# Assessment of Epidemiological Indicators for Evaluation of National Malaria Elimination Programme: A Retrospective Study

## TL;DR

This study evaluates India's progress in reducing malaria cases from 2014 to 2021 using epidemiological indicators, finding significant reductions but highlighting the need for continued efforts.

## Contribution

The study provides an analysis of the National Malaria Elimination Programme's effectiveness using state-specific epidemiological indicators and highlights gaps in achieving elimination targets.

## Key findings

- A statistically significant reduction in malaria cases was observed from 2017 to 2021 in most states, except category-3 states/UTs.
- Despite progress, zero indigenous malaria cases were not achieved in category-1 states/UTs.
- The national-level reduction in malaria cases from 2014 to 2020 was 83.6%, but some states with strong health systems still had significant cases.

## Abstract

Malaria has been one of India's most considerable health problems since 1940. The objective of our study is to determine the status of the National Malaria Elimination Programme in India by using epidemiological indicators.

The annual reports of malaria for the years 2014-2021 and monthly reports for 2020 and 2021 were collected from the official web portal and were analysed for study specific assessments.

The API has shown a statistically significant reduction from 2017-2021 in all states along with category-1(P=0.003) and category-2(P=0.029) states/UTs, but there was no statistically significant reduction from 2017-2021 in category-3 (P=0.166) states/UTs. The zero indigenous cases had not been achieved in category-1 states/UTs. The overall percentage reduction in number of malaria cases in 2020 at the national level compared with 2014 was 83.6%. Despite states with strong health systems such as Gujarat, Maharashtra and Karnataka, have not shown zero indigenous cases in 2020 and the malaria cases noted were very far from reaching the targets.

Although we observed a significant drop in malaria incidence from 2014 to 2020, demonstrating that the country is moving nearer to malaria elimination, it is crucial to implement the strategies to reduce Plasmodium falciparum% and re-establish surveillance programmes and execute national and state programmes in order to achieve the success of the National Malaria Elimination Programme. The recategorization of states/UTs are in accordance to the API, and implementation strategies were also needed.