening and their haemoglobin levels ranged from 9.7–14.7 g/dl. All 31 individuals (excluding the index case treated previously) were treated with the recommended dose of CQ. The G6PD test results were inconclusive in 45% of the RDT results and were discrepant between the two tests in 31% of the remaining test events. Seven workers who tested G6PD deficient in either test were excluded from PQ and the rest, 24 workers, received PQ. No serious adverse events occurred. Conclusions Mass treatment may be an option in prevention of reintroduction settings for groups of migrants who are likely to be carrying latent malaria infections, and resident in areas of high receptivity. However, in the case of Plasmodium vivax and Plasmodium ovale, a more reliable and affordable point-of-care test for G6PD activity would be required. Most countries which are eliminating malaria now are in the tropical zone and face considerable and similar risks of malaria re-introduction due to massive labour migration between them and neighbouring countries. Regional elimination of malaria should be the focus of global strategy if malaria elimination from countries is to be worthwhile and sustainable.
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Affiliation(s)
| | | | | | | | - Deepika Fernando
- Department of Parasitology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
| | - Rajitha Wickremasinghe
- Department of Public Health, Faculty of Medicine, University of Kelaniya, Colombo, Sri Lanka
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Bharti PK, Rajvanshi H, Nisar S, Jayswar H, Saha KB, Shukla MM, Mishra AK, Sharma RK, Das A, Kaur H, Wattal SL, Lal AA. Demonstration of indigenous malaria elimination through Track-Test-Treat-Track (T4) strategy in a Malaria Elimination Demonstration Project in Mandla, Madhya Pradesh. Malar J 2020; 19:339. [PMID: 32943065 PMCID: PMC7499908 DOI: 10.1186/s12936-020-03402-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 08/31/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Many malaria endemic countries are heading towards malaria elimination through the use of case management and vector control strategies, which employ surveillance, improving access to early diagnosis, prompt treatment., and integrated vector control measures. There is a consensus that elimination of malaria is feasible when rapid detection and prompt treatment is combined with mosquito-human contact interruption in an efficient and sustainable manner at community levels. This paper describes results of an integrated case management and vector control strategy for reducing malaria cases in 1233 villages over 3 years in district Mandla, Madhya Pradesh, India. METHODS The project enrolled the entire population (1,143,126) of Mandla district for fever surveillance followed by testing of febrile cases and treatment of positive subjects using T4 strategy, which is Track (by fever), Test (by RDTs), Treat (by ACT) and Track (for completion of treatment). In addition to the active and passive surveillance for detection and treatment of febrile cases, the project conducted mass screening and treatment to clear the asymptomatic reservoirs of infection. Febrile cases were also tested in the out-patient department of the District Hospital from June 2018 to September, 2018 and in a community-based medical camp from November 7 to 14, 2019. The project also used vector control measures for interrupting human-mosquito contact, and information, education and communication (IEC) campaigns to increase demand for malaria services at community level. RESULTS This project has revealed about 91% reduction of indigenous cases of malaria during the period from June 2017 to May 2020, through case management and vector control strategies. A total 357,143 febrile cases were screened, out of which 0.19% were found positive for the presence of malaria parasites, with Plasmodium falciparum and Plasmodium vivax ratio of 62:38. The prevalence of malaria was higher in individuals > 15 years of age (69% cases). The positivity rate was 0.33% in 2017-18, 0.13% in 2018-19, and 0.06% in 2019-20. In all of the 3 years of the project, the peak transmission correlated with rains. Mass screening revealed 0.18% positivity in Sep-Oct 2018, followed by 0.06% in June 2019, and 0.03% in December 2019, and these were mostly asymptomatic cases in the community. Imported cases into the district were mostly contributed by the distant state of Telangana (51.13%). Fever patients tested for malaria parasites in the District Hospital and medical camp revealed zero cases. CONCLUSION Using the current intervention and prevention tools along with optimum utilization of human resources, a 91% reduction in indigenous cases of malaria was seen in the district in 3 years. The reduction was similar in the three high prevalence blocks of the district. These results reveal that malaria elimination is achievable in India within a stipulated time frame. The reduction of malaria at the community level was further validated when zero malaria cases were diagnosed during hospital and community-based studies in Mandla. Prompt detection and treatment of imported/migratory cases may have prevented outbreaks in the district. This project has demonstrated that field programmes backed by adequate technical, management, operational, and financial controls with robust monitoring are needed for achieving malaria elimination.
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Affiliation(s)
- Praveen K Bharti
- Indian Council of Medical Research - National Institute of Research in Tribal Health (ICMR-NIRTH), Jabalpur, Madhya Pradesh, India.
| | - Harsh Rajvanshi
- Malaria Elimination Demonstration Project, Mandla, Madhya Pradesh, India
| | - Sekh Nisar
- Malaria Elimination Demonstration Project, Mandla, Madhya Pradesh, India
| | - Himanshu Jayswar
- Government of Madhya Pradesh, Directorate of Health Services, Bhopal, India
| | - Kalyan B Saha
- Indian Council of Medical Research - National Institute of Research in Tribal Health (ICMR-NIRTH), Jabalpur, Madhya Pradesh, India
| | - Man Mohan Shukla
- Indian Council of Medical Research - National Institute of Research in Tribal Health (ICMR-NIRTH), Jabalpur, Madhya Pradesh, India
| | - Ashok K Mishra
- Indian Council of Medical Research - National Institute of Research in Tribal Health (ICMR-NIRTH), Jabalpur, Madhya Pradesh, India
| | - Ravendra K Sharma
- 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
- Indian Council of Medical Research, Department of Health Research, Ministry of Health and Family Welfare, New Delhi, India
| | - Suman L Wattal
- National Vector Borne Disease Control Programme, Ministry of Health and Family Welfare, New Delhi, India
| | - Altaf A Lal
- Malaria Elimination Demonstration Project, Mandla, Madhya Pradesh, India
- Foundation for Disease Elimination and Control of India, Mumbai, Maharashtra, India
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