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Burden of Malaria in India: Retrospective and Prospective View

In India, nine Anopheline vectors are involved in transmitting malaria in diverse geo-ecological paradigms. About 2 million confirmed malaria cases and 1,000 deaths are reported annually, although 15 million cases and 20,000 deaths are estimated by WHO South East Asia Regional Office. India contributes 77% of the total malaria in Southeast Asia. Multi-organ involvement/dysfunction is reported in both Plasmodium falciparum and P. vivax cases. Most of the malaria burden is borne by economically productive ages. The states inhabited by ethnic tribes are entrenched with stable malaria, particularly P. falciparum with growing drug resistance. The profound impact of complicated malaria in pregnancy includes anemia, abortions, low birth weight in neonates, still births, and maternal mortality. Retrospective analysis of burden of malaria showed that disability adjusted life years lost due to malaria were 1.86 million years. Cost–benefit analysis suggests that each Rupee invested by the National Malaria Control Program pays a rich dividend of 19.7 Rupees.

Received August 21, 2006. Accepted for publication March 23, 2007.

Acknowledgments: The authors thank Prof N. K. Ganguly, Director General, Indian Council of Medical Research, for encouragement; Dr Lalit Kant, Senior Deputy Director General, for initiating Disease Burden Estimation Studies in the Institutes of Indian Council of Medical Research and arranging training of the first author; and the World Health Organization, South Eastern Regional Office, New Delhi, and the USAID for providing funds for review of literature and expert group meetings on malaria burden in India.

^* Address correspondence to Aditya P. Dash, National Institute of Malaria Research, 22 Sham Nath Marg, Delhi 110 054, India. E-mail: apdash2{at}rediffmail.com

Authors’ addresses: Ashwani Kumar and Tanu Jain, National Institute of Malaria Research, Field Station, Campal, Panaji, Goa, Pin 403 001, India, Telephone: 91-832-2222444, Fax: 91-832/2421406, E-mail: ashwani07{at}gmail.com. Neena Valecha and Aditya P. Dash, National Institute of Malaria Research, 22 Sham Nath Marg, Delhi 110 054, India, Telephone: 91-11-23915658, Fax: 91-11-23946150, E-mails: director{at}mrcindia.org and neenvalecha{at}gmail.com.

Reprint requests: Ashwani Kumar, National Institute of Malaria Research, Field Station, Campal, Panaji, Goa, Pin 403 001, India.

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