Malaria In India Case Study 2022

Running head: MALARIA IN INDIA
MALARIA IN INDIA
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Introduction:
With the global burden of disease, vector-borne diseases are considered highly prevalent
disease worldwide that impacts more than thousands of individuals every year. One such disease
Malaria has been chosen for this assignment which is highly prevalent in Third world countries
like India. During the end of the 19th and 20th centuries, about 1/4th of the Indian population has
already been subjected to malaria, especially the population of West Bengal and Punjab. As
discussed by Kakkilaya (2019), in 1935, due to the high prevalence and incidence rate of
malaria, India experienced a high economic loss of approximately 10,000 million where major
contributing factors were geographical factors and socioeconomic factors. World health
organization (2019) report suggested that in 1990-2019, 666-1000 individuals experienced
premature death where central and eastern areas of the country such as Odisha, Chhattisgarh,
Maharashtra, and also some northeastern states such as Tripura, Meghalaya, and Mizoram
reported highest prevalence and incidence of malaria. Hence, this paper intended to discuss the
prevalence and in the incidence of malaria in India, barriers to the health care sector and
strategies to mitigate it in the following paragraphs.
Discussion:
Malaria is considered as a vector-borne disease by mosquitoes that affects humans and
other species (Www.cdc.gov 2020). The disease is caused by plasmodium Falciparum, a
unicellular parasite. The disease is most prevalent in the western and north-central parts of the
country, while scattered pockets in the east of the country are reported (Anvikar et al., 2016).
The common transmission process of malaria includes blood transfusion of blood of the infected
individual or being bitten by the infected anopheles mosquito (Samby et al., 2019). However, the
use of needles contaminated with the blood of infected mosquito can spread malaria. Malaria

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may also be transmitted to foetus before or during delivery which may lead to congenital
malaria (Van Eijk et al., 2019).
The incidence rate of malaria in India:
Incidence is a measure of disease that enable individuals to determine a person’s
probability of being diagnosed with a disease during a given period. The annual incidence of
parasites (API) is a malariometric index that expresses cases of malaria per 1,000 population.
According to the National Vector Borne Disease Control Programme (NVBDCP), the API was
less than 2 in most parts of India, whereas 2-5 APIs were in dispersed geographical areas. The
areas with >5 APIs were dispersed in states such as Rajasthan, Karnataka, Southern Madhya
Pradesh, Chhattisgarh, and Orissa, and the Northeastern states(ICMR, 2020). In various parts of
India, the percentage of P. Vivax and P. falciparum differs. As per the report of ICMR, in 1990 -
2019, approximately 1.5 to 2.6 million cases were reported in various parts of India which
contributed to premature death. While 2018 the incidence rate of malaria in India has steadily
decreased from 2.08 million in 2001 to about 4 lakhs, the prevalence rate is high various part of
India (Lal et al., 2019).
The prevalence rate of malaria in India:
The prevalence rate is defined as a measure of disease that enables individuals to
determine a person’s likelihood of having a disease. Considering the prevalent rate in India,
while most of the indo-Gangetic plains and southern Tamil Nadu state have less than 10 %
malaria caused by P. falciparum, in various area of India such as Odisha the prevalence is 30–90
% and in the remaining areas, it is 10% to 30%, indicating malaria has become a long-standing
challenge for government to mitigate (ICMR, 2020). As discussed above, the states such as

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Gujarat, , Goa, Southern Madhya Pradesh, Jharkhand and Orissa not exhibit a high incidence of
the disease but also exhibit high prevalence rate which requires comprehensive strategies to
mitigate (Nvbdcp.gov.in 2020). Odisha contributed to 25% of total 1.5 to 2 million reported
annual malaria incidence, indicating the need for involvement of governing bodies in the
management of malaria (De et al., 2019). However, considering the recent report of the National
Vector Borne Disease Control Programme, the report suggested that the prevalence rate of the
infection decreased by 24% between 2016 and 2017, indicating that existing strategies are
successful in reducing high incidence and prevalence (Singh & Mahanty, 2019).
Barriers to health care:
In India, various factors such as gender issues, cultural belief, language, and geographical
factors directly hinder health service seeking behaviours of the population in India. Considering
the cultural issues, there are several tribal communities across all the states of India who live in
remote, heavily forested, and rural areas and due to discrimination and racism, language barriers
have limited access to the health care sectors which hindered their health-seeking behaviour
(Narain & Nath, 2018). On the other hand, Manohar et al. (2017), suggested that various
Healthcare seeking behaviour in tribal communities is guided by cultural-specific beliefs. The
majority of the tribal individual and other ethnic groups believe in the traditional meditational
practice which hindered them to seek clinical help. Individuals who are living in the
socioeconomically disadvantageous area have limited ability to access health care services. Due
to social determinants of health such as lack of educational opportunities, lack of health literacy
they failed to seek health care services which further contributed to development of malaria
(Santos-Vega et al., 2016). The majority of the individuals in India are living in unhygienic
environments such as poor house conditions, lack of water, sanitization food which become a

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crucial barrier to manage malaria in India. In India, discriminatory approach towards the men
have existed for generations which impacted malaria management (Davy et al., 2016). While
India render equal rights to both the genders, gender differences existed in India where women
have limited opportunities to seek clinical assistance since gender discrimination mostly in
favour of men. Hence, these gender bias, cultural issues negatively influence the quality of life.
On the other hand, geographical factors such as temperature rainfall and climate influence
malaria and malaria management. Santos-Vega et al. (2016), suggested that temperature impacts
the life cycle of the malaria parasite and as the temperature reduces, the time to complete the life
cycle drastically increases which in turn impact malaria management. P. vivax and P.
falciparum have the shortest development cycles and the optimum temperature is 25 to 27
degree which resembles the temperature of India and thereby, the temperature is one of the major
barriers to manage malaria (Lee et al., 2016). The climate factors greatly influence malaria
transmission as rainfall and humidity are optimum for the multiplication of mosquitoes, making
it difficult to manage malaria. The intergovernmental panel on the climate has made an increase
in temperature and precipitation of 1.4 to 5.8 degrees C and 7 percent, respectively impacted
malaria management (Lee et al., 2016). The distance among communities creates a challenge in
upholding this norm, as the health care worker might not be able to finish weekly supervision or
send the slides to the laboratory within 24 hours of selection due to poor infrastructure,
highlighting infrastructure is one of the greatest hindrances of malaria control strategies.
Malaria control strategies:
The NBVDCP Directorate is a fundamental nodal agency in India to prohibit and
regulate vector-borne conditions such as malaria and other VBDs (Dengue, Filariose Lymphatic,
Kala-azar, Encephalitis Japanese and Chikungunia) (NHP, 2020). The knowledge of malaria and

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the action taken by the government play a major role in reducing the incidence of malaria.
NVBDCP, Ministry of Health and Familiar Welfare, Government of India and World Health
Organization have collaboratively established the National Strategic Plan (NSP) to develop a
blueprint for India to prevent and eliminate malaria by 2027 (NHP, 2020). The strategies
developed are –
Early case detection and prompt treatment (EDPT):
In order to detect malaria in the early phase, health professionals are required to develop
a health promotional camp where health literacy can be provided regarding the impact of malaria
on the population, management strategies such as cleaning the segment water after rainfall,
proper sanitization, and water supply (Singh et al., 2016). Apart from literacy, professionals can
develop a partnership with governing bodies to conduct early screening in the clinical setting of
the areas with a high incidence of mosquito. In this case, frontline health care professionals can
ensure access to the malaria diagnosis and incorporate cultural values in management for
improving adherence. The immediate treatment can be given to the population when detected
such as Artesunate plus Sulfadoxine-pyrimethamine, Artemether plus Lumefantrine to treat.
Vector control:
Vector control is considered as the fundamental element of malaria control as well as
elimination strategies as it can be highly efficient in preventing infection. Two crucial strategies
were designed by the Entomology and vector control department of a world health organization
that can be effective strategies to manage malaria. The two essential interventions of vector
control include insecticide-treated nets (ITNs) as well as indoor residual spraying (IRS) (World
health organization., 2019). In specific areas of the locality and under special circumstances,
these interventions can be provided where each member of the community can be provided with

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insecticide-treated nets which will reduce the mosquito bite and indoor residual spraying will
reduce the mosquito multiplication and diminishes larval sources. The house type pattern is an
important determinant of malaria patterns. Open-air houses are more likely to be attacked by
mosquitoes than closed ventilations. Adequate clean housing can be provided to the community
along with clean water source and food sources so that malaria can be prevented and immunity
can be prevented.
Personal protective measures and education:
The community members who are at higher risk of developing malaria or living in an
area where can be provided with personal protective equipment such as mosquito repellent
creams, drinks, spindles, sheets, respectively. Covering all the windows and doors with mosquito
nets or wired mesh can prevent malaria. Covering the beds with mosquito nets and applying
insecticides on the nets. Wearing clothes that cover the whole body can reduce mosquito. The
nursing professionals and other professionals can be provided with training and education
regarding the advance management of malaria. Monitoring and active surveillance of the
epidemic nature of malaria can provide the idea of malaria management.
Conclusion:
On a concluding note, it can be said that Malaria management has been a long-standing
challenge in India which contributed to million deaths each year. Several believe that in the
conceivable future global malaria elimination will be practicable. The number of malaria cases
prompted by the most dangerous species of parasite, Plasmodium falciparum, is on the surge
globally. The ecological and environmental conditions, gender biases, language barriers are
common contributing factors that hindered management. In India, malaria is a prevalent and
active transmission from many parts of the country is reported.. Awareness and careful

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monitoring of the parasite load from population groups in general and asymptomatic carriers, in
general, is important for total elimination. Timing, effective and reliable operation for the
complete elimination of malaria should be preferred for places known as hot spots in malaria. As
the general population is afraid of malaria, the public health measures must be complied with by
the government. The population can be provided with the health promotional program, personal
protective equipment to improve management.

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References:
Anvikar, A. R., Shah, N., Dhariwal, A. C., Sonal, G. S., Pradhan, M. M., Ghosh, S. K., &
Valecha, N. (2016). Epidemiology of Plasmodium vivax malaria in India. The American
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