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      Malaria epidemiology in an area of stable transmission in tribal population of Jharkhand, India

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          Abstract

          Background

          Malaria remains an important health problem in India with approximately 1 million cases in 2014. Of these, 7% occurred in the Jharkhand state mainly in the tribal population.

          Methods

          This study was conducted in Dumargarhi, a tribal village about 42 km east of Ranchi city, Jharkhand, from May 2014 to September 2016. Four point prevalence surveys were carried out during consecutive high (October–December) and low (June–August) transmission seasons. Malaria cases were recorded from April 2015 to April 2016 through fortnightly visits to the village. Adult mosquito densities were monitored fortnightly by manual catching using suction tube method.

          Results

          The study area consists of five hamlets inhabited by 945 individuals living in 164 households as recorded through a house-to-house census survey performed at enrollment. The study population consisted predominantly of the Munda (n = 425, 45%) and Oraon (n = 217, 23%) ethnic groups. Study participants were categorized as per their age 0–5, 6–10, 11–15 and >15 years. There were 99 cases of clinical malaria from April 2015 to April 2016 and all malaria cases confirmed by microscopy were attributed to Plasmodium falciparum (94 cases) and Plasmodium vivax (5 cases), respectively. During the high transmission season the mean density of P. falciparum parasitaemia per age group increased to a peak level of 23,601 parasites/μl in the 6–10 years age group and gradually declined in the adult population. Malaria attack rates, parasite prevalence and density levels in the study population showed a gradual decrease with increasing age. This finding is consistent with the phenomenon of naturally acquired immunity against malaria. Three vector species were detected: Anopheles fluviatilis, Anopheles annularis, and Anopheles culicifacies. The incoherence or complete out of phase pattern of the vector density peaks together with a high prevalence of parasite positive individuals in the study population explains the year-round malaria transmission in the study region.

          Conclusions

          The collection of clinical data from a well-characterized tribal cohort from Jharkhand, India, has provided evidence for naturally acquired immunity against malaria in this hyperendemic region. The study also suggests that enforcement of existing control programmes can reduce the malaria burden further.

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          Most cited references33

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          Gamma-globulin and acquired immunity to human malaria.

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            The Dielmo project: a longitudinal study of natural malaria infection and the mechanisms of protective immunity in a community living in a holoendemic area of Senegal.

            The Dielmo project, initiated in 1990, consisted of long-term investigations on host-parasite relationships and the mechanisms of protective immunity in the 247 residents of a Senegalese village in which malaria is holoendemic. Anopheles gambiae s.l. and An. funestus constituted more than 98% of 11,685 anophelines collected and were present all year round. Inoculation rates of Plasmodium falciparum, P. malariae, and P. ovale averaged respectively 0.51, 0.10, and 0.04 infective bites per person per night. During a four-month period of intensive parasitologic and clinical monitoring, Plasmodium falciparum, P. malariae, and P. ovale were observed in 72.0%, 21.1% and 6.0%, respectively, of the 8,539 thick smears examined. Individual longitudinal data revealed that 98.6% of the villagers harbored trophozoites of P. falciparum at least once during the period of the study. Infections by P. malariae and P. ovale were both observed in individuals of all age groups and their cumulative prevalences reached 50.5% and 40.3%, respectively. Malaria was responsible for 162 (60.9%) of 266 febrile episodes; 159 of these attacks were due to P. falciparum, three to P. ovale, and none to P. malariae. The incidence of malaria attacks was 40 times higher in children 0-4 years of age than in adults more than 40 years old. Our findings suggest that sterile immunity and clinical protection are never fully achieved in humans continuously exposed since birth to intense transmission.
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              World malaria report 2015

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                Author and article information

                Contributors
                manojdas2@gmail.com
                bbrijesh83@gmail.com
                gql140@sund.ku.dk
                rstar85@gmail.com
                badu@noguchi.ug.edu.gh
                amitpharmacy21@gmail.com
                kheraharvinder87@gmail.com
                nrajpharma@gmail.com
                academics.tev@gmail.com
                ikhlaqhssn@gmail.com
                suryaksharma@gmail.com
                subhash@iiim.res.in
                mth@ssi.dk
                Journal
                Malar J
                Malar. J
                Malaria Journal
                BioMed Central (London )
                1475-2875
                2 May 2017
                2 May 2017
                2017
                : 16
                : 181
                Affiliations
                [1 ]ISNI 0000 0000 9285 6594, GRID grid.419641.f, Field Unit, , National Institute of Malaria Research, ; Ranchi, Jharkhand India
                [2 ]ISNI 0000 0000 9285 6594, GRID grid.419641.f, , National Institute of Malaria Research, Indian Council of Medical Research, ; New Delhi, 110077 India
                [3 ]ISNI 0000 0004 0417 4147, GRID grid.6203.7, Department for Congenital Disorders, , Statens Serum Institut, ; Artillerivej 5, 2300 Copenhagen, Denmark
                [4 ]ISNI 0000 0001 0674 042X, GRID grid.5254.6, Centre for Medical Parasitology at Department of International Health, Immunology and Microbiology, , University of Copenhagen, ; Copenhagen, Denmark
                [5 ]GRID grid.475435.4, Department of Infectious Diseases, , Copenhagen University Hospital, Rigshospitalet, ; Copenhagen, Denmark
                [6 ]ISNI 0000 0004 1937 1485, GRID grid.8652.9, Noguchi Memorial Institute for Medical Research, , University of Ghana, ; Legon, Ghana
                [7 ]ISNI 0000 0004 1802 6428, GRID grid.418225.8, , Indian Institute of Integrative Medicine, ; Canal Road, Jammu, 180001 India
                Article
                1833
                10.1186/s12936-017-1833-9
                5414148
                28464875
                91d2bb8e-56e4-4601-b2e7-83f3abac31b9
                © The Author(s) 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 17 February 2017
                : 23 April 2017
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100007398, Strategiske Forskningsråd;
                Award ID: 13127
                Award Recipient :
                Funded by: Department of Biotechnology, Government of India
                Award ID: BT/IN/Denmark/13/SS/2013
                Award Recipient :
                Categories
                Research
                Custom metadata
                © The Author(s) 2017

                Infectious disease & Microbiology
                malaria,plasmodium falciparum,plasmodium vivax,morbidity,age,jharkhand,india

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