Malaria cases in Mangaluru have continued to decline thanks to malaria control system (MCS) technology that has helped to aid efforts, alongside active source reduction exercises taken in recent years against the spread of vector-borne disease.
Mangaluru, a coastal city known for having endemic malaria issues for three decades, has seen malaria incidence significantly reduced by 83 percent because of the effect of MCS technology launched in October 2015. This is according to a study published in Malaria Journal.
The MCS technology primarily aids the reporting and tracking of malaria cases through a digital system made possible through Android-based geographical information system-tagging tablet, and a web-based incident reporting system. Using this, the MCS technology tracks whether a malaria case is ‘open’ or ‘closed’, and blood smear tests help aid detection.
Speaking about the study, Susanta Ghosh, head of the Indian Council of Medical Research-National Institute of Malaria Research, said the MCS technology “fulfills the Global Technical Strategy (GTS) for malaria elimination from 2016 to 2030 by the WHO [World Health Organization]…this device [MCS] is a game-changer in this direction.”
Uptake and use of the MCS technology
Fundamental to the uptake and use of any technology is accepted adoption. The MCS technology has seemingly been afforded that, according to data published in the study. This meant that the MCS technology not only aided developments in tracking and detection of cases, but also brought about behavioural changes among health care providers and communities.
Such community benefits have allowed civic bodies to maintain control and continuity over the fight towards malaria elimination, and even divert resources to fight new battles. For example, 89 percent of newly diagnosed cases were uploaded into the system within 48 hours followed by complete treatment and vector control.
Furthermore, since its inception in and deployment as part of the study, the MSC technology helped to track 90 per cent of malaria cases in Mangaluru, with numbers largely made up by P. vivax and P. falciparum, two malaria parasites that pose the greatest threat in India.
Why these two parasites pose problems
In India, both the P. vivax and P. falciparum parasites pose particular problems for malaria elimination. The prevalence of the former sees it stand out amongst diagnosis statistics.
As per the Indian national statistics, the country reported 338,000 malaria cases in 2019, of which roughly 53 percent were caused by P. vivax. This meant that almost half of global P. vivax burden was in India.
They also cause concern due to the barriers preventing successful treatment that currently exist such as lack of compliance to treatment regimes, and also instances where treatment through primaquine is not appropriate. These have all left studies asking the question of whether relapses of P. vivax malaria threaten disease elimination in India.
With this, it is clear that the country has hurdles to overcome. Whilst the deployment of treatment such as primaquine and tafenoquine has been touted to help, the issue of antimicrobial resistance lingers causing further greater concern as more and more strains develop immunity to commonly-used therapies rendering them ineffective.
Working towards the 2030 malaria elimination goal
Yet for all these concerns, progress is tangible. The number of cases is heading in the right direction, and there is a roadmap for improvements in India’s malaria crisis. As the Malaria Journal study notes, smart management and surveillance will be the ‘backbone of an effective system that supports malaria elimination’ in India, and poor data on detection and cases numbers will curb countries working towards malaria elimination.
The broader picture shows that the current trajectory for malaria cases in Mangaluru, and India as a whole, which bodes positively for optimistic plans set out in 2016 to have zero indigenous cases and deaths by 2030. For a country that has suffered damningly in the past, there is now room to look forward, and the study showing the success of the MCS technology begins to point the way.