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Malaria Surveillance

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Introduction

  • Core intervention under National Centre for Vector Borne Diseases Control (NCVBDC) (formerly NVBDCP) and National Malaria Elimination Programme (NMEP)
  • National Strategic Plan (NSP) 2023–2027: Transforms malaria surveillance into a real-time, case-based, foci-based core strategy for elimination (target: zero indigenous cases by 2027)
  • Integrated with Integrated Health Information Portal (IHIP) for near real-time web-based reporting
  • Follows Test-Treat-Track (3Ts) strategy with mandatory public + private sector notification

Objectives

  • Early detection of every case and focus to interrupt transmission
  • Prompt case management and vector control response
  • Monitor trends, classify cases (indigenous/imported), and certify elimination
  • Strengthen entomological surveillance for evidence-based vector control
  • Reduce under-reporting and achieve >95% case detection

Types of Surveillance

1. Passive Case Detection (PCD)

  • Routine testing at all health facilities (public/private) for fever cases
  • All fever cases tested with RDT or microscopy (universal testing policy)

2. Active Case Detection (ACD)

  • House-to-house fever screening by ASHAs/Health Workers in endemic areas
  • Monthly blood examination rate (MBER) target: ≥10% in high-transmission areas

3. Reactive Case Detection (RACD)

  • Triggered around every confirmed case (50-house radius)
  • Fever screening + testing of contacts

4. Sentinel Surveillance

  • Designated hospitals for severe malaria monitoring and drug resistance

5. Entomological Surveillance

  • Vector density, larval habitats, insecticide resistance monitoring
  • Integrated Vector Management (IVM) guidance

1-3-7 Timeline (NSP 2023–27)

  • Day 1: Case notification through IHIP within 24 hours
  • Day 3: Complete case investigation & classification (indigenous/imported)
  • Day 7: Foci investigation + response (focal IRS, LLIN distribution, active detection)

Case Definitions & Diagnosis

  • Suspected: Fever with or without chills/rigors
  • Confirmed: Positive RDT or microscopy (Pf/Pv/Pm/Po/Pk)
  • Severe Malaria: As per WHO criteria (cerebral malaria, severe anemia, ARDS, etc.)
  • Universal access to quality-assured RDT/microscopy; PCR for confirmation in elimination settings
  • Private sector mandatory reporting via IHIP

Case & Foci Management

  • Every case geo-tagged & mapped on GIS dashboard
  • Foci classified (active/residual/cleared)
  • Immediate response: ACT (for Pf), Primaquine (for Pv), focal IRS/LLIN
  • Follow-up: Day 3, 7, 14, 28 for radical cure

Integration with Child Health Programmes

  • RBSK: Screening for fever/anemia in school children
  • RKSK: Adolescent malaria awareness
  • FBNC/SNCU: Severe malaria management in neonates/infants
  • SAANS/Anemia Mukt Bharat: Overlap with ARI/anemia
  • ABDM/ABHA: Digital case records & tracking

Monitoring & Reporting

  • Real-time IHIP-Malaria dashboard
  • Annual Parasite Incidence (API), Annual Blood Examination Rate (ABER), Slide Positivity Rate (SPR)
  • Monthly/quarterly reviews at district/state level
  • Private sector inclusion mandatory

Recent Developments (2026)

  • NSP 2023–27 fully operational; IHIP-Malaria rolled out nationwide
  • Category-wise state stratification (Category 0–3) with tailored surveillance intensity
  • Focus on urban, tribal, forest, migrant & cross-border areas
  • India on track for WHO certification of elimination

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