Assessment of Epidemiological Indicators for Evaluation of National Malaria Elimination Programme: A Retrospective Study

Abstract

Background: Malaria has been one of India's most considerable health problems since 1940. The objective of our study is to determine the status of the National Malaria Elimination Programme in India by using epidemiological indicators.

Methods and materials: The annual reports of malaria for the years 2014-2021 and monthly reports for 2020 and 2021 were collected from the official web portal and were analysed for study specific assessments.

Results: The API has shown a statistically significant reduction from 2017-2021 in all states along with category-1(P=0.003) and category-2(P=0.029) states/UTs, but there was no statistically significant reduction from 2017-2021 in category-3 (P=0.166) states/UTs. The zero indigenous cases had not been achieved in category-1 states/UTs. The overall percentage reduction in number of malaria cases in 2020 at the national level compared with 2014 was 83.6%. Despite states with strong health systems such as Gujarat, Maharashtra and Karnataka, have not shown zero indigenous cases in 2020 and the malaria cases noted were very far from reaching the targets.

Conclusions: Although we observed a significant drop in malaria incidence from 2014 to 2020, demonstrating that the country is moving nearer to malaria elimination, it is crucial to implement the strategies to reduce Plasmodium falciparum% and re-establish surveillance programmes and execute national and state programmes in order to achieve the success of the National Malaria Elimination Programme. The recategorization of states/UTs are in accordance to the API, and implementation strategies were also needed.

Keywords: Annual Parasite Incidence; Malaria; National Framework for Malaria Elimination in India; National Malaria Elimination Programme; Plasmodium falciparum.

Figure 1

Study flow chart

Figure 2

a) Mean of malaria cases from 2017-2020 of category-1 states/UTs. b) Mean of malaria cases from 2017-2020 of category-2 states/UTs. c) Mean of malaria cases from 2017-2020 of category-3 states/UTs d) Trend of API in all 15 category-1 states/UTs for 2014 and 2020. e) Trend of API in all 11 category-2 states/UTs for 2014 and 2020. f) Trend of API in all 10 category-3 states/UTs for 2014 and 2020

Figure 3

a) Category wise reported malaria cases from 2017-2021 b) The number of cases and other traits reported from 2017-2021 c) The malaria cases and deaths reported category wise from 2014-2021 d) The percentage change of malaria from 2014-2020 (Mean and SD) in category-1 states/UTs e) The percentage change of malaria from 2014-2020 (Mean and SD) in category-2 states/UTs f) The percentage change of plasmodium falciparum malaria from 2014-2020 (Mean and SD) in category-3 states/UTs