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Boresa K, Belay T, Biruksew A, Alemayehu E, Zemene E. Ten-year trend analysis of malaria prevalence in Gindabarat district, West Shawa Zone, Oromia Regional State, Western Ethiopia. Malar J 2024; 23:152. [PMID: 38755638 PMCID: PMC11100101 DOI: 10.1186/s12936-024-04975-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 05/03/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Malaria is a major public health concern in Ethiopia, where more than half of the population lives in malaria risk areas. While several studies have been conducted in different eco-epidemiological settings in Ethiopia, there is a notable scarcity of data on the prevalence of malaria in the Gindabarat district. Therefore, this study aimed to analyse 10-year trend of malaria prevalence in Gindabarat district, West Shawa Zone of Oromia, Western Ethiopia. METHODS A retrospective laboratory record review was conducted at Gindabarat General Hospital and Gindabarat District Health Office from September 2011 to August 2020. The retrieved data included the date of examination, age, sex and laboratory results of the blood smears, including the Plasmodium species identified. Data were summarized and presented in the form of tables, figures, and frequencies to present the results. The data were analysed using SPSS (version 25.0) and Microsoft Excel. RESULTS Over the course of 10 years, a total of 11,478 blood smears were examined in the public health facilities in the district. Of the total blood smears examined, 1372 (11.95%) were microscopically confirmed malaria. Plasmodium falciparum, Plasmodium vivax and mixed infections (P. falciparum and P. vivax) accounted for 70.77%, 20.55% and 8.67% of the cases, respectively. Malaria prevalence was significantly higher among individuals aged ≥ 15 years (12.60%, x2 = 13.6, df = 2, p = 0.001) and males (14.21%, x2 = 59.7, df = 1, p = 0.001). The highest number of malaria cases was recorded from September to November. CONCLUSION Malaria remains a public health problem in the district. P. falciparum was the most predominant parasite species in the area. Malaria prevalence was significantly higher among individuals aged ≥ 15 years and males. There was a remarkable fluctuation in the number of malaria cases in different months and years. In the study area malaria cases peaked in 2015 and 2017 then decreasing from 2017 to 2019, with sharp increase in 2020. Moreover, this study showed malaria cases were reported in all seasons and months, but the highest was observed from September to November. Strengthening malaria control activities is essential to further reduce the burden of malaria and pave the way for the anticipated elimination.
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Affiliation(s)
- Kinfu Boresa
- Department of Medical Laboratory Sciences, Institute of Health Sciences, Wallaga University, Nekemte, Ethiopia.
| | - Tariku Belay
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Abdissa Biruksew
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Eshetu Alemayehu
- Department of Epidemiology and Biostatistics, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Endalew Zemene
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
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Chaturvedi HK, Tiwari P. Determinants of malaria prevention and control at household level in Assam: An analysis of data using composite index. Heliyon 2024; 10:e28799. [PMID: 38576584 PMCID: PMC10990942 DOI: 10.1016/j.heliyon.2024.e28799] [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: 06/22/2023] [Revised: 03/19/2024] [Accepted: 03/25/2024] [Indexed: 04/06/2024] Open
Abstract
Background Malaria prevention and control is a major public health problem of tropical countries including India. Usage of insecticide-treated bed nets, and early treatment especially in high-risk areas are the crucial factors for the malaria prevention at household levels. This study aimed to determine the crucial factors associated with malaria prevention at households' level such as household's characteristics, education, knowledge and awareness, insecticide treated bed nets usage, early treatment etc. Methods Data of 1989 households was used from the cross-sectional survey of malaria-endemic areas of Assam. Principal component analysis and multinomial logistic regression model were used to compute the composite scores of malaria awareness and prevention practices, and to estimate the associated factors with malaria prevention practices, respectively. Results The average age of household respondents were 41.1 ± 12.0 years and among them 71% were males. Almost 47% respondents were illiterate, and 38.6% of the respondents were farmers and 35% were employed. Multinomial logistic regression analysis indicates that malaria prevention practices are associated with age, education, religion, type of house and occupation of household heads and their level of malaria awareness among them. The prevention practices were significantly five times associated [Adjusted Rates Ratio (ARR): 5.0, 95% CI: 2.7-9.4] with the high level of malaria awareness compared with the low level of awareness. Overall, the level of prevention awareness, education, occupation, and house type related to the standard of living was significantly associated with the malaria prevention practices. Conclusion Malaria awareness and education are the key factors of malaria prevention practices that need to be accelerated for effective control of malaria. Malaria education and increasing awareness of people have a high impact on malaria prevention practices and their control.
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Affiliation(s)
- Himanshu K. Chaturvedi
- Corresponding author. National Institute of Medical Statistics, Indian Council of Medical Research, Ansari Nagar, New Delhi, 110029, India.
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Patel P, Mishra KK, Ghosh K. Confirmatory Assay for Laboratory Diagnosis of Malaria Using Molecular Approach. Acta Parasitol 2024; 69:1000-1004. [PMID: 38498250 DOI: 10.1007/s11686-024-00831-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 02/26/2024] [Indexed: 03/20/2024]
Abstract
BACKGROUND Prompt malarial treatment and surveillance is crucial for accurate diagnosis of Plasmodium Sp. Gold standard microscopic examination has been widely applied for diagnosis of malaria in most part of the endemic areas. But in case of submicroscopic and asymptomatic microscopic diagnosis is questioned. The study aims to develop a simple, cost effective & robust nucleic acid amplification technique for the detection of malaria parasite. METHODS Study population included 50 clinically diagnosed positive malaria patient samples from various pathological laboratories. Microscopy by preparing thick film was carried out of every sample for primary screening in the available facility of Surat Raktadan Kendra & Research Centre- Blood Bank. The conventional PCR (Polymerase Chain Reaction) was applied for genus-specific amplification targeting the 18 S rRNA gene of Plasmodium. Agarose gel electrophoresis was used to separate and analyze the amplified PCR product using 2% Agarose gel. RESULTS AND CONCLUSION The study shows that nested PCR not only detected all microscopic positive samples, but also detected submicroscopic infections that were missed or misread by microscopy. Hence, the sensitivity of molecular based detection technique is proved to be more compared to microscopic examination.
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Affiliation(s)
- Parizad Patel
- Surat Raktadan Kendra & Research Centre (Regional Blood Transfusion & Research Centre), Khatodara Health Centre, 1st Floor, Udhana Magdalla Road, Khatodara, Surat, Gujarat, 395002, India
| | - Kanchan Kumar Mishra
- Surat Raktadan Kendra & Research Centre (Regional Blood Transfusion & Research Centre), Khatodara Health Centre, 1st Floor, Udhana Magdalla Road, Khatodara, Surat, Gujarat, 395002, India
| | - Kanjaksha Ghosh
- Surat Raktadan Kendra & Research Centre (Regional Blood Transfusion & Research Centre), Khatodara Health Centre, 1st Floor, Udhana Magdalla Road, Khatodara, Surat, Gujarat, 395002, India
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Singh MP, Rajvanshi H, Bharti PK, Anvikar AR, Lal AA. Time series analysis of malaria cases to assess the impact of various interventions over the last three decades and forecasting malaria in India towards the 2030 elimination goals. Malar J 2024; 23:50. [PMID: 38360708 PMCID: PMC10870538 DOI: 10.1186/s12936-024-04872-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 02/06/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Despite the progress made in this decade towards malaria elimination, it remains a significant public health concern in India and many other countries in South Asia and Asia Pacific region. Understanding the historical trends of malaria incidence in relation to various commodity and policy interventions and identifying the factors associated with its occurrence can inform future intervention strategies for malaria elimination goals. METHODS This study analysed historical malaria cases in India from 1990 to 2022 to assess the annual trends and the impact of key anti-malarial interventions on malaria incidence. Factors associated with malaria incidence were identified using univariate and multivariate linear regression analyses. Generalized linear, smoothing, autoregressive integrated moving averages (ARIMA) and Holt's models were used to forecast malaria cases from 2023 to 2030. RESULTS The reported annual malaria cases in India during 1990-2000 were 2.38 million, which dropped to 0.73 million cases annually during 2011-2022. The overall reduction from 1990 (2,018,783) to 2022 (176,522) was 91%. The key interventions of the Enhanced Malaria Control Project (EMCP), Intensified Malaria Control Project (IMCP), use of bivalent rapid diagnostic tests (RDT-Pf/Pv), artemisinin-based combination therapy (ACT), and involvement of the Accredited Social Health Activists (ASHAs) as front-line workers were found to result in the decline of malaria significantly. The ARIMA and Holt's models projected a continued decline in cases with the potential for reaching zero indigenous cases by 2027-2028. Important factors influencing malaria incidence included tribal population density, literacy rate, health infrastructure, and forested and hard-to-reach areas. CONCLUSIONS Studies aimed at assessing the impact of major commodity and policy interventions on the incidence of disease and studies of disease forecasting will inform programmes and policymakers of steps needed during the last mile phase to achieve malaria elimination. It is proposed that these time series and disease forecasting studies should be performed periodically using granular (monthly) and meteorological data to validate predictions of prior studies and suggest any changes needed for elimination efforts at national and sub-national levels.
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Affiliation(s)
- Mrigendra P Singh
- Foundation for Disease Elimination and Control of India, Mumbai, India
| | - Harsh Rajvanshi
- Foundation for Disease Elimination and Control of India, Mumbai, India
- Asia Pacific Leaders' Malaria Alliance, Singapore, Singapore
| | - Praveen K Bharti
- Indian Council of Medical Research-National Institute of Malaria Research, New Delhi, 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, Mumbai, India.
- Sun Pharmaceutical Industries Ltd, Mumbai, India.
- Global Health and Pharmaceuticals, Inc, Atlanta, GA, USA.
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Naik BR, Tyagi BK, Xue RD. Mosquito-borne diseases in India over the past 50 years and their Global Public Health Implications: A Systematic Review. JOURNAL OF THE AMERICAN MOSQUITO CONTROL ASSOCIATION 2023; 39:258-277. [PMID: 38108431 DOI: 10.2987/23-7131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Mosquito-borne diseases (MBDs) pose a significant public health concern globally, and India, with its unique eco-sociodemographic characteristics, is particularly vulnerable to these diseases. This comprehensive review aims to provide an in-depth overview of MBDs in India, emphasizing their impact and potential implications for global health. The article explores distribution, epidemiology, control or elimination, and economic burden of the prevalent diseases such as malaria, dengue, chikungunya, Japanese encephalitis, and lymphatic filariasis, which collectively contribute to millions of cases annually. It sheds light on their profound effects on morbidity, mortality, and socioeconomic burdens and the potential for international transmission through travel and trade. The challenges and perspectives associated with controlling mosquito populations are highlighted, underscoring the importance of effective public health communication for prevention and early detection. The potential for these diseases to spread beyond national borders is recognized, necessitating a holistic approach to address the challenge. A comprehensive literature search was conducted, covering the past five decades (1972-2022), utilizing databases such as Web of Science, PubMed, and Google Scholar, in addition to in-person library consultations. The literature review analyzed 4,082 articles initially identified through various databases. After screening and eligibility assessment, 252 articles were included for analysis. The review focused on malaria, dengue, chikungunya, Japanese encephalitis, and lymphatic filariasis. The included studies focused on MBDs occurrence in India, while those conducted outside India, lacking statistical analysis, or published before 1970 were excluded. This review provides valuable insights into the status of MBDs in India and underscores the need for concerted efforts to combat these diseases on both national and global scales through consilience.
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Chalageri VH, Marinaik SB, Nath SN, Singhal R, Rawat S, Ravikumar K, Shariff M, Eapen A. Malaria control - lessons learned from trends of Malaria indices over three decades in Karnataka, India. Malar J 2023; 22:353. [PMID: 37978494 PMCID: PMC10655460 DOI: 10.1186/s12936-023-04774-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 10/27/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Karnataka is one of the largest states in India and has a wide range of geographical terrains, ecotypes, and prevalence of malaria. It experiences a voluminous influx and efflux of people across the state that affects the spread of malaria. The state deployed focused intervention measures keeping the national objective of malaria elimination as the foremost priority. This brought down malaria cases below a thousand by the year 2021. Furthermore, the state is motivated toward malaria elimination by 2025. This study analyzes the trends in malaria indices over the past three decades in the state and highlights the key intervention measures that impacted the reduction in the malaria burden. METHODS Data from 1991 to 2021 at the district level was collected from the archives of Regional Office for Health & Family Welfare (ROH&FW), Bangalore. Time-tend analysis on this data was conducted after categorization into three decades. Sequence plots were then plotted on the moving average of Annual Parasite Index for all those three decades. Generalized estimating equation model with Poisson distribution were used to evaluate difference in these indicators with pre and post interventions like LLIN, RDT with ACT and Guppy and Gambusia fishes. RESULTS Malaria burden across the state has consistently declined over the last three decades with few years of exception. This has coincided with the mortality also steadily declining from 2006 and culminating in zero malaria deaths reported from 2011 to 2019. Morbidity had drastically reduced from the hundred-thousand (1993-2003) to ten thousand (2004-2016) thousands (2017-2020) of cases in this period and less than thousand cases were reported by 2021. Generalized estimating equation (GEE) model revealed significant difference of incidence risk ratio of malaria incidence and deaths, post introduction of interventions like LLIN, RDT with ACT and Guppy and Gambusia fishes, indicating these three as important interventions for reducing the malaria burden. Time trend analysis revealed a linear decreasing trend in malaria cases during 2011-2021 decade. CONCLUSIONS A linear decreasing trend in malaria cases was observed during 2011-2021 decade. LLIN, RDT with ACT and Guppy and Gambusia fish's interventions significantly helped in reducing the state malaria burden.
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Affiliation(s)
| | - Shrinivasa B Marinaik
- ICMR - National Institute of Malaria Research Field Unit, Bengaluru, 562110, Karnataka, India.
| | - Sujith N Nath
- ICMR - National Institute of Malaria Research Field Unit, Bengaluru, 562110, Karnataka, India
| | - Richa Singhal
- ICMR - National Institute of Malaria Research, New Delhi, India
| | - Smita Rawat
- Regional Office for Health & Family Welfare (ROHFW), Chief Medical Officer, Bengaluru, Karnataka, India
| | - Krishnappa Ravikumar
- Regional Office for Health & Family Welfare (ROHFW), Ex-Senior Regional Director, Bengaluru, Karnataka, India
| | - Mahamood Shariff
- Deputy Director, NCVBDC, Directorate of Health & FW Services, Bangalore, Karnataka, India
| | - Alex Eapen
- ICMR- National Institute of Malaria Research Field Unit, Chennai, 600077, Tamil Nadu, India
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Khodaiji S, Sehgal K, Sethi M, Mansukhani D. Rapid Detection of Plasmodium vivax by the Hematology Analyzer for Population Screening. Diagnostics (Basel) 2023; 13:3397. [PMID: 37998533 PMCID: PMC10670845 DOI: 10.3390/diagnostics13223397] [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: 09/14/2023] [Revised: 10/27/2023] [Accepted: 10/31/2023] [Indexed: 11/25/2023] Open
Abstract
In India, where malaria is endemic, the prompt and accurate detection of infections is crucial for disease management and vector control. Our study aimed to evaluate the "iRBC" flag, a novel parameter developed for routine hematology analyzers, for its sensitivity and specificity in detecting Plasmodium vivax (P. vivax) infections. We used residual blood samples from patients with suspected malaria and compared the iRBC flag results with microscopy, which serves as the gold standard. Additionally, we compared the results with rapid immuno-chromatographic tests (RDTs) commonly used in the field. Our study included 575 samples, of which 187 were positive for P. vivax. The iRBC flag demonstrated a high sensitivity of 88.7% and 86.1% on the XN and XN-L hematology analyzers, respectively, and a clinical specificity of 100% on both analyzers. Furthermore, the scattergram derived from each positive dataset exhibited distinct patterns, which facilitated rapid confirmation by laboratory specialists. Notably, the iRBC flag remained effective even in the presence of interfering conditions. Overall, our results indicate that the iRBC flag is a reliable and rapid screening tool for identifying P. vivax in routine blood testing. Our findings have significant implications for malaria detection and control in endemic regions like India.
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Affiliation(s)
- Shanaz Khodaiji
- P.D. Hinduja National Hospital & Medical Research Centre, Mumbai 400016, India
| | | | | | - Dia Mansukhani
- P.D. Hinduja National Hospital & Medical Research Centre, Mumbai 400016, India
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Singh SK, Lhungdim H, Shekhar C, Dwivedi LK, Pedgaonkar S, James KS. Key drivers of reversal of trend in childhood anaemia in India: evidence from Indian demographic and health surveys, 2016-21. BMC Public Health 2023; 23:1574. [PMID: 37596564 PMCID: PMC10436448 DOI: 10.1186/s12889-023-16398-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 07/25/2023] [Indexed: 08/20/2023] Open
Abstract
AIM Recent National Family Health Survey results portray striking improvements in most population and health indicators, including fertility, family planning, maternal and child health, gender treatment, household environments, and health insurance coverage of the Pradhan Mantri Jan Arogya Yojana (PM-JAY), with all India resonance. However, the prevalence of any anaemia (< 11 g/dl) among children under age five has exhibited a reversed trajectory in recent years. Therefore, the present study explores key drivers of the reversal of the trend in the prevalence of childhood anaemia between 2015 and2021. METHODS Data of four rounds of the National Family Health Survey (NFHS) were used to show the overall trend of anaemia among children. However, for the analysis of key drivers of the reversal trend of childhood anaemia, only the recent two rounds (NFHS-4 & NFHS-5) were used. Descriptive, bivariate multivariable analysis and Fairlie decomposition model were used to explore the drivers of the reversal of the trend in childhood anaemia. RESULTS During the past two decades, India has seen a decline in the prevalence of childhood anaemia (NFHS-2 to NFHS-4). However, a reversal of trend was observed recently. The prevalence of anaemia among children aged 6-59 months increased from 59 percent in NFHS-4 to 67 percent in NFHS-5. In addition, the prevalence of mild anaemia increased from 23.3 percent in NFHS-2 to 28.7 percent in NFHS-5. However, the prevalence of moderate and severe anaemia declined considerably from NFHS-2 (40 percent and 4.1 percent) to NFHS-4 (28.7 percent and 1.6 percent), but showed an increase in the prevalence in NFHS-5 (36.3 percent and 2.2 percent). Among others, mothers' educational attainment, anaemia status and socio-economic status emerge as the key drivers of the change in the prevalence of childhood anaemia. CONCLUSION These findings may have vital implications for the ongoing Anaemia Mukt Bharat Programme, one of the government's dream projects in India.
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Affiliation(s)
- S K Singh
- Department of Survey Research and Data Analytics, International Institute for Population Sciences, Mumbai, India.
| | - H Lhungdim
- Department of Public Health & Mortality Studies, International Institute for Population Sciences, Mumbai, India
| | - Chander Shekhar
- Department of Fertility Studies, International Institute for Population Sciences, Mumbai, India
| | - L K Dwivedi
- Department of Survey Research and Data Analytics, International Institute for Population Sciences, Mumbai, India
| | - S Pedgaonkar
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, India
| | - K S James
- International Institute for Population Sciences, Mumbai, India
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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] [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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Ghosal J, Bal M, Ranjit M, Das A, Behera MR, Satpathy SK, Dutta A, Pati S. To what extent classic socio-economic determinants explain trends of anaemia in tribal and non-tribal women of reproductive age in India? Findings from four National Family Heath Surveys (1998-2021). BMC Public Health 2023; 23:856. [PMID: 37170116 PMCID: PMC10172723 DOI: 10.1186/s12889-023-15838-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 05/06/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND Despite unprecedented socio-economic growth experienced by Indians in the past few decades, and a long history of anti-anaemia public health measures, prevalence of anaemia in Indian non-pregnant women of reproductive age group (NPWRA) has not declined. This warrants a firm understanding of what explains the anaemia situation over time, preferably by sub-populations. Therefore, we aimed to examine the trends of anaemia in tribal NPWRA (least privileged) and compare with the trends in the NPWRA of general caste (most privileged) between 1998 to 2021. Additionally, the study also explored explanation of any decline and tribal/general narrowing of these trends. METHODS We studied four rounds of National Family Health Survey (1998-99, 2005-06, 2015-16, 2019-21). We examined the trend of anaemia (haemoglobin < 12 g/dl) and its possible determinants in tribal and general NPWRA and estimated the portion of "decline" and "narrowing" that could be explained by the underlying and intermediate determinants (wealth, education, residence, parity and food security) using multiple logistic regression. RESULTS The distribution of determinants improved over 23 years in both the groups but more in tribals. But anaemia either remained unchanged or increased in both except 7.1 points decline in tribals between 2006-2016, leading also to 7 points narrowing of tribal/general gap. The modest attenuation of beta coefficients representing the change of anaemia prevalence (log of odds) in tribals from -0.314(-0.377, -0.251) to -0.242(-0.308, -0.176) after adjustment with determinants could explain only 23% of the decline. Similarly, only 7% of the narrowing of the tribal/general anaemia gap could be explained. CONCLUSIONS The structural determinants wealth, education, food security, parity and urban amenities improved immensely in India but anaemia did not decline in this 23-year period. This implies that the "usual suspects" - the structural determinants are not the main drivers of anaemia in the country. The main driver may be absolute and/or functional deficiency status of micronutrients including iron attributable to inadequate uptake and absorption of these elements from Indian diets; and therefore, their effects are noticeable in every socio-economic stratum of India. Future research for aetiologies and new interventions for anaemia alleviation in India may focus on these factors.
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Affiliation(s)
- Jyoti Ghosal
- School of Public Health, KIIT Deemed to be University, Bhubaneswar, Odisha, India
- ICMR-Regional Medical Research Center, Odisha, Bhubaneswar, India
| | - Madhusmita Bal
- ICMR-Regional Medical Research Center, Odisha, Bhubaneswar, India
| | | | - Arundhuti Das
- ICMR-Regional Medical Research Center, Odisha, Bhubaneswar, India
| | - Manas Ranjan Behera
- School of Public Health, KIIT Deemed to be University, Bhubaneswar, Odisha, India
| | | | - Ambarish Dutta
- Indian Institute of Public Health, Public Health Foundation of India, Odisha, Bhubaneswar, India.
| | - Sanghamitra Pati
- ICMR-Regional Medical Research Center, Odisha, Bhubaneswar, India.
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Moorthy P, Kavitha HP. Comparative Evaluation of Bioefficiency and Photocatalytic Activity of Green Synthesized Bismuth Oxide Nanoparticles Using Three Different Leaf Extracts. ACS OMEGA 2023; 8:14752-14765. [PMID: 37125094 PMCID: PMC10134460 DOI: 10.1021/acsomega.3c00792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 03/31/2023] [Indexed: 05/03/2023]
Abstract
Nanotechnology has emerged as a promising method for wastewater recycling. In this line, the current study emphasizes the leaf-extract-mediated biosynthesis of bismuth oxide nanostructures (BiONPs) using three different plants, namely Coldenia procumbens Linn (Creeping Coldenia), Citrus limon (Lemon), and Murraya koenigii (Curry) through a greener approach and evaluates their biological properties as well as photocatalytic performance for the first time. As-synthesized BiONPs were physiochemically characterized using UV-visible spectroscopy, Fourier transform infrared (FTIR) spectroscopy, X-ray diffraction (XRD), scanning electron microscopy (SEM), and high-resolution transmission electron microscopy (HRTEM) with energy dispersive X-ray analysis (EDAX). Using the well diffusion method, research on the antibacterial efficiency of BiONPs against human pathogenic Gram-positive bacteria, such as Staphylococcus aureus and Enterococcus faecalis, and Gram-negative bacteria, including Escherichia coli and Klebsiella pneumonia, revealed that Gram-negative bacteria exhibited relatively strong activity. The larvicidal activity assessed against Aedes aegypti and Aedes albopictus mosquito larvae reveals promising larvicidal activity with a minimal dosage of BiONPs with LC50 values of 5.53 and 19.24 ppm, respectively, after 24 h of exposure. The excellent photocatalytic activity of as-synthesized BiONPs was demonstrated through the photodegradation of malachite green (MG) and methylene blue (MB) dyes with respective degradation performance parameters of 70 and 90%. The biogenic synthetic approach reported here enables the scalable commercial synthesis of bismuth nanostructures for their widespread use in catalysis for wastewater treatment and environmental cleanup.
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12
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Naik H, Acharya A, Rout S. Clinical Profile and Treatment Outcomes of Patients with Malaria Complicated by Acute Kidney Injury. SAUDI JOURNAL OF KIDNEY DISEASES AND TRANSPLANTATION 2023; 34:117-124. [PMID: 38146720 DOI: 10.4103/1319-2442.391889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023] Open
Abstract
As Odisha is an endemic region for malaria with many acute kidney injury (AKI) cases, this study evaluated the clinical profile and treatment outcomes of patients with malaria complicated by AKI. This prospective observational study was conducted between December 2015 and September 2017. Detailed histories and clinical examinations were recorded. On admission, tests for routine hematology, plasma glucose, liver function, renal function, serum electrolytes, thick smears, thin smears, and malarial parasites were performed. Of the 958 AKI malarial patients admitted, 202 (82.6 % males) were included in the study, with a mean age of 38.37 years. In total, 86.14%, 3.46%, and 10.39% of patients had Plasmodium falciparum, Plasmodium vivax, and mixed malaria, respectively. Headache and decreased urination (83.66% each) were the most common symptoms after fever (100%). Anuria and oliguria were reported in 5.95% and 67.82% of patients, respectively, whereas 26.23% reported a urine output of >400 mL/24 h. All patients had raised serum creatinine and urea levels, and >60% had anemia, proteinuria, and/or hyponatremia. Multiple organ dysfunction syndrome was observed in 62.87% of patients. Acute tubular necrosis was seen in 60% of renal biopsy specimens (n = 15). Of the 75.75% of patients requiring dialysis, 82.12% and 17.88% of patients required hemodialysis and peritoneal dialysis, respectively, during which 11 patients died. AKI, a serious complication of P. falciparum or P. vivax malaria, is a life-threatening condition. Fever, anemia, oligo/anuria, hepatic involvement, cerebral malaria, high serum creatinine and urea, and disseminated intravascular coagulation were the main predictors of mortality in our study.
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Affiliation(s)
- Haladhar Naik
- Department of Nephrology, Srirama Chandra Bhanja Medical College, Cuttack, Odisha, India
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Roy SS. Spatial patterns of malaria case burden and seasonal precipitation in India during 1995-2013. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2023; 67:157-164. [PMID: 36287259 DOI: 10.1007/s00484-022-02395-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/14/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
The majority of malaria cases in Southeast Asia occur in India. It is a major public health problem in India, which accounts for substantial morbidity, mortality, and economic loss. The spatial distribution of malaria widely varies due to geo-ecological diversity, multi-ethnicity, and wide distribution of the different anopheline vectors. The predominant malaria parasites in India for malaria are P. Falciparum (Pf) and P. Vivax (Pv). This study analyzes the spatial patterns of malaria cases, specifically the two dominant malaria vectors, at the regional level and its relation to seasonal precipitation. The results of our study revealed an overall decline in malaria cases in the later years. The spatial spread of malaria cases was more widespread during the normal monsoon years vs drought years, which can be attributed to more conducive environment for mosquitos to breed. The correlation analysis revealed a stronger correlation between malaria case burden and monsoon precipitation. Spatially, the strongest correlation between seasonal and annual precipitation, and malaria case burden were located across the northern plains and northeast India. The results of this research further our understanding of the relationship between seasonal precipitation and malaria case burden at the regional level across India.
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Affiliation(s)
- Shouraseni Sen Roy
- Department of Geography & Sustainable Development, University of Miami, Coral Gables, FL, USA.
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Yadav CP, Gupta S, Bharti PK, Rahi M, Faizi N, Sharma A. India may need an additional metric to assess the endemicity of malaria in low surveillance districts. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000326. [PMID: 36962502 PMCID: PMC10021988 DOI: 10.1371/journal.pgph.0000326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 10/19/2022] [Indexed: 06/18/2023]
Abstract
India's National Framework for malaria elimination is essentially dependent on Annual Parasite Incidence (API). API is the primary criterion for classifying states and districts into different categories: intensified control, pre-elimination, elimination, prevention and re-establishment of malaria. However, API's validity is critically dependent on multiple factors, one such important factor is Annual Blood Examination Rate (ABER) and is often considered as indicator of operational efficiency. Therefore, the present study aimed to determine whether the API is a sufficiently good malaria index to assess malaria endemicity in India. An in-depth analysis of malaria data (2017-19) was done to determine the appropriateness of API as a sole indicator of malaria endemicity. We stratified the Indian districts into three strata based on Annual Blood Examination Rate (ABER): <5, 5.0-5.0, >15, further APIs was compared with Slide Positivity Rates (SPRs) using sign rank test, independently in each stratum. API and SPR were found comparable (p-value 0.323) in stratum 2 only. However, in the case of lower ABER (<5%, strata 1), the API was significantly lower than the SPR, and higher ABER (>15%), the API was found substantially higher than the SPR. Thus, ABER tunes the validity of API and should avoid to use as a single indicator of malaria endemicity. API is an appropriate measure of malaria endemicity in high and moderate transmission areas where surveillance is good (ABER≥5%). However, it is vitally dependent upon surveillance rate and other factors such as population size, the selection of individuals for malaria testing. Therefore, where surveillance is poor (<5%), we propose that API should be complemented with SPR and the number of cases. It will significantly aid the design and deployment of interventions in India.
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Affiliation(s)
- Chander Prakash Yadav
- ICMR-National Institute of Malaria Research (NIMR), New Delhi, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
| | - Sanjeev Gupta
- ICMR-National Institute of Malaria Research (NIMR), New Delhi, India
| | - Praveen K. Bharti
- ICMR-National Institute of Malaria Research (NIMR), New Delhi, India
| | - Manju Rahi
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
- Indian Council of Medical Research (ICMR), New Delhi, India
| | - Nafis Faizi
- ICMR-National Institute of Malaria Research (NIMR), New Delhi, India
- Jawaharlal Nehru Medical College, AMU, Aligarh, India
| | - Amit Sharma
- ICMR-National Institute of Malaria Research (NIMR), New Delhi, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
- Molecular Medicine, International Centre for Genetic Engineering and Biotechnology (ICGEB), New Delhi, India
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Sharma P, Tailang M. Primaquine-loaded transdermal patch for treating malaria: design, development, and characterization. FUTURE JOURNAL OF PHARMACEUTICAL SCIENCES 2022. [DOI: 10.1186/s43094-022-00433-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The goal of the current study was to create, improve, and test a transdermal patch loaded with primaquine for the treatment of malaria. Several ingredients were used to create the transdermal patch. For the choosing of polymers, placebo patches were created. The optimization of polymer ratios for patch development and testing their impact on tensile strength, in vitro drug release, in vitro drug permeation, and ex vivo drug permeation employed response surface methods. The F5 formulation was chosen as the optimal formulation based on these answers to the data. The stability of the F5 formulation was examined. According to the findings of trials on acute skin irritation, no place where transdermal patches were given showed any signs of clinical abnormalities or a change in body weight. No erythema or edema of the skin was seen in the rabbit’s skin.
Results
It was observed that tensile strength of the transdermal films formulated with Eudragit RL100 and hydroxypropyl methylcellulose (Pmix) was found between 0.32 ± 0.017 and 0.59 ± 0.013 kg/cm2, which were 0.32 ± 0.017 (F1), 0.36 ± 0.012 (F2), 0.35 ± 0.015 (F3) for Pmix ratio 1:1, 0.42 ± 0.011 (F4), 0.49 ± 0.010 (F5), 0.55 ± 0.016 (F6) for Pmix ratio 1:2 and 0.56 ± 0.014 (F7), 0.57 ± 0.010 (F8), 0.59 ± 0.013 (F9) for Pmix ratio 1:3. Data fitting to the Peppas, Hixon–Crowell, Higuchi, and Zero-order models was used to examine the optimized transdermal patch (F5) release kinetic mechanism. Data comparison was done using the correlation coefficient (R2). Zero-order had an observed correlation coefficient (R2) of 0.9988, which was greater than that for other models. Therefore, it was clear that the medication was released from the formulation after the Zero-order release.
Conclusion
The ideal thickness, percent elongation, and tensile strength of the primaquine therapeutic transdermal patches were prepared for transdermal delivery. The therapeutic transdermal patch was prepared by using Eudragit RL100: HPMC K15M (1:2) into the patch because this combination was responsible for the significant delivery of the drug into the bloodstream. The therapeutic transdermal patch has a notable penetration rate. Dimethyl sulfoxide was used as a permeation enhancer, which helped to obtain a high penetration rate. The statistical analysis was used to support the improved formulation. The therapeutic transdermal patch is a potential vehicle for the administration of primaquine, according to stability studies.
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Kamaraj C, Gandhi PR, Ragavendran C, Sugumar V, Kumar RCS, Ranjith R, Priyadharsan A, Cherian T. Sustainable development through the bio-fabrication of ecofriendly ZnO nanoparticles and its approaches to toxicology and environmental protection. BIOMASS CONVERSION AND BIOREFINERY 2022:1-17. [PMID: 36320445 PMCID: PMC9610317 DOI: 10.1007/s13399-022-03445-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 10/13/2022] [Accepted: 10/17/2022] [Indexed: 06/16/2023]
Abstract
Mosquito control is becoming more difficult as a result of the rise in resistance to toxic chemical insecticides. The insecticides of bio-fabrication sources may serve as a convenient alternative to environmentally acceptable methods in the future. The larvicidal and pupicidal activities of bio-fabricated zinc oxide nanoparticles (ZnO NPs) on the different instar larvae and pupae of Anopheles subpictus Grassi (Malaria vector) and Culex quinquefasciatus Say (lymphatic filariasis) were investigated in this study. The results recorded from XRD, FTIR, SEM-EDX, and TEM analyses confirmed the bio-fabrication of ZnO NPs. Such nanoparticles were nearly spherical and agglomerated with a size of 34.21 nm. GC-MS analysis of methanol extract revealed the compound, stigmasterol (C29H48O) as major one. Mosquito larvae and pupae of targeted mosquito were tested against varied concentrations of the bio-fabricated ZnO NPs and methanol extract of Vitex negundo for 24 h. The maximum activity was recorded from ZnO NPs against the larvae and pupae of A. subpictus LC50 which were 1.70 (I), 1.66 (II), 1.93 (III), 2.48 (IV), and 3.63 mg/L (pupa) and C. quinquefasciatus LC50 were 1.95 (I), 2.63 (II), 2.90 (III), 4.32 (IV), and 4.61 mg/L (pupa) respectively. ZnO NPs exhibited strong DPPH radical and FRAP scavengers compared to the aqueous extract of V. negundo. Also, V. negundo leaf methanol extract (VNLME) and ZnO NPs were evaluated for their cytotoxicity on HeLa cells, which exhibited the IC50 values of 72.35 and 43.70μg/mL, respectively. The methylene blue (MB) dye, which is harmful to both aquatic and terrestrial life, was degraded using the biosynthesized ZnO nanoparticles. At 664 nm, 81.2% of the MB dye had degraded after 120 min of exposure to sunlight. Overall, our results revealed that ZnO NPs are the perfect biological agent and economical for the control of malaria, filariasis vectors, antioxidant, HeLa cells, and MB blue dye degradation under sunlight irradiation. Graphical abstract
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Affiliation(s)
- Chinnaperumal Kamaraj
- Interdisciplinary Institute of Indian System of Medicine (IIISM), Directorate of Research, SRM Institute of Science and Technology (SRMIST), Kattankulathur, Tamil Nadu 603203 India
| | - Pachiyappan Rajiv Gandhi
- Department of Zoology, Division of Nano-biotechnology, Auxilium College (Autonomous), Vellore District, Gandhi Nagar, Tamil Nadu 632 006 India
| | - Chinnasamy Ragavendran
- Department of Cariology, Saveetha Dental College and Hospitals, Chennai, Tamil Nadu India
| | - Vimal Sugumar
- Department of Biochemistry, Saveetha Medical College & Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS), Thandalam, Chennai, Tamil Nadu 602105 India
| | - R. C. Satish Kumar
- Interdisciplinary Institute of Indian System of Medicine (IIISM), Directorate of Research, SRM Institute of Science and Technology (SRMIST), Kattankulathur, Tamil Nadu 603203 India
| | - Rajendran Ranjith
- Department of Physics, KSR College Engineering Tiruchengode, Namakkal, Tamil Nadu 637215 India
| | - A. Priyadharsan
- Department of Cariology, Saveetha Dental College and Hospitals, Chennai, Tamil Nadu India
| | - Tijo Cherian
- Department of Ocean Studies and Marine Biology, Pondicherry University, Port Blair campus, Brookshabad, Port Blair, Andamans 744112 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] [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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Jana S, Fu SH, Gelband H, Brown P, Jha P. Spatio-temporal modelling of malaria mortality in India from 2004 to 2013 from the Million Death Study. Malar J 2022; 21:90. [PMID: 35300715 PMCID: PMC8932160 DOI: 10.1186/s12936-022-04112-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 03/01/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND India has a substantial burden of malaria, concentrated in specific areas and population groups. Spatio-temporal modelling of deaths due to malaria in India is a critical tool for identifying high-risk groups for effective resource allocation and disease control policy-making, and subsequently for the country's progress towards United Nations 2030 Sustainable Development Goals. METHODS In this study, a spatio-temporal model with the objective of understanding the spatial distribution of malaria mortality rates and the rate of temporal decline, across the country, has been constructed. A spatio-temporal "random slope" model was used, with malaria risk depending on a spatial relative risk surface and a linear time effect with a spatially-varying coefficient. The models were adjusted for urban/rural status (residence of the deceased) and Normalized Difference Vegetation Index (NDVI), using 2004-13 data from the Million Death Study (MDS) (the most recent data available), with nationwide geographic coverage. Previous studies based on MDS had focused only on aggregated analyses. RESULTS The rural population had twice the risk of death due to malaria compared to the urban population. Malaria mortality in some of the highest-risk regions, namely the states of Odisha and Jharkhand, are declining faster than other areas; however, the rate of decline was not uniformly correlated with the level of risk. The overall decline was faster after 2010. CONCLUSION The results suggest a need for increased attention in high-risk rural populations, which already face challenges like inadequate infrastructure, inaccessibility to health care facilities, awareness, and education around malaria mortality and prevalence. It also points to the urgent need to restart the MDS to document changes since 2013, to develop appropriate malaria control measures.
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Affiliation(s)
- Sayantee Jana
- Indian Institute of Technology, Hyderabad, India.
- Indian Institute of Management, Nagpur, India.
| | - Sze Hang Fu
- Dalla Lana School of Public Health, Centre for Global Health Research, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | - Hellen Gelband
- Dalla Lana School of Public Health, Centre for Global Health Research, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
| | - Patrick Brown
- Dalla Lana School of Public Health, Centre for Global Health Research, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
- Department of Statistical Sciences, University of Toronto, Toronto, Canada
| | - Prabhat Jha
- Dalla Lana School of Public Health, Centre for Global Health Research, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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Malaria Elimination in Two Endemic Coastal Environments of Southern India: An Eco-Epidemiological Analysis from 2004 to 2019. Acta Parasitol 2022; 67:428-436. [PMID: 34677798 DOI: 10.1007/s11686-021-00479-0] [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: 04/23/2021] [Accepted: 10/04/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Presently, India is heading towards malaria elimination. In this context, analysing malaria epidemiological data of endemic pockets is important. In the present investigation, malaria prevalence in two endemic coastal localities of India viz., Besant Nagar (Chennai district) and Pamban (Ramanathapuram district) was analysed from 2004 to 2019 and correlated with the highest maximum temperature. METHODS Malaria surveillance data and entomological data from the malaria clinics were used to investigate epidemiological parameters. The annual malaria cases were correlated with the highest maximum temperature. RESULTS The analysis showed that the malaria case (P.v. and P.f.) reports were directly proportional to the temperature increase. Malaria cases were remarkably increased from 2004 to 2011 and subsequently, both Plasmodium vivax and Plasmodium falciparum cases were drastically reduced till 2019. P. vivax was higher than P. falciparum and the male population was found to be more affected. Mixed infection of P. vivax and P. falciparum was observed only in the Besant Nagar site (0.3%). The most affected age group was the adult age group (15 years and above) in both Besant Nagar (76.1%) and Pamban (69.5%). CONCLUSION Improved surveillance, complete treatment and integrated vector control activities correlated with a declining trend of malaria cases in both the coastal sites towards malaria elimination.
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Essa M, Taj MA, Khan MH, Amjad Bashir M, Farooq H, Alajmi RA, Hashem M, Alamri S, El-Zohri MA, Ullah K. Awareness and perception of malaria and dengue at school and college level in the district of Multan. PLoS One 2022; 17:e0260868. [PMID: 35143507 PMCID: PMC8830651 DOI: 10.1371/journal.pone.0260868] [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: 08/25/2021] [Accepted: 11/19/2021] [Indexed: 12/24/2022] Open
Abstract
The purpose of this study is to examine the awareness and perception of malaria and dengue fever in Multan Punjab, Pakistan while taking into account the important role of government policies and other variables. The goal of this study is to examine the awareness of students in Multan, Pakistan on malaria and dengue. This study is based on a quantitative approach of secondary evidence from scientific journals and questionnaire surveys. It is also based on observational evidence gathered in Multan Punjab Pakistan, in a field study. The survey with school children, teachers and healthcare professionals were both formal and semi-structuralize. Studies have found that malaria and dengue mainly affect children’s schooling through their absence, but can also induce brain loss and cognitive disability. In questionnaires, students were seen to have different understanding of the illness, but also to be able to serve as agents of health reform only through teachers. A sample size of 500 respondents has been selected from different colleges of district Multan Punjab, Pakistan. Correlation technique is used for the data analysis. According to our results it is concluded that the students at college level are aware of malaria and dengue diseases, but they are not capable of engaging and serving as agents for health reform. On the basis of results it is recommended that students must teach about epidemics diseases regarding how to handle these diseases.
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Affiliation(s)
- Muhammad Essa
- Medical Officer Basic Health Unit, Health Department, Talpur Kot Chuta Dera Ghazi Khan, Punjab, Pakistan
| | - Muhammad Ahmed Taj
- Health Department, Rural Health Center 222EB, District Vehari, Punjab, Pakistan
| | - Muhammad Hakim Khan
- Medical Officer Rural Health Unit, Health Department, Kalur Kot, District Bakhar, Punjab, Pakistan
| | - Muhammad Amjad Bashir
- Department of Plant Protection, Faculty of Agricultural Sciences, Ghazi University, Dera Ghazi Khan, Punjab, Pakistan
- * E-mail:
| | - Hasnain Farooq
- Department of Environmental Sciences, University of California, Riverside, CA, United States of America
- Department of Forestry, Faculty of Agricultural Sciences, Ghazi University, Dera Ghazi Khan, Pakistan
| | - Reem A. Alajmi
- Zoology Department, College of Science, King Saud University, Riyadh, Saudi Arabi
| | - Mohamed Hashem
- Botany and Microbiology Department, Faculty of Science, Assiut University, Assiut, Egypt
| | - Saad Alamri
- Botany and Microbiology Department, Faculty of Science, Assiut University, Assiut, Egypt
| | - Manal A. El-Zohri
- Botany and Microbiology Department, Faculty of Science, Assiut University, Assiut, Egypt
| | - Kaleem Ullah
- Department of Zoology, Faculty of Sciences, Ghazi University, Dera Ghazi Khan, Punjab, Pakistan
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Mandal S. Round up. Indian J Urol 2022; 38:85-90. [PMID: 35400875 PMCID: PMC8992724 DOI: 10.4103/iju.iju_84_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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22
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Rotejanaprasert C, Ekapirat N, Sudathip P, Maude RJ. Bayesian spatio-temporal distributed lag modeling for delayed climatic effects on sparse malaria incidence data. BMC Med Res Methodol 2021; 21:287. [PMID: 34930128 PMCID: PMC8690908 DOI: 10.1186/s12874-021-01480-x] [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: 05/31/2021] [Accepted: 11/22/2021] [Indexed: 12/03/2022] Open
Abstract
Background In many areas of the Greater Mekong Subregion (GMS), malaria endemic regions have shrunk to patches of predominantly low-transmission. With a regional goal of elimination by 2030, it is important to use appropriate methods to analyze and predict trends in incidence in these remaining transmission foci to inform planning efforts. Climatic variables have been associated with malaria incidence to varying degrees across the globe but the relationship is less clear in the GMS and standard methodologies may not be appropriate to account for the lag between climate and incidence and for locations with low numbers of cases. Methods In this study, a methodology was developed to estimate the spatio-temporal lag effect of climatic factors on malaria incidence in Thailand within a Bayesian framework. A simulation was conducted based on ground truth of lagged effect curves representing the delayed relation with sparse malaria cases as seen in our study population. A case study to estimate the delayed effect of environmental variables was used with malaria incidence at a fine geographic scale of sub-districts in a western province of Thailand. Results From the simulation study, the model assumptions which accommodated both delayed effects and excessive zeros appeared to have the best overall performance across evaluation metrics and scenarios. The case study demonstrated lagged climatic effect estimation of the proposed modeling with real data. The models appeared to be useful to estimate the shape of association with malaria incidence. Conclusions A new method to estimate the spatiotemporal effect of climate on malaria trends in low transmission settings is presented. The developed methodology has potential to improve understanding and estimation of past and future trends in malaria incidence. With further development, this could assist policy makers with decisions on how to more effectively distribute resources and plan strategies for malaria elimination.
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Affiliation(s)
- Chawarat Rotejanaprasert
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Ratchathewi, Bangkok, 10400, Thailand. .,Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
| | - Nattwut Ekapirat
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Prayuth Sudathip
- Division of Vector Borne Diseases, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Richard J Maude
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Harvard T.H. Chan School of Public Health, Harvard University, Cambridge, MA, USA.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.,The Open University, Milton Keynes, UK
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Baharia RK, Yadav CP, Sharma A. Four decades of epidemiological data reveal trajectories towards malaria elimination in Kheda district (Gujarat), western part of India. BMJ Glob Health 2021; 6:bmjgh-2021-005815. [PMID: 34880060 PMCID: PMC8655587 DOI: 10.1136/bmjgh-2021-005815] [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: 03/30/2021] [Accepted: 10/03/2021] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Malaria is a main public health problem in India and was so particularly in the state of Gujarat in the western part of the country. This study assesses the effects of various interventions on malaria cases using data from the last 33 years (1987-2019). METHODS Here we have analysed 33 years of malaria epidemiological data from a malaria clinic in Kheda district in Gujarat. The data were digitised yearly and monthly, age-wise and gender-wise, and descriptive analysis was performed to assess the effects of several interventions on malaria burden. RESULTS During 1987-2019, our clinic diagnosed 5466 Plasmodium vivax and 4732 P. falciparum malaria cases. Overall, there was a declining trend in malaria cases except for the years 1991, 1994, 2004 and 2005. The year 2004 especially witnessed an epidemic in Kheda as well as throughout Gujarat. Malaria infections were most common (40%) among the 21-40 years age group. Fever was the most common symptom in all age groups. INTERPRETATION Introduction of revised drug policy and improved surveillance technique (rapid diagnosis kits) have strengthened the diagnosis and treatment of malaria in the district. Use of pyrethroid in indoor residual insecticide spray has also strengthened vector control. Among the various interventions used, long-lasting insecticide nets and introduction of artemisinin-based combination therapy have played significant roles in controlling malaria cases. A more drastic decline in P. falciparum cases versus P. vivax is evident, but the latter persists in high proportions and therefore new tools for malaria control will be needed for elimination.
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Affiliation(s)
- Rajendra Kumar Baharia
- Department of Parasite and Vector Control, ICMR-National Institute of Malaria Research, Nadiad, Gujarat, India
| | - Chander Prakash Yadav
- Indian Council of Medical Research-National Institute of Malaria Research, New Delhi, India
| | - Amit Sharma
- Indian Council of Medical Research-National Institute of Malaria Research, New Delhi, India
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Chinnaswamy S. SARS-CoV-2 infection in India bucks the trend: Trained innate immunity? Am J Hum Biol 2021; 33:e23504. [PMID: 32965717 PMCID: PMC7536963 DOI: 10.1002/ajhb.23504] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 07/26/2020] [Accepted: 08/24/2020] [Indexed: 01/08/2023] Open
Abstract
SARS-CoV-2, the causative agent of COVID-19 pandemic caught the world unawares by its sudden onset in early 2020. Memories of the 1918 Spanish Flu were rekindled raising extreme fear for the virus, but in essence, it was the host and not the virus, which was deciding the outcome of the infection. Age, gender, and preexisting conditions played critical roles in shaping COVID-19 outcome. People of lower socioeconomic strata were disproportionately affected in industrialized countries such as the United States. India, a developing country with more than 1.3 billion population, a large proportion of it being underprivileged and with substandard public health provider infrastructure, feared for the worst outcome given the sheer size and density of its population. Six months into the pandemic, a comparison of COVID-19 morbidity and mortality data between India, the United States, and several European countries, reveal interesting trends. While most developed countries show curves expected for a fast-spreading respiratory virus, India seems to have a slower trajectory. As a consequence, India may have gained on two fronts: the spread of the infection is unusually prolonged, thus leading to a curve that is "naturally flattened"; concomitantly the mortality rate, which is a reflection of the severity of the disease has been relatively low. I hypothesize that trained innate immunity, a new concept in immunology, may be the phenomenon behind this. Biocultural, socioecological, and socioeconomic determinants seem to be influencing the outcome of COVID-19 in different regions/countries of the world.
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Affiliation(s)
- Sreedhar Chinnaswamy
- Infectious Disease GeneticsNational Institute of Biomedical GenomicsKalyaniIndia
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25
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Singh J, George M. Intolerable Burden of Malaria among Primitive Tribal Community in Odisha: Examining the Fundamental Cause. JOURNAL OF HEALTH MANAGEMENT 2021. [DOI: 10.1177/09720634211050459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study seeks to examine the living conditions, working conditions, and health seeking behaviour for malaria among Kondho community after one is infected with malaria. The residential surroundings of those diagnosed with malaria positive cases were extremely conducive for mosquito breeding. For instance, the majority of households threw garbage near their house, went for open defecation, the cowshed was beside their houses, and above all the houses were mostly situated in the jungle or near thick forest. Sub-centre followed by the community health centres was the first point of contact in most cases but medical care was sought only after routine life was affected. While malaria treatment plans are changing towards administering more powerful drugs as a result of chloroquine resistance but not as much has been done in the ground to prevent malaria at the first place. Therefore, together with continuing curative care for malaria—more emphasis is needed on its prevention. Community, civil society and the government need to work in tandem to improve the living and working conditions of backward communities particularly those living in malaria endemic zone so as to be able to take effective preventive measures for malaria.
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Affiliation(s)
- Jayakant Singh
- School of Health Systems Studies, Tata Institute of Social Sciences, Mumbai, Maharashtra, India
| | - Mathew George
- School of Health Systems Studies, Tata Institute of Social Sciences, Mumbai, Maharashtra, India
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26
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Bonam SR, Rénia L, Tadepalli G, Bayry J, Kumar HMS. Plasmodium falciparum Malaria Vaccines and Vaccine Adjuvants. Vaccines (Basel) 2021; 9:1072. [PMID: 34696180 PMCID: PMC8541031 DOI: 10.3390/vaccines9101072] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 09/10/2021] [Accepted: 09/22/2021] [Indexed: 12/02/2022] Open
Abstract
Malaria-a parasite vector-borne disease-is a global health problem, and Plasmodium falciparum has proven to be the deadliest among Plasmodium spp., which causes malaria in humans. Symptoms of the disease range from mild fever and shivering to hemolytic anemia and neurological dysfunctions. The spread of drug resistance and the absence of effective vaccines has made malaria disease an ever-emerging problem. Although progress has been made in understanding the host response to the parasite, various aspects of its biology in its mammalian host are still unclear. In this context, there is a pressing demand for the development of effective preventive and therapeutic strategies, including new drugs and novel adjuvanted vaccines that elicit protective immunity. The present article provides an overview of the current knowledge of anti-malarial immunity against P. falciparum and different options of vaccine candidates in development. A special emphasis has been made on the mechanism of action of clinically used vaccine adjuvants.
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Affiliation(s)
- Srinivasa Reddy Bonam
- Institut National de la Santé et de la Recherche Médicale, Centre de Recherche des Cordeliers, Equipe-Immunopathologie et Immunointervention Thérapeutique, Sorbonne Université, Université de Paris, F-75006 Paris, France;
| | - Laurent Rénia
- A*STAR Infectious Diseases Labs, 8A Biomedical Grove, Singapore 138648, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore
- School of Biological Sciences, Nanyang Technological University, Singapore 308232, Singapore
| | - Ganesh Tadepalli
- Vaccine Immunology Laboratory, Organic Synthesis and Process Chemistry Division, CSIR-Indian Institute of Chemical Technology, Hyderabad 500007, India;
| | - Jagadeesh Bayry
- Institut National de la Santé et de la Recherche Médicale, Centre de Recherche des Cordeliers, Equipe-Immunopathologie et Immunointervention Thérapeutique, Sorbonne Université, Université de Paris, F-75006 Paris, France;
- Biological Sciences & Engineering, Indian Institute of Technology Palakkad, Palakkad 678623, India
| | - Halmuthur Mahabalarao Sampath Kumar
- Vaccine Immunology Laboratory, Organic Synthesis and Process Chemistry Division, CSIR-Indian Institute of Chemical Technology, Hyderabad 500007, India;
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Mohan A, Wara UU, Amjad SW, Rackimuthu S, Hunain R, Khan H, Carla Dos Santos Costa A, Ahmad S, Essar MY. Malaria amidst COVID-19 in India: Challenges, Efforts, and Recommendations. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021; 12:100867. [PMID: 34522826 PMCID: PMC8431839 DOI: 10.1016/j.cegh.2021.100867] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 09/06/2021] [Indexed: 12/23/2022] Open
Abstract
Since the outbreak of COVID-19 in India, the country has faced a slew of new challenges, spawning a slew of other deadly viruses and diseases while also serving as a breeding ground for them. Not only did Malaria (a vector-borne disease) emerge as a coincidental outbreak during the pandemic, but many others did as well, causing severe diseases in humans due to flaws in health-care systems that were already overburdened with identifying, preventing, and treating the recently introduced coronavirus disease. Inadequate water cleanliness, as well as the delayed and misdiagnosis of Malaria with COVID-19 due to overlapping symptoms, are major impediments in the incidence of these unique outbreaks. Appropriate steps, such as providing clean water and diagnostic facilities to control Malaria cases, should be adopted to prevent such epidemics in the country.
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Affiliation(s)
- Anmol Mohan
- Karachi Medical & Dental College, Karachi, Pakistan
| | - Um Ul Wara
- Karachi Medical & Dental College, Karachi, Pakistan
| | | | | | | | - Hiba Khan
- Dubai Medical College, Dubai, United Arab Emirates
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Abstract
India observed a significant reduction in malaria cases in the previous year, reaffirming our trust and efficiency of the existing tools to achieve malaria elimination. On 25 April, 2019, countries around the world marked World Malaria Day under the theme “Zero malaria starts with me”. This provides an opportunity to rejoice the success and re-evaluate ongoing challenges in the fight against this preventable and treatable parasitic disease. We highlight the potential gaps in the malaria elimination program, and underscore potential solutions and strategies to implement, improve and intensify the success of the national goal of malaria elimination by 2030.
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Mohan I, Kodali NK, Chellappan S, Karuppusamy B, Behera SK, Natarajan G, Balabaskaran Nina P. Socio-economic and household determinants of malaria in adults aged 45 and above: analysis of longitudinal ageing survey in India, 2017-2018. Malar J 2021; 20:306. [PMID: 34233690 PMCID: PMC8265067 DOI: 10.1186/s12936-021-03840-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 06/29/2021] [Indexed: 11/13/2022] Open
Abstract
Background Even though malaria cases have drastically come down in the last decade, malaria remains a serious public health concern in many parts of India. National Framework for Malaria Elimination in India (2016–2030) has been launched with the goal to eliminate malaria by 2030. Understanding the socio-economic and household determinants of malaria at the national level will greatly aid India’s malaria elimination efforts. Methods The data from Longitudinal Ageing Survey of India (LASI) Wave 1 (2017–2018) survey comprising 70,671 respondents ≥ 45 years across all the States and Union Territories were used for the analysis. Simple and multiple logistic regressions were used to obtain the unadjusted and adjusted odds ratio respectively of the socio-economic and household variables. Results The major socio-economic variables that increase the likelihood of malaria are caste (‘scheduled tribes’), low education levels and rural residence. The scheduled tribes have 1.8 times higher odds of malaria than the scheduled castes (AOR: 1.8; 95% CI: 1.5–2.1). Respondents with high school education (6–12 grade) (AOR: 0.7; 95% CI: 0.6–0.8) and college education (AOR: 0.5; 95% CI: 0.4–0.6) had a very low risk of malaria than those with no school years. Rural residence and occupation (agriculture and allied jobs) also increases the odds of malaria. The major housing determinants are household size (≥ 6), housing type (kutcha), use of unclean fuel, outside water source, improper sanitation (toilet facilities) and damp wall/ceiling. Conclusions The study has identified the major socio-economic and housing factors associated with malaria in adults aged 45 and above. In addition to vector and parasite control strategies in the tribal dominated regions of India, improving literacy and housing conditions may help India’s malaria elimination efforts.
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Affiliation(s)
- Indumathi Mohan
- Department of Epidemiology and Public Health, Central University of Tamil Nadu, Tiruvarur, Tamil Nadu, India
| | - Naveen Kumar Kodali
- Department of Epidemiology and Public Health, Central University of Tamil Nadu, Tiruvarur, Tamil Nadu, India
| | | | | | - Sujit Kumar Behera
- Department of Epidemiology and Public Health, Central University of Tamil Nadu, Tiruvarur, Tamil Nadu, India
| | - Gopalan Natarajan
- Department of Epidemiology and Public Health, Central University of Tamil Nadu, Tiruvarur, Tamil Nadu, India
| | - Praveen Balabaskaran Nina
- Department of Epidemiology and Public Health, Central University of Tamil Nadu, Tiruvarur, Tamil Nadu, India.
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Rao MRK, Das MK. Malaria among the Sauria Paharia, a primitive and vulnerable tribe of Jharkhand state, India. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021. [DOI: 10.1016/j.cegh.2021.100778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Rahi M, Sharma A. For malaria elimination India needs a platform for data integration. BMJ Glob Health 2021; 5:bmjgh-2020-004198. [PMID: 33380414 PMCID: PMC7780526 DOI: 10.1136/bmjgh-2020-004198] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 12/05/2020] [Accepted: 12/09/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Manju Rahi
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Amit Sharma
- National Institute of Malaria Research, New Delhi, India .,International Centre For Genetic Engineering and Biotechnology, New Delhi, India
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32
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Kaur J, Kaura T, Sharma A, Kumar A, Pangotra MK, Upadhyay AK, Anvikar A, Grover GS, Chaturvedi HK, Sharma SK. Surveillance-based estimation of the malaria disease burden in a low endemic state of Punjab, India, targeted for malaria elimination. Trans R Soc Trop Med Hyg 2021; 115:512-519. [PMID: 33539517 DOI: 10.1093/trstmh/trab005] [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: 09/28/2020] [Revised: 11/10/2020] [Accepted: 01/11/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The state of Punjab in India qualifies for malaria elimination because the number of cases reported through routine surveillance is in decline. However, surveillance system prevalence mainly provides malaria trends. Therefore, a prospective epidemiological study was designed to estimate the malaria burden in the state. METHODS District-wise annual parasite incidence (API) was used for identification of three strata, representing high, moderate and low API zones. A total of 0.9 million people from nine districts was under malaria surveillance for 1 y. The weighted estimates of API for the three regions was calculated and combined to give an estimate of API for the total population of the state. RESULTS Based upon the primary data generated, malaria cases from high, moderate and low malaria-endemic areas were estimated to be 3727, 904 and 106, respectively. Further, the total number of malaria cases in the state was estimated to be 4737 (95% CI 4006 to 5469) cases per annum. CONCLUSION Actual burden of malaria in the state of Punjab, India, is about seven to eight times higher than that reported by routine surveillance activities. However, the state still qualifies for malaria elimination but needs vigorous efforts to strengthen the active surveillance and reporting system along with implementation of effective control strategies to achieve malaria elimination.
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Affiliation(s)
- Jaspreet Kaur
- ICMR-National Institute of Malaria Research, Field site, CHC Dhakoli, Zirakpur, Punjab, India
| | - Taruna Kaura
- ICMR-National Institute of Malaria Research, Field site, CHC Dhakoli, Zirakpur, Punjab, India
| | - Ayush Sharma
- ICMR-National Institute of Malaria Research, Field site, CHC Dhakoli, Zirakpur, Punjab, India
| | - Ashish Kumar
- ICMR-National Institute of Malaria Research, Field site, CHC Dhakoli, Zirakpur, Punjab, India
| | - M K Pangotra
- ICMR-National Institute of Malaria Research, Field site, CHC Dhakoli, Zirakpur, Punjab, India
| | - A K Upadhyay
- ICMR-National Institute of Malaria Research, Field site, CHC Dhakoli, Zirakpur, Punjab, India
| | - Anupkumar Anvikar
- ICMR-National Institute of Malaria Research, Sector-8, Dwarka, New Delhi, India
| | - Gagandeep S Grover
- Directorate of Health Services, Government of Punjab, Parivar Kalyan Bhavan, Sector-34, Chandigarh, India
| | - H K Chaturvedi
- ICMR-National Institute of Medical Statistics, Ansari Nagar, New Delhi, India
| | - Surya K Sharma
- ICMR-National Institute of Malaria Research, Field site, CHC Dhakoli, Zirakpur, Punjab, India
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Krishna S, Mishra S, Tiwari P, Vishwakarma AK, Khandai S, Shrivastava S, Verma AK, Tiwari S, Barman H, Jhariya S, Tiwari P, Tidgam AS, Varun BM, Singh S, Yerane N, Tembhurne CR, Mandavi PL, Tekam SS, Malik M, Behera KP, Jayswar H, Sonwani K, Diggikar MS, Pradhan MM, Khasotiya SS, Kumar A, Dhingra N, Bustos MDG, Christophel EM, Ringwald P, Kumari R, Shukla MM, Singh N, Das A, Bharti PK. Therapeutic efficacy of artemether-lumefantrine for the treatment of uncomplicated Plasmodium falciparum malaria in four malaria endemic states of India. Malar J 2021; 20:229. [PMID: 34020652 PMCID: PMC8139028 DOI: 10.1186/s12936-021-03762-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 05/11/2021] [Indexed: 11/10/2022] Open
Abstract
Background Malaria is a major public health problem in India and accounts for about 88% of malaria burden in South-East Asia. India alone accounted for 2% of total malaria cases globally. Anti-malarial drug resistance is one of the major problems for malaria control and elimination programme. Artemether-lumefantrine (AL) is the first-line treatment of uncomplicated Plasmodium falciparum in north eastern states of India since 2013 after confirming the resistance against sulfadoxine-pyrimethamine. In the present study, therapeutic efficacy of artemether-lumefantrine and k13 polymorphism was assessed in uncomplicated P. falciparum malaria. Methods This study was conducted at four community health centres located in Koraput district of Odisha, Bastar district of Chhattisgarh, Balaghat district of Madhya Pradesh and Gondia district of Maharashtra state. Patients with uncomplicated P. falciparum malaria were administered with fixed dose combination (6 doses) of artemether-lumefantrine for 3days and clinical and parasitological response was recorded up to 28days as per World Health Organization protocol. Nucleotide sequencing of msp1 and msp2 gene was performed to differentiate between recrudescence and reinfection. Amplification and sequencing of k13 propeller gene region covering codon 450680 was also carried out to identify the polymorphism. Results A total 376 malaria patients who fulfilled the enrolment criteria as well as consented for the study were enrolled. Total 356 patients were followed up successfully up to 28days. Overall, the adequate clinical and parasitological response was 98.9% and 99.4% with and without PCR correction respectively. No case of early treatment failure was observed. However, four cases (1.1%) of late parasitological failure were found from the Bastar district of Chhattisgarh. Genotyping of msp1 and msp2 confirmed 2 cases each of recrudescence and reinfection, respectively. Mutation analysis of k13 propeller gene showed one non-synonymous mutation Q613H in one isolate from Bastar. Conclusions The study results showed that artemether-lumefantrine is highly effective in the treatment of uncomplicated P. falciparum malaria among all age groups. No functional mutation in k13 was found in the study area. The data from this study will be helpful in implementation of artemether-lumefantrine in case of treatment failure by artesunate plus sulfadoxine-pyrimethamine.
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Affiliation(s)
- Sri Krishna
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Sweta Mishra
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Prakash Tiwari
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Anup K Vishwakarma
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Sushrikanta Khandai
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Suyesh Shrivastava
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Anil K Verma
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Shashikant Tiwari
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Hari Barman
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Surendra Jhariya
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Pradeep Tiwari
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | | | - Brij M Varun
- District Malaria Office, Balaghat, Madhya Pradesh, India
| | - Sunil Singh
- Community Health Centre Damoh, Balaghat, Madhya Pradesh, India
| | - Naresh Yerane
- Community Health Centre Darekasa, Gondia, Maharashtra, India
| | | | - Prem L Mandavi
- Community Health Centre, District Bastar, Darbha, Chhattisgarh, India
| | - Shyam S Tekam
- District Malaria Office, District Bastar, Jagdalpur, Chhattisgarh, India
| | - Manas Malik
- Community Health Centre Bandhgram, District Koraput, Dasmantpur, Odisha, India
| | - Kali P Behera
- District Malaria Office, District Koraput, Dasmantpur, Odisha, India
| | - Himanshu Jayswar
- Directorate of Health Services, Satpura Bhawan, Bhopal, Madhya Pradesh, India
| | - Khemraj Sonwani
- Directorate of Health Services, Indravati Bhawan, Raipur, Chhattisgarh, India
| | | | - Madan M Pradhan
- State NVBDCP, Public Health Directorate, Bhubaneswar, Odisha, India
| | - Sher S Khasotiya
- National Vector Borne Disease Control Programme (NVBDCP), New Delhi, India
| | - Avdhesh Kumar
- National Vector Borne Disease Control Programme (NVBDCP), New Delhi, India
| | - Neeraj Dhingra
- National Vector Borne Disease Control Programme (NVBDCP), New Delhi, India
| | | | | | - Pascal Ringwald
- Global Malaria Programme, World Health Organization, Geneva, Switzerland
| | - Roop Kumari
- World Health Organization, Country Office for India, New Delhi, India
| | - Man M Shukla
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Neeru Singh
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Aparup Das
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India
| | - Praveen K Bharti
- ICMR-National Institute of Research in Tribal Health, Jabalpur, Madhya Pradesh, India.
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Sangwan J, Minhas A, Mane P, Dhingra A. Pattern of severe malaria with special reference to Plasmodium vivax in pediatric population of the most aspirational region of North India. INTERNATIONAL JOURNAL OF ADVANCED MEDICAL AND HEALTH RESEARCH 2021. [DOI: 10.4103/ijamr.ijamr_21_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Pandit N, Kalaria T, Lakhani JD, Jasani J. Assessment of protective relationship of G6PD and other lifestyle factors with Malaria: A case-control study of medical professionals from a teaching medical institute, Gujarat. J Family Med Prim Care 2020; 9:5638-5645. [PMID: 33532407 PMCID: PMC7842447 DOI: 10.4103/jfmpc.jfmpc_947_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 08/31/2020] [Accepted: 09/18/2020] [Indexed: 11/04/2022] Open
Abstract
Background There remains equivocal evidence in terms of glucose-6-phosphate dehydrogenase (G6PD) and malaria occurrence. A case-control study was performed to assess protective relationship of G6PD and other lifestyle factors with malaria. Methods One-hundred twenty six medical professionals were randomly selected from a tertiary care clinical institute. Along with demographic and lifestyle details, subjects were interviewed about their history of occurrence of malaria at all in previous 10 years. Their hematological, biochemical, and metabolic profile was assessed clinically as well as by investigations. The analysis was carried out with two groups: (1) those who were subjected with malaria at least once in past 10 years (Malaria Ever Group); (2) those who never encountered malaria (Malaria Never Group). Results Out of 126, 65 subjects were in Malaria Ever Group and 61were in Malaria Never Group. There was no difference in lifestyle measures, hematological, and biochemical parameters. Mean G6PD levels were found similar in both the groups. Of 61 subjects in "malaria-never" group, 1 had deficient (1.1 unit/gm of Hb), 9 had low normal (between 2.5 and 10 units/gm of Hb), 48 had normal (10.1-20.5 units/gm of Hb), and 3 had higher than normal (>20.5 units/gm of Hb) G6PD levels. In comparison, 65 participants from "malaria ever" group, none was deficient, 6 had low normal, 58 had normal, and none had higher than normal G6PD levels. HPLC-based hemoglobin analysis showed significant higher number of participants in "malaria-never" group having altered hemoglobin. 12 participants had increased hemoglobin A2 levels, of which 10 were in "Malaria Occurrence Never" group; of them 6 could be diagnosed having hemoglobinopathy of specified variety. 3 of these 10 participants of "malaria-never" group had low G6PD levels also. Conclusion Malaria Protection Hypothesis was not found to be true as per our findings, but there were subtle hints that G6PD protection with or without change in hemoglobin alteration maybe operable.
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Affiliation(s)
- Niraj Pandit
- Prof and Head, Department of Community Medicine, SBKS Medical Institute and Research Centre and Dhiraj Hospital, Sumandeep Deemed University, Piparia, (Dist :Vadodara) Gujarat, India
| | - Tejaskumar Kalaria
- Ex. Assistant Professor in Biochemistry, SBKS Medical Institute and Research Centre and Dhiraj Hospital, Sumandeep Deemed University, Piparia, (Dist :Vadodara) Gujarat, India
| | - Jitendra D Lakhani
- Professor of Medicine and Academic Director, SBKS Medical Institute and Research Centre and Dhiraj Hospital, Sumandeep Deemed University, Piparia, (Dist :Vadodara) Gujarat, India
| | - Jasmin Jasani
- Professor of Pathology and Incharge Central Laboratory, SBKS Medical Institute and Research Centre and Dhiraj Hospital, Sumandeep Deemed University, Piparia, (Dist :Vadodara) Gujarat, India
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van Eijk AM, Choubey S, Barla P, Haque MA, Nandini P, Acharya S, Sullivan SA, Mohanty S, Satpathi S, Carlton JM. Malaria in Sundargarh district, Odisha, India: Epidemiological and behavioral aspects from surveys. Acta Trop 2020; 211:105647. [PMID: 32735794 DOI: 10.1016/j.actatropica.2020.105647] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/27/2020] [Accepted: 07/27/2020] [Indexed: 12/25/2022]
Abstract
To characterize malaria and assist in prevention efforts, we conducted a series of epidemiological studies in Sundargarh district, India, as part of an NIH-funded International Center of Excellence for Malaria Research. In a published survey around Rourkela in 2013-2014 (N = 1307), malaria prevalence was found to be 8.3%. Using these data, villages were divided into low (<2%), medium (2-10%) and high (>10%) malaria prevalence, and risk factors assessed by type of village. In the six low malaria villages, four persons were positive by PCR; in the four medium malaria villages, prevalence was 7% (35 infections, 7 P. vivax); and in the three high malaria villages, prevalence was 21% (62 infections, 10 P. vivax and 5 mixed with P. vivax and P. falciparum). A total of 30.6% infections were submicroscopic and 40.6% were asymptomatic. Our analyses showed that the rainy season and male gender were risk factors for malaria; in high malaria villages, young age was an additional risk factor, and indoor and outdoor spraying was protective compared to no spraying. We undertook a subsequent behavioral survey in four of the medium and high malaria villages in 2017 to investigate the behavioral aspects of malaria risk. Among 500 participants in 237 households, adult men (15+ years) were more likely to be outside in the evening (34.5% vs. 7.9% among adult women 15+ years and 0.7% among children, p < 0.001), or to sleep outside (7.5% vs. 0.5% and 0%, respectively, p < 0.001). Although women were more likely to get up before 6 a.m. (86.6%, vs. 70.5% among men, 50.7% among children, p < 0.001), men were more likely to be outside in the early morning (77.6% among men, 11.2% among women, and 11.1% among children, p < 0.001). More children used insecticide treated nets the previous night (73.4%) than men (45.6%) or women (39.6%), and repellents were used by 29.5% of 234 households (insecticide creams were not used at all). Malaria control and elimination in India will need local approaches, and the promotion of repellent cream use by at-risk groups could be further explored in addition to mass-screen or treat programs in high-risk villages.
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Affiliation(s)
- Anna Maria van Eijk
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY 10003, USA
| | - Sandhya Choubey
- Jigyansha, International Center of Excellence for Malaria Research, Sector 1 Health Center, Rourkela, Odisha, India
| | - Punam Barla
- Jigyansha, International Center of Excellence for Malaria Research, Sector 1 Health Center, Rourkela, Odisha, India
| | - Mohammed A Haque
- Jigyansha, International Center of Excellence for Malaria Research, Sector 1 Health Center, Rourkela, Odisha, India
| | - P Nandini
- Jigyansha, International Center of Excellence for Malaria Research, Sector 1 Health Center, Rourkela, Odisha, India
| | - Subrata Acharya
- Jigyansha, International Center of Excellence for Malaria Research, Sector 1 Health Center, Rourkela, Odisha, India
| | - Steven A Sullivan
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY 10003, USA
| | - Sanjib Mohanty
- Jigyansha, International Center of Excellence for Malaria Research, Sector 1 Health Center, Rourkela, Odisha, India
| | - Sanghamitra Satpathi
- Jigyansha, International Center of Excellence for Malaria Research, Sector 1 Health Center, Rourkela, Odisha, India
| | - Jane M Carlton
- Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY 10003, USA.
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Pradhan N, Rath A, Panda BB, Mohanty I, Somalkar NM, Hazra RK. Implementation of molecular method in routine malaria diagnosis and entomological studies. J Vector Borne Dis 2020; 57:314-324. [PMID: 34856711 DOI: 10.4103/0972-9062.313973] [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: 11/04/2022] Open
Abstract
BACKGROUND & OBJECTIVES Molecular methods for malaria vector species and parasite identification have received great attention in recent years. Accurate and precise identification of the target species has direct medical and practical implications, such as in malaria diagnosis and vector dynamics study. Translation of molecular techniques will help in evaluation of epidemiological and entomological profile of malaria even in highly inaccessible areas where there is lack of an expert microscopist or entomologist. METHODS In the present study, we have developed a simple yet accurate molecular tool for malaria diagnosis as well as for malaria vector studies. We have standardized, simplified and improvised the DNA isolation (using Chelex; a cationic exchanger), its storage and multiplex PCR for parasite detection from dried blood spot (DBS) filter paper as well as malaria vector identification and infection status study. RESULTS The chelex-PCR based molecular method was highly sensitive (sensitivity >90%) and specific (specificity >80%) for parasite detection as well as vector species identification. This method has proven readily adaptable for use in the clinical diagnostic/research laboratory for epidemiological investigation and vector dynamics study that can challenge the conventional gold standard approach such as microscopy/ morphological methods not only in response to accuracy but also in relation to cost, time and technical expertise. INTERPRETATION & CONCLUSION Transfer of this molecular technology from laboratory to field condition is highly essential for its availability to the common public rather than being restricted to only academic research. This can be achieved by implementation of the technology in terms of conducting mass training and awareness programs in various resource-limited endemic zones for the purpose of malaria elimination.
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Affiliation(s)
- Nitika Pradhan
- KIIT School of Biotechnology, KIIT University; Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Animesha Rath
- KIIT School of Biotechnology, KIIT University; Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | | | - Ipsita Mohanty
- Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Nilam M Somalkar
- Regional Office for Health and Family Welfare, Bhubaneswar, Odisha, India
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Bal M, Das A, Ghosal J, Pradhan MM, Khuntia HK, Pati S, Dutta A, Ranjit M. Assessment of effectiveness of DAMaN: A malaria intervention program initiated by Government of Odisha, India. PLoS One 2020; 15:e0238323. [PMID: 32898853 PMCID: PMC7478908 DOI: 10.1371/journal.pone.0238323] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 08/12/2020] [Indexed: 01/01/2023] Open
Abstract
India, a persistently significant contributor to the global malaria burden, rolled out several anti-malaria interventions at the national and state level to control and recently, to eliminate the disease. Odisha, the eastern Indian state with the highest malaria burden experienced substantial gains shown by various anti-malaria initiatives implemented under the National Vector-borne Disease Control Programme (NVBDCP). However, recalcitrant high-transmission "pockets" of malaria persist in hard-to-reach stretches of the state, characterised by limited access to routine malaria surveillance and the forested hilly topography favouring unbridled vector breeding. The prevalence of asymptomatic malaria in such pockets serves as perpetual malaria reservoir, thus hindering its elimination. Therefore, a project with the acronym DAMaN was initiated since 2017 by state NVBDCP, targeting locally identified high endemic 'pockets' in 23 districts. DAMaN comprised biennial mass screening and treatment, provisioning of long-lasting insecticidal net (LLIN) and behavioural change communication. Subsequently, to inform policy, assessment of DAMaN was conceived that aims to estimate the coverage of the various components of the project; the prevalence of malaria, even at sub-patent level especially among pregnant/lactating women and children; and its impact on malaria incidence. A survey of DAMaN beneficiaries will measure coverage; and knowledge and practices related to LLIN; along with collection of blood specimens from a probability sample. A multi-stage stratified clustered sample of 2228 households (~33% having pregnant/lactating women) will be selected from 6 DAMaN districts. Routine DAMaN project data (2017-2018) and NVBDCP data (2013-2018) will be extracted. Rapid Diagnostic Test, Polymerase Chain Reaction and blood smear microscopy will be conducted to detect malarial parasitemia. In addition to measuring DAMaN's coverage and malarial prevalence in DAMaN pockets, its impact will be estimated using pre-post differences and Interrupted Time Series analysis using 2017 as the "inflection" point. The assessment may help to validate the unique strategies employed by DAMaN.
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Affiliation(s)
- Madhusmita Bal
- ICMR- Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Arundhuti Das
- ICMR- Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Jyoti Ghosal
- ICMR- Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | | | | | - Sanghamitra Pati
- ICMR- Regional Medical Research Centre, Bhubaneswar, Odisha, India
| | - Ambarish Dutta
- Indian Institute of Public Health, Bhubaneswar, Odisha, India
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Milligan R, Daher A, Villanueva G, Bergman H, Graves PM. Primaquine alternative dosing schedules for preventing malaria relapse in people with Plasmodium vivax. Cochrane Database Syst Rev 2020; 8:CD012656. [PMID: 32816320 DOI: 10.1002/14651858.cd012656.pub3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Plasmodium vivax liver stages (hypnozoites) may cause relapses, prolonging morbidity, and impeding malaria control and elimination. The World Health Organization (WHO) recommends three schedules for primaquine: 0.25 mg/kg/day (standard), or 0.5 mg/kg/day (high standard) for 14 days, or 0.75 mg/kg once weekly for eight weeks, all of which can be difficult to complete. Since primaquine can cause haemolysis in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency, clinicians may be reluctant to prescribe primaquine without G6PD testing, and recommendations when G6PD status is unknown must be based on an assessment of the risks and benefits of prescribing primaquine. Alternative safe and efficacious regimens are needed. OBJECTIVES To assess the efficacy and safety of alternative primaquine regimens for radical cure of P vivax malaria compared to the standard or high-standard 14-day courses. SEARCH METHODS We searched the Cochrane Infectious Diseases Group Specialized Register; the Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE (PubMed); Embase (Ovid); LILACS (BIREME); WHO International Clinical Trials Registry Platform and ClinicalTrials.gov up to 2 September 2019, and checked the reference lists of all identified studies. SELECTION CRITERIA Randomized controlled trials (RCTs) of adults and children with P vivax malaria using either chloroquine or artemisinin-based combination therapy plus primaquine at a total adult dose of at least 210 mg, compared with the WHO-recommended regimens of 0.25 or 0.5 mg/kg/day for 14 days. DATA COLLECTION AND ANALYSIS Two review authors independently assessed trial eligibility and quality, and extracted data. We calculated risk ratios (RRs) with 95% confidence intervals (CIs) for dichotomous data. We grouped efficacy data according to length of follow-up, partner drug, and trial location. We analysed safety data where included. MAIN RESULTS 0.5 mg/kg/day for seven days versus standard 0.25 mg/kg/day for 14 days There may be little or no difference in P vivax recurrences at six to seven months when using the same total dose (210 mg adult dose) over seven days compared to 14 days (RR 0.96, 95% CI 0.66 to 1.39; 4 RCTs, 1211 participants; low-certainty evidence). No serious adverse events were reported. We do not know if there is any difference in the number of adverse events resulting in discontinuation of primaquine (RR 1.04, 95% CI 0.15 to 7.38; 5 RCTs, 1427 participants) or in the frequency of anaemia (RR 3.00, 95% CI 0.12 to 72.91, 1 RCT, 240 participants) between the shorter and longer regimens (very low-certainty evidence). Three trials excluded people with G6PD deficiency; two did not provide this information. Pregnant and lactating women were either excluded or no details were provided. High-standard 0.5 mg/kg/day for 14 days versus standard 0.25 mg/kg/day for 14 days There may be little or no difference in P vivax recurrences at six months with 0.5 mg/kg/day primaquine for 14 days compared to 0.25 mg/kg/day for 14 days (RR 0.84 (95% CI 0.49 to 1.43; 2 RCTs, 677 participants, low-certainty evidence). No serious adverse events were reported. We do not know whether there is a difference in adverse events resulting in discontinuation of treatment with the high-standard dosage (RR 4.19, 95% CI 0.90 to 19.60; 1 RCT, 778 participants, very low-certainty evidence). People with G6PD deficiency and pregnant or lactating women were excluded. 0.75 mg/kg/week for eight weeks versus high-standard 0.5 mg/kg/day for 14 days We do not know whether weekly primaquine increases or decreases recurrences of P vivax compared to high-standard 0.5 mg/kg/day for 14 days, at 11 months' follow-up (RR 3.18, 95% CI 0.37 to 27.60; 1 RCT, 122 participants; very low-certainty evidence). No serious adverse events and no episodes of anaemia were reported. G6PD-deficient patients were not randomized but included in the weekly primaquine group (only one patient detected). 1 mg/kg/day for seven days versus high standard 0.5 mg/kg/day for 14 days There is probably little or no difference in P vivax recurrences at 12 months between 1.0 mg/kg/day primaquine for seven days and the high-standard 0.5 mg/kg/day for 14 days (RR 1.03, 95% CI 0.82 to 1.30; 2 RCTs, 2526 participants; moderate-certainty evidence). There may be moderate to large increase in serious adverse events in the 1.0 mg/kg/day primaquine for seven days compared with the high-standard 0.5 mg/kg/day for 14 days, during 42 days follow-up (RR 12.03, 95% CI 1.57 to 92.30; 1 RCT, 1872 participants, low-certainty evidence). We do not know if there is a difference between 1.0 mg/kg/day primaquine for seven days and high-standard 0.5 mg/kg/day for 14 days in adverse events that resulted in discontinuation of treatment (RR 2.50, 95% CI 0.49 to 12.87; 1 RCT, 2526 participants, very low-certainty evidence), nor if there is difference in frequency of anaemia by 42 days (RR 0.93, 95% CI 0.62 to 1.41; 2 RCTs, 2440 participants, very low-certainty evidence). People with G6PD deficiency were excluded. Other regimens Two RCTs evaluated other rarely-used doses of primaquine, one of which had very high loss to follow-up. Adverse events were not reported. People with G6PD deficiency and pregnant or lactating women were excluded. AUTHORS' CONCLUSIONS Trials available to date do not detect a difference in recurrence between the following regimens: 1) 0.5 mg/kg/day for seven days versus standard 0.25 mg/kg/day for 14 days; 2) high-standard 0.5 mg/kg/day for 14 days versus standard 0.25 mg/kg/day for 14 days; 3) 0.75 mg/kg/week for eight weeks versus high-standard 0.5 mg/kg/day for 14 days; 4) 1 mg/kg/day for seven days versus high-standard 0.5 mg/kg/day for 14 days. There were no differences detected in adverse events for Comparisons 1, 2 or 3, but there may be more serious adverse events with the high seven-day course in Comparison 4. The shorter regimen of 0.5 mg/kg/day for seven days versus standard 0.25 mg/kg/day for 14 days may suit G6PD-normal patients. Further research will help increase the certainty of the findings and applicability in different settings.
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Affiliation(s)
- Rachael Milligan
- Cochrane Infectious Diseases Group, Liverpool School of Tropical Medicine, Liverpool, UK
| | - André Daher
- Vice-Presidency of Research and Biological Collections, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | | | | | - Patricia M Graves
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Australia
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A micro-epidemiological report on the unstable transmission of malaria in Aligarh, India. Parasite Epidemiol Control 2020; 11:e00161. [PMID: 32642569 PMCID: PMC7334815 DOI: 10.1016/j.parepi.2020.e00161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 05/14/2020] [Accepted: 06/18/2020] [Indexed: 11/22/2022] Open
Abstract
India contributes approximately 70% to the malaria burden of Southeast Asia. The transmission of disease in the country is generally hypoendemic, seasonal and unstable. Most researchers focus upon the hyperendemic malarious regions with stable malaria transmission. There is paucity of data regarding malaria transmission in hypoendemic regions, here we are presenting an epidemiological picture of clinical manifestations through a hospital-based survey in Aligarh, India, during 2016-18. Two thousand sixty-eight patients were diagnosed with malaria infection in Jawaharlal Nehru Medical College and Hospital (JNMCH), out of which 1104 were enrolled for clinical analysis. Ninety per cent of the cases were reported during July-November, and the rest in the dry season. A progressive increase in the prevalence rate was observed during the study period, i.e. 4.8, 7.57 and 8.7% in 2016, 2017 and 2018, respectively. Of the total cases, 75.77% had vivax malaria, while rest suffered from falciparum malaria. The risk of disease was significantly higher in the age group 0-15 years compared to all other age groups (p < .0001). The infection rate was higher in males (61%) compared to females (39%) p < .0001. Overall 8.6% of the patients had severe malaria who fulfilled the WHO criteria. The increasing rate of malaria infection during the study period and a considerable no. of severe vivax malaria cases warrant an efficient disease monitoring system, pointing towards the need to carry out micro-epidemiological studies in order to estimate the real burden of malaria in the country.
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Shah S, Abbas G, Riaz N, Anees Ur Rehman, Hanif M, Rasool MF. Burden of communicable diseases and cost of illness: Asia pacific region. Expert Rev Pharmacoecon Outcomes Res 2020; 20:343-354. [PMID: 32530725 DOI: 10.1080/14737167.2020.1782196] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Communicable diseases such as AIDS/HIV, dengue fever, and malaria have a great burden and subsequent economic loss in the Asian region. The purpose of this article is to review the widespread burden of communicable diseases and related health-care burden for the patient in Asia and the Pacific. AREAS COVERED In Central Asia, the number of new AIDS cases increased by 29%. It is more endemic in the poor population with variations in the cost of illness. Dengue is prevalent in more than 100 countries, including the Asia-Pacific region. In Southeast Asia, the annual economic burden of dengue fever was between $ 610 and $ 1,384 million, with a per capita cost of $ 1.06 to $ 2.41. Globally, 2.9 billion people are at risk of developing malaria, 90% of whom are residents of the Asia and Pacific region. The annual per capita cost of malaria control ranged from $ 0.11 to $ 39.06 and for elimination from $ 0.18 to $ 27. EXPERT OPINION The cost of AIDS, dengue, and malaria varies from country to country due to different health-care systems. The literature review has shown that the cost of dengue disease and malaria is poorly documented.
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Affiliation(s)
- Shahid Shah
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Government College University Faisalabad , Faisalabad, Pakistan
| | - Ghulam Abbas
- Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, Government College University Faisalabad , Faisalabad, Pakistan
| | - Nabeel Riaz
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Government College University Faisalabad , Faisalabad, Pakistan
| | - Anees Ur Rehman
- Department of Clinical Pharmacy, School of Pharmaceutical Sciences, University Sains Penang , Gelugor, Malaysia
| | - Muhammad Hanif
- Faculty of Pharmacy, Bahauddin Zakariya University , Multan, Pakistan
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Kumar A, Chaturvedi HK, Mohanty AK, Sharma SK, Malhotra MS, Pandey A. Surveillance based estimation of burden of malaria in India, 2015-2016. Malar J 2020; 19:156. [PMID: 32299426 PMCID: PMC7160962 DOI: 10.1186/s12936-020-03223-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 04/06/2020] [Indexed: 12/02/2022] Open
Abstract
Background India has launched the malaria elimination initiative in February 2016. Studies suggest that estimates of malaria are useful to rationalize interventions and track their impact. Hence, a national study was launched to estimate burden of malaria in India in 2015. Methods For sampling, all 624 districts of India were grouped in three Annual Parasite Incidence (cases per thousand population) categories, < two (low); two-five (moderate) and > five (high) API. Using probability proportional to size (PPS) method, two districts from each stratum were selected covering randomly 200,000 persons per district. Active surveillance was strengthened with 40 trained workers per study district. Data on malaria cases and deaths was collated from all health care providers i.e. pathological laboratories, private practitioners and hospitals in private and public health sectors and was used for analysis and burden estimation. Results Out of 1215,114 population under surveillance, 198,612 (16.3%) tests were performed and 19,386 (9.7%) malaria cases were detected. The malaria cases estimated in India were 3875,078 (95% confidence interval 3792,018–3958,137) with API of 3.05 (2.99–3.12) including 2789,483 (2740,577–2838,389) Plasmodium falciparum with Annual Falciparum Incidence of 2.2 (2.16–2.24). Out of 8025 deaths investigated, 102 (1.27%) were attributed to malaria. The estimated deaths in India were 29,341 (23,354–35,327) including 19,067 (13,665–24,470) confirmed and 10,274 (7694–12,853) suspected deaths in 2015–2016. Conclusions Estimated malaria incidence was about four folds greater than one million reported by the national programme, but three folds lesser than thirteen million estimated by the World Health Organization (WHO). However, the estimated deaths were 93 folds more than average 313 deaths reported by the national malaria programme in 2015–2016. The 29,341 deaths were comparable with 24,000 deaths in 2015 and 22,786 deaths in 2016 estimated by the WHO for India. These malaria estimates can serve as a benchmark for tracking the success of malaria elimination campaign in India.
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Affiliation(s)
- Ashwani Kumar
- Indian Council of Medical Research, National Institute of Malaria Research, Field Unit, Campal, Panaji, 403 001, Goa, India.
| | - Himanshu K Chaturvedi
- Indian Council of Medical Research, National Institute of Medical Statistics, Ansari Nagar, Medical Enclave, New Delhi, 110 029, India
| | - Ajeet Kumar Mohanty
- Indian Council of Medical Research, National Institute of Malaria Research, Field Unit, Campal, Panaji, 403 001, Goa, India
| | - Surya Kant Sharma
- Indian Council of Medical Research, National Institute of Malaria Research, Sector 8, Dwarka, 110 077, New Delhi, India
| | - Mantoshkumar S Malhotra
- Indian Council of Medical Research, National Institute of Malaria Research, Sector 8, Dwarka, 110 077, New Delhi, India
| | - Arvind Pandey
- Indian Council of Medical Research, National Institute of Medical Statistics, Ansari Nagar, Medical Enclave, New Delhi, 110 029, India
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Baghbanzadeh M, Kumar D, Yavasoglu SI, Manning S, Hanafi-Bojd AA, Ghasemzadeh H, Sikder I, Kumar D, Murmu N, Haque U. Malaria epidemics in India: Role of climatic condition and control measures. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 712:136368. [PMID: 32050403 DOI: 10.1016/j.scitotenv.2019.136368] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 12/24/2019] [Accepted: 12/25/2019] [Indexed: 05/28/2023]
Abstract
Malaria is a major public health problem in India, which is the second most populous country in the world. This study aimed to investigate the impact of climatic parameters and malaria control efforts implemented by the Indian national malaria control program on malaria epidemics between January of 2009 and December of 2015. A chi-squared test was used to study the correlation of all implemented control methods with occurrence of epidemics within 30, 45, 60 and 90 days and in the same district, 50, 100 and 200 km distance radiuses. The effect of each control method on probability of epidemics was also measured, and the effects of district population, season, and incidence of malaria parasite types were evaluated using logistic regression models. Fever survey was found to be effective for decreasing the odds of epidemics within 45, 60 and 90 days in 100 km. Anti-larval activity was also effective within 30, 45 and 60 days in 200 km. Winter had negative effects on odds ratio while summer and fall were more likely to trigger epidemics. These results contribute to understanding the role of climate variability and control efforts performed in India.
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Affiliation(s)
- Mahdi Baghbanzadeh
- Department of Business Development, Ofogh Kourosh Chain Stores, Tehran, Iran
| | - Dewesh Kumar
- Department of Preventive and Social Medicine, Rajendra Institute of Medical Sciences, Ranchi, India
| | - Sare I Yavasoglu
- Department of Biology, Faculty of Arts & Sciences, Aydin Adnan Menderes University, Aydin, Turkey
| | - Sydney Manning
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | - Ahmad Ali Hanafi-Bojd
- Department of Medical Entomology and Vector Control, School of Public Health, Tehran School of Medical Science, Tehran, Iran
| | - Hassan Ghasemzadeh
- School of Electrical Engineering and Computer Science, Washington State University, Pullman, WA, United States
| | - Ifthekar Sikder
- Department of Information System in Cleveland State University, USA
| | - Dilip Kumar
- Department of Preventive and Social Medicine, Rajendra Institute of Medical Sciences, Ranchi, India
| | - Nisha Murmu
- Department of Preventive and Social Medicine, Rajendra Institute of Medical Sciences, Ranchi, India
| | - Ubydul Haque
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, TX 76107, USA.
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Khuman SN, Bharat G, Chakraborty P. Spatial distribution and sources of pesticidal persistent organic pollutants in the Hooghly riverine sediment. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:4137-4147. [PMID: 31828711 DOI: 10.1007/s11356-019-06973-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 11/05/2019] [Indexed: 06/10/2023]
Abstract
Given the extensive indiscriminate usage in the past and limited ongoing use, organochlorine pesticides (OCPs) have been widely reported in the Hooghly riverine environment. Hence, surface riverine sediment samples were collected along the urban and suburban transects of the Hooghly River and OCPs were quantified in gas chromatography mass spectrometry (GC-MS). Mean concentration of HCH, DDT, and endosulfan was 5 ng g-1, 10 ng g-1, and 4 ng g-1 respectively. DDT was dominant among all the OCPs and contributed nearly 40% to the total OCPs possibly due to the ongoing use of DDT for vector control programs. Diagnostic ratios suggest recent source of lindane, DDT, and endosulfan. Using OCP concentration from previously published data in surface water during the same time frame, sediment-water partitioning of OCPs was estimated. Excluding α-HCH and γ-HCH in few pockets, majority of the OCPs tend to partition more on to sediment. Comparing the sediment concentration with the sediment quality guideline values, risk on ecological integrities was indicated due to DDT and HCH contamination. Suburban sites indicated higher risk than urban sites according to the calculated sediment quality guideline quotient (SQGQ). A brief review on the approach to pesticidal POP pollution management in India revealed that older management approaches should be replaced with a unique, integrated, and holistic system.
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Affiliation(s)
- Sanjenbam Nirmala Khuman
- Department of Civil Engineering, SRM Research Institute, SRM Institute of Science of Technology, Kattankulathur, Tamil Nadu, India
| | | | - Paromita Chakraborty
- Department of Civil Engineering, SRM Research Institute, SRM Institute of Science of Technology, Kattankulathur, Tamil Nadu, India.
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Bhardwaj N, Ahmed MZ, Sharma S, Srivastava B, Pande V, Anvikar AR. Clinicopathological study of potential biomarkers of Plasmodium falciparum malaria severity and complications. INFECTION GENETICS AND EVOLUTION 2020; 77:104046. [DOI: 10.1016/j.meegid.2019.104046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 09/06/2019] [Accepted: 09/19/2019] [Indexed: 11/28/2022]
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Baliga BS, Jain A, Koduvattat N, Kumar BGP, Kumar M, Kumar A, Ghosh SK. Indigenously developed digital handheld Android-based Geographic Information System (GIS)-tagged tablets (TABs) in malaria elimination programme in Mangaluru city, Karnataka, India. Malar J 2019; 18:444. [PMID: 31878929 PMCID: PMC6933888 DOI: 10.1186/s12936-019-3080-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 12/17/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Under-reporting, delayed diagnosis, incomplete treatment and inadequate vector management are few among many factors responsible for uninterrupted transmission of malaria in India. Information technology (IT) and mobile apps can be utilized effectively to overcome these hurdles. Indigenously developed digital handheld geographic information system (GIS)-tagged Android-based tablets (TABs) has been designed especially for implementation of digitization protocol. This has changed the effectiveness of malaria surveillance and intervention strategies in a malaria endemic area of Mangaluru city, Karnataka, India. METHODS A software was developed and implemented for control measures to create a digital database of each malaria case. Secondary data analyses were carried out to determine and compare differences in malariometric indices between pre- and post-digitization years. With the introduction of this software active surveillance, information education and communication (IEC), and anti-vector measures were made 'incidence-centric'. This means that the entire control measures were carried out in the houses where the malaria cases (index cases) were reported and also in surrounding houses. RESULTS Annual blood examination rate (ABER) increased from 13.82 to 32.8%. Prompt reporting of new cases had improved (36% within 24 h and 80% within 72 h). Complete treatment and parasite clearance time were documented in 98% of cases. In the second post-digitization year untraceable cases reduced from 11.3 to 2.7%; contact blood smears collection also increased significantly (p < 0.001); Slide Positivity Rate (SPR) decreased from 15.5 to 10.48%; malaria cases reduced by 30%. CONCLUSIONS IT is very useful in translation of digitized surveillance to core interventions thereby effectively reduce incidence of malaria. This technology can be used effectively to translate smart surveillance to core interventions following the '1-3-7-14' strategy.
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Affiliation(s)
- B Shantharam Baliga
- Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, Karnataka, 575003, India
| | - Animesh Jain
- Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, Karnataka, 575003, India
| | - Naren Koduvattat
- I-Point Consulting, Punja Arcade, Lalbagh, Mangalore, Karnataka, 575003, India
| | - B G Prakash Kumar
- Directorate of Health and Family Welfare Services, Government of Karnataka, Bangalore, Karnataka, 560009, India
| | - Manu Kumar
- City Corporation, Lalbagh, Mangalore, Karnataka, 575003, India
| | - Arun Kumar
- Department of Public Health, Dakshina Kannada District, Mangalore, Karnataka, 575001, India
| | - Susanta K Ghosh
- ICMR-National Institute of Malaria Research (Field Unit), Nirmal Bhawan-ICMR Campus, Poojanahalli, Kannamangla Post, Devanahalli Taluk, Bangalore, Karnataka, 562110, India.
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Dayanand KK, Kishore P, Chandrashekar V, Achur RN, Ghosh SK, Kakkilaya SB, Kumari SN, Tiwari S, Boloor A, Devi R, Gowda DC. Malaria Severity in Mangaluru City in the Southwestern Coastal Region of India. Am J Trop Med Hyg 2019; 100:275-279. [PMID: 30734693 DOI: 10.4269/ajtmh.18-0005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Dakshina Kannada district in the Southwestern region of Karnataka state, India, including Mangaluru city is endemic to malaria. About 80% of malaria infections in Mangaluru and its surrounding areas are caused by Plasmodium vivax and the remainder is due to Plasmodium falciparum. Malaria-associated clinical complications significantly occur in this region. Here, we report the pathological conditions of 41 cases of fatal severe malaria, admitted to the district government hospital in Mangaluru city during January 2013 through December 2016. The results of clinical, hematological, and biochemical analyses showed that most of these severe malaria cases were associated with thrombocytopenia, anemia, metabolic acidosis, acute respiratory distress, and single or multi-organ dysfunction involving liver, kidney, and brain. Of the 41 fatal malaria cases, 24, 10, and seven patients had P. vivax, P. falciparum, and P. vivax and P. falciparum mixed infections, respectively. These data suggest that besides P. falciparum that is known to extensively cause severe and fatal malaria illnesses, P. vivax causes fatal illnesses substantially in this region, an observation that is consistent with recent findings in other regions.
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Affiliation(s)
- Kiran K Dayanand
- Department of Biochemistry, Kuvempu University, Shankaraghatta, India.,Department of Biochemistry, K. S. Hegde Medical Academy, NITTE University, Mangaluru, India
| | - Punnath Kishore
- Department of Biochemistry, Kuvempu University, Shankaraghatta, India.,Department of Biochemistry, K. S. Hegde Medical Academy, NITTE University, Mangaluru, India
| | - Valleesha Chandrashekar
- Department of Biochemistry, Kuvempu University, Shankaraghatta, India.,Department of Biochemistry, K. S. Hegde Medical Academy, NITTE University, Mangaluru, India
| | | | - Susanta K Ghosh
- Department of Biological Control, National Institute of Malaria Research, Poojanahalli, India
| | | | - Suchetha N Kumari
- Department of Biochemistry, K. S. Hegde Medical Academy, NITTE University, Mangaluru, India
| | - Satyanarayan Tiwari
- Department of Biological Control, National Institute of Malaria Research, Poojanahalli, India
| | - Archith Boloor
- Department of Medicine, Kasturba Medical College, Mangalore, India
| | | | - D Channe Gowda
- Department of Biochemistry and Molecular Biology, Pennsylvania State University College of Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania
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Lingala MAL, Singh P, Verma P, Dhiman RC. Determining the cutoff of rainfall for Plasmodium falciparum malaria outbreaks in India. J Infect Public Health 2019; 13:1034-1041. [PMID: 31837999 DOI: 10.1016/j.jiph.2019.11.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 10/16/2019] [Accepted: 11/10/2019] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Malaria outbreaks due to Plasmodium falciparum have been reported from various parts of India. Rainfall is considered as one of the major determinants for malaria outbreaks, however, an estimate of rainfall threshold for malaria is not known. Owing to the vast geographic area, the present study was planned to determine the amount of rainfall required for malaria outbreaks and the lag period between outbreak and rainfall in different Indian climatic regions. METHODS Simple statistical methods of overall mean and moving mean (case/mean ratio, CMR) were used to identify the districts with P. falciparum malaria outbreak due to rainfall and the amount of rainfall required for outbreaks. Of 120 districts reporting P. falciparum malaria outbreaks, 99 districts having substantially low number of cases (<100); <3 CMR in any year from 2009 to 2012 and districts having stable malaria transmission were excluded. Finally, analysis of outbreak month, lag period and the threshold of rainfall were determined in respect of 21 districts which represent different agro-climatic zones in the country. Whenever the moving mean of cases attained the value ≥3 in any month, that month was identified as P. falciparum malaria outbreak. The threshold amount of rainfall critical for malaria outbreak was calculated by the average mean of previous months (i.e., lag period). RESULTS The rainfall cutoff ranged from >70 to >600mm in different districts. The month of outbreak varied with the climatic zones viz. arid, semi-arid, humid and per-humid districts. In humid and per-humid districts, outbreaks occurred during monsoon period whereas in arid and semi-arid regions outbreaks occurred during the post monsoon period. The lag period varied from 1-3 months; long lag period was observed in arid, semi-arid region, while short lag period in humid and per-humid regions. CONCLUSION Malaria outbreaks can occur in post monsoon in arid and semi-arid region whereas in summer/monsoon in humid and per-humid regions. The lag period between rainfall and outbreak differs from one month with short lag (humid and per-humid) to long lag (arid and semi-arid). Based on the determined threshold of rainfall, the findings would be helpful in forewarning of imminent outbreak of malaria for the timely preparedness of malaria outbreaks not only in 21 studied districts, but also in several other districts of different climatic regions of India.
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Affiliation(s)
| | - Poonam Singh
- ICMR-National Institute of Malaria Research, New Delhi, India.
| | - Preeti Verma
- ICMR-National Institute of Malaria Research, New Delhi, India.
| | - Ramesh C Dhiman
- ICMR-National Institute of Malaria Research, New Delhi, India.
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Milligan R, Daher A, Graves PM. Primaquine at alternative dosing schedules for preventing relapse in people with Plasmodium vivax malaria. Cochrane Database Syst Rev 2019; 7:CD012656. [PMID: 31274189 PMCID: PMC6611223 DOI: 10.1002/14651858.cd012656.pub2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Malaria caused by Plasmodium vivax requires treatment of the blood-stage infection and treatment of the hypnozoites that develop in the liver. This is a challenge to effective case management of P vivax malaria, as well as being a more general substantial impediment to malaria control. The World Health Organization (WHO) recommends a 14-day drug course with primaquine, an 8-aminoquinoline, at 0.25 mg/kg/day in most of the world (standard course), or 0.5 mg/kg/day in East Asia and Oceania (high-standard course). This long treatment course can be difficult to complete, and primaquine can cause dangerous haemolysis in individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency, meaning that physicians may be reluctant to prescribe in areas where G6PD testing is not available. This Cochrane Review evaluated whether more patient-friendly alternative regimens are as efficacious as the standard regimen for radical cure ofP vivax malaria. OBJECTIVES To assess the efficacy and safety of alternative primaquine regimens for radical cure of P vivax malaria compared to the standard or high-standard 14 days of primaquine (0.25 or 0.5 mg/kg/day), as well as comparison of these two WHO-recommended regimens. SEARCH METHODS We searched the Cochrane Infectious Diseases Group (CIDG) Specialized Register; the Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE (PubMed); Embase (Ovid); and LILACS (BIREME) up to 17 December 2018. We also searched the WHO International Clinical Trials Registry Platform (ICTRP) and ClinicalTrials.gov, and checked the reference lists of all studies identified by the above methods. SELECTION CRITERIA Randomized controlled trials (RCTs) of adults and children with P vivax malaria using any regimen of either chloroquine or an artemisinin-based combination therapy (ACT) plus primaquine with either higher daily doses for 14 days, shorter regimens with the same total dose, or using weekly dosing regimens; compared with the usual standard regimens recommended by the WHO (0.25 or 0.5 mg/kg/day for 14 days), or a comparison of these two WHO-recommended regimens. DATA COLLECTION AND ANALYSIS Two review authors independently assessed trial eligibility and quality, and extracted data. We calculated risk ratios (RRs) with 95% confidence intervals (CIs) for dichotomous data. We grouped efficacy data according to length of follow-up. We analysed safety data where this information was included. MAIN RESULTS High-standard 14-day course versus standard 14-day courseTwo RCTs compared the high-standard 14-day regimen with the standard 14-day regimen. People with G6PD deficiency and pregnant or lactating women were excluded. We do not know if there is any difference in P vivax recurrences at 6 months with 0.5 mg/kg/day primaquine therapy for 14 days compared to 0.25 mg/kg/day primaquine therapy for 14 days (with chloroquine: RR 0.82, 95% CI 0.47 to 1.43, 639 participants, very low-certainty evidence; with chloroquine or an ACT: RR 1.11, 95% CI 0.17 to 7.09, 38 participants, very low-certainty evidence). No serious adverse events were reported. We do not know whether there is a difference in adverse events with the higher dosage (very low-certainty evidence).0.5 mg/kg/day primaquine for 7 days versus standard 14-day courseFive RCTs compared 0.5 mg/kg/day primaquine for 7 days with the standard 14-day course. There may be little or no difference in P vivax recurrences at 6 to 7 months when using the same total dose (0.5 mg/kg/day to 210 mg) over 7 days as compared to 14 days (RR 0.96, 95% CI 0.66 to 1.39; 1211 participants; low-certainty evidence). No serious adverse events were reported. There may be little or no difference in the number of adverse events known to occur with primaquine between the primaquine shorter regimen as compared to the longer regimen (RR 1.06, 95% CI 0.64 to 1.76; 1154 participants; low-certainty evidence). We do not know whether there is any difference in the frequency of anaemia or discontinuation of treatment between groups (very low-certainty evidence). Three trials excluded people with G6PD deficiency, and two did not provide this information. Pregnant and lactating women were either excluded or no details were provided regarding their inclusion or exclusion.0.75 mg/kg primaquine/week for 8 weeks versus high-standard course One RCT compared weekly primaquine with the high-standard 14-day course. G6PD-deficient patients were not randomized but were included in the weekly primaquine group. Only one G6PD-deficient participant was detected during the trial. We do not know whether weekly primaquine increases or decreases recurrences of P vivax compared to the 14-day regimen at 11 months' follow-up (RR 3.18, 95% CI 0.37 to 27.6; 122 participants; very low-certainty evidence). No serious adverse events and no episodes of anaemia were reported.Three other RCTs evaluated different alternative regimens and doses of primaquine, but one of these RCTs did not have results available, and two used regimens that have not been widely used and the evidence was of very low certainty. AUTHORS' CONCLUSIONS Although limited data were available, the analysis did not detect a difference in recurrence between the 7-day regimen and the standard 14-day regimen of 0.5 mg/kg/day primaquine, and no serious adverse events were reported in G6PD-normal participants taking 0.5 mg/kg/day of primaquine. This shorter regimen may be useful in G6PD-normal patients if there are treatment adherence concerns. Further large high-quality RCTs are needed, such as the IMPROV trial, with more standardised comparison regimens and longer follow-up to help resolve uncertainties.
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Affiliation(s)
- Rachael Milligan
- Liverpool School of Tropical MedicineCochrane Infectious Diseases GroupPembroke PlaceLiverpoolUKL3 5QA
| | - André Daher
- Oswaldo Cruz Foundation (FIOCRUZ)Vice‐Presidency of Research and Biological CollectionsRio de JaneiroBrazil
- Liverpool School of Tropical MedicineDepartment of Clinical SciencesLiverpoolUK
| | - Patricia M Graves
- James Cook UniversityCollege of Public Health, Medical and Veterinary SciencesPO Box 6811CairnsQueenslandAustralia4870
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Maude RJ, Mercado CEG, Rowley J, Ekapirat N, Dondorp A. Estimating malaria disease burden in the Asia-Pacific. Wellcome Open Res 2019. [DOI: 10.12688/wellcomeopenres.15164.1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: The Asia-Pacific aims to eliminate malaria by 2030. Many of the 22 endemic countries have earlier targets. To track progress towards elimination and predict timelines and funding required it is essential to have an accurate picture of the true burden of malaria over time. Estimating this is a major challenge with most countries having incomplete data on numbers of cases and wide variation between health system access and performance. Regular estimates are published by the World Health Organization (WHO), but these are not split by species, can have a wide range of uncertainty, change over time and are not available for every year. Methods: For the Asia Pacific Leaders Malaria Alliance, the burden of malaria for the 22 malaria-endemic countries in the Asia-Pacific from 2000 to 2015 was estimated by combining data submitted by countries to WHO with a systematic review to estimate the proportion of cases recorded. Due to a lack of suitable data, it was only possible to apply this method to 2013-2015. A simplified method was then derived to estimate the annual burden of falciparum and vivax malaria as inputs to a mathematical model to predict the cost of elimination, which is described elsewhere. Results: The total number of estimated cases was around double the number of confirmed cases reported in the Asia Pacific with a broad range of uncertainty around these estimates due primarily to sparsity of data with which to estimate proportions of cases reported. The ranges of estimated burdens were mostly like those published for countries by WHO, with some exceptions. Conclusions: The accuracy and precision of malaria burden estimates could be greatly improved by having more regular large surveys on access to healthcare in malaria-endemic areas and making subnational data on malaria incidence and reporting completeness publicly available.
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