Malaria is running rampant in the Uttar Pradesh city of Bareilly, with both plasmodium vivax (PV) and the deadly plasmodium falciparum (PF) being reported in high numbers.
The cumulative figure of PF malaria cases in Bareilly over the course of the year stands at 4,207 at the time of writing. Across the same period, 21,887 people have also tested positive for the PV malaria strain. Around 3,500 cases of the PF strain have been reported only recently.
While the figures seem alarming, and the sudden reporting of 3,500 cases would usually underline an outbreak, this rise in cases may be attributable to increased and improved surveillance techniques.
“Cases of PF malaria have risen in the past few days because we’ve been conducting massive active case surveillance, in which teams are holding camps in villages and testing fever patients,” said chief medical officer, Dr Vineet Shukla. “If any person tests positive for either PF or PV malaria, we immediately begin their treatment. Our aim is to end the parasite by diagnosing all cases.” The intensive “active case surveillance” involved 400 teams of auxiliary nurse midwives (ANMs) testing individuals across the city.
The high prevalence of the PF strain is of particular concern. This strain of malaria is regarded as one of the more dangerous strains due to its capacity to replicate rapidly within the blood. This leads to symptoms worsening considerably within days of the initial infection, leading to a higher mortality rate than is observed for PV cases.
PF also holds a unique trait among malaria strains in which infected red blood cells have their shape altered in a process referred to as sequestration. This altered shape leaves red blood cells “stickier” in a way similar to sickle cell anaemia. These stickier cells are more prone to aggregation and, therefore, the blockage of blood vessels. This can result in blood clots in major organs, a factor that adds to the strain’s high mortality rate.
Malaria is a major priority in India, with drives mentioned by the government aiming to eradicate the disease. “We are working towards ending malaria as soon as possible,” said Union Health Minister Dr Harsh Vardhan recently in Pune, describing it as one of the government’s “topmost priorities.”
Surveillance programmes such as those conducted in Bareilly are a vital first step in achieving this goal. However, prolonged commitment must be made by both the Centre and grassroot campaigns to see these diagnoses through to treatment. If malaria is to be eradicated in India, it will need a sustained effort that is likely to be taxing on the health system. However, a malaria-free India would undoubtedly be a major boon in freeing up healthcare resources in the future.