Malaria Control in Mangaluru

Mangaluru is a coastal city in southern Karnataka with a population of 4,99,000 (2011 Census). The city has witnessed resurgence of malaria since 1990-91. [See Malaria in Mangaluru] The surge in malaria has been largely attributed to increased urbanisation and vigorous construction activities that brought in migrant labour from malarious regions of the country.

First deaths from malaria in Mangalore were reported in 1995. Alarmed by this, a voluntary initiative for malaria control was started by private medical practitioners in association with the local medical college, Mangalore City Corporation (MCC) and District Administration; Malaria Control Action Committee (MCAC) was thus constituted. In June 2003, a Malaria Cell was started with financial aid from the city based Corporation Bank.

The MCAC had drawn up a comprehensive strategy for control of malaria in Mangalore. With relentless efforts, Passive Surveillance was strengthened; almost all the hospitals and private laboratories were made to report the incidence of malaria cases on a weekly basis. A Hot Line was also established at the Malaria Cell for reporting cases and complaints. Computerization of data helped in analysis and monitoring.

MCAC had also helped in improving inter-departmental co-ordination. Better understanding between health dept. and the town planning dept. in the city A bye-law was enacted in 1998 and provisions were made for a Malaria clause in the construction license. Corporation had ensured that data on construction sites were readily available, the malaria clause was added in all licenses for construction and it was possible to initiate co-ordinated action against the offenders. Improved co-ordination between the MCC and DHO resulted in clear demarcation of responsibilities and areas of operation, better co-ordination in supply of drugs and insecticides, and in deputing staff (ANMs, Lab technicians) etc. Various other departments had also been brought to use: Fisheries College for Guppy breeding; Horticulture Dept for Guppy breeding tanks; Education Dept., NSS, Scouts and Guides for survey and IEC activities etc.

IEC activities were conducted all over the district. A video film on malaria and its control was prepared with the help of Corporation Bank. Hoardings, banners, pamphlets, posters, messages on radio, cinema halls and local cable network and regular press briefings were all used for the purpose.

Workshops were conducted for medical professionals, lab technicians, school teachers, builders and hoteliers. Hundreds of lectures and audio-visual presentations were held at schools, colleges and public places.

As a result, there was a significant decline in the incidence of malaria and by 2000, the annual incidence has dropped to 1798. However, due to complacence, the control actvities were relaxed and by 2003-4, the cases started rising yet again.

The Malaria Cell was constituted in June 2003 with financial aid from Corporation Bank. It had a co-ordinator, a computer operator and more than 30 field staff, including supervisors, ANMs, spray workers and Guppy distributors divided into six teams. Logistical support was provided by the MCC and DHO. These teams carried out active surveillance with special emphasis on migrant workers, construction workers, hotel workers and inmates of orphanages. The teams also carried out door-to-door surveys, IEC activities, source reduction, anti larval and anti adult spray operations, fogging, distribution of Guppy fish besides administering treatment to positive cases.

Five Fever Treatment Depots (FTDs) cum labs were established in the city, with one lab open during the evening hours (3pm-8pm) to cater to labourers. A Mobile FTD consisting of a health visitor and ANM and partly funded by Builders’ Association, was also started. The team visited construction sites to collect peripheral smear and provide treatment for all fever cases on intimation by mobile phone.

Active and inactive major constructions were closely monitored by the teams of the malaria cell on a weekly basis. Builders who failed to take anti larval measures were fined and repeated offenders were fined up to Rs. 25000.

Biolarvicides were also introduced into the wells and permanent water collections. Eight dedicated tanks for Guppy breeding were provided. Guppy fish were made available to general public through malaria cell. More than 6000 wells were covered.

However, with changes in the authorities at the City Corporation, the malaria control activities have taken a turn for the worse. The well placed malaria control programme was disbanded and the collection of data from private hospitals and labs was discontinued so as to show a sharp reduction in the number of cases. The Malaria Cell, funded by a Nationalised Bank, was shut and the field work was instead outsourced to a private security agency with an annual budget of Rs. 5500000. Malaria has continued to increase ever since and by 2015, almost 60% of cases from the state are occurring in Mangaluru alone.

The City Corporation claims to have developed a new strategy yet again to try and tackle the menace. A new software has been developed and is expected to go on field trials soon. However, not much is happening on the ground and people are continuing to get infected and die of malaria.

Sustained blood smear tests keep malaria under double digit figure in Dakshina Kannada: Malaria cases in Mangaluru have decreased from 4,741 in 2018 to 689 in 2022; till April only 18 cases have been reported in 2023. Malaria cases have been on a gradual decline since 2018, from 4,741 to 3,897 in 2019, 2,797 in 2020 and 1,397 in 2021. [See] This success has been achieved due to concerted and sustained efforts over the past 30 years.

News Reports:

1. New Software being Developed to Aid Malaria Control in Mangalore, Supported by Mangalore Medical Relief Society [See]
2. Mangalore City Corporation to Revamp Malaria Control Programme: Mayor Presides Meeting on July 21, 2014 [See The Hindu | Times of India| Deccan Herald | Vijaya Karnataka | Udayavani | Varthabharathi] Mangalore City Corporation Criticised for Failure to Tackle Malaria | MCC in dark about personnel doing its anti-malaria drives | MCC to revive panel on malaria control
3. Deputy Commissioner Orders Probe into Lapses that Led to the Deaths of Two Kids | More on Malaria in Mangalore [The Hindu Feb 1 | The Hindu Feb 3 | Vijaya Karnataka | The Hindu
4. 35 deaths due to malaria in two years in Mangalore; probe and act against officials: Dr Kakkilaya [See Press Statement | Report | Report | Report Jan 17]
5. Lackadaisical attitude of malaria control officials claims the life of two siblings from rural Shishila, 90kms from Mangalore [Report]

 ©malariasite.com ©BS Kakkilaya | Last Updated: May 25, 2023