A spatial statistical approach to analyze malaria situation at micro level for priority control in Ranchi district, Jharkhand

BACKGROUND & OBJECTIVES: The presence of efficient malaria vectors namely Anopeles culicifacies, An. fluviatilis and An. annularis (Diptera: Culicidae), rapid industrialization causing large influx of population and poor health infrastructure are some of the factors that make malaria an important public health problem in Ranchi, the capital of Jharkhand State, India. A geographical information system (GIS) based retrospective study using spatial statistical tools was initiated in 328 subcentres of 14 primary health centres (PHCs) of the district using malaria epidemiological data of three years (2007-2009) to identify spatial distribution pattern of Plasmodium vivax (Pv) and Plasmodium falciparum (Pf) occurrence, delineation of hot spots and to map directional distribution trend of Pf spread to help formulate evidence-based policy and to prioritize control during 2011. METHODS: Spatial statistics tools like Global Moran's I index, Getis-Ord Gi(*) and Standard Deviational Ellipse were used in GIS domain for analysis. RESULTS: Spatial distribution pattern of Pv occurrence was found random while Pf distribution was significantly clustered. During 2007-2009, the number of subcentres under Pf hot spot category exhibited downward trend while high Pf risk subcentres exhibited upward trend. One consistent Pf hot spot consisting of five subcentres was identified in Silli PHC. During 2009, one Pf hot spot consisting of 20 subcentres and 18 subcentres under high Pf risk category were identified in Angara, Silli, Burmu and Kanke PHCs. A shifting trend in Pf spread was noticed from north-west to western direction from 2008 onwards. INTERPRETATION & CONCLUSIONS: The study recommended priority control in 20 Pf hot spot and 18 high Pf risk reporting subcentres including five consistent Pf hot spot subcentres in Angara, Silli, Burmu and Kanke PHCs during 2011 to address grave malaria situation in the district in a cost-effective manner.