264 malaria cases in Delhi so far — highest in five years for January-Sept period

While a total of 792 such cases were reported in 2024, 426 were reported in 2023, 263 in 2022 and 167 in 2021. Only two deaths — one each in 2022 and 2023 — were reported in the last five years, the data also showed.

Senior MCD officials, meanwhile, attributed the surge in cases to increased surveillance and testing. “Earlier, blood slide was the only test conducted to detect malaria, and the staffers and medical equipment required for the same were unavailable at many hospitals, dispensaries and testing labs. Now we have been testing extensively using rapid diagnostics kits,” an official said.

The official, however, said that not all the registered cases are indigenous. “Many positive cases are migratory. For example, when patients from nearby areas come to Delhi hospitals or when someone visiting a relative or others in Delhi get infected, the cases are added to Delhi’s numbers,” he said. Delhi this year has reported 54 migratory cases, as per the MCD data.

There are relapse cases as well. This is usually when a patient does not complete the course of medication. “When a patient does not complete a full course, the symptoms go but the parasite stays and grows in the liver. Also, a mosquito can bite a person, get infected and then spread the disease to others,” the official added.

Dr Jugal Kishore, Director Professor, Vardhaman Medical College and former head of community medicine department at Safdarjung Hospital, said that when local doctors prescribe medicines without proper diagnosis, it may lead to non-removal of the parasite. “Chloroquine and Primaquine, used to treat malaria, should be prescribed for 15 days, but that is usually not done.”

Kishore added that even if one positive case of malaria is detected, the space should be investigated for breeding or any other positive cases. “These are high numbers, we need an extensive programme to eliminate malaria, the MCD needs to take actions,” he said adding that open nallahs and dense population and unhygienic conditions are a very conducive environment for the disease.

The MCD health official added that the civic body has ensured that there is no shortage of staff and that transfers have also been halted ahead of the transmission period which starts after the monsoon.

“We have around 5,000 posts of multi-tasking staff, earlier known as domestic breeding checkers (responsible for search of breeding, focal spray and fogging) , and only 30-40 posts are lying vacant. These staffers are supervised by malaria inspectors and we have filled vacant posts by hiring assistant public health inspectors,” the official added, stating that once a positive case is detected, 100 houses are inspected.

“If a staff is assigned to check 50 houses per day, a total of 500 can be done in ten days. However the houses again need to be inspected again after 10 days since new breeding can take place, but with increased construction, sometimes a staff has to inspect 1,500 households that makes it difficult to maintain the 10-day window.”

Dr Roopa Kumari, senior scientist, public health strategist and malariologist who has worked with the ICMR, said that malaria is caused by plasmodium parasites and these parasites are spread to people through the bites of infected anopheles mosquitoes, which bite mainly between dusk and dawn.

She says malaria manifests itself 9-14 days after the mosquito bite.

Clinical features include high fever, headache, chills and shivers, nausea, vomiting, convulsion and unconsciousness in severe malaria. “People with symptoms are advised to visit the nearest public health facility for early diagnosis and prompt treatment. Antimalarial drugs are effective for curing malaria, but it is essential to complete the full course of prescribed medicines to ensure complete recovery, prevent relapse, and avoid the development of drug-resistant malaria,” she adds.

“Destroy mosquito breeding places. Keep tanks, drums, and vessels tightly covered and maintain clean and hygienic surroundings,” she adds.

The Centre on the World Malaria Day this year, observed on April 25, also termed the “testing, treating, tracking, and surveillance” approach as a core strategy to eliminate the disease.

The Ministry of Health and Family Welfare had formulated a National Strategic Plan: Malaria Elimination 2023-27, aimed at zero indigenous malaria cases by 2027 and elimination by 2030. Under the plan, steps including district-based planning, implementation and monitoring were recommended.

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