Malaria and the Narmada-river development in India: a case study of the Bargi dam.

The largest river-valley development to be proposed in India is that in the Narmada valley. The building of the Bargi dam, a multi-purpose irrigation and hydro-electric project, in Jabalpur, in central India, formed part of the first phase of the development of this valley (1974-1988). Many villages and several hectares of land in three districts were submerged as the waters rose behind the dam, the worst affected area being the catchment area of the primary health centre (PHC) at Narayanganj, in Mandla district. Until recently, cases of malaria were relatively rare in Narayanganj. However, an epidemic of malaria in late 1996 claimed hundreds of lives in the area and the outbreak spread, during 1997, to new villages in the region. A review of the records collected by the National Malaria Eradication Programme (NMEP) not only indicated that the slide positivity rate (SPR) for Narayanganj increased > 7.45-fold between 1979 and 1997 but also that the slide falciparum rate (SFR) increased > 32-fold over the same period. The NMEP data available for Mandla district as a whole indicated a doubling in mean SPR and SFR between 1979 and 1997. There is no evidence that a new species of vector has established since 1979. In fact, indoor-resting densities of anophelines and of the most established vector, Anopheles culicifacies, have fallen since the dam was built, but densities of another vector, An. fluviatilis, have increased.