New strategies reducing malaria deaths in Odisha (April 25 is World Malaria Day)

New Delhi, April 25 (IANS) India's health ministry is pinning its hopes on new strategies to bring down malaria deaths in Odisha's tribal and urban populations.

"In the last two years, our key strategies are working well. We have introduced new mosquito protection nets, a new guideline for malaria treatment and have been getting positive response from the tribal community," S.K. Sharma, a scientist at National Institute of Malaria Research (NIMR), a part of the health ministry, told IANS.

In 2010, Odisha saw the highest number of malaria deaths in the country at 247. However, the next year, the number of deaths came down to 73, said the National Vector-Borne Disease Control Programme (NVBDCP).

This year, over 28,000 people in the state have so far been found suffering from malaria but there have been no deaths, said a NVBDCP report.

For the towns and cities, NVBDCP's Urban Malaria Scheme has been trying to curb mosquito breeding and addresses issues such as trimming drains, water disposal and sanitation, emptying water containers once a week and observing a weekly "Dry Day".

However, the tribal areas, which lie in the Maoist guerrilla zones, remain the focus area.

"Highly endemic tribal areas are our target group. There have been some challenges for health workers such as wide forest areas, inaccessibility, resistance from Naxals (Maoist guerrillas) and, of course, drug resistance," said Sharma, who was part NIMR's field unit at Rourkela, a city in Odisha.

NVBCDP data also said that the districts that reported high number of deaths in 2010 have mortality fall in 2011 due to scaled-up strategies, better monitoring and supervision at all levels.

To prevent mosquito bites, Sharma said the NIMR was conducting two trials on World Health Organisation-sponsored long-lasting insecticide-treated nets (LLINs).

"Duranet is in the 2009-2012 trial phase while Permanet is undergoing field trial for the 2011-2014 period. These mosquito bed nets have been showing good results among the community," he said.

The nets come with a treatment of insecticide that keeps malaria causing anopheles at bay. With an efficacy of three years, the LLINs can prevent malaria in adivasi areas, which health officials cannot visit regularly, he said.

The other interventions by the Odisha health department and NIMR include the introduction of the indoor residual spray (IRS) through the network of Accredited Social Health Activists (ASHAs) and community health workers.

These health workers are also helping bring down malaria cases among the tribals of Chhattisgarh, a state bordering Odisha.

"ASHAs go to the communities with rapid diagnostic kits which help us diagnose malaria early. It is through ASHAs that we are informing communities about malaria prevention," said R.M Bhatt, a NIMR field officer in Chhattisgarh, told IANS over the phone.

Malaria cases are also high among the security forces posted in the Maoist zones of the two states, said a NIMR scientist, who did not want to be named. "The problem is so grave in the Maoists regions that more soldiers are dying of malaria than bullets."

In Chhattisgarh, 18 people died of the disease last year.

However, across India, the total number of malaria deaths has come down from 1,018 in 2010 to 463 in 2011. The other malaria-endemic states of India are Maharashtra, Assam and Arunachal Pradesh.

However, the adoption of national drug policy in 2010 has brought in a new approach to tackling the disease, say experts.

Artemisinin Combination Therapies (ACT) has replaced the older chloroquine, to which the malaria-causing parasite had become resistant.

"Now we are using a combination of different drugs to kill the malaria parasite in the body within 24-36 hours. But if this ACT also shows signs of resistance, it could can a problem in controlling malaria," a senior health ministry official said.

According to WHO, around 1.32 billion people are at the risk of contracting malaria in Southeast Asia. It marks April 25 as the World Malaria Day.