2 lakh in India die of malaria annually: Lancet-22/10/2010

22/10/2010

2 lakh in India die of malaria annually: Lancet

New Delhi: Malaria kills nearly 2 lakh people in India every year, including 80,000 children below the age of 15 years, according to a new study published in reputed medical journal The Lancet.

The report contradicts the findings of the World Health Organisation (WHO) which had put the number of deaths due to malaria in India at 15,000.

The Lancet report says that 90 per cent of the deaths were recorded in rural areas, of which 86 per cent occurred at home without any medical attention. The study, which began in 2002, covered 6,671 areas, each with about 200 households.

The research, led by teams from the office of the Registrar General of India, Centre for Global Health Research at St Michael's Hospital and University of Toronto, Canada, found that Orissa reported the highest number of deaths -- 50,000. The other "high-malaria" states are Chhattisgarh, Jharkhand and Assam.

"In the absence of other diseases, on current death rates, a newborn in Orissa has 12 per cent chance of dying from malaria before the age of 70 years, as against 2 per cent for the average Indian baby," Prof Prabhat Jha, co-lead author of the study, told The Indian Express.

"The WHO relies on properly diagnosed malaria patients for the estimates, which can be misleading," said Jha.

But WHO's India representative, Dr Nate Menabde, said its methodology is "universal". "The method of verbal autopsy is suitable only for diseases with distinctive symptoms and not for malaria. Malaria has symptoms common with many other diseases and cannot be correctly identified by the local population. The use of verbal autopsy for malaria may result in many false positives.

In this method, deaths due to fever from any cause are likely to be misinterpreted as malaria in areas with high incidence. In areas with low malaria incidence, the symptoms are difficult to distinguish and would result in overestimates of malaria deaths," said a statement issued by Menabde.

"The limitations of verbal autopsy, and the implausibly high case incidence rates implied by the malaria mortality estimates, indicate that the findings of the study cannot be accepted without further validation," it added.

But Jha countered that the "WHO itself uses verbal autopsy for estimating malaria. So why aren't they accepting it this time?"

Source: The Indian Express