Lok Sabha Question No. 172 (STARRED), answered on 2017-12-29
Subject: Combating Malaria
Ministry: HEALTH AND FAMILY WELFARE
Asked by: SRIRAM MALYADRI

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA STARRED QUESTION NO. 172 TO BE ANSWERED ON THE 29 TH DECEMBER, 2017 COMBATING MALARIA

## *172. SHRI MALYADRI SRIRAM:

Will  the  Minister  of HEALTH AND  FAMILY  WELFARE be  pleased  to state:

- (a)  whether  the  Government  has  downgraded  focus  on  combating  malaria  in country and if so, the reasons therefor;
- (b) whether the Government has identified areas with highest prevalence of across the c ountry and if so, the details thereof, State - wise;
- (c) whether the Government has given any directions to the malaria surveillan to keep a regular and close watch over malaria outbreaks in such areas and i details thereof; and
- (d) the steps taken/proposed to be taken by the Government to enhance the mal control and prevention across the country in 2017 - 18?

## ANSWER THE MINISTER OF HEALTH AND FAMILY WELFARE ( SHRI JAGAT PRAKASH NADDA )

- (a)to( d) : A Statement is laid on the Table of the House.

## STATEMENT REFERRED TO IN REPLY TO LOK SABHA TH

## STARRED QUESTION NO. 172* FOR 29 DECEMBER, 2017

- (a) No.   The malaria control activities have been increased with a call fo elimination.
- (b)  Yes.  Based on the malaria burden, States/Union Territories (UTs) have been categorized for malaria elimination in India as under:

| Category                                         | Definition                                                                               |
|--------------------------------------------------|------------------------------------------------------------------------------------------|
| Category 0 Prevention of re -establishment phase | States/UTs with zero indigenous cases malaria (Currently, no State/UT)                   |
| Category 1 Elimination phase                     | States/UTs with API less than one, their districts reporting API < 1 (15 States/UTs).    |
| Category 2 Pre- elimination phase                | States/UTs) States/UTs with API < 1, but some of districts reporting API ≥ 1 (11 States) |
| Category 3 Intensified control phase             | States/UTs with API ≥ 1 (10 States/UTs)                                                  |

Details of Malaria epidemiological situation in these States /UTs (Bas 2014) are at Annexure - 1

Detailed Malaria situation for the years 2014, 2015, 2016 and 2017 is a at Annexure -2.  Malaria has been decreasing especially in the high prevalent like North East States and Odisha.

(c)  Yes.  Malaria Surveillance is carried out throug hout the country based on various reporting formats in the Malaria Programme.  Malaria surveillance is based diagnosis by rapid diagnostics and malaria microscopy.  All states/UTs hav given  directions  to  promote  early  diagnosis  and  prompt  trea tment  and  take appropriate vector control measures including indoor residual spray and dist of Long Lasting Insecticide Impregnated Nets (LLINs).  Advisories are issued time  to  time  to  States/UTs  before  and  during  the  transmission  season  for aking appropriate measures to keep malaria cases under check and avert deaths.

(d) Government of India in response to Global Technical Strategy of World H Organization  (WHO)  has  called  for  malaria  elimination  by  2030  and  for National Framework for Malaria Elimination (2016 - 2030) and a National Strategic Plan 2017 - 2022 have been drafted in consultation with the States/UTs.  Based o above, measures for malaria control have been strengthened (including provis rapid  diagnostics)  and  near ly  40  million  LLINs  have  been  provided  across  the country in the year 2017 - 18.

Annexure-I Malaria epidemiological situation for elimination planning by Category

| Category (Base year 2014)                                                                                  | State/ UT                 | Population at risk (in thousands)   |   Total districts | Total positive cases   | Pf%   |   ABER |   API |   SPR |   Deaths |
|------------------------------------------------------------------------------------------------------------|---------------------------|-------------------------------------|-------------------|------------------------|-------|--------|-------|-------|----------|
| Category 1 - states/Uts with API less than one, and all the districts in state with API less than one (15) | Chandigarh                | 1080                                |                 1 | 114                    | 0%    |   4.17 |  0.11 |  0.25 |        0 |
| Category 1 - states/Uts with API less than one, and all the districts in state with API less than one (15) | Daman & Diu               | 274                                 |                 2 | 56                     | 7%    |  12.51 |  0.2  |  0.16 |        0 |
| Category 1 - states/Uts with API less than one, and all the districts in state with API less than one (15) | Delhi                     | 16 753                              |                 1 | 98                     | 0%    |   1.07 |  0.01 |  0.05 |        0 |
| Category 1 - states/Uts with API less than one, and all the districts in state with API less than one (15) | Goa                       | 1506                                |                 2 | 824                    | 5%    |  28.67 |  0.55 |  0.19 |        0 |
| Category 1 - states/Uts with API less than one, and all the districts in state with API less than one (15) | Haryana                   | 26 695                              |                21 | 4485                   | 1%    |   9.46 |  0.17 |  0.18 |        1 |
| Category 1 - states/Uts with API less than one, and all the districts in state with API less than one (15) | Himachal Pradesh          | 5721                                |                10 | 102                    | 1%    |   8.6  |  0.02 |  0.02 |        0 |
| Category 1 - states/Uts with API less than one, and all the districts in state with API less than one (15) | Jammu & Kashmir           | 5626                                |                12 | 291                    | 7%    |   8.04 |  0.05 |  0.06 |        0 |
| Category 1 - states/Uts with API less than one, and all the districts in state with API less than one (15) | the Kerala                | 33 901                              |                14 | 1,751                  | 17%   |   7.89 |  0.05 |  0.07 |        6 |
| Category 1 - states/Uts with API less than one, and all the districts in state with API less than one (15) | Lakshadweep               | 65                                  |                 1 | -                      | 0%    |   0.2  |  0    |  0    |        0 |
| Category 1 - states/Uts with API less than one, and all the districts in state with API less than one (15) | Manipur                   | 2856                                |                12 | 145                    | 50%   |   2.32 |  0.05 |  0.22 |        0 |
| Category 1 - states/Uts with API less than one, and all the districts in state with API less than one (15) | Puducherry                | 1245                                |                 4 | 79                     | 4%    |  14.53 |  0.06 |  0.04 |        0 |
| Category 1 - states/Uts with API less than one, and all the districts in state with API less than one (15) | Punjab                    | 28 677                              |                22 | 1036                   | 1%    |  10.78 |  0.04 |  0.03 |        0 |
| Category 1 - states/Uts with API less than one, and all the districts in state with API less than one (15) | Rajasthan                 | 77 057                              |                33 | 15 118                 | 4%    |  11.43 |  0.2  |  0.17 |        4 |
| Category 1 - states/Uts with API less than one, and all the districts in state with API less than one (15) | Sikkim                    | 203                                 |                 4 | 35                     | 51%   |   3.93 |  0.17 |  0.44 |        0 |
| Category 1 - states/Uts with API less than one, and all the districts in state with API less than one (15) | Uttrakhand                | 10 112                              |                13 | 1171                   | 8%    |   3.84 |  0.12 |  0.3  |        0 |
| Category 2 - states/ UTs with API less than one and one or more districts reporting API more than one (11) | Andhra Pradesh            | 51 171                              |                13 | 21 077                 | 74%   |  19.26 |  0.41 |  0.21 |        0 |
| Category 2 - states/ UTs with API less than one and one or more districts reporting API more than one (11) | Assam                     | 33 226                              |                27 | 14 540                 | 77%   |  11.09 |  0.44 |  0.39 |       11 |
| Category 2 - states/ UTs with API less than one and one or more districts reporting API more than one (11) | Bihar                     | 105 664                             |                38 | 2043                   | 34%   |   0.17 |  0.02 |  1.11 |        0 |
| Category 2 - states/ UTs with API less than one and one or more districts reporting API more than one (11) | Gujarat                   | 62 878                              |                41 | 41 608                 | 15%   |  21.38 |  0.66 |  0.31 |       16 |
| Category 2 - states/ UTs with API less than one and one or more districts reporting API more than one (11) | Karnataka                 | 54 681                              |                34 | 14 794                 | 9%    |  17.93 |  0.27 |  0.15 |        2 |
| Category 2 - states/ UTs with API less than one and one or more districts reporting API more than one (11) | Maharashtra               | 114 973                             |                34 | 53 385                 | 48%   |  15.31 |  0.46 |  0.3  |       68 |
| Category 2 - states/ UTs with API less than one and one or more districts reporting API more than one (11) | Nagaland                  | 2008                                |                12 | 1936                   | 33%   |  11.69 |  0.96 |  0.83 |        2 |
| Category 2 - states/ UTs with API less than one and one or more districts reporting API more than one (11) | Tamil Nadu                | 73 104                              |                43 | 8729                   | 4%    |  12.31 |  0.12 |  0.1  |        0 |
| Category 2 - states/ UTs with API less than one and one or more districts reporting API more than one (11) | Telangana                 | 34 324                              |                10 | 5189                   | 89%   |  10.49 |  0.15 |  0.14 |        0 |
| Category 2 - states/ UTs with API less than one and one or more districts reporting API more than one (11) | Uttar Pradesh             | 203 980                             |                75 | 41 612                 | 1%    |   2.37 |  0.2  |  0.86 |        0 |
| Category 2 - states/ UTs with API less than one and one or more districts reporting API more than one (11) | West Bengal               | 93 675                              |                21 | 26 484                 | 19%   |   7.28 |  0.28 |  0.39 |       66 |
| Category 3 - States/Uts with API more than one (10)                                                        | Andaman & Nicobar Islands | 466                                 |                 3 | 557                    | 20%   |  16.07 |  1.2  |  0.74 |        0 |
|                                                                                                            | Arunachal Pradesh         | 1415                                |                16 | 6082                   | 38%   |   8.73 |  4.3  |  4.92 |        9 |
|                                                                                                            | Chhattisgarh              | 27 349                              |                27 | 128 993                | 84%   |  14.42 |  4.72 |  3.27 |       53 |
|                                                                                                            | Dadra & Nagar Haveli      | 409                                 |                 1 | 669                    | 13%   |  17.54 |  1.64 |  0.93 |        1 |
|                                                                                                            | Jharkhand                 | 35 253                              |                24 | 103 735                | 45%   |   9.63 |  2.94 |  3.06 |        8 |
|                                                                                                            | Madhya Pradesh            | 77 041                              |                50 | 96 879                 | 43%   |  13.35 |  1.26 |  0.94 |       26 |
|                                                                                                            | Meghalaya                 | 3128                                |                 7 | 39 168                 | 95%   |  13.99 | 12.52 |  8.95 |       73 |
|                                                                                                            | Mizoram                   | 1116                                |                 9 | 23 145                 | 91%   |  29.65 | 20.74 |  6.99 |       31 |
|                                                                                                            | Odisha                    | 43 501                              |                30 | 395 035                | 87%   |  14.6  |  9.08 |  6.22 |       89 |
|                                                                                                            | Tripura                   | 3862                                |                 8 | 51 240                 | 97%   |  15.71 | 13.27 |  8.44 |       96 |

Annexure-II State-wise malaria situation (total malaria cases & Annual Parasite Incidence)

| SN   | States/UTs           | 2014                | 2014      | 2015                | 2015      | 2016                | 2016      | 2017(till November)   | 2017(till November)   |
|------|----------------------|---------------------|-----------|---------------------|-----------|---------------------|-----------|-----------------------|-----------------------|
|      |                      | Total Malaria cases | API       | Total Malaria cases | API       | Total Malaria cases | API       | Total Malaria cases   | API                   |
| 1    | Andhra Pradesh       | 21077               | 0.41      | 25042               | 0.49      | 23613               | 0.48      | 16275                 | 0.33                  |
| 2    | Arunachal Pradesh    | 6082                | 4.30      | 5088                | 3.52      | 3128                | 2.02      | 1415                  | 0.92                  |
| 3    | Assam                | 14540               | 0.44      | 15557               | 0.46      | 7826                | 0.24      | 4811                  | 0.15                  |
| 4    | Bihar                | 2043                | 0.02      | 4006                | 0.04      | 5189                | 0.05      | 2977                  | 0.03                  |
| 5    | Chhattisgarh         | 128993              | 4.72      | 144886              | 5.21      | 148220              | 5.31      | 127838                | 4.58                  |
| 6    | Goa                  | 824                 | 0.55      | 651                 | 0.44      | 742                 | 0.48      | 592                   | 0.38                  |
| 7    | Gujarat              | 41608               | 0.66      | 41566               | 0.65      | 44783               | 0.69      | 37028                 | 0.57                  |
| 8    | Haryana              | 4485                | 0.17      | 9308                | 0.34      | 7866                | 0.29      | 6861                  | 0.25                  |
| 9    | Himachal Pradesh     | 102                 | 0.02      | 60                  | 0.01      | 106                 | 0.02      | 95                    | 0.02                  |
| 10   | Jammu & Kashmir      | 291                 | 0.05      | 216                 | 0.04      | 242                 | 0.04      | 224                   | 0.04                  |
| 11   | Jharkhand            | 103735              | 2.94      | 104800              | 2.91      | 141414              | 3.83      | 88143                 | 2.39                  |
| 12   | Karnataka            | 14794               | 0.27      | 12445               | 0.21      | 11078               | 0.16      | 5768                  | 0.08                  |
| 13   | Kerala               | 1751                | 0.05      | 1549                | 0.05      | 1547                | 0.05      | 1125                  | 0.03                  |
| 14   | Madhya Pradesh       | 96879               | 1.26      | 100597              | 1.28      | 69106               | 0.86      | 36242                 | 0.45                  |
| 15   | Maharashtra          | 53385               | 0.46      | 56603               | 0.47      | 23983               | 0.20      | 16876                 | 0.14                  |
| 16   | Manipur              | 145                 | 0.05      | 216                 | 0.07      | 122                 | 0.04      | 77                    | 0.03                  |
| 17   | Meghalaya            | 39168               | 12.52     | 48603               | 15.10     | 35147               | 10.70     | 15917                 | 4.85                  |
| 18   | Mizoram              | 23145               | 20.74     | 28593               | 24.71     | 7583                | 6.47      | 5450                  | 4.65                  |
| 19   | Nagaland             | 1936                | 0.96      | 1527                | 0.76      | 828                 | 0.41      | 388                   | 0.19                  |
| 20   | Orissa               | 395035              | 9.08      | 436850              | 9.97      | 444843              | 10.06     | 344893                | 7.86                  |
| 21   | Punjab               | 1036                | 0.04      | 596                 | 0.02      | 693                 | 0.02      | 803                   | 0.03                  |
| 22   | Rajasthan            | 15118               | 0.20      | 11796               | 0.15      | 12741               | 0.15      | 6549                  | 0.08                  |
| 23   | Sikkim               | 35                  | 0.17      | 27                  | 0.13      | 15                  | 0.07      | 12                    | 0.06                  |
| 24   | Tamil Nadu           | 8729                | 0.12      | 5587                | 0.07      | 4341                | 0.06      | 5142                  | 0.07                  |
| 25   | Telangana            | 5189                | 0.15      | 10951               | 0.30      | 3512                | 0.10      | 2391                  | 0.07                  |
| 26   | Tripura              | 51240               | 13.27     | 32525               | 8.37      | 10546               | 2.68      | 6759                  | 1.72                  |
| 27   | Uttrakhand           | 1171                | 0.12      | 1466                | 0.14      | 961                 | 0.09      | 522                   | 0.05                  |
| 28   | Uttar Pradesh        | 41612               | 0.20      | 42767               | 0.21      | 39238               | 0.20      | 31162                 | 0.16                  |
| 29   | West Bengal          | 26484               | 0.28      | 24208               | 0.26      | 35236               | 0.37      | 25753                 | 0.27                  |
| 30   | A & N Islands        | 557                 | 1.20      | 409                 | 0.88      | 485                 | 1.04      | 388                   | 0.83                  |
| 31   | Chandigarh           | 114                 | 0.11      | 152                 | 0.14      | 157                 | 0.14      | 114                   | 0.10                  |
| 32   | D & N Haveli         | 669                 | 1.64      | 418                 | 0.97      | 375                 | 0.82      | 292                   | 0.64                  |
| 33   | Daman & Diu          | 56                  | 0.20      | 84                  | 0.29      | 48                  | 0.16      | 37                    | 0.12                  |
| 34   | Delhi                | 98                  | 0.01      | 54                  | 0.00      | 31                  | 0.00      | 572                   | 0.03                  |
| 35   | Lakshadweep          | 0                   | 0.00      | 4                   | 0.06      | 2                   | 0.03      | 1                     | 0.02                  |
| 36   | Puducherry All India | 79 1102205          | 0.06 0.89 | 54 1169261          | 0.04 0.92 | 76 1085823          | 0.06 0.85 | 56 793548             | 0.05 0.62             |