Universal access to malaria diagnosis and treatment and follow-up of patients with enhanced surveillance can dramatically reduce the number of malaria cases.
‘Live project’
This is according to a ‘live project’ — ‘Comprehensive Case Management Programme (CCMP)’ — carried jointly by the Indian Council of Medical Research (ICMR)-National Institute of Malaria Research, New Delhi; National Vector Borne Disease Control Programme (NVBDCP) and Medicines for Malaria Venture, Geneva, in four districts of Odisha. A research paper of this project, ‘Improved Access to Early Diagnosis and Complete Treatment of Malaria in Odisha, India’, has been published and was released here on Wednesday at ICMR.
“Already there has been significant progress in bringing down the caseload. The ICMR has been carrying out a research that has been relevant to elimination of various diseases from the country and CCMP is an example of such research. CCMP is a sustainable model for improving access to malaria control tools in hard-to-reach areas, and other states could take a cue from this, and intensify efforts towards malaria elimination,” said Balram Bhargava, Secretary, Department of Health Research and Director General, ICMR.
Total cases
In 2016, India accounted for 6% of the global malaria burden and 90% of the malaria cases in the World Health Organization (South-East Asia region). India aims to eliminate malaria by 2030. Odisha, has reported the highest malaria burden in the country contributing 45% of the total cases annually.
Meanwhile, the project was implemented in four districts of Odisha — Dhenkanal, Angul, Balangir and Kandhamal. In each district, one block was control block where routine malaria tackling measures were undertaken; while another was intervention block. CCMP activities in these intervention blocks included training and supervision, ensuring no stock-outs of malaria tests and drugs, analysing verified surveillance data, stratifying areas based on risk factors, and appointing alternative providers to underserved areas.
Universal access
The programme provided universal access to malaria diagnosis and treatment, and improved the quality of services and surveillance. “There has been an 85% decline in malaria burden in the intervention blocks, 47% of which can be attributed to CCMP, from the period when universal access to malaria services was reached [pre: 2013-2015] to after [post: 2016-2017],” explained Anup Anvikar, scientist, ICMR-NIMR.
National framework
“The national framework for malaria elimination has already been launched and the programme is in progress. There is a need to reach out to remote areas in order to control malaria. The Indian government has already distributed four crore long-lasting insecticide nets for malaria control. The country has seen a drastic decline in malaria cases and deaths this year. The ICMR has been complementing the programme by conducting operational research on various vector-borne diseases, and this project is an example of the same,” said Neeraj Dhingra, Additional Director, NVBDCP.
Calling CCMP a living laboratory, Madan Mohan Pradhan, Additional District Public Health Officer, VBD, Department of Health and Family Welfare, Odisha, said that CCMP learning experience and several best practices from CCMP have been incorporated into the existing NVBDCP programme.
Mass screening
“The most notable is the CCMP mass screening and treatment of malaria patients along with simultaneous vector control using insecticidal nets/ indoor residual spray in inaccessible areas. This led to creation of DAMAN [Durgama Anchalare Malaria Nirakaran or Malaria Control in Inaccessible Areas]. Utilisation of malaria services in the intervention areas improved as ASHAs and other service providers had the required commodities and skills to diagnose and treat patients at the village level,” he said.
