Malaria in Mangaluru

Mangaluru (formerly Mangalore) is a picturesque city in Southern India, on the shore of the Arabian Sea. It is the headquarters of Dakshina Kannada district with a population of 4,55,217 (2001 Census). Known for hundreds of rivers and rivulets and plenty of coconut and areca nut gardens and paddy fields, the district is home for many world-known educational and financial institutions. The people of the district are generally considered as intelligent, educated and peace loving. The district has been witnessing a great spurt in construction activities in the recent years, owing to rapid industrialization. And this has brought the dreaded disease, malaria, to this peaceful land. A disease that was unknown in Mangaluru until 1990 has already killed more than 300 people in the district in the past 15 years. And it has now spread, not only to all the villages of this district, but also to the neighbouring districts of Udupi and Kasaragod (in the state of Kerala).

See Malaria in India, Karnataka and Dakshina Kannada

Incidence of Malaria in India, Karnataka State and Mangalore

YearAll IndiaKarnatakaMangalore
19902.02 million19
19912.12 million198
19922.13 million707
19932.21 million3907
19942.51 million2666823131
19952.93 million2858835245
19963.04 million2191989874
19972.66 million1814477862
19982.22 million1186856475
19992.28 million961563415
20002.03 million1079991798
20012.09 million1963063309
20021.84 million1326093739
20031.87 million1002189138
20041.92 million8131416321
20051.82 million8318120083
20061.79 million6286415664
20071.51 million4935510930
20081.53 million473445915
20091.56 million365595154
20101.49 million441226335
20111.31 million242375724
20121.06 million164665327
20130.881 million133024714
20141.07 million123357360

Annual Incidence of Malaria in Mangalore (1990-2014)

YearP. vivaxP. falciparumTotal Deaths
1990190190
199119531980
1992692157070
199338961139070
19943124731310
19954374871524526
19968324155098745
1997700186178624
1998589657964751
1999314626934151
200017128617980
2001296534433092
2002296277737395
20037189194991382
2004121104211163213
2005140166067200834
20061076149031566411
200786262304109308
2008*525566059150
2009451164351541
2010538495163350
2011511560957240
2012496436353270 (>14#)
2013435136347140 (>20 #)
2014669666473602

[Table legend: *New CHO appointed, New NVBDCP Officer appointed; Data tweaked by stopping collection from private hospitals; #Official figures show no deaths, but >14 deaths in 2012 and >20 deaths in 2013 have been reported to NVBDCP, Mangalore.]

In the year 2006, a total of 62864 cases of malaria were reported from Karnataka state and Mangaluru accounted for 15664 (24%) of these cases. Of the 16446 cases of P. falciparum malaria reported from Karnataka in the same year, 4903 (29%) cases were from Mangaluru. And among 29 malaria related deaths from Karnataka, 11 were from Mangaluru. Whereas the incidence of malaria is showing a downward trend in Karnataka, it is continuing in Mangaluru, and in 2013, of the 13302 cases reported from Karnataka, 4714 (35%) were from Mangaluru and in 2014, of the 12335 cases from Karnataka, 7360 (59%) were from Mangaluru. Although only 2 deaths have been officially reported, the actual number of deaths may be 8-10 times more as all the cases are not reported and even among the reported deaths, all cannot be confirmed for want of evidence in the form of a preserved blood smear of the victim. Alarmed by this trend, the Karnataka State Government has intensified the malaria control drive in Mangaluru.

Graph showing Malaria in Mangalore (1990-2007)

Graph showing Malaria in Mangalore (1990-2007)

There was a sudden rise in the cases of P. falciparum in the year 1995-96 that resulted in more than 100 deaths due to malaria (26 in 1995 as per official figures). The high mortality was probably related to delayed diagnosis and treatment due to lack of awareness among the general public as well as doctors. Alarmed by these events, a voluntary initiative for malaria control was started by private medical practitioners in association with the local medical college, Mangaluru City Corporation (MCC) and District Administration; Malaria Control Action Committee (MCAC) was thus constituted. Due to the concerted efforts and also decline in the construction activities, the annual incidence declined by the year 2000, with only 1798 cases reported. However, by 2001 the incidence again showed an upward trend. Despite strengthening the anti-malaria drive under MCAC, the cases have continued to rise, largely due to resurgence in construction activities.

In June 2003, a Malaria Cell was started with financial aid from the city based Corporation Bank. It has 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 is provided by the MCC and DHO. These teams are carrying out active surveillance with special emphasis on migrant workers, construction workers, hotel workers and inmates of orphanages. The teams also carry 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. [See Malaria Control in Mangaluru]

Monthwise Incidence of Malaria in Mangalore (Jan 2003-Dec 2007)

MonthP. vivaxP. falciparumTotal
Jan03451108559
Feb0326271333
Mar0334480424
Apr0327067337
May0331849367
Jun0350069569
Jul03793162955
Aug0310462921338
Sep038562421098
Oct037243171041
Nov038352591094
Dec037902331023
Jan04581172753
Feb0435595450
Mar04486141627
Apr04665134799
May04796157953
Jun0414604491909
Jul0416286132241
Aug0411715641735
Sep0412244971721
Oct0412274421669
Nov0411464661612
Dec0413714811852
Jan058172871104
Feb058552531108
Mar05714221935
Apr05740259999
May0510613351396
Jun0515294421971
Jul0520226982720
Aug 0514567262182
Sep0512318092040
Oct 0512727652037
Nov0512557702025
Dec0510645021566
Jan069234041327
Feb06647220867
Mar06513203716
Apr06526245771
May067644171181
Jun069393911330
Jul0610855661651
Aug0613066101916
Sep0611555731728
Oct068913041195
Nov0610484701518
Dec069645001464
Jan077962961092
Feb07479112591
Mar0736795462
Apr0733266398
May0749099589
Jun079051391044
Jul0712292811510
Aug0711193381457
Sep078592361095
Oct078192741093
Nov07635238873
Dec07590130720

Monthwise Malaria Cases in Mangalore

Monthwise Malaria Cases in Mangaluru

Water logging at construction site

Water logging at construction site

Month-wise mosquito density

Month-wise mosquito density and malaria cases (2003-2004)

Month-wise larval density and malaria cases (2003-2004)

Month-wise larval density and malaria cases (2003-2004)

The teams of Malaria Cell visit construction sites, hotels, orphanages, apartments and other high risk areas on a regular basis. Active surveillance and treatment of migrant workers staying in open areas is regularly conducted during early hours of the morning and evenings.

Active Surveillance among high risk population in Mangalore

Risk Group20042005 (Up to March)Total
SmearsVivaxFalciparumTotalSmearsVivaxFalciparumTotalSmearsTotal PositiveSPR
Total62523605141115151404818877655997.71
Construction workers8251781919748510035135131033225.34
Hotel workers580751590691872564911517.71
Orphanages, hostel inmates72050106054639774698.91
Moving labourers412757764907163195032831.64

Monthwise Adult Anopheles Mosquito Density, Larval Density and Malaria Cases

MonthAdult Mosquito DensityLarval DensityTotal Cases
Jan032.33559
Feb032.22.6333
Mar0322.6424
Apr0322.5337
May0334367
Jun0346569
Jul034.26.4955
Aug0346.71338
Sep033.261098
Oct03351041
Nov03341094
Dec032.831023
Jan042.42.6753
Feb042.22.6450
Mar042.22.3627
Apr0422.4799
May042.63.8953
Jun0445.81909
Jul044.16.22241
Aug043.96.51735
Sep043.15.81721
Oct04351669
Nov042.641612
Dec042.53.11852

See Guide to malaria treatment in Mangaluru

Drug Resistance Pattern in Mangaluru

Mangaluru is identified to have chloroquine resistance in P. falciparum. Accordingly, Mangaluru was one of the first cities in India to have switched over to artemisinin based combination for the treatment of P. falciparum malaria. Resistance to other antimalarial drugs is not known. NVBDCP now recommends Artesunate Plus Pyrimethamine-sulfadoxine for the treatment of all cases of P. falciparum in Mangaluru. P. vivax remains sensitive to chloroquine and therefore must be treated with chloroquine alone.

Travel to Mangaluru- Recommendations for Chemoprophylaxis

Mangaluru has now become endemic for malaria and as the figures above clearly indicate, nearly 10% of cases of malaria are caused by P. falciparum infection. And, resistance to chloroquine, of various degrees, has been noticed in Mangalore. Therefore, all travelers planning to visit Mangaluru are recommended the following chemoprophylaxis regimen:

Tablet Doxycycline 100 mg once daily (1.5mg/kg body weight for children above 8 years), (start 2 days before, continue during the stay at Mangaluru and for 4 weeks thereafter); alternatively, Tablet Mefloquine can be used at a dose of 250mg (5mg/kg body weight) weekly, starting 2 weeks before travel, continued during and for 4 weeks after travel.

For further details and dosage in children, see Chemoprophylaxis

©malariasite.com ©BS Kakkilaya | Last Updated: Apr 28, 2015

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