Malaria Epidemiology, Symptoms, Control Strategies, and UMS
Malaria is a life
threatening disease known as Plasmodium vivax (Pvvax), Plasmodium falciparum
(P. malaria), and Plasmodium ovale (P. vale). It is spread by the infectious
bite of Anopheles mosquitoes. Person develops disease after 10-14 days of being
bitten by an infectious mosquito.
There are two types of human malaria parasites, Plasmodium vivax, P. falciparum, that are commonly reported in India. Within the human host, the parasite undergoes a series of changes as part of its complex life cycle. The parasite completes the life cycle in liver cells (pre-erythrocytic schizophrenia) and red blood cells (erythrocytic schizophrenia). Infection with falciparum is the most deadly form of malaria.
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Epidemiological Situation
Malaria cases have
declined significantly by 49.09% and deaths due to malaria have been reduced by
50.51% in 2018 as compared to 2017. World Malaria Report (WMR) 2018 of the WHO,
which gives the estimated cases for malaria worldwide, based on mathematics
projections indicates that India is the only high endemic country that has
reported a decrease by 24% in 2017 compared to 2016.
Symptoms of Malaria
Malaria typically
produces fever, headache, vomiting, and other flu-like symptoms. The parasite infects and destroys red blood cells, resulting in anemia, seizures
and loss of consciousness.
Parasites are
carried by the blood to the brain (cerebral malaria) and other vital organs. Malaria in pregnancy represents a substantial risk to the mother, fetus, and
newborn. Pregnant women are less able to cope with and eliminate malaria
infections, negatively affecting the unborn fetus
Symptoms of Serious and Complicated Malaria
Symptoms may
include a history of high fever and one of the following:
- Prostration (inability to sit), impaired consciousness, lethargy, or coma
- Breathing difficulties
- Severe anemia
- Generalized seizures /attacks
- Inability to drink /vomit
- Dark and /or limited urine production.
Malaria Control Strategies
- Early case detection and immediate treatment (EDPT)
- EDPT is the main strategy for malaria control: radical treatment is necessary for all cases of malaria to prevent transmission of malaria.
- Chloroquine is the main antimalarial drug for uncomplicated malaria.
- Drug Distribution Centers (DDCs) and Fever Treatment Depots (FTDs) have been set up in rural areas to give the community easy access to antimalarial drugs.
- Alternative medicines for chloroquine resistant malaria are recommended according to the Malaria Pharmaceutical Policy.
Vector control
Chemical control
- Use of Residual Indoor Spray (IRS) with insecticides recommended under the program
- Use of chemical larvicides as Abate in drinking water.
- Space spray in daytime spray
- Malathion fogging up during outbreaks
Biological control
- Larvivorous fish can be kept in tanks, fountains, etc.
- Biocides can be used
- Personal prophylactic measures that individuals / communities can take
- Coils, mats, mosquito repellent creams, liquids, etc.
- Screening of houses with wire mesh.
- Use of insecticide-treated mosquito nets.
- Wear clothing that covers the maximum surface area of the body.
Community participation
- Raise awareness and involve the community for the detection of anopheles breeding sites and their elimination.
- NGO schemes involving them in program strategies
- Environmental management and source reduction methods
- Reduction of the source that is, filling of the places of reproduction.
- Adequate coating of stored water.
- Channeling the source of reproduction.
- Monitoring and evaluation of the program.
- Monthly computerized management information system
- Field visits by state by national state program officers
- Field visits of the Malaria Research Centers and other ICMR Institutes
Urban Malaria Scheme
The Urban Malaria
Scheme (UMS) was launched in 1971 in urban areas. It is centrally sponsored
Program. Initially only 23 towns, but now 131 towns and cities in 19 states and
Union territories are covered under this scheme. The incidence of malaria in
urban areas increased due to urbanization, construction, industrialization.
Objectives
The main objective
of the urban malaria scheme (UMS) is to control malaria by reducing the vector
population in urban areas through recurrent anti-larval measures; from residual
insecticide indoors spraying is generally not acceptable for urban population.
Standards for the establishment of urban malaria.
- Cities must have a minimum population of 50,000.
- The API must be 2 or higher.
- Cities must enact and strictly implement the civic statutes to prevent
Control strategy
- Anti-varival measures at weekly intervals.
- Source reduction, i.e. fill / drain through minor engineering methods.
- Biological control by introducing larvivorous fish
- Antiparasitic measures through the passive, surveillance for case detection and complete treatment.
- Legislative measures