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Study design and operational framework for a community-based Malaria Elimination Demonstration Project (MEDP) in 1233 villages of district Mandla, Madhya Pradesh.
Rajvanshi, Harsh; Bharti, Praveen K; Nisar, Sekh; Jain, Yashpal; Jayswar, Himanshu; Mishra, Ashok K; Sharma, Ravendra K; Saha, Kalyan B; Shukla, Man Mohan; Das, Aparup; Kaur, Harpreet; Wattal, Suman L; Singh, Neeru; Lal, Altaf A.
  • Rajvanshi H; Malaria Elimination Demonstration Project, Mandla, Madhya Pradesh, India. rajvanshiharsh@gmail.com.
  • Bharti PK; Indian Council of Medical Research, National Institute of Research in Tribal Health (ICMR-NIRTH), Jabalpur, Madhya Pradesh, India.
  • Nisar S; Malaria Elimination Demonstration Project, Mandla, Madhya Pradesh, India.
  • Jain Y; Malaria Elimination Demonstration Project, Mandla, Madhya Pradesh, India.
  • Jayswar H; Jhpiego, Jaipur, Rajasthan, India.
  • Mishra AK; Directorate of Health Services, Government of Madhya Pradesh, Bhopal, India.
  • Sharma RK; Indian Council of Medical Research, National Institute of Research in Tribal Health (ICMR-NIRTH), Jabalpur, Madhya Pradesh, India.
  • Saha KB; Indian Council of Medical Research, National Institute of Research in Tribal Health (ICMR-NIRTH), Jabalpur, Madhya Pradesh, India.
  • Shukla MM; Indian Council of Medical Research, National Institute of Research in Tribal Health (ICMR-NIRTH), Jabalpur, Madhya Pradesh, India.
  • Das A; Indian Council of Medical Research, National Institute of Research in Tribal Health (ICMR-NIRTH), Jabalpur, Madhya Pradesh, India.
  • Kaur H; Indian Council of Medical Research, National Institute of Research in Tribal Health (ICMR-NIRTH), Jabalpur, Madhya Pradesh, India.
  • Wattal SL; Indian Council of Medical Research, Department of Health Research, Ministry of Health and Family Welfare, New Delhi, India.
  • Singh N; National Vector Borne Disease Control Programme, Ministry of Health and Family Welfare, New Delhi, India.
  • Lal AA; Indian Council of Medical Research, National Institute of Research in Tribal Health (ICMR-NIRTH), Jabalpur, Madhya Pradesh, India.
Malar J ; 19(1): 410, 2020 Nov 16.
Article in English | MEDLINE | ID: covidwho-1067237
ABSTRACT

BACKGROUND:

In the past decade substantial reduction in malaria morbidity and mortality has been observed through well-implemented case management and vector control strategies. India has also achieved a significant reduction in malaria burden in 2018 and has committed to eliminate malaria by 2030. The Mandla Malaria Elimination Demonstration Project (MEDP) was started in 2017 in 1233 villages of District Mandla to demonstrate malaria elimination in a tribal district with hard-to-reach areas was possible using active and passive surveillance, case management, vector control, and targeted information, education and communication campaigns. An operational plan was developed to strengthen the existing surveillance and malaria elimination systems, through fortnightly active case detection to ensure that all cases including those that are introduced into the communities are rapidly identified and treated promptly. The plan also focused on the reduction of human-mosquito contact through the use of Long-Lasting Insecticial Nets (LLINs) and Indoor Residual Spray (IRS). The operational plan was modified in view of the present COVID-19 pandemic by creating systems of assistance for the local administration for COVID-related work while ensuring the operational integrity of malaria elimination efforts.

RESULTS:

The use of MEDP study design and operational plan, with its built-in management control systems, has yielded significant (91%) reduction of indigenous cases of malaria during the period from June 2017 to May 2020. The malaria positivity rate was 0.33% in 2017-18, 0.13% in 2018-19, and 0.06% in 2019-20. Mass screening revealed 0.18% malaria positivity in September-October 2018, followed by 0.06% in June 2019, and 0.03% in December 2019, and these were mostly asymptomatic cases in the community. The project has been able to sustain the gains of the past three years during the ongoing COVID-19 pandemic.

CONCLUSION:

This paper provides the study design and the operational plan for malaria elimination in a high-burden district of Central India, which presented difficulties of hard to reach areas, forest malaria, and complex epidemiology of urban and rural malaria. The lessons learned could be used for malaria elimination efforts in rest of the country and other parts of South Asia with comparable demography and epidemiology.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Population Surveillance / Coronavirus Infections / Endemic Diseases / Delivery of Health Care / Pandemics / Malaria Type of study: Diagnostic study / Observational study / Prognostic study Limits: Animals / Humans Country/Region as subject: Asia Language: English Journal: Malar J Journal subject: Tropical Medicine Year: 2020 Document Type: Article Affiliation country: S12936-020-03458-4

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Population Surveillance / Coronavirus Infections / Endemic Diseases / Delivery of Health Care / Pandemics / Malaria Type of study: Diagnostic study / Observational study / Prognostic study Limits: Animals / Humans Country/Region as subject: Asia Language: English Journal: Malar J Journal subject: Tropical Medicine Year: 2020 Document Type: Article Affiliation country: S12936-020-03458-4