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One of the public health problems in many countries including India is Malaria. It is a life-threatening disease caused by parasites that are transmitted to people through the bites of infected female Anopheles mosquitoes. It is preventable and curable. Data shows that in 2019, there were an estimated 229 million cases of malaria worldwide and the estimated number of malaria deaths stood at 409 000 in 2019. Data also showed that children aged under 5 years are the most vulnerable group affected by malaria; in 2019, they accounted for 67% (274 000) of all malaria deaths worldwide. We are aware that it is caused by Plasmodium parasites. The parasites are spread to people through the bites of infected female Anopheles mosquitoes, called "malaria vectors."
It is an acute febrile illness. In a non-immune individual, symptoms usually appear 10–15 days after the infective mosquito bite. The first symptoms – fever, headache, and chills – may be mild and difficult to recognise as malaria. If not treated within 24 hours, P. falciparum malaria can progress to severe illness, often leading to death.
According to the latest world malaria report, released on 30 November 2020, there were 229 million cases of malaria in 2019 compared to 228 million cases in 2018. The estimated number of malaria deaths stood at 409 000 in 2019, compared with 411 000 deaths in 2018. In 2019, 6 countries accounted for approximately half of all malaria deaths worldwide: Nigeria (23%), the Democratic Republic of the Congo (11%), United Republic of Tanzania (5%), Burkina Faso (4%), Mozambique (4%) and Niger (4% each).
Vector control is the main way to prevent and reduce malaria transmission. Sleeping under an insecticide-treated net (ITN) can reduce contact between mosquitoes and humans by providing both a physical barrier and an insecticidal effect. Indoor residual spraying (IRS) with insecticides is another powerful way to rapidly reduce malaria transmission.
Over the last two decades, 11 countries have been certified by the WHO Director-General as malaria-free: United Arab Emirates (2007), Morocco (2010), Turkmenistan (2010), Armenia (2011), Sri Lanka (2016), Kyrgyzstan (2016), Paraguay (2018), Uzbekistan (2018), Algeria (2019), Argentina (2019) and El Salvador (2021).
Malaria is still a challenge in India. The majority of malaria is being reported from states in the eastern, central and north-eastern part of the country, such as Odisha, Chhattisgarh, Jharkhand, Madhya Pradesh, Maharashtra, Tripura and Meghalaya. Most of these states are characterised by widespread hilly, tribal, forested and conflict-affected areas which are pockets of high malaria transmission. Passive surveillance of malaria is carried out by PHCs, Malaria Clinics, CHCs and other secondary and tertiary level health institutions that patients visit for treatment.
Though it is a major public health problem in India it is preventable and curable. The National Framework for Malaria Elimination (NFME) in India 2016–2030 has been developed through an extensive consultative process beginning in October 2015, culminating in the launching of the Framework by the National Vector Borne Disease Control Programme (NVBDCP) of the Ministry of Health and Family Welfare on February 11 2016. Its vision is to eliminate malaria nationally and contribute to improved health, quality of life and alleviation of poverty.
World Malaria Day which is observed on 25th April is an opportunity to focus more on this health challenge. This year, World Health Organisation and partners will mark World Malaria Day by celebrating the achievements of countries that are approaching – and achieving – malaria elimination. Malaria can be eliminated from our country and from the entire world. More funding would be needed to eliminate the same. Everyone can play a different role in eliminating malaria. Government, international agencies, media, corporate, civil society engaged in health activities and every individual can make a difference. Let us all take up the challenge to end malaria from our country and from the world.
Ranjan K Baruah
(With inputs from WHO publication and feedback may be sent to bkranjan@gmail.com)