BHUBANESWAR: Odisha has lost the momentum in malaria reduction and is once again in top of the list of states with high cases of the vector-borne disease in 2023, thanks to disruption in supply of long-lasting insecticidal nets (LLIN) considered a global best practice to prevent the disease.
As per National Centre for Vector Borne Diseases Control, malaria cases in the state almost doubled last year as compared to 2022. The state reported 41,971 cases and four deaths in 2023. It had 23,770 cases and five deaths in 2022. Odisha contributed around 18.7 per cent of the country’s malaria tally. The state was followed by Chhattisgarh (31,713), Jharkhand (31,140), West Bengal (26,493), Tripura (22,412), Maharashtra (16,164) and Uttar Pradesh (13,585).
At least five districts - Rayagada, Kalahandi, Malkangiri, Koraput and Kandhamal have recorded maximum cases fuelling the numbers in the state. The districts are among nine where targeted interventions were made to achieve malaria elimination by 2030. The highest 9,925 cases were reported in Rayagada followed by 7,543 in Kalahandi, 7,007 in Koraput, 5,062 in Kandhamal and 3,888 in Malkangiri. The annual parasite index (API) that had come down to 0.52 in 2022, again shot up to 0.93 and it was more than four in five districts. The API was over 10 in Rayagada, 6.9 in Kandhamal, 6.3 in Malkangiri, 5.07 in Koraput and 4.7 in Kalahandi.
Health experts working in malaria-prone areas of the state attributed the alarming rise in cases to drop in guard and behavioural changes of local populace towards routine practices suggested by health teams.
“The insecticide effect in LLINs lasts up to three years or 20 washes. The nets distributed in the malaria-prone districts in 2019 needed to be replaced by the end of 2022. Though more than a year has lapsed, the nets are yet to be replaced. In many villages, the old nets have been damaged and people in last summer did not use the nets at all citing sweltering weather conditions leading to rise in malaria cases,” said a health staff.
As many as 1.16 crore nets were distributed in the state four years back. Even as the state government had requested the Ministry of Health and Family Welfare (MoHFW) to supply 1.56 crore fresh LLINs early last year, the consignment is yet to reach Odisha. Admitting that no or less use of LLINs could have pushed the cases up, director of public health Dr Niranjan Mishra said the nets can be used beyond three years if preserved properly. “Besides, the WHO had warned that the cases of zoonotic diseases like malaria would rise due to climate change. We have intensified awareness and stepped up measures in the high caseload districts,” he said.
Health experts said Odisha, which is spending heavily on health infrastructure and care, could have procured LLINs and distributed them instead of waiting for the Central supply and allowing malaria cases to rise.
Secretary of Health and Family Welfare Shalini Pandit said the supply of nets by the Centre is getting delayed as the tender floated last year resulted in a single bid. “The MoHFW has re-tendered this year. Odisha could not procure as it also faced litigation on mosquito net tender,” she added. Once a high prevalence state with around 3.23 lakh malaria cases in 2017, Odisha had seen an 80 per cent decline since 2018 due to large-scale distribution of LLINs and Durgama Anchalare Malaria Nirakaran (DAMaN), a multi-component malaria intervention in hard-to-reach villages, drawing appreciation from WHO.
