State health officials confirmed the outbreak of a malaria epidemic in Chhattisgarh’s Rajnandgaon and Bilaspur districts. While the neighbouring districts of Durg and Koriya have also reported a spurt in malaria infections, officials have embarked on a state-wide intervention programme to contain the disease.

State Health Secretary, Mr. Vikas Sheel said that ten people had died of falciparum malaria in Bilaspur thus far, and that the administration was conducting door to door surveys in affected regions. Health workers are also distributing insecticide embedded mosquito nets and spraying village homes with pesticides like DDT.

“We have tested nearly 5000 fever patients over the last month and a half, of which between 30 and 40 percent tested positive for falciparum malaria,” said Mr. Amar Singh Thakur, Bilaspur’s chief medical officer, indicating that between 1500 and 2000 patients have been infected in Bilaspur district alone.

Malaria surveys are still underway in Rajnandgaon, but preliminary reports suggest that about 20 villages have been affected and over 100 patients have tested positive for falciparum malaria thus far.

Malaria is endemic to several of Chhattigarh’s 18 districts, and the state has among the highest malaria incidence rates in the country. In India, the malaria parasite has two strains: the relatively mild plasmodium vivax, and the virulent plasmodium falciparum which is responsible for almost all malaria-related deaths.

Chhattisgarh’s response to the epidemic could be hampered by a shortage of medicines.

“We have already used up about 80 percent of our supplies of ACT [Artesunate Combination Therapy] medicines,” said Mr. Sheel, adding that the state had requested the central government for more supplies and would consider buying ACT medicines in the open market. According to the National Drug Policy on Malaria 2010, all falciparum malaria cases must be treated with ACT.

Doctors said that the short two year shelf life of ACT (as opposed to the 5 year shelf life of traditional chloroquin based treatment) could have contributed to the shortage of medicines.

Health officials are also struggling to comprehend the scale of the crisis. On October 31, The Hindu reported that inconsistencies in Chhattisgarh’s malaria statistics were affecting the state’s anti-malaria programme.

“The lack of surveillance could be a key factor in the escalation of the epidemic,” said Dr Yogesh Jain of Jan Swasthya Sahyog (JSS), a community health project in Bilaspur. At present, more than 40 patients have been admitted the JSS hospital with severe malaria, of which seven have died from the disease. JSS has already recorded 234 cases and seven deaths of falciparum malaria in the first fortnight of November.

Speaking off-record, sources said that years of underreporting malaria statistics may put pressure on the administration to underplay the current crisis as well. For instance, government figures claim that only 137 people have died of malaria in Chhattisgarh since the creation of the state in 2000; a figure that has been widely criticized as unrealistically low.

Mr. Sheel said that this time the administration was encouraging field workers to report their finds as accurately and transparently as possible. “We need to recognize reality before we deal with it,” he said.