Chalageri Vani H, Shrinivasa B M, Sujith Nath N, Nandish Prerana, Anvikar Anup
ICMR-National Institute of Malaria Research, Field Unit Bengaluru, India.
ICMR-National Institute of Malaria Research, Delhi, India.
J Vector Borne Dis. 2025 Apr 1;62(2):129-134. doi: 10.4103/JVBD.JVBD_92_24. Epub 2024 Oct 5.
Malaria continues to remain a serious threat to public health, especially in regions with socio-economic and healthcare disparities. The work attempts to contextualize the current scenario of malaria transmission, the advancement made towards its elimination and the multi-dimensional strategies that may be required to overcome cultural and regional barriers; with a focus on India's goal to eliminate malaria by 2030. The epidemiological spread of malaria across the country is nuanced; wherein an overall reduction of malaria cases recorded over the years (signifying success) could be juxtaposed with more concentration of cases in certain regions. These areas with higher transmission rates are majorly populated by vulnerable social categories like communities living in and near isolated areas, forests, and mountainous regions. This disproportionate distribution signifies the need for focused interventions that take into account localised cultural contexts. Obstacles like drug-resistant strains of parasites, insecticide resistance being developed by vectors and the limitations of existing diagnostic tools are also discussed in the context of socio-demographic changes like urbanization and migration. As India is moving towards elimination phase, health equity has been identified as a key concern. Ensuring equitable access to diagnostic tools, curative facilities and preventive measures becomes key for malaria elimination. In addition to a strong healthcare system, community level involvement engendering community ownership is put forth as a key factor for the success of interventions. Opportunities to improve these efforts through the incorporation of cutting-edge technology, like drone surveillance for vector control and artificial intelligence for diagnosis and rapid identification and response to outbreak have also been brought to the fore. This work emphasizes the significance of an equity-focused approach to malaria elimination, integrating innovative tools and engendering community level cooperation.
疟疾仍然是对公共卫生的严重威胁，特别是在存在社会经济和医疗保健差距的地区。这项工作试图将当前疟疾传播的情况、在消除疟疾方面取得的进展以及克服文化和区域障碍可能需要的多维度策略置于具体情境中；重点关注印度到2030年消除疟疾的目标。疟疾在全国的流行病学传播情况较为微妙；多年来记录的疟疾病例总体减少（这表明取得了成功），但某些地区的病例却更为集中。这些传播率较高的地区主要居住着弱势群体，如生活在偏远地区、森林和山区及其附近的社区。这种分布不均表明需要采取针对性的干预措施，同时考虑到当地的文化背景。文中还在城市化和移民等社会人口变化的背景下，讨论了诸如寄生虫耐药菌株、病媒产生杀虫剂抗性以及现有诊断工具的局限性等障碍。随着印度迈向消除疟疾阶段，卫生公平已被确定为一个关键问题。确保公平获得诊断工具、治疗设施和预防措施成为消除疟疾的关键。除了强大的医疗保健系统外，社区层面的参与并形成社区主人翁意识被认为是干预措施成功的关键因素。通过采用前沿技术来改进这些努力的机会也已凸显出来，如利用无人机监测病媒控制，以及利用人工智能进行诊断、快速识别疫情并做出应对。这项工作强调了以公平为重点的消除疟疾方法的重要性，整合创新工具并促进社区层面的合作。
