Impact assessment of Intensified Malaria Control Project in transitioning a high malaria-endemic district to a low-endemic district: an epidemiological aspect

Pathog Glob Health. 2023 Jul;117(5):493-504. doi: 10.1080/20477724.2023.2194498. Epub 2023 Mar 24.

Abstract

Intensified Malaria Control Project (IMCP) was implemented in 2005 to control malaria in all North-Eastern and Odisha states of India. The present study aimed to investigate the impact of IMCP in reducing the malaria burden in Udalguri district, Assam state of North-East India. Malaria epidemiological data were obtained for IMCP intervention (Udalguri) and nonintervention district (West Singhbhumi, Jharkhand state). IMCP activities include introducing bi-valent rapid diagnostic kits (RDTs), Artemether-Lumefantrine drug in North-East India, long-lasting insecticidal nets (LLINs) distribution, and creating awareness programs about malaria in an intensified mode. The data revealed a significant decline in annual parasite incidence (API) from 14.94 (2005) to 2.61 (2018), -37% (95%CI: -57%, -19%, p = 001) after using LLINs in 2009 and -64% (95%CI: -116%, -14%, p = 013) after the introduction of RDTs in district Udalguri. Whereas control district showed a -28% (95%CI: -63%, 6.3%, p = 0.051) decrease in API using LLINs and a 10% (95%CI: -7.6%, 28%, p = 0.122) increase after the introduction of RDTs. Plasmodium falciparum (Pf) and P. vivax (Pv) were the major malarial parasites in Udalguri. Pv-malaria was much higher (71%) than Pf-malaria (29%) during the study period. An increasing trend of Pf cases was observed in Udalguri. Udalguri and Khoirabari BPHCs showed an overall reduction of 94% (95%CI: -143%, -45%, p = 0.001) and 84% (95%CI: -126%, -39%, p = 0.003), respectively; however, only a 10% (95%CI: -65%, -41%, p = 0.360) reduction in API was observed in Orang BPHC. An overall decrease in malaria indicates the effective implementation of vector and disease control strategies in the Udalguri district.

Keywords: Annual parasite incidence; Plasmodium falciparum; Plasmodium vivax; epidemiology; malaria.

MeSH terms

  • Antimalarials* / therapeutic use
  • Artemether
  • Artemether, Lumefantrine Drug Combination
  • Humans
  • Malaria* / epidemiology
  • Malaria, Falciparum* / parasitology
  • Malaria, Vivax* / diagnosis
  • Plasmodium falciparum
  • Plasmodium vivax

Substances

  • Antimalarials
  • Artemether
  • Artemether, Lumefantrine Drug Combination

Grants and funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.