Investigation of malaria outbreak in Bahraich district, Uttar Pradesh

Background & objectives: Based on the reports of 139 fever related deaths in Jarwal primary health centre (PHC) of Bahraich district, Uttar Pradesh (UP) during April to September 1999, a study was undertaken to explore the possibility of outbreak of Plasmodium falciparum malaria in the area and reasons of outbreak. Methods: The study was undertaken during September-October 1999 in Bahraich district, UP. The study included a parasitological and an entomological survey. Blood slides from fever cases were collected and examined following standard procedures for detection of species and stage of parasite. The resting adult mosquitoes were collected from human dwellings and cattle sheds from selected villages. Susceptibility status of Anopheles culicifacies to 4 per cent DDT and 0.05 per cent deltamethrin was determined under laboratory conditions following the WHO procedure. In vitro drug sensitivity of P. falciparum to chloroquine was also estimated. Results: Overall slide positivity rate (SPR) was found to be 33.8 with a preponderance of P. falciparum (88.4%). There was an outbreak of Pf malaria in Jarwal and surrounding areas as well. Foci of P. falciparum malaria were found in Jarwal, Fakharpur and Hazoorpur PHCs around Kaisarganj PHC. In addition, P. falciparum cases, were also reported from Motipur and Tejwapur. Interpretation & conclusion: Poor surveillance of affected areas resulting in low annual parasite incidence (API), lack of insecticidal spray in the currently affected PHCs as the API was less than 2 and development of resistance in P. falciparum to chloroquine were found as the possible reasons for the outbreak. It is recommended that surveillance be strengthened in all PHCs of Bahraich district to contain further extension of malaria in northeastern UP.