Under-reporting of malaria cases a big concern in Karnataka

As India is gearing up to eliminate malaria by 2030, Karnataka has greater challenges in controlling the vector-borne disease. While the number of positive cases is on the decline, Dakshina Kannada and Udupi districts have been consistently reporting the highest cases in the State. However, health authorities and experts in vector control are worried that the low numbers in other districts would be because of under-reporting of cases. Although it is a notifiable disease, not all private practitioners report every case to the Health Department. This is a major concern for the State Health Department, which is now working on a comprehensive roadmap for malaria elimination. Malaria is caused by parasites that are transmitted to people through the bites of infected female anopheles mosquitoes. According to data sourced from the Directorate of National Vector Borne Disease Control Programme (NVBDCP), the number of positive cases in Karnataka has come down from 16,466 in 2012 to 12,445 last year. In 2016, till October, Karnataka reported 9,356 cases. Of this, nearly 70 per cent are from Dakshina Kannada and Udupi districts. State Deputy Director (NVBDCP) B.G. Prakash told The Hindu that a robust reporting system had been adopted in Dakshina Kannada thanks to an IT solution developed by a team led by Mangaluru-based paediatrician B.S. Baliga, who is also a member of the Malaria Control Action Committee in Mangaluru City Corporation. “Every health facility in Mangaluru has been linked through this software and hence the reporting is up to 90 per cent. Whereas, in other parts of the State, especially Bengaluru the reporting is only up to 50 per cent from private hospitals. Although we have been insisting on mandatory reporting of every case, only some major hospitals have been doing it,” Dr. Prakash said, adding that the district health officers (DHO’s) would now start issuing notices to hospitals under the Karnataka Private Medical Establishments (KPME) Act. Under category 2 Although the average annual parasite incidence (API) in the State is 0.27 per 1,000 population, the State falls under category 2 (where the API is more than 2 per 1,000 population). “This is because of Dakshina Kannada and Udupi districts, where the API is higher than 2 per 1,000 population,” said senior scientist S.K. Ghosh, who heads the field station of National Institute of Malaria Research (ICMR) in Bengaluru. Mangaluru is 22 m above sea level and its climatic conditions favour vector-borne diseases. The rapid rise in development work and stagnant water at construction sites in urban areas have also led to a rise in the incidence of malaria there, he explained.

In comparison, the incidence is low in Bengaluru because of its high altitude. “Bengaluru is 920 m above sea level, whereas mosquito transmission occurs below 200 m, so occurrence of malaria is rare here. Even the climate, with low humidity, prevents the survival of the vector population here,” Dr. Ghosh added.