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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 malaria....

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Autores principales: Yadav, Chander Prakash, Gupta, Sanjeev, Bharti, Praveen K., Rahi, Manju, Faizi, Nafis, Sharma, Amit
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021988/
https://www.ncbi.nlm.nih.gov/pubmed/36962502
http://dx.doi.org/10.1371/journal.pgph.0000326
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author Yadav, Chander Prakash
Gupta, Sanjeev
Bharti, Praveen K.
Rahi, Manju
Faizi, Nafis
Sharma, Amit
author_facet Yadav, Chander Prakash
Gupta, Sanjeev
Bharti, Praveen K.
Rahi, Manju
Faizi, Nafis
Sharma, Amit
author_sort Yadav, Chander Prakash
collection PubMed
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.
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spelling pubmed-100219882023-03-17 India may need an additional metric to assess the endemicity of malaria in low surveillance districts Yadav, Chander Prakash Gupta, Sanjeev Bharti, Praveen K. Rahi, Manju Faizi, Nafis Sharma, Amit PLOS Glob Public Health Research Article 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. Public Library of Science 2022-11-10 /pmc/articles/PMC10021988/ /pubmed/36962502 http://dx.doi.org/10.1371/journal.pgph.0000326 Text en © 2022 Yadav et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Yadav, Chander Prakash
Gupta, Sanjeev
Bharti, Praveen K.
Rahi, Manju
Faizi, Nafis
Sharma, Amit
India may need an additional metric to assess the endemicity of malaria in low surveillance districts
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
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021988/
https://www.ncbi.nlm.nih.gov/pubmed/36962502
http://dx.doi.org/10.1371/journal.pgph.0000326
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