Malaria eradication: Gadchiroli among 24 worst performing districts in India

These districts have annual parasite incidence (API)—the number of new infections per year per 1000 individuals under surveillance — above 1, which is considered ‘concerning’.

Although, in the last eight years, malaria cases have dropped by 50 per cent in Gadchiroli, it is still the biggest contributor to the state’s tally. In 2014, the district recorded 24,439 malaria cases which surged to 34,206 the next year. In 2016, it dropped to 9,163 which further plunged to 5,484 in 2017. In 2018 and 2019, the cases further dropped to 2,584 and 2,428 respectively.

However, during the pandemic, due to the similar symptoms with Covid-19 like fever, many of the patients didn’t consult doctors due to the fear of getting quarantined which contributed in spreading the disease from the carriers. This pushed up the cases.

In 2020 the number of malaria patients rose to 6,485 and further surged to 12,326 in 2021. In this period, a total of 59 patients in the district have succumbed to the disease.

Data from the National Vector Borne Disease Control Programme, Gadchiroli, showed that the district’s API was 20.23 in 2014 which gradually dropped to 2.16 in 2019. Amid the pandemic in 2020, it increased to 5.73 and 10.97 in 2021. “If API is above 1, it is concerning,” said Sanjay Samarth, malaria laboratory scientist officer, Gadchiroli.

The district, with around 11.23 lakh population, conducts an average of 6 lakh examinations for malaria detection. But the health officers claim malaria control in forest and hilly areas is difficult due to various socio-economical, geographical and ecological factors, like mosquito breeding habitats such as grassy margins, marshy land, and streams. Also, cattle sheds attached with human dwellings, houses with mud-plastered walls, migration of people, presence of asymptomatic carriers in the community are contributing factors.

“Nearly, 70 per cent of the district is covered by the forest which provides the most suitable breeding ground for the mosquitoes. Later, when the citizens go for farming, infected mosquitoes transmit the Plasmodium parasites (the causative agents of malaria) to humans. Back in the village, the carriers infect others,” said Gadchiroli CEO Ashirwad Kumar.

But the tribals often refuse to visit the doctor because of superstitions and go to the local ‘pujaris’ or so-called local faith healers. “Due to this, most of the patients reach hospitals only after their health deteriorates. During our door-to-door testing, we have to accompany local leaders and gramsevak to convince the villagers to take medicines,” said Kalidas Raut, assistant health officer, Gadchiroli.

There are 1,658 villages in the district. Every year, during the pre-monsoon season, the public health department conducts camps to test villagers to identify ‘silent or asymptomatic’ carriers. “We conduct rapid diagnosis tests (RDT) which give the results within 10 minutes. As soon as we find a silent carrier, we start their treatment. In fact, ASHA workers regularly visit them for health updates,” said Dr Kunal Modak, district malaria officer.

However, a study—Decline of malaria in Gadchiroli district of Maharashtra state, India, published by The National Institute of Malaria Research in 2019 stated that under-reporting of malaria cases was detected due to mis-detection or misdiagnosis by RDT kits and microscopic methods or due to human error.

During monsoon, around 200 villages get flooded, becoming inaccessible for health officers, thus posing a further challenge to conduct blood test for malaria. So now, the public health department supplies the testing kits to the health officers in problematic taluks before the monsoon hits the district.