The intersection of geography and sociocultural factors in malaria epidemiology: A study of 6 years (2018-2023) surveillance data from three districts of Maharashtra, India, with diverse landscape.

Abstract

Background/objectives: Outside of Africa, India is the main contributor to malaria-related morbidity and mortality in Southeast Asia. This retrospective study included 6 years of malaria data (2018-2023) from three districts in Maharashtra: Gadchiroli, Gondia, and Nagpur. The study examines the patterns of malaria, the distribution of Plasmodium species, and the effects of malaria control efforts under the National Vector Borne Disease Control Programme (NVBDCP).

Materials and methods: Six years of data on all malaria indicators collected under NVBDCP were taken from the respective districts. The sociocultural behavior of the population was analyzed by visiting the study area.

Results: Gadchiroli, primarily a hilly/tribal area, had the highest number of malaria cases, with the slide positivity rate (SPR) and annual parasite index reaching their peak in 2021. On the other hand, Gondia and Nagpur had consistently low levels of malaria transmission, with minimal fluctuations in key epidemiological indicators. The analysis demonstrates the significant differences in malaria transmission across various landscapes, with the highest SPR observed in tribal and hilly areas, followed by rural areas, and the lowest in urban regions. Plasmodium falciparum was the dominant species in Gadchiroli and Gondia, while Plasmodium vivax was more prevalent in urban areas of Nagpur.

Conclusion: The study emphasizes the need for targeted interventions in high-risk areas, especially in tribal regions, where sociocultural factors and ecological conditions contribute to sustained transmission. The findings highlight the importance of ongoing surveillance, culturally sensitive education, and advanced diagnostic tools to eliminate malaria in India by 2030.