Home-bred IT tool for malaria gets global recognition

Effective micro-implementation of all anti-Malarial activities reduced the number of high-risk wards from 43 to only 5 (in fifth post digitisation year).

New cases of malaria decreased by 83% and decades-old transmission cycle of malaria in Mangaluru was finally broken by a home-bred IT (information technology) solution, ‘Malaria Control System (MCS)’, within five years of its implementation.

The success of MCS has been hailed worldwide, with peer-reviewed British Journal—Malaria Journal, publishing the article in its online edition in March. Science journals including Medical Express also have published the first-ever study on how the indigenously developed GIS (Geographic Information System)-tagged smart surveillance system can eliminate urban malaria.

Malaria surveillance is weakest in countries with highest malaria burden, informed Dr Susanta Kumar Ghosh, senior author of the study and former head of Indian Council of Medical Research-National Institute of Malaria Research, Bengaluru field station. Mangaluru was classified as high-risk region for urban malaria by NVBDCP (National Vector borne disease control programme).

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“Mangaluru was contributing 85% of total malaria cases in Karnataka,” informs Prof B Shantharam Baliga, Professor Emeritus at Kasturba Medical College (KMC). Malaria has been endemic in Mangaluru for three decades (since the boom in construction) and previous anti-malarial initiatives like National Malaria Eradication Programme (NMEP) were not able to contain malaria, he said.

Dr Baliga said the programmes failed as reporting of cases and action taken were done manually. This led to delayed surveillance, inadequate vector management among others.

After deciding to digitise malaria surveillance and control programme, MCS was launched in October 2015. Under the new approach, a case of malaria diagnosed in any laboraty or malaria clinic, was uploaded online within 48 hours.

The online entry of new cases sent an alert to tab devices of 54 trained MPWs (multipurpose workers). These handheld GIS-tagged tabs had apps guiding MPWs on implementing anti-malarial activities like collecting blood smears of contacts (infected Anopheles mosquitoes can continue to transmit parasites to healthy individuals), destroying mosquito breeding sites as per NVBDCP guidelines.

Features in software ensured follow-up of patients and closure of malaria cases (14 days in case of Plasmodium vivax Malaria). The IT-driven surveillance faced many hurdles including Mangaluru City Corporation’s (MCC) decision to withdraw MPWs from malarial work in June 2018 and during Covid-19 Pandemic in 2020. Yet house-visits, early reporting and closure of cases (90% cases were closed) continued and broke the chain of transmission cycles, Dr Baliga said.

MCS, by emphasising on timely dependent interventions established accountability, which was missing in previous manual system, informs Dr Baliga. Entrepreneur and MCS architect Naren Koduvattat says the software should be scaled-up for more capabilities. Dr Baliga said MCS, which is still in operation, will reduce malaria incidence to double-digit soon.

Dr Shantharam Baliga said that under MCS, timely reporting activated anti-larval, anti-mosquito measures, elimination of breeding was achieved in 98% of reported sites. Increase in active blood smear collection from contacts of newly diagnosed malarial patient (which contributes 1.2% of malaria cases), penal action on construction owners for non-compliance of vector control measures, releasing guppy fish in open wells to control malaria and easy access of data on each malaria case helped in accurate assessing of disease trends in high-risk wards, month-wise and plan interventions.

“This method of smart surveillance can also contain all communicable and other vector borne diseases,” informed Dr Baliga. Dr Ghosh said the digitised smart surveillance system fulfils Global Technical strategy (GTS) for malaria elimination from 2016 to 2030 by the WHO.