Delivering a sort of stinging defiance to the much touted National Malaria Control and Eradication Programme in the State, falciparum malaria, also known as cerebral malaria, is going endemic in Odisha. Dubiously, Odisha is now the only State in the mainland of the country to join the ranks of the seven sisters - the north-eastern States - where brain malaria is endemic in nature.
Consider the ominous portends. Brain malaria or falciparum malarial cases in the State account for over 86 per cent of the total malarial cases reported. Worse indication is with such a high rate Odisha even fared poorer than some north-eastern States like Assam, Sikkim, Nagaland and Manipur.
Significantly, the slide falciparum positive rate in Odisha in December 2014 has increased to over five per 100 blood slides examined from around four in 2013. An increase has also been noticed in the high-burden north-eastern States like Tripura, Meghalaya and Mizoram, where the slide falciparum positive rates were in the range of 9-6 per 100 blood slides. For this, Odisha has been grouped along with three north-eastern States that have high load of cerebral malaria cases in the country.
However, the fact of some respite for Odisha is it was able to bring down the annual fatality rate to almost half of the national average. The annual fatality rate in 2014 in Odisha has been around 22 per 1 lakh malaria cases against the national average of 54. As per the data available with the National Vector Borne Disease Control Programme (NVBDCP) here, when high load State like Tripura has a better rate of 22 per 1 lakh, Mizoram with a very high rate of 202 per 1 lakh tops the national chart.
According to Public Health Director Dr Kailash Das, early detection of cases has led to effectively bringing down the fatality rate in the State below that of national average. The ASHAs armed with RDT (Rapid Diagnostic Test) toolkits are visiting every household in the endemic villages, and, as a result, the annual blood examination rate in Odisha is higher than the ideal norm, he explained.
Despite the measures, the blips that show up on the radar are mortality cases that have shown a spike in 2014 and the malaria cases - both benign and cerebral - have recorded a rise of over 61 per cent over that of 2013. Sources attribute the spike to certain regular slip-ups the State witnesses in its fight against malaria over the years.
As nearly half of the State populace is at risk, the National Malaria Eradication Programme (NMEP) envisages distribution of long-lasting insecticide mosquito nets to around 86-90 per cent of the risk populace. But the actual availability of such nets is far less from that of requirement. Moreover, the shortage of insecticides during the rainy season last year dealt a body blow to NMEP’s vector control programme via IRS (Insecticide Residual Spray). Above all, the huge vacancies of ASHAs in endemic districts threw a spanner in the Government’s drive for early detection of cases to prevent complication and curb fatality rate, added sources.