Malaria situation in India with special reference to tribal areas

Abstract

Background & objectives: In India, malaria is a major public health problem in States having predominantly tribal population. The objective of this analysis was to find out the incidence of malaria in various States/districts having varied proportions of tribal population using National Vector Borne Disease Control Programme (NVBDCP) data.

Methods: States and districts were classified into three categories based on proportions of Scheduled Tribes (ST) population as <10, 10-29.9 and 30 per cent + ST population. Five year average (2008-2012) of all important malaria indicators collected by NVBDCP was taken to normalize the effect of annual fluctuations in malaria incidence.

Results: State level analysis revealed that ten States/UTs with 30 per cent or more tribal population comprising only three per cent of total population, contributed 14 per cent of total malaria, 21 per cent Plasmodium falciparum and 29 per cent of deaths due to malaria. Similarly, district level analysis showed that districts with 30 per cent or more tribal population comprising about eight per cent country's population contributed to 46 per cent of total malaria cases, 70 per cent P. falciparum and 47 per cent malarial deaths in the country.

Interpretation & conclusions: Our analysis showed that the neglect of the ethnic communities in tribal areas would be detrimental to the overall reduction of morbidity and mortality due to malaria. The fight against the increasing burden of malaria in tribal belt requires adoption of multiple approaches and socio-economic development of the tribal communities.

Fig. 1

Map showing states in three categories of ST population.

Fig. 2a

Trends of slide positivity rate (SPR) over 2008-2012 among different categories of districts.

Fig. 2b

Trends of annual parasite index (API) over 2008-2012 among different categories of districts.

Fig. 3

Odds ratio for Pf, Pv total malaria cases and API among different categories of districts. Figures present odds ratios (OR) with respect to category –I (districts with <10% ST population) on Y axis and different districts categories (i.e. districts with <10. 10-29.9 and >30% ST population) on X axis. UCI, upper confidence limit; LCI, lower confidence limit.