Changing Trends In Malaria

 World Health Organization (WHO) estimates that global malaria incidence has decreased by 17% and death due to malaria by 26% from 2000-2010. 91% of deaths and 81% of the cases were reported from the African Region. These improvements are attributed to human interventions, greater funding, greater use of insecticide treated bednets, indoor residual spraying, rapid diagnostic tests, and artemisinin-based combination therapies. Many epidemiologic changes have been noted in malaria-eliminating countries. Malaria cases are increasingly male, adult, clustered geographically, imported, among migrant and other hard-to-reach groups, and caused by Plasmodium vivax. Despite these encouraging trends the sad fact is that 219 million cases and 660,000 deaths from malaria were reported by WHO in 2010. When undocumented deaths were taken into account, this number was a staggering 1.24 million. 65% of the cases occurred in children under 15 years of age. Malaria is presently endemic in a broad band around the equator, in areas of the Americas, many parts of Asia, and much of Africa. The efforts of the Malaria Atlas Project, which aimed to map the global endemic levels of malaria and assess disease burdens, led to the publication of the P. falciparum endemicity map in 2010. Malaria is one of the major public health problems in India with around 1.5 million confirmed cases reported annually by the National Vector Borne Disease Control Programme (NVBDCP). About 50% cases are attributed to Plasmodium falciparum as compared to only 14% in 1970. The increased proportion of falciparum cases is mainly due to the continued use of chloroquine despite the drastic increase in chloroquine resistant falciparum. Another significant factor is the role played by mosquito vectors including increasing resistance to insecticides seen in Anopheles culicifacies and Anopheles fluviatilisthe two main vectors in rural India. The poor functioning of Government schemes like the Urban Malaria scheme has also contributed to the resurgence of malaria.