Malaria in Sundargarh district, Odisha, India: Epidemiological and behavioral aspects from surveys

• Published in: Acta tropica 2020-11, Vol.211, p.105647-105647, Article 105647
• Main Authors: van Eijk, Anna Maria, Choubey, Sandhya, Barla, Punam, Haque, Mohammed A., Nandini, P, Acharya, Subrata, Sullivan, Steven A., Mohanty, Sanjib, Satpathi, Sanghamitra, Carlton, Jane M.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Child; Child, Preschool; Delivery of Health Care; Family Characteristics; Female; Humans; India - epidemiology; Insect Repellents - pharmacology; Insecticides - pharmacology; Malaria risk factors; Malaria, Falciparum - epidemiology; Malaria, Falciparum - prevention & control; Malaria, Vivax - epidemiology; Malaria, Vivax - prevention & control; Male; Middle Aged; Mosquito control; Plasmodium falciparum; Plasmodium vivax; Prevalence; Risk Factors; Surveys and Questionnaires; Young Adult
• ISSN: 0001-706X; 1873-6254
• DOI: 10.1016/j.actatropica.2020.105647

•Previous studies identified rainy season and male gender as risk factors for malaria in India.•A subsequent behavioral survey investigated the behavioral aspects of malaria risk.•Men were more likely to be involved in outside activities in the evening and early morning.•The use of rmosquito epellents and creams was low.•Malaria is a localized disease in India, and requires local prevention plans whereby behavior-related factors taken into account. To characterize malaria and assist in prevention efforts, we conducted a series of epidemiological studies in Sundargarh district, India, as part of an NIH-funded International Center of Excellence for Malaria Research. In a published survey around Rourkela in 2013-2014 (N = 1307), malaria prevalence was found to be 8.3%. Using these data, villages were divided into low (10%) malaria prevalence, and risk factors assessed by type of village. In the six low malaria villages, four persons were positive by PCR; in the four medium malaria villages, prevalence was 7% (35 infections, 7 P. vivax); and in the three high malaria villages, prevalence was 21% (62 infections, 10 P. vivax and 5 mixed with P. vivax and P. falciparum). A total of 30.6% infections were submicroscopic and 40.6% were asymptomatic. Our analyses showed that the rainy season and male gender were risk factors for malaria; in high malaria villages, young age was an additional risk factor, and indoor and outdoor spraying was protective compared to no spraying. We undertook a subsequent behavioral survey in four of the medium and high malaria villages in 2017 to investigate the behavioral aspects of malaria risk. Among 500 participants in 237 households, adult men (15+ years) were more likely to be outside in the evening (34.5% vs. 7.9% among adult women 15+ years and 0.7% among children, p