National Project Implementation Plan - NVBDCP

years, the Indian surveillance system has been reporting around 2 million
cases of malaria every year. Increasing proportion of Pf, which currently
stands at about 45% of total reported cases, is a major cause of concern.
India is estimated to contribute 77% of cases in the South East Asia (SEA)
region of the WHO though only 66% of SEA population actually lives in
India. Within India, about 80% of malaria burden is confined to 20% of
population residing in high risk areas. States like Orissa, Jharkhand and
Chhattisgarh lead the country in incidence of malaria while the case fatality
rates are highest in Arunachal Pradesh, Assam, Meghalaya& West Bengal.
All these high burden states have a very high proportion of tribal
population. Even though, the number of cases and deaths attributable to
malaria, have declined significantly during last decade, there is however,
increase in P. falciparum proportion out of total malaria positive cases.
During 2006, 1.78 million malaria positive cases were reported with 1704
deaths. In 2005, the figures were 1.81 million cases with 963 deaths. The
malaria cases and Death in the country for the last 3 years is enclosed at
Annexure 1.
1.1 b. Kala-azar Situation
After decline to negligible number of cases due to collateral benefits of
indoor residual spray on the vector Phlebotomus argentipes, Kala-azar
resurged in the state of Bihar in sixties and by seventies the disease got
firmly established in endemic form in the state of Bihar followed by West
Bengal, Jharkhand and Uttar Pradesh. Currently, kala-azar is endemic in 52
districts from the states of Bihar (33 districts), West Bengal (11 districts),
Jharkhand (4 districts) and Uttar Pradesh (4 districts) located in the eastern
parts of the country. The state of Bihar contributes 70-80% of the total
disease burden in the country.
The four endemic states reported 39,178 cases and 187 deaths due to kalaazar
in the year 2006. While the disease mostly affects poorest socioeconomic
groups primarily living in rural areas, among these 4 states about
129 million populations are estimated to be at risk of acquiring kala-azar.
The year wise cases and deaths are presented in Annexure 2.
The data available with NVBDCP suggests an increasing trend in the
reported cases of Kala-azar since 2003. This increase may partially be due
to intensification of active case search in affected areas.
The NHP (2002) envisages elimination of Kala-azar by the year 2010. The
Govt. of India is also a signatory to Tripartite Memorandum of
Understanding (2005) along with Nepal and Bangladesh, on elimination of
Kala-azar from the South-East Asia Region by 2015 by reducing the annual
incidence of Kala-azar to less than one per 10,000 population at sub-district
level in Bangladesh and India and at the district level in Nepal.
2