More than 900 cases of malaria have been reported across Rajasthan. It seems that the recent pre-monsoon showers have already triggered a rise in incidences of seasonal diseases Hanumangarh district alone registered 150 cases. So far, nearly 7,000 cases of the disease have been registered in the state. Rajasthan has also receded 40 dengue cases so far.

Epidemiology

Of the 7,000 malaria cases registered this year, 500 cases are of PF malaria (Plasmodium falciparum), which is a comparatively higher number than those registered last year. In 2008 there were around 54,000 malaria cases recorded, most of which occurred during months from June to November.

In case of dengue, last year, around 500 cases were diagnosed across the state which resulted in the death of over a dozen people. This year, the death count started in March itself.

Assam & Mizoram:Twenty-six people died of malaria in a single hospital in this northeastern Indian state this winter. In Assam alone, there had been at least 1,500 deaths last year. Malaria remains the biggest killer disease in Mizoram and has claimed 111 lives till August this year as compared to the 91 deaths during 2008.

Factors favoured

The high temperature and stagnant, shallow water during monsoons creates optimum breeding conditions for mosquitoes, which are responsible for spreading dengue and malaria. This may be found in abandoned household utensils and stagnant water in desert coolers.

The administration may be slow in addressing the issue, but public neglect of mosquito breeding grounds worsens the situation. Water collected in desert coolers and other small vessels have been found to be a major breeding ground for mosquitoes.

Remedies taken:

Though chemicals have been sprayed in disease-affected areas, people reciprocation is not so appreciable as reported by the Directorate of Medical and Health Services (DMHS). The directorate has been actively tracking reports and has initiated preventive measures like collecting blood samples from the areas where dengue and PF malaria cases are reported.

The diseases have reportedly caused four deaths this year. The health department has  initiated necessary actions to keep the disease under check. After the first dengue death in the city this year on March 6, extensive anti-larval activities were held in disease-affected areas.

In Assam, the situation is worse that district administration reported no deaths, and nobody except members of a local NGO took any notice. Aizawl, the capital of Mizoram recorded the highest number of 40 deaths due to malaria in the first eight months of the year. Funds received from the Centre for malaria control under the National Vector Borne Disease Control Programme was Rs 210.68 lakh and Rs 282.35 lakh in 2007-08 and 2008-09 respectively.

Prevention measures taken for Malaria in Rajasthan

Effect of Swine flu

The pressure which the state is building on the doctors to check swine flu should instead be built for malaria and dengue. For one swine flu death, there are over 100 malarial deaths, as per the epidemic statistics. As compared to swine flu, dengue and malaria are far more fatal. Dengue has a mortality rate of about 5%-10%, whereas for swine flu it is 2%. The complications and morbidity of dengue and malaria are more severe than swine flu. Doctors’ perception is that “the state and the health department officials should have a balanced approach, rather than concentrating on just swine flu”.

Major backlogs:

The underreporting of malaria cases is one of the main reasons that India has been unable to prevent malaria or treat malaria cases. It has led to an astounding absence of knowledge even among supposedly qualified private and government health workers. The comprehension has been too low to ascertain that malaria occurs in different topographies for different reasons and must be prevented differently in each area.

These problems are further complicated by foreign agencies such as the World Health Organization (WHO), which under the influence of global lending agencies like the World Bank and big pharmaceutical companies have pushed India to adopt prevention methods that don't suit the local conditions and to initiate huge, ill-considered projects rather than targeted ones.

For example, under the National Vector Borne Disease Control Program, the umbrella program for prevention and control of malaria, the Indian government has introduced new “rapid diagnostic tests,” put a legion of India's version of barefoot doctors in the field and rushed to convert to expensive Artemisinin-based Combination Therapy (ACT). None of these tools is sufficient, according to the grassroots health workers who are fighting this disease in the jungles.

Post control measures- Scenario and suggestions:

The mosquito commonly called ‘tiger mosquito’ usually bites on the leg. Children are adviced to cover their legs while sitting in parks or gardens. Mosquito sprays and drainage cleaning are some of the ways to prevent the breeding of mosquitoes causing malaria. The state too, has completed the first round of its regular checking, and has identified some of the malaria-prone districts like Hanumangarh, Sanganer.

Mosquito breeding can be controlled with biological, chemical and heath education measures. Under the biological, gambuji fish (popularly known as larvae-bhukhi) is used to destroy the larvae of mosquitoes in the small ponds and wells. Mosquitocidal sprays can also help in checking the mosquito breeding, especially in urban areas. This apart, education on health and sanitation can check the rising incidences of malaria and dengue.