New Delhi: India has done fairly well to reduce the incidence of malaria cases in the country but India still carries a huge burden of the disease, according to the WHO’s 2019 World Malaria report.
This report summarises the global progress in the fight against malaria until the close of 2018. This is the fourth such report since the WHO launched its global technical strategy for malaria, for the period 2016-2030.
It states, “The burden in 2018 was similar to that of 2017 in all other countries, apart from in Uganda and India, where there were reported reductions of 1.5 and 2.6 million malaria cases, respectively, in 2018 compared with 2017. But nearly 85% of global malaria deaths in 2018 were concentrated in 20 countries in the WHO African Region and India”.
In 2018, there were an estimated 405,000 deaths due to malaria around the world, compared to 416,000 estimated deaths in 2017 and 585,000 in 2010, according to the report.
Three countries accounted for 98% of the total reported cases in the South and Southeast Asian region: India (58%), followed by Indonesia (30%) and Myanmar (10%). At the same time, the number of reported cases in India reduced 51% relative to 2017 and 60% relative to 2016.
In India, only seven out of 36 states and union territories accounted for 90% of the estimated cases in 2018. In these seven states, the number of malaria cases in 2018 were lower than there were in 2010, from a total of 14.3 million to 5.7 million. For most other countries, however, the rates of reduction were generally lower in the last three years than before.
Around the world, 53% of the burden of Plasmodium vivax, the pathogen that causes recurring malaria, lies is in the Southeast Asian region; of this, India alone bears 47%. And the malaria incidence in this region fell from 17 cases of the disease per 1,000 people in the population at risk in 2010 to only five cases in 2018 – a 70% decline.
Nigeria (25%), the Congo (12%), Uganda (5%), Côte d’Ivoire (4%), Mozambique (4%) and Niger (4%) accounted for over half of all cases worldwide. The WHO report also records notable increases in malaria cases in Ghana (8% up, i.e. 0.5 million more cases) and Nigeria (6%, 3.2 million more).
India has extensively monitored the efficacy of artesunate-sulfadoxine-pyrimethamine (AS-SP), a first-line treatment that the WHO recommends, and found treatment failure rates ranging from 0% to 21.4%. Failure rates of more than 10% in the country’s northeast forced the government to switch from AS-SP to artemether-lumefantrine (AL). All studies conducted for AL in India between 2011 and 2017 found treatment failure rates to be lower than 10%.
Jyoti Singh writes for India Science Wire and tweets at @ashajyoti11.