MAGNITUDE OF THE PROBLEM

MAGNITUDE OF THE PROBLEM

Malaria is a public health problem in several parts of the country. About 95% population in the country resides in malaria endemic areas and 80% of malaria reported in the country is confined to areas consisting 20% of population residing in tribal, hilly, difficult, and inaccessible areas. Directorate of National Vector Borne Disease Control Programme (NVBDCP) has framed technical guidelines/ policies and provides most of the resources for the programme. Indicators have been developed at national level for monitoring of the programme and there is uniformity in collection, compilation, and onward submissions of data. 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. Apart from that, ASHA- a village volunteer is involved in the programme to provide diagnostic and treatment services at the village level as a part of introduction of intervention like Rapid Diagnostic Tests and use of Artemisinin Combination Therapy (ACT) for the treatment of Pf cases.

The countrywide malaria situation as reflected in surveillance data from 1995-2024 is given in the following Table: 1.

Table 1: Countrywide Epidemiological Situation (1995 – 2024)

(P)=Provisional

The case load, though steady around 2 million cases annually in the late nineties, has shown a declining trend since 2002. When interpreting API, it is important to evaluate the level of surveillance activity indicated by the Annual Blood Examination Rate (ABER). At low levels of surveillance, the Total Positivity Rate (TPR) may be a better indicator. The TPR has also shown gradual decline from 3.50 in 1995 to 0.14 in 2024. The reported Pf cases declined from 1.14 million in 1995 to 0.15 million cases in 2024. The Pf% has gradually increased from 39% in 1995 to 60.07% in 2024.

Number of reported deaths has been levelling around 1000 per year. The mortality peak in 2006 was related to severe malaria epidemics affecting Assam caused by population movements.

The data in Table 1 shows that Annual Parasite Incidence (API) rate has consistently come down from 3.29 per thousand in 1995 to 0.18 per thousand in 2024 and confirmed deaths due to malaria have been continuously down during this period between 1151 and 86. The table shows the information on indicators by which malaria prevention/control activity in India are monitored and evaluated. Total Positivity Rate (TPR) and Total falciparum Rate (TfR) have reduced over the years 1995-2024.

Trend of Malaria Cases and Deaths 1995-2024

Trend of Malaria Parameters in India (1995- 2024)