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While Covid raged, Chhattisgarh covered over 6,000 villages under ‘Malaria Mukt Bastar’ project

Chhattisgarh government launched the 'Malaria Mukt Bastar' project in January this year. Malaria cases are down by 65% in the seven districts covered in the project.

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New Delhi: When the rest of the country was attempting to fine-tune its testing, tracing and treatment strategy for Covid-19, Chhattisgarh was doing the same for malaria under the Malaria Mukt Bastar project, which was launched in January by the state government. Healthcare workers in the state covered 100 per cent of the region, which is made up of over 6,000 villages.

Armed with rapid testing kits and permanent markers, the workers overcame initial resistance from Left-wing extremism, and completed two phases of the programme — the first in January and February, and the second in June and July. The programme was carried out under the National Health Mission, which was launched by the Government of India in 2013.

Health workers went door-to-door, testing people, to achieve 100 per cent coverage in the districts of Bastar, Kanker and Kondagaon. Sukma, Dantewada, Bijapur and Narayanpur — which are among the districts worst-affected by the Naxal insurgency — were also covered.

About 10 months after the initiative was launched, the seven districts in Chhattisgarh have seen a 65.5 per cent year-on-year decline in the total cases of malaria recorded.

This year, the malaria mortality rate in the Bastar region also declined to 0.5 in the January to September period, compared to 0.39 last year. In Sukma, it is down from 1.5 to 0.37 and in Dantewada from 2.16 to 0.30.

The malaria mortality rate is calculated by dividing the number of deaths due to malaria by the total population and multiplying by 1,00,000.

The test positivity rate — the number of people testing positive — in the first round of the programme was 4.6 per cent while in the second phase, it was 1.27 per cent.

According to state health officials, the first analysis of the results till September are encouraging. However, carrying out the drive during a pandemic required the healthcare workers to take special precautions.

“Due to the Covid situation, every survey team was provided with masks, gloves and sanitisers and they were instructed to maintain physical distance everywhere. Supervising teams ensured that the teams that visited door-to-door, followed Covid appropriate behaviour,” Dr Priyanka Shukla, mission director of the National Health Mission in Chhattisgarh, told ThePrint.

“During the abhiyan (survey) some areas were declared as containment zones and were covered only after their de-containment was announced,” Shukla added.

Also read: How malaria remains dormant in human body and reappears months later

Permanent markers to ensure 100% coverage

Shukla noted that the initial plan was to use indelible ink on the villagers’ fingers, to distinguish those tested from those who were not. However, since the survey began after panchayat elections, some villagers already had the voting mark on their hands.

“So we decided to mark the toes with permanent markers. It stayed for about a week but when the drive was going on in a particular area, if we saw people in the market without the toe mark, we could test them right there,” said Shukla.

“It also gave us an unexpected advantage, people thought we were being very respectful in marking their toes,” she added.

The active surveillance meant that the system sought out and tested every person. All healthcare workers were given rapid diagnostic kits for testing.

As a result of this intensive survey, a large number of people in the region were found to be positive for malaria but had no symptoms of the disease.

Asymptomatic malaria is known to cause anaemia and malnutrition. In the first phase, 57 per cent of the population was asymptomatic while 60 per cent of positive cases displayed no symptoms in the second phase.

Toes of those tested was marked with permanent marker | By special arranegement

Also read: How to handle Covid plus dengue, malaria or seasonal flu? Health ministry issues guidelines

Decline in malaria cases in second phase

The team also provided food to those who had tested positive to ensure that they did not take the medicine, chloroquine, on an empty stomach. If taken without food, the drug can cause nausea and is one of the reasons why people drop it without completing the course.

A senior health department official told ThePrint, “We issued treatment cards to all malaria-positive cases to ensure complete treatment and verified during case follow-up. Wall stickers or stencils were pasted outside the house. We carried out surveillance in the weekly markets and carried out programmes such as ‘matka badlo’ (change the water container) to generate awareness and reduce breeding by the vector.” Malaria is spread by the female Anopheles mosquito.

During the first phase, 64,646 people were found to be infected with malaria from a total of 14,06,000 people tested.

In the second phase, the health department team examined 23,75,000 people and provided immediate treatment to 30,076 people.

There was a decrease of 75.2 per cent in Kanker district, 73.1 per cent in Kondagaon, 71.9 percent in Sukma, 71.3 per cent in Bijapur, 57 per cent in Narayanpur, 54.7 per cent in Bastar and 54 per cent in Dantewada in the incidence of malaria during the second phase.

According to data collated by the World Health Organization (WHO), India contributes 77 per cent of the total malaria cases in Southeast Asia. It is mainly prevalent in Chhattisgarh, Rajasthan, Gujarat, Jharkhand, Karnataka, Goa and parts of the Northeast.

Also read: Malaria drug chloroquine, used for Covid treatment, linked to amnesia, delirium, depression


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