India must take urgent, proactive measures to banish malaria

Health Care, Heart Care Foundation of India Comments Off

Large-scale detection and awareness are the need of the hour

New Delhi, 26th April 2018: India has the fourth highest number of malaria cases and deaths in the world as per recent reports. Malaria exists in all Indian states and about 95% of the people are at risk. Most cases are reported from Chhattisgarh, Jharkhand, Madhya Pradesh and Odisha. Arunachal Pradesh, Meghalaya, Mizoram and Tripura also have high transmission. There is an urgent need to document cases and take integrated action at the earliest.

India has set a target of being malaria-free by 2027 and eliminating the disease by 2030.However, there are many challenges before this can be achieved. What is needed is large-scale detection of cases and major awareness campaigns.

Speaking about this, Padma Shri Dr K K Aggarwal, President, Heart Care Foundation of India (HCFI), said, “Malaria is a life-threatening mosquito-borne blood disease caused by a Plasmodium parasite. It is transmitted to humans through the bite of the Anopheles mosquito. Once an infected mosquito bites a human, the parasites multiply in the host’s liver before infecting and destroying red blood cells. India still has an extremely weak malaria surveillance system. Each case of malaria has been shown to cost households at least US$ 2.67 (range US$ 0.34–7.66) in direct out-of-pocket expenses. In adults, this leads to an average of 3.4 days (range 2–6 days) of lost productivity, at a minimum additional indirect cost of US$ 10.85.Despite efforts at various levels, this disease still remains an acute public health challenge.”

Symptoms of severe malaria include the following: fever and chills; impaired consciousness, prostration, or adopting a prone position; multiple convulsions; deep breathing and respiratory distress; abnormal bleeding and signs of anemia; and clinical jaundice and evidence of vital organ dysfunction.

Adding further, Dr Aggarwal, who is also the Vice President of CMAAO, said, “India has been central to the fight against malaria since the beginning of the battle. The breakthrough discovery that malaria is transmitted by mosquitoes was made 120 years ago in Secunderabad, India. Since then, half of the world’s countries have banished malaria. It is high time that India takes urgent action to do the same.”

Some tips from HCFI for prevention.

  • Malaria mosquitoes grow in fresh water collected in the house. It is therefore important to not let water stagnate in your house and the surrounding areas. Mosquito cycle takes 7-12 days to complete. So, if any utensil or container that stores water is cleaned properly once in a week, there are no chances of mosquito breeding.
  • Mosquitoes can lay eggs in money plant pots or in water tanks on the terrace if they are not properly covered. If the water pots for birds kept on terraces are not cleaned every week, then mosquitoes can lay eggs in them.
  • Using mosquito nets/repellents in the night may not prevent malaria because these mosquitoes bite during the day time.
  • Malaria mosquitoes do not make a sound. Therefore, mosquitoes that do not produce a sound do not cause diseases.
  • Wearing full sleeves shirt and trousers can prevent mosquito bites. Mosquito repellent can be helpful during the day.

There has been a paradigm shift in the behavior of Aedes mosquitoes

Health Care Comments Off

Over the past years, there has been a paradigm shift in Aedes mosquitoes, which cause dengue fever.

Traditionally, Aedes aegypti has been regarded as a day biter and one which breeds indoors and also bites inside the house. This perception no longer holds true.

Then – It bites only in the day.Now – It bites in the light. Day and night does not matter.

Then – It breeds in safe water.Now – It breeds in stagnant water from natural sources.

Then – It breeds only inside the house.Now – It breeds both inside and outside the house, in any discarded objects/containers with stagnant rainy water collection.

Then – Mosquito breeds in water tanks on the roof and coolers.Now – It breeds both in small and large water collections. It can even grow in the caps of bottled water.

Earlier, a temperature ranging between 30oC and 32oC was considered as the optimal temperature for Aedes mosquito breeding. But, now this range has been lowered to between 24oC and 28oC.

The use of air conditioners (ACs) in homes generally coincides with the arrival of summer. ACs are usually set at a temperature of 24oC, now an ideal temperature for the Aedes mosquito to breed and also survive all through the year. The extrinsic incubation period of the dengue virus is also reduced i.e. decrease in the time required for the virus to replicate and disseminate in the mosquito. The result is a higher rate of disease transmission.

Hospitals have central air conditioning. It is important to check for mosquito breeding sites in central ACs in hospitals and also in homes.

The mosquito cannot comprehend the difference between day and night, or indoor and outdoor. It is the environment that counts. The climate is changing, so is the behavior of mosquitoes and so is the epidemiology of the disease they cause. Earlier prevalent as a monsoon disease, dengue is now reported all through the year.