BHUBANESWAR: Odisha’s much-celebrated success in reducing malaria by 80 per cent (pc) in 2018 appears to be fading away with the state witnessing an alarming 63.6 pc rise in malaria cases in 2024 as compared to the previous year, and topping the incidence chart in the country.
According to National Centre for Vector Borne Diseases Control (NCVBDC) data, the state reported 68,693 malaria cases, including the highest 50,501 P falciparum, and eight deaths last year. Around 41,973 cases and four deaths were recorded in 2023.
It fuelled the country’s malaria tally by contributing around 26.7 pc of the total 2.57 lakh cases. The state was followed by Jharkhand (42,352), Chhattisgarh (33,023) West Bengal (21,802), Maharashtra (21,078), Mizoram (16,899) and Uttar Pradesh (13,477).
Officials said 78 pc cases were from five districts - Kalahandi, Rayagada, Kandhamal, Koraput and Malkangiri. The districts are among 21 high prevalent areas where targeted interventions are being made under the state’s flagship initiative Durgama Anchalare Malaria Nirakaran (DAMaN) to achieve malaria elimination by 2030.
The resurgence of the disease coupled with a spike in asymptomatic cases has prompted the Centre to raise serious concern over the effectiveness and reporting mechanisms of DAMaN. What has sent the alarm bells ringing is under-reporting of asymptomatic cases by the state.
In an official communication (accessed by TNIE) to the Odisha government, the NCVBDC has questioned why a significant portion of malaria cases detected through mass screening exercises under the DAMaN programme and in tribal residential schools are not being reported in the national surveillance system M4. The M4 format is used to record fortnightly case information from a sub-centre, PHC, district or state, and is part of the health management information system.
The NCVBDC data indicated 28,293 malaria cases were detected in 2023 through DAMaN. However, these cases are not part of the 41,973 cases officially reported through routine surveillance, indicating over two-thirds of the actual cases are being overlooked in national records. Asymptomatic patients become a ‘reservoir’ for parasite transmission and may act as a precursor of symptomatic malaria.
“All cases detected in DAMaN are identified using rapid diagnostic tests (RDTs), which can detect high-parasitemia infections with more than 100-200 parasites per microlitre,” the letter noted.
It suggested that these are not mild or borderline infections, but clinically significant ones that merit inclusion in the official data.
The Centre also underlined that mass screenings conducted twice annually among tribal residential school children are identifying several positive cases, yet these remain unaccounted for in the M4 database.
Urging immediate corrective measures, the NCVBDC has recommended that at least symptomatic positive cases from such targeted screenings be included in national reporting formats to reflect the true disease burden at the sub-centre level.
The Centre has also directed the state government to share detailed, districtwise data on all types of malaria mass screening initiatives with the Regional Office of Health and Family Welfare (ROHFW), Bhubaneswar, to facilitate a clearer understanding of species prevalence and epidemiological trends.