TY - JOUR
T1 - Malaria elimination in India and regional implications
AU - Wangdi, Kinley
AU - Gatton, Michelle L
AU - Kelly, Gerard C
AU - Banwell, Cathy
AU - Dev, Vas
AU - Clements, Archie C A
N1 - Copyright © 2016 Elsevier Ltd. All rights reserved.
Funding Information:
After several years of increasing malaria morbidity and mortality, the Government of India sought and received $165 million from the World Bank in 1997 to implement the Enhanced Malaria Control Project in 100 high-risk districts in eight north Indian states. A primary goal of the Enhanced Malaria Control Project was to enable the malaria programme to transition from its unsuccessful eradication strategy to more modern control methods. The widespread use of insecticide residual spraying was curtailed and instead targeted to high-risk areas. The Enhanced Malaria Control Project have put emphasis on full-scale implementation of early diagnosis and prompted treatment of cases at facility and village levels, introduction of insecticide-treated bednets, and alternative vector control methods (including environmental management and use of larvivorous fish). The quality and completeness of malaria surveillance was improved and laboratory diagnostic capacity was expanded. 21 Malaria morbidity decreased by 43% in districts targeted by the Enhanced Malaria Control Project and nationwide by 38% with almost 1 million fewer cases diagnosed in 2004 than in 1997. 27 Three states, Gujarat, Andra Pradesh, and Maharashtra reduced malaria morbidity by 65–70%. At the same time, the population covered by insecticide residual spraying in Enhanced Malaria Control Project districts decreased by almost 50%. 27 Some states have achieved very low incidence of malaria with the potential of embarking on malaria elimination in the near future. 28 From 2005 to 2010, intensified malaria control projects were started in the northeastern region with financial support from the Global Fund to Fight AIDS, Tuberculosis, and Malaria. With the Intensified Malaria Control Projects, malaria control activities were intensified. The Global Fund supports extended through project round 9 for another 5 years (2010–15) to cover all 89 districts of seven northeastern region states. 21,22
Publisher Copyright:
© 2016 Elsevier Ltd
PY - 2016/10/1
Y1 - 2016/10/1
N2 - The malaria situation in India is complex as a result of diverse socio-environmental conditions. India contributes a substantial burden of malaria outside sub-Saharan Africa, with the third highest Plasmodium vivax prevalence in the world. Successful malaria control in India is likely to enhance malaria elimination efforts in the region. Despite modest gains, there are many challenges for malaria elimination in India, including: varied patterns of malaria transmission in different parts of the country demanding area-specific control measures; intense malaria transmission fuelled by favourable climatic and environment factors; varying degrees of insecticide resistance of vectors; antimalarial drug resistance12veillance system; and poor national coordination of state programmes. Prevention and protection against malaria are low as a result of a weak health-care system, as well as financial and socioeconomic constraints. Additionally, the open borders of India provide a potential route of entry for artesunate-resistant parasites from southeast Asia. This situation calls for urgent dialogue around tackling malaria across borders-between India's states and neighbouring countries-through sharing of information and coordinated control and preventive measures, if we are to achieve the aim of malaria elimination in the region.
AB - The malaria situation in India is complex as a result of diverse socio-environmental conditions. India contributes a substantial burden of malaria outside sub-Saharan Africa, with the third highest Plasmodium vivax prevalence in the world. Successful malaria control in India is likely to enhance malaria elimination efforts in the region. Despite modest gains, there are many challenges for malaria elimination in India, including: varied patterns of malaria transmission in different parts of the country demanding area-specific control measures; intense malaria transmission fuelled by favourable climatic and environment factors; varying degrees of insecticide resistance of vectors; antimalarial drug resistance12veillance system; and poor national coordination of state programmes. Prevention and protection against malaria are low as a result of a weak health-care system, as well as financial and socioeconomic constraints. Additionally, the open borders of India provide a potential route of entry for artesunate-resistant parasites from southeast Asia. This situation calls for urgent dialogue around tackling malaria across borders-between India's states and neighbouring countries-through sharing of information and coordinated control and preventive measures, if we are to achieve the aim of malaria elimination in the region.
KW - Animals
KW - Antimalarials/pharmacology
KW - Climate
KW - Delivery of Health Care
KW - Disease Transmission, Infectious/prevention & control
KW - Drug Resistance, Multiple
KW - Humans
KW - India/epidemiology
KW - International Cooperation
KW - Malaria/drug therapy
KW - Plasmodium vivax/parasitology
UR - http://www.scopus.com/inward/record.url?scp=84990057583&partnerID=8YFLogxK
U2 - 10.1016/S1473-3099(16)30123-2
DO - 10.1016/S1473-3099(16)30123-2
M3 - Review article
C2 - 27527748
SN - 1473-3099
VL - 16
SP - e214-e224
JO - The Lancet Infectious Diseases
JF - The Lancet Infectious Diseases
IS - 10
ER -
