India improving on malaria front, but detection still poor: WHO

29 Nov 2017

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India accounted for 6 per cent of the world's 216 million new malaria cases in 2016, according to the World Malaria Report 2017 by the World Health Organization.

According to the UN health body, 15 countries accounted for 80 per cent of all malaria cases globally in 2016. Nigeria accounted for the highest proportion of cases globally at 27 per cent. Democratic Republic of Congo had 10 per cent, India 6 per cent and Mozambique recorded 4 per cent of the global malaria cases.

India saw a total of 331 malaria deaths in 2016, making it the highest in the entire Southeast Asia region and second only to sub-Saharan Africa. The malaria deaths in India were only less than in the Africa region, where the figure soared as high as 33,997 for Democratic Republic of Congo.

Nigeria, Democratic Republic of the Congo, Burkina Faso and India accounted for 58 per cent of all malaria deaths globally.

India is also among the weakest countries in detecting the disease. ''Countries with weak malaria surveillance systems include India and Nigeria, two major contributors to the global burden of malaria, with 8 per cent and 16 per cent of cases respectively detected by the surveillance system,'' the report says.

"Odisha, the highest endemic state of India, reported an increase in cases in 2016 (to double the number in 2013). The other countries had no major outbreaks reported," according to report.

Between 2014 and 2016, just 15.5 million insecticide treated mosquito nets, regarded as the primary prevention method for malaria were distributed in India.

However India, the WHO report noted, is on track for a 20 – 40 per cent reduction by 2020.

Malaria is a potentially life-threatening parasitic disease caused by parasites known as Plasmodium viviax (P.vivax), Plasmodium falciparum (P.falciparum), Plasmodium malariae (P.malariae) and Plasmodium ovale (P.ovale). It is transmitted by the infective bite of Anopheles mosquito. The disease has an incubation period of 10-15 days, which means a person may develop symptoms after a fortnight of being bitten by an infected mosquito. Infection by P falciparum is believed to be the most deadly.

In his foreword in the report, WHO director general Dr Tedros Adhanom Ghebreyesus says from the time when malaria was among the big public health success stories, the overall decline in the global malaria burden has ''unquestionably levelled off'' and some countries are actually showing reversals in trends.

In 2016, 91 countries reported a total of 216 million cases of malaria, an increase of 5 million cases over the previous year. The global tally of malaria deaths reached 445 000 deaths, about the same number reported in 2015.

''A minimum investment of $6.5 billion will be required annually by 2020 in order to meet the 2030 targets of the WHO global malaria strategy. The $2.7-billion invested in 2016 represents less than half of that amount. Of particular concern is that, since 2014, investments in malaria control have, on average, declined in many high-burden countries,'' Dr Tedros wrote.

Between 2014 and 2016, substantial increases in case incidence occurred in the WHO Region of the Americas, and marginally in the WHO Southeast Asia, Western Pacific and African regions.

"In 2016, 85 per cent of estimated vivax malaria cases occurred in just five countries (Afghanistan, Ethiopia, India, Indonesia and Pakistan)," the report said.

In 2016, there were an estimated 445,000 deaths from malaria globally, compared to 446,000 estimated deaths in 2015.

"Plasmodium falciparum is the most prevalent malaria parasite in sub-Saharan Africa, accounting for 99 per cent of estimated malaria cases in 2016. Outside of Africa, P. vivax is the predominant parasite in the WHO Region of the Americas, representing 64 per cent of malaria cases, and is above 30 per cent in the WHO SouthEast Asia and 40 per cent in the Eastern Mediterranean regions," said the report.

The report states some of the challenges impeding countries' abilities to stay on track and advance towards elimination include lack of sustainable and predictable international and domestic funding, risks posed by conflict in malaria endemic zones among many others.

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