Mangalore: City in control of Malaria

Mangalore as a city that is enlightened and medically equipped to handle the scrouge of Malaria is now feeling confident of controlling the deadly infection.

Malaria is not new for Mangalore, the city which has been fighting this disease since 1930. It was in that year that the outbreak of Malaria went out of control and the extent of infection had carried on till end of the Second World War say some of the elder citizens of the city. They remember they had to be issued 'passports' to get out of Mangalore with a stamp that he did not carry malaria parasite. Till 1990 there was somehow a restrained infection and the medical records show that between 1930 and 1948 over 50,000 people were affected by this disease and more than 2000 people died in Dakshina Kannada district which was a part of the Kanara district that included Uttara Kannada, Udupi and Kasargod with over 90 percent of them in Mangalore alone. But during the last 17 years starting from 1990 till 2007 nearly a lakh of people have been affected but the death rates have come down to almost minimal as the modern medicines have become more potent.

In 1996 the district was dangerously perched to be enlisted among the hyper endemic zones in the country for Malaria. It was on the sixth slot of the high propensity to become a high endemic zone with over 5.7 percent of its population affected by Malaria at any given time (1997 figures) Other high endemic areas in the state were Hassan, Chikmagalur, Tumkur, Chitradurga, Mysore, Kolar and Bijapur. Mangalore Bangalore, Bellary was on the verge of being declared hyper endemic zone.

According to the experts, Malaria has two dimensions - social and medical. There is very little the world of medicine has to do in control of Malaria. It can effectively control malaria with potent medicines, but in malaria even the medical experts agree that prevention was better than cure. Malaria can only spread through one carrier that is mosquito. It is basic knowledge that only mosquitoes carry the malaria vectors - Vivax and Falcifarum. The latter is also known as the carrier of cerebral Malaria which is most dangerous. If not treated in time with adequate doses of medicine, cerebral Malaria can be fatal.

The social aspect is the awareness about Malaria. People should know how to escape from being infected and to do that they should also know how best to control the breeding of mosquitoes. The National Institute of Malaria Research at Bangalore has already created a benchmark for control of Malaria. The best way to achieve annihilation of mosquitoes was to destroy their breeding places. They breed in fresh water and that is the reason why they breed extensively during the monsoons.

Mangalore is experiencing a spurt in construction activities, this has a relation with the high phase of Malaria incidents in the city say the Mangalore City Corporation health authorities. The construction site very conducive for breeding, fresh water used for curing concrete, storage of large quantities of water in the tanks which is generally open are some of the areas available for the mosquitoes to breed. The construction workers, who migrate to Mangalore from high Malaria endemic places in other parts of the state, reside in the construction sites. This gives rise to a situation where the mosquito can get easy blood from the workers who might be already carriers of the parasite. The mosquitoes then move around the place of construction and infect uncanny residents around the construction sites.

A study carried out by the Roshni Nilaya School of social work in 2002 had found out that incidences of Malaria were found 0.5 kilometers around the construction sites. The mosquito has a range of 500 meters of flight and the study showed that a single mosquito can infect 30 people during its life span of 7 days.

The Mangalore City Corporation has been fighting Malaria since 1990 with some rudimentary and outdated methods like fogging and spraying but only in 1999-2000 that other methods like bio-control, preventive methods and information and awareness campaign began with the help of the people, school children, youth clubs and NGOs, which have shown commendable results.

The experts are now convinced that the destruction of breeding places of mosquitoes should be taken up consciously by all the people in and around their houses anything that can hold fresh water should be kept upside down. Special movement for creating awareness on Malaria has been taken up by the district health authorities along with the Mangalore City Corporation. In many cases the Mangalore City Corporation has fined builders and promoters and those who give rise to mosquito breeding in their premises. But largely the situation on mosquito breeding remains to be controlled further.

According to Health Inspector Gopalakrishna Delampady 93 individuals and construction companies have been fined for mosquito breeding in their premises. To give more thrust to the anti malaria drive the Mangalore City Corporation will be empowered to employ Non Governmental Organisations (NGOs) to actively participate in the drive. They will be given specific tasks like spreading the anti malaria awareness, reporting of malaria cases and taking part in the field work along with the Corporation authorities in controlling of Malaria. The existing penalty for first time was only Rs. 50 and did not make any impact on the habitual offenders. He said he was also examining if the existing rules pertaining to Malaria control needs to be amended to make it more effective.

He said people should be extra careful in the monsoons and not allow waste cans, discarded tyres, Coconut shells to litter in their area. If found they should immediately destroy them. Special care should be taken to introduce guppy fishes into the open water bodies and close their overhead tanks and sumps with airtight lids. He has asked the people to spread this information among their neighbours and complain to the Mangalore City Corporation at the following number 2220344, 155313 and 4277968 (Malaria Cell).

According to the Health Officer Manjaiah Shetty the anti malaria drive will continue both intensively and extensively for the entire monsoon period. He said old and discarded tyres were one of the concerns of the Corporation, but now with the help of the tyre dealers and the vulcanizing outlets the old tyres will be 'properly discarded'. He said the recovered old tyres will be buried at the dumping yard in Moodushedde and Vamanjoor in the outskirts of the city. 14 places where old tyres have been dumped have been cleared, which means so many breeding places have been destroyed Shetty told.

In an alarming development the Biological Malaria Control- an NGO working in this field has found out that there were 28 cases of Malaria in an area that has 50 houses in Dhoomavati compound in Hoige Bazaar on 10 July 2007. Convener of the NGO Suresh Shetty told that According to the statistics of the Malaria cell the cases of Malaria - Falciferum, Vivax and mixed infections had come down by 50 percent in comparison to 2006. The statistics indicate that in May 2006 there were 1081 cases but in June 2007 (upto 30) 598 cases have been reported in the Mangalore City Corporation areas. The highest being reported in Kankanady area at 116 which has been identified as one of the five high risk areas in the city. Other areas includes Bejai (104 cases), Kodialbail (95 cases) Car Street (42 cases) and Falnir (93) cases. Kankanady was also a place where a number of new construction were taking place and notices have been served to the promoters to keep their construction sites free of mosquito breeding.

Deputy Director of National Institute of Malaria Research field centre at Bangalore S.K. Ghosh says that once the mosquito larvae gets wings it is difficult to control their movement and best way to control them was during the larvae stage itself. Malaria was showing a great problem in the coastal city of the western ghat. In 1994 there were 3149 malaria cases, 5222 cases in 1995; 9880 cases in 1996; 7872 cases in 1997; 6475 cases in 1998; 4598 cases in 1999 and 1572 cases in 2000. In 1996 four deaths due to malaria were reported. In such condition malaria control in this city was initiated in October 1998 with the request of a local NGO - Mangalore Parisarasakta Okkuta, Training and workshops were organized to have suitable control strategies. In 2001, 52, 000 Guppies have been supplied for release in wells and other breeding sites as a part of the biological control of mosquitoes.

Some India Facts

India contributes nearly 70-75 malaria cases in the South East Asian Region. Nearly 95 percent of the population is at risk due to conditions which are conducive for mosquito breeding. Malaria cases are detected by active case detection (ACD) and passive case detection (PCD) mechanisms. Each year 80-90 million fever cases are screened for the presence of malaria parasites, of which 2 to 3 million cases are detected parasite positive. National Malaria Programme's surveillance system is applied uniformly to the entire country, regardless of malaria situation. In many areas of the country disproportionate efforts are made to detect malaria cases. Even with the nation-wide surveillance, estimates of malaria burden remain unclear; the epidemiology of malaria is complex and the disease is unevenly distributed in time and space.

It is notable to mention that malaria has been contained to a large extent in 80 percent of the country's population. The remaining 20% population lives in highly malarious areas. This comprises of 7 percent tribal population (70 million) in peninsular India that contributes 30 percent malaria cases and 50 percent are falciparum cases. Likewise 4 percent populations in the 7-north eastern states have high proportion of falciparum and the drug resistant malaria. Another 9 percent population (85 million) contributes 22 percent malaria cases, 18 percent P. falciparum cases and 20 percent deaths due to malaria in the country. There are two prevalent malaria parasite infections which are parasite vivax and parasite falciparum. These parasites are in equal proportion in the country. However, parasite formula varies from place to place and seasonally, and profoundly affects the burden of the disease. Disease burden estimates may be more reliable for small homogeneous populations for a specified time period, and such estimates will lead to better targeting of malaria control operations to enhance sustainability of interventions.

Source: www.mangalorean.com