Abstract
Malaria control in Madhya Pradesh is complex because of vast tracts of forest with tribal settlement. Fifty four million individuals of various ethnic origins, accounting for 8% of the total population of India, contributed 30% of total malaria cases, 60% of total falciparum cases and 50% of malaria deaths in the country. Ambitious goals to control tribal malaria by launching "Enhanced Malaria Control Project" (EMCP) by the National Vector Borne Disease Control Programme (NVBDCP), with the World Bank assistance, became effective in September 1997 in eight north Indian states. Under EMCP, the programme used a broader mix of new interventions, i.e. insecticide-treated bed nets, spraying houses with effective residual insecticides, use of larvivorous fishes, rapid diagnostic tests for prompt diagnosis, treatment of the sick with effective radical treatment and increased public awareness and IEC. However, the challenge is to scale up these services.A retrospective analysis of data on malaria morbidity and associated mortality reported under the existing surveillance system of the Madhya Pradesh (Central India) for the years 1996–2007 was carried out to determine the impact of EMCP on malaria morbidity and associated mortality. Analysis revealed that despite the availability of effective intervention tools for the prevention and control of malaria, falciparum malaria remains uncontrolled and deaths due to malaria have increased. Precisely, the aim of this epidemiological analysis is to draw lessons applicable to all international aid efforts, bureaucracy, policy makers and programme managers in assessing its project performance as a new Global Malaria Action Plan is launched with ambitious goal of reducing malaria and its elimination by scaling up the use of existing tools.
Highlights
Madhya Pradesh (Central India) is situated in the central part of India with an area of 308 thousand km2 of which forest covers 76,429 km2
The magnitude of the problem can be assessed from an estimate made in 1987, that 54 million individuals of various ethnic origins residing in forested areas of India and accounting for 8% of the total population contributed 30% of total malaria cases, 60% of total falciparum cases and 50% of malaria deaths in the country [3]
The "Enhanced Malaria Control Project" (EMCP) or Tribal Malaria Action Plan was introduced in 1997 by the National Anti-Malaria Programme (NAMP) with the World Bank assistance, which became effective in September 1997 [5]
Summary
Madhya Pradesh (Central India) is situated in the central part of India with an area of 308 thousand km of which forest covers 76,429 km (about 25% of the total land area). Paracheck® RDTs, HRP2 based antigen detection test, (Orchid Biomedical System, Goa, India) were introduced in phased manner i.e. 15,500, 7935, 80,000, 1,50,000, 200,000 and 248,000 RDTs respectively in 1999, 2002, 03, 04, 05, 06 and 07 for falciparum malaria [11] For this analysis year wise state VBDCP surveillance data was undertaken [8], which showed clear and measurable impact in districts where the World Bank supported malaria control project (EMCP) was implemented. Despite the World Bank initiative, the overall malaria risk remains stable, cases may appear to have shown a declining trend These results are in line with results from Orissa, the adjacent highest malarious state, contributing 23% malaria, 40% P. falciparum and 50% of malaria deaths of the country even after the implementation of EMCP [18]. This results in an overburdening of health care staff, which coupled with low financial remuneration, leads to low moral and poor performance
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
