Evaluation of the model malaria elimination strategy in Mandla district along with its neighbouring districts: a time series analysis from 2008 to 2020.

BACKGROUND: Compared to 2017, India achieved a significant reduction in malaria cases in 2020. Madhya Pradesh (MP) is a tribal dominated state of India with history of high malaria burden in some districts. District Mandla of MP state showed a considerable decline in malaria cases between 2000 and 2013, except in 2007. Subsequently, a resurgence of malaria cases was observed during 2014 and 2015. The Malaria Elimination Demonstration Project (MEDP) was launched in 2017 in Mandla with the goal to achieve zero indigenous malaria cases. This project used: (1) active surveillance and case management using T4 (Track fever, Test fever, Treat patient, and Track patient); (2) vector control using indoor residual sprays and long-lasting insecticidal nets; (3) information education communication and behaviour change communication; and (4) regular monitoring and evaluation with an emphasis on operational and management accountability. This study has investigated malaria prevalence trends from 2008 to 2020, and has predicted trends for the next 5 years for Mandla and its bordering districts. METHODS: The malaria prevalence data of the district Mandla for the period of January 2008 to August 2017 was obtained from District Malaria Office (DMO) Mandla and data for the period of September 2017 to December 2020 was taken from MEDP data repository. Further, the malaria prevalence data for the period of January 2008 to December 2020 was collected from DMOs of the neighbouring districts of Mandla. A univariate time series and forecast analysis was performed using seasonal autoregressive integrated moving average model. FINDINGS: Malaria prevalence in Mandla showed a sharp decline [- 87% (95% CI - 90%, - 84%)] from 2017 to 2020. The malaria forecast for Mandla predicts zero cases in the next 5 years (2021-2025), provided current interventions are sustained. By contrast, the model has forecasted a risk of resurgence of malaria in other districts in MP (Balaghat, Dindori, Jabalpur, Seoni, and Kawardha) that were not the part of MEDP. CONCLUSION: The interventions deployed as part of MEDP have resulted in a sustainable zero indigenous malaria cases in Mandla. Use of similar strategies in neighbouring and other malaria-endemic districts in India could achieve similar results. However, without adding extra cost to the existing intervention, sincere efforts are needed to sustain these interventions and their impact using accountability framework, data transparency, and programme ownership from state to district level.

Role of biochemical and inflammatory markers in assessing COVID-19 severity among the Indian population: An observational study

Introduction: Different laboratory parameters get altered in coronavirus disease 2019 (COVID-19);therefore, the changes of these parameters could help recognize the patients with severe disease. This study was conducted to achieve a comprehensive biochemical and inflammatory profile of COVID-19 among the Indian population. Methods: The study consisted of 730 patients admitted to Jaya Arogya Hospital, Gwalior, with COVID-19 from August 2020 to December 2020. The patients were divided into mild disease group (MDG) (n=533) and severe disease group (SDG) (n=197) depending on certain criteria, and their biochemical and inflammatory markers were collected. Data were analyzed using SPSS version 25. Results: Statistically significant rise in blood urea (P=0.011), serum creatinine (P=0.008), serum bilirubin (P=0.012), interleukin 6 (IL-6) (P<0.001), and troponin I (P<0.001) was observed in SDG as compared to MDG. Serum electrolytes (sodium and potassium) and serum protein (total protein and albumin) showed a significant fall in SDG as compared to MDG (P<0.001 for electrolytes and P=0.023 for proteins). The area under the receiver operating characteristic curve (AUROC) showed a high diagnostic value of IL-6. Conclusion: Patients with severe COVID-19 showed a high prevalence of hyperbilirubinemia, hypoproteinemia, electrolyte imbalance, and raised inflammatory markers (IL-6, troponin I, and procalcitonin). Results showed their effectiveness in assessing disease severity and predicting outcomes in patients with COVID-19. © 2022 The Author(s).