Prevalence of malaria in two highly endemic Community Health Centers in the Bastar district, Chhattisgarh showing mixed infections with Plasmodium species

Abstract

Malaria is a major public health problem in India and in the Chhattisgarh state. The diagnosis of malaria presents a major challenge in remote areas The prevalence of malaria in Darbha and Kilepal Community Health Centers (CHCs) of the Jagdalpur district, Chhattisgarh affected by conflict was determined using microscopy and polymerase chain reaction (PCR). In the year 2015, 29.4% and 21.5% cases were found to be positive for malaria at the Darbha and Kilepal CHCs, respectively, by microscopy, and 7.4% and 1.6% of cases had mixed infections, respectively. Among the suspected cases of mixed infections and doubtful diagnoses, 21% had mixed infections with two or more species at the Darbha CHC, and 17% from the Kilepal CHC, as determined by PCR. Both the P. vivax subspecies Pv210 (56%) and Pv247 (44%) and the P. ovale curtisi subspecies were found in this area. The high proportion of mixed malaria parasitic infections detected in this study indicate the need to adequately train health staff involved in diagnosing malaria. This study showed that there is a need for site-specific data to understand the epidemiological picture and to develop appropriate intervention strategies and management guidelines for controlling and eliminating malaria in India.

Figure 1

Gel image showing the results of molecular diagnosis of Plasmodium species by Polymerase chain reaction (PCR). 1: 100 bp ladder; 2: NC, 3: PC P. falciparum; 4–13: P. falciparum positive results; 14: NC; 15: PC P. vivax; 16–25: P. vivax positive and negative results; 26: 100 bp Ladder; 27: NC; 28: PC P. malariae; 29–38: P. malariae positive and negative results; 39: NC; 40: PC P. ovale; 41–50: P. ovale positive and negative results. NC: Negative control; PC: Positive control.

Figure 2

Map of India (A), Madhya Pradesh and Chhattisgarh (B), district of Chhattisgarh (C) and the study sites (Darbha and Kilepal CHCs) in the Bastar district (D). The map was generated in-house (the base map was taken from the following website: http://d-maps.com/m/asia/india/chhattisgarh/chhattisgarh66s.gif) and was modified using Adobe software Photoshop_CS3, version 10.0.