India may need an additional metric to assess the endemicity of malaria in low surveillance districts.
India's National Framework for malaria elimination is essentially dependent on Annual Parasite Incidence (API). API is the primary criterion for classifying states and districts into different categories: intensified control, pre-elimination, elimination, prevention and re-establishment of mala...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2022-01-01
|
| Series: | PLOS Global Public Health |
| Online Access: | https://doi.org/10.1371/journal.pgph.0000326 |
| _version_ | 1797703613026402304 |
|---|---|
| author | Chander Prakash Yadav Sanjeev Gupta Praveen K Bharti Manju Rahi Nafis Faizi Amit Sharma |
| author_facet | Chander Prakash Yadav Sanjeev Gupta Praveen K Bharti Manju Rahi Nafis Faizi Amit Sharma |
| author_sort | Chander Prakash Yadav |
| collection | DOAJ |
| description | India's National Framework for malaria elimination is essentially dependent on Annual Parasite Incidence (API). API is the primary criterion for classifying states and districts into different categories: intensified control, pre-elimination, elimination, prevention and re-establishment of malaria. However, API's validity is critically dependent on multiple factors, one such important factor is Annual Blood Examination Rate (ABER) and is often considered as indicator of operational efficiency. Therefore, the present study aimed to determine whether the API is a sufficiently good malaria index to assess malaria endemicity in India. An in-depth analysis of malaria data (2017-19) was done to determine the appropriateness of API as a sole indicator of malaria endemicity. We stratified the Indian districts into three strata based on Annual Blood Examination Rate (ABER): <5, 5.0-5.0, >15, further APIs was compared with Slide Positivity Rates (SPRs) using sign rank test, independently in each stratum. API and SPR were found comparable (p-value 0.323) in stratum 2 only. However, in the case of lower ABER (<5%, strata 1), the API was significantly lower than the SPR, and higher ABER (>15%), the API was found substantially higher than the SPR. Thus, ABER tunes the validity of API and should avoid to use as a single indicator of malaria endemicity. API is an appropriate measure of malaria endemicity in high and moderate transmission areas where surveillance is good (ABER≥5%). However, it is vitally dependent upon surveillance rate and other factors such as population size, the selection of individuals for malaria testing. Therefore, where surveillance is poor (<5%), we propose that API should be complemented with SPR and the number of cases. It will significantly aid the design and deployment of interventions in India. |
| first_indexed | 2024-03-12T05:08:09Z |
| format | Article |
| id | doaj.art-d5d33b4db9634ed9ab39ce5a06e3bc37 |
| institution | Directory Open Access Journal |
| issn | 2767-3375 |
| language | English |
| last_indexed | 2024-03-12T05:08:09Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLOS Global Public Health |
| spelling | doaj.art-d5d33b4db9634ed9ab39ce5a06e3bc372023-09-03T08:52:31ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752022-01-01211e000032610.1371/journal.pgph.0000326India may need an additional metric to assess the endemicity of malaria in low surveillance districts.Chander Prakash YadavSanjeev GuptaPraveen K BhartiManju RahiNafis FaiziAmit SharmaIndia's National Framework for malaria elimination is essentially dependent on Annual Parasite Incidence (API). API is the primary criterion for classifying states and districts into different categories: intensified control, pre-elimination, elimination, prevention and re-establishment of malaria. However, API's validity is critically dependent on multiple factors, one such important factor is Annual Blood Examination Rate (ABER) and is often considered as indicator of operational efficiency. Therefore, the present study aimed to determine whether the API is a sufficiently good malaria index to assess malaria endemicity in India. An in-depth analysis of malaria data (2017-19) was done to determine the appropriateness of API as a sole indicator of malaria endemicity. We stratified the Indian districts into three strata based on Annual Blood Examination Rate (ABER): <5, 5.0-5.0, >15, further APIs was compared with Slide Positivity Rates (SPRs) using sign rank test, independently in each stratum. API and SPR were found comparable (p-value 0.323) in stratum 2 only. However, in the case of lower ABER (<5%, strata 1), the API was significantly lower than the SPR, and higher ABER (>15%), the API was found substantially higher than the SPR. Thus, ABER tunes the validity of API and should avoid to use as a single indicator of malaria endemicity. API is an appropriate measure of malaria endemicity in high and moderate transmission areas where surveillance is good (ABER≥5%). However, it is vitally dependent upon surveillance rate and other factors such as population size, the selection of individuals for malaria testing. Therefore, where surveillance is poor (<5%), we propose that API should be complemented with SPR and the number of cases. It will significantly aid the design and deployment of interventions in India.https://doi.org/10.1371/journal.pgph.0000326 |
| spellingShingle | Chander Prakash Yadav Sanjeev Gupta Praveen K Bharti Manju Rahi Nafis Faizi Amit Sharma India may need an additional metric to assess the endemicity of malaria in low surveillance districts. PLOS Global Public Health |
| title | India may need an additional metric to assess the endemicity of malaria in low surveillance districts. |
| title_full | India may need an additional metric to assess the endemicity of malaria in low surveillance districts. |
| title_fullStr | India may need an additional metric to assess the endemicity of malaria in low surveillance districts. |
| title_full_unstemmed | India may need an additional metric to assess the endemicity of malaria in low surveillance districts. |
| title_short | India may need an additional metric to assess the endemicity of malaria in low surveillance districts. |
| title_sort | india may need an additional metric to assess the endemicity of malaria in low surveillance districts |
| url | https://doi.org/10.1371/journal.pgph.0000326 |
| work_keys_str_mv | AT chanderprakashyadav indiamayneedanadditionalmetrictoassesstheendemicityofmalariainlowsurveillancedistricts AT sanjeevgupta indiamayneedanadditionalmetrictoassesstheendemicityofmalariainlowsurveillancedistricts AT praveenkbharti indiamayneedanadditionalmetrictoassesstheendemicityofmalariainlowsurveillancedistricts AT manjurahi indiamayneedanadditionalmetrictoassesstheendemicityofmalariainlowsurveillancedistricts AT nafisfaizi indiamayneedanadditionalmetrictoassesstheendemicityofmalariainlowsurveillancedistricts AT amitsharma indiamayneedanadditionalmetrictoassesstheendemicityofmalariainlowsurveillancedistricts |