In the present study Epidemiological status of Malaria in Karimganj disctrict of Assam is monitored from 2001–2020. Plasmodium falciparum accounts for 81% disease burden in the the district but survey also revealed that 41% & 32% cases caused by P. vivax in Block Primary Health Centre (BPHC)- Patharkandi & R.K. Nagar respectively. As per 20 years data from 2001–2020 it was noticed that the Slide Falciparum Rate (SFR) declined from 0.54% (2001) to 0% (2020) but contrastingly high intensity of P. vivax positive cases reported in 2018, 2019 & 2020 with Pv% 60, 45 & 100 respectively, indicating P. vivax as threat in future years. Out of 5 BPHCs in the district 3 BPHCs- Kachuadam, R.K. Nagar & Grishganj viewed mortality zero in last 5 years (2016–2020). In 2016, total 4 mortality recorded in Assam out of which 2 deaths reported from Karimganj district 1 each from BPHCs- Patharkandi and Nilambazar. In 2019 Assam witnessed 6 mortality of which 2 again reported from Karimganj district under same BPHC Nilambazar. From the survey it is also noted that malaria cases are temperature, humidity and rainfall dependent. Favourable temperature is 20-35o & humidity 57–76%. Thus, maximum cases recorded between between April to July. Study also revealed that gradual decrease in Annual Parasite Index in the district in past 20 years with only 4 mortality in last five years (2016–2020). Hence, from the survey it can be presumed that the National Centre for Vector Borne Disease Control Programme working sincerely towards malaria free district in future years.
Case Report
Epidemiological Status of Malaria in Karimganj District of Assam, India (2001-2020)
https://doi.org/10.21203/rs.3.rs-1402869/v1
This work is licensed under a CC BY 4.0 License
Version 1
posted 11 Mar, 2022
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Epidemiology
Malaria
Plasmodium falciparum
P. vivax
Karimganj
Assam
Malaria is a potentially life-threatening disease caused by plasmodium parasite, that are transmitted to humans through the bites of infected female Anopheles mosquitoes. According to the World Health Organization's (WHO) latest World malaria report, there were 241 million cases of malaria worldwide in 2020 as compared to 227 million cases in 2019. The estimated number of malaria deaths stood at 6,27,000 in 2020, an increase of 69,000 deaths over the previous years. African Regions alone accounts 95% of malaria cases and 96% of malaria deaths (WHO., 2020). As per latest World malaria report, 2020: India continues to make Impressive Gains in reduction of Malaria Burden. Worldwide there are total 11 countries including India that account for 70 % & 71 % of the global estimated case burden and global estimated deaths respectively. But whereas India is the only country reported drop in Malaria cases, as many as 116 districts in ndia reported zero malaria cases in 2020 and the country has been able to achieve remarkable success in reducing the diseas burden in terms of cases by 84.5% and deaths by 83.6%, Union Health Minister Harsh Vardhan (The Hindu newspaper article 23rd April, 2021). According to Ministry of Health and Family Welfare last 5 years records, highest death recorded in 2016 and most positive cases in 2017, though 2020 recorded fewer cases compared to last 5 years data but mortality still persist (Fig.1). Similarly, Assam state witnessed highest no. of malaria cases in 2016 and least in 2020. Zero mortality reported in 2017 even though cases were quite high above 5k in the state (Fig.2). Karimganj district reported only 4 Mortality in last 5 years with zero death in 2017, 2018 and 2020 & maximum cases reported in 2019 above 1.4 Lakhs (Fig.3).
The severity of malaria is based on causative plasmodium species. There are five malarial parasite species- Plasmodium falciparum, P. malariae, P. vivax, P. ovale and P. knowlesi. Out of five species –P. falciparum and P. vivax pose the greatest threat in India and P. falciparum is also termed as deadliest malaria parasite as it influences blood coagulation by sticking RBCs together causing blockage in arteries. In Karimganj P. falciparum accounts for 81% of the malaria cases. Although P. falciparum dominant but from the survey it is revealed that 41% & 32% cases caused by P. vivax .
Life cycle of Plasmodium:Plasmodium is a protozoan parasite its life cycle divided into three stages (Primary exo-erythrocytic, Erythrocytic & Sexual cycle) which involves two hosts (man & female anopheles mosquitoes). i) Exo-erythrocytic cycle- During a blood meal sporozoites are inoculated into human blood stream by infected female Anopheles. Within 30mins of their entry sporozoites take shelter in liver parenchyma cells & matures into schizonts, which furter rupture and releases about 1200 merozoites. ii) Erythrocytic cycle- Merozoites now invade red blood cells (RBC) where they undergo asexual multiplication & develops into ring stage trophozoites by absorbing haemoglobin. Trophozoites further matures into schizonts, which rupture releasing merozoites. iii) Sexual cycle- Some merozoites enter RBC for schizogony & some are diffetentiated into gamonts or gametocytes, where lager female gamonts are designated as macrogametocytes & small male gamonts as microgametocytes. This gametes are then ingested by female Anopheles during a blood meal. Inside mosquito’s stomach, the microgametes fertilizes the macrogametes to produce zygotes. The zygotes are motile & elongated in shape called ookinetes or vermicule, this penetrate through inner lining of stomach & develops into oocysts in subepithelial tissue. The oocysts grow, rupture and liberated cluster of sporozoites in the haemocoel, which further find their way into the mosquito’s salivary glands. When mosquito bite new human for blood meal releases sporozoites into blood stream unknowingly as mosquito inject saliva as anticoagulant before sucking blood. Hence, in new human host sporozoites completes one part of life cycle & other part in female anopheles mosquitoes (Fig.4)
2.1 Study Area
The survey was conducted in the Karimganj districtthroughout the year from 2014-2020. Karimganj district is one of the 34 district of state Assam and is situated at the southern most corner of the state, and Assam is located north-eastern corner of India. The geographical location of the district is between longitude 92° 21' 32.9544'' E & latitude 24° 51' 53.6904'' N (LatLong.net) and it covers an area of 1,809 km2i.e 698 mi2(Srivastava et al., 2010).The district together with neighbouring districts- Cachar and Hailakandi form Barak Valley, also called as Southern Assam.The district shares border with two districts of Assam (Cachar on the east & Hailakandi district on the east & south), two states of Northeast (Mizoram on the south & Tripura on the southwest) and with the country Bangladesh on the west and northwest (Syleth division demarcated by the Kushiyara river). Karimganj town is named after its district Karimganj, therefore bearing same name (Karimganj.gov.in). It is the biggest town & administrative headquarters of the district situated between Longitude 92° 21' 19E & Latitude 24° 52' 9N(Fallingrain) at the northern edge of the district (Fig.5)
2.2 Method of study
Karimganj district is divided into five Block Primary Healtn Center (BPHC)- Patharkandi, Kachuadam, Nilambazar, Ramkrishna Nagar (a.ka. R.K. Nagar) & Girishganj (Source Health & Family Welfare Dept.). Malaria epidemiological status of the Karimganj district has been studied for 6 years from 2014–2020 under this five BPHCs (Fig. 6). The data regarding malaria epidemiology in the district were collected from the district National Vector Borne Disease Control Programme (NVBDCP) Unit under the establishment of Joint Director of Health Services, Karimganj. The acquired informations from aforesaid department were computed, tabulated, graphed snd statistically analysed year wise to estimate the health hazard caused by female anopheles mosquitos in the southern most district of Assam, the Karimganj.
2.3 Epidemiological data analysis
To access the malaria epidemicity following parameters were calculated:
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Total blood examined (TBE) = total blood smears examined + total rapid diagnostic test (RTD) conducted
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Total Malaria Positive = malaria positive blood smear slide + RDT positve for malaria
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Annual Blood Examination Rate (ABER) = TBE in a year / total population ×100
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Annual Parasite Index (API) = Total malaria parasite positive slide in a year/ total population × 1000
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Slide Positive Rate (SPR) = malaria positive blood smear slide /TBE ×100
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Slide Faliciparum Rate = Total P. falciparum positive / TBE × 100
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P. falciparum (Pf) % = Total P. falciparum positive blood/ Total Malaria Positive ×100
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P. vivax (Pv) % = Total P. vivax positive blood /Total Malaria Positive × 100
3.1 Demographic profile of Karimganj district:
Table (A) showing the demographic profile of Karimganj district. With area 1809 Km2 & population 1422760 (Acc. to Malaria Census) in 238961 families (NVBDCP Census), the current population density per km is 786.5 Nos. The district comprises of 1250 villages, 16 sectors, 2 towns - Karimganj & Badarpur. The district also has satisfactory sex ratio of 961 females for every 1000 males & an impressive literacy rate of 79.72% (Source NVBDCP Karimganj).
3.2 Strength Of Capacity Building Of Karimganj Districrt
Table (B) Showing capacity building for malaria control programme of Karimganj district. The public health-care system of Karimganj district comprises of five Block Primary Health Centers (BPHC)- Patharkandi, Kachuadam, Nilambazar, Ramkrishna Nagar (a.ka. R.K. Nagar) & Girishganj (Source Health & Family Welfare Dept.), FourMini PHC & 16 PHC. Under this PHCs there are 222 Sub Centers. There are twoCommunity Health Centre ( CHC), with one Civil Hospital & fiveModel Hospitals. Public health delivery system of the district consist of forty Laboratory Technician & one District Malaria Officer (DMO), District Vector Borne Disease (VBD) Consultant and Secretarial Assistant (SA) cum Data Entry operator (DEO) to monitor and supervise the programme activity in the district. For effective malaria surveillance, district also has oneMalaria Technical supervisor & Senior Malaria Inspector and threeMalaria Inspector. Health worker designated as Surveillance Inspector (SI) 14 nos., Surveillance Worker (SW) 16 nos., SW (NHM) 15 nos., Auxiliary Nurse Midwife (ANM) 350 nos. & Multi Purpose Worker (MPW) 60 nos. are appointed for active surveillance.
District also has 1280 nos. dedicated Accredited Social Health Activist (ASHA). They are trained in diagnosis and treatment of malaria cases at village level through passive surveillance. The workers were provided with Rapid diagnostic test kits (RDTKs) & Slides (for blood smear) for sample collection from fever detected patients. They also get remuneration of 15/- per blood sample slide and 75/- for each positive slide (Source NHM). They also administer anti-malarial dugs like Chloroquine phosphate (CQ),Artemisinin-based Combination Therapy (ACT), Sulfadoxine pyrimethamine (SP-ACT) & Artemether-Lumefantrine (ACT-AL) with adequate dosage to positive patient. As preventive measure time to time they spread awareness & supervise sanitization of waterlogging area using suitable insecticides like DDT, malathion, deltamethrin, cyfluthrin & different formulation of synthetic pyrethroids. ASHA worker also distribute Insecticide Treated Mosquito Nets (ITMN) / Long Lasting Insecticidal Nets (LLN) as a part of vector control strategies in the district (Source NVBDCP).
3.3 Disease burden of Malaria in Karimganj district (2001–2020)
District with tropical climate (Average Annual Temp.- 22oC, Humidity- 78%), good amount of rainfall (Average Annual Rainfall- 3000mm) & vast forest area (761 Km2) covering almost half of Karimganj district, forming a heaven for mosquito breeding. Thus, making Karimganj malaria-endemic district. Table 1 showing 20 years data from 2001 to 2020 for population sizes, fever cases, blood sample examined, positive cases as well as death reported in Karimganj district,Assam. Two major Plasmodium species- P. falciparum and P. vivax were reported from the district & P. falciparum found to be most active one as it is the source of 88.5% cases. It has been noticed that 506,559 population increased from 2001 to 2020. However, sudden increase recorded during 2003–2004. Since 2005 onwards till 2020 steady population growth achieved. In the year 2001, 238 positive cases reported but after 20 years cases declined to only 4 in 2020, sharp drop noticed between 2019–2020 in the district. Annual Parasite Index (API) is an important parameter expressed malaria morbidity in a specific year per 1000 individuals under surveillance. Average API2001 − 2020 of the district is 0.26. Highest API recorded 0.85 in 2006 with Pf 95%. The API was found to be 0.25 in 2001 and then sharply declined to 0.02 by 2020, hence, showing positive impact of precautionary measures in the district. Average Annual Blood Examination Rate (ABER)2001−2020 was 5.08% but highest was noted in 2019 with 10.08%, as maximum fever cases reported during the year with 57 positive & 2 death (last reported death in the district). With the introduction of Rapid Diagnostic Test (RDT) kits in the year 2014 for instant detection of malarial parasites results in shrap decline in Blood Smear Collected and Examined value & Slide positivity rate (SPR). SPR per 100 individual was 0.59% in 2001 and then declined to 0 by 2020. Highest SPR recorded 1.96% in 2006. SFR is calculated to record the P. falciparum induced cases. It was noticed that the SFR declined from 0.54% (2001) to 0% (2020) but contrastingly high intensity of P. vivax positive cases reported in 2018, 2019 & 2020 with Pv% 60, 45 & 100 respectively, indicating most active malaria causing species in the district in present & in future years. Study also revealed that gradual decrease in API, SFR & SPR in the district in past 20 years & also viewed only 4 mortality in last five years (2016–2020).
| Year | Total Population | Total fever case detected (Tested) | RDT positive | BSC/BSE positive | Total Malaria positive | ABER (%) | Pf | Pf (%) | SPR | API | SFR | Death |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2001 | 939053 | 40661 | 0 | 238 | 238 | 4.33 | 220 | 92 | 0.59 | 0.25 | 0.54 | 0 |
| 2002 | 896466 | 35773 | 0 | 328 | 328 | 3.99 | 310 | 94 | 0.92 | 0.37 | 0.87 | 0 |
| 2003 | 956863 | 42102 | 0 | 350 | 350 | 4.40 | 335 | 95 | 0.83 | 0.37 | 0.80 | 0 |
| 2004 | 1209445 | 43661 | 0 | 292 | 292 | 3.61 | 252 | 86 | 0.67 | 0.24 | 0.58 | 0 |
| 2005 | 1231362 | 39773 | 0 | 302 | 302 | 3.23 | 274 | 90 | 0.76 | 0.25 | 0.69 | 01 |
| 2006 | 1252488 | 54358 | 0 | 1068 | 1068 | 4.34 | 1015 | 95 | 1.96 | 0.85 | 0.19 | 02 |
| 2007 | 1259561 | 48871 | 0 | 470 | 470 | 3.88 | 427 | 90 | 0.96 | 0.37 | 0.87 | 02 |
| 2008 | 1315186 | 57735 | 0 | 708 | 708 | 4.38 | 667 | 94 | 1.22 | 0.53 | 1.16 | 0 |
| 2009 | 1322265 | 68187 | 0 | 710 | 710 | 5.15 | 673 | 94 | 1.04 | 0.53 | 0.99 | 01 |
| 2010 | 1332605 | 102298 | 0 | 425 | 425 | 7.67 | 361 | 84 | 0.41 | 0.31 | 0.35 | 02 |
| 2011 | 1345221 | 83799 | 0 | 366 | 366 | 6.22 | 310 | 84 | 0.56 | 0.27 | 0.37 | 0 |
| 2012 | 1362575 | 64283 | 0 | 228 | 228 | 4.71 | 179 | 78 | 0.27 | 0.16 | 0.28 | 0 |
| 2013 | 1376447 | 65649 | 0 | 343 | 343 | 4.76 | 282 | 82 | 0.52 | 0.24 | 0.23 | 03 |
| 2014 | 1385335 | 75884 | 74 | 143 | 217 | 5.47 | 176 | 81 | 0.18 | 0.15 | 0.23 | 02 |
| 2015 | 1416750 | 65611 | 130 | 92 | 221 | 4.63 | 159 | 72 | 0.14 | 0.09 | 0.24 | 01 |
| 2016 | 1419904 | 61132 | 90 | 87 | 177 | 4.31 | 129 | 72 | 0.28 | 0.12 | 0.21 | 02 |
| 2017 | 1423597 | 75458 | 67 | 24 | 91 | 5.30 | 69 | 76 | 0.02 | 0.06 | 0.09 | 0 |
| 2018 | 1422760 | 97441 | 42 | 20 | 62 | 6.82 | 25 | 40 | 0.06 | 0.04 | 0.03 | 0 |
| 2019 | 1421858 | 143450 | 39 | 18 | 57 | 10.08 | 31 | 54 | 0.01 | 0.04 | 0.009 | 02 |
| 2020 | 1445612 | 64974 | 4 | 0 | 4 | 4.4 | 0 | 0 | 0 | 0.02 | 0 | 0 |
| RDT- Rapid diagnostic test; BSC/BSE- Blood Smear Collected/ Examined; ABER- Annual Blood Examination Rate; Pf- Plasmodium falciparum; SPR – Slide Positivity Rate; API – Annual Parasite Index; SFR – Slide Falciparum Rate | ||||||||||||
3.3.1 Monthly Prevalence of Malaria in Karimganj district (2016–2020)
Seasonal occurences of Malaria studied in last 5 years 2016 to 2020 (Fig. 7). From the study it is correlated that malaria cases are temperature, humidity and rainfall dependent. Favourable temperature range lies between 20-35o, humidity 57–76% (as in high humidity mosquitoes are more active). Average suitable rainfall for malaria transmission is 3000mm. Thus, malaria cases are in peaks between between April to July after that cases gradually declines. On the other hand colder months from Nov-Feb reported least cases. Highest spike reported in 2016 with 177 positive cases & maximum cases were documented in the month of July.
3.3.2 Block PHC wise Prevalance of Malaria in Karimganj district (2016–2020)
Malaria prevalence varied largely between five BPHC of the district. Table 3 Showing the Prevalence of Malaria in BPHC wise in Karimganj district from 2016–2020. Patharkand recorded highest positive cases with 203 patient & Girishganj recorded least with 17. Patharkandi positive cases sharply drop to 4 in 2020 from 78 in 2016, steep decrease was seen between 2017–2018 & 2019–2020. Kachuadam population size is nearly half of Patharkandi & R.K. Nagar population. Kachuadam haven't seen any positive cases in last 3 years i.e since 2017 onwards, followed by Girishganj with last positive case in 2018, Nilambazar & R. K Nagar in 2019. P. falciparum accounts for 81% of the malaria cases in the the district. Although P. falciparum dominant but from the survey it is revealed that 41% & 32% cases caused by P. vivax in Patharkandi & R.K. Nagar respectively. Kachuadam, R.K. Nagar & Grishganj mortality zero in last 5 years (2016–2020). From 2001–2020 highest & lowest average ABER was recorded in Patharkandi (9.26% ) & Girishganj (3.84%) respectively. Highest average API2001 − 2020 observed in Nilambazar (0.2), followed by Patharkamdi (0.11), R.K. Nagar (0.05), Kachuadam (0.02) & Girishganj (0.01). For positive impact API value should go down & ABER should increase.
| BPHC | Year | Population | Total malaria + ve | Pf | Pf (%) | ABER (%) | TPR (%) | SPR (%) | API | SFR (%) | Death |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Patharkandi | 2016 | 345007 | 78 | 49 | 63 | 7.51 | 0.25 | 0.05 | 0.22 | 0.01 | 1 |
| 2017 | 345611 | 56 | 39 | 70 | 8.66 | 0.19 | 0.003 | 0.16 | 0.003 | 0 | |
| 2018 | 346076 | 29 | 16 | 55 | 11.2 | 0.07 | 0.005 | 0.08 | 0.004 | 0 | |
| 2019 | 349739 | 36 | 16 | 44 | 13.33 | 0.07 | 0.004 | 0.1 | 0.004 | 0 | |
| 2020 | 356994 | 4 | 0 | 0 | 5.6 | 0.02 | 0 | 0.01 | 0 | 0 | |
| 2016–2020 | 1,743,427 | 203 | 120 | 46.4 | 9.26 | 0.12 | 0.012 | 0.11 | 0.004 | 1 | |
| Kachuadam | 2016 | 174545 | 13 | 13 | 100 | 4.6 | 0.13 | 0.16 | 0.07 | 0.16 | 0 |
| 2017 | 176691 | 2 | 2 | 100 | 6.11 | 0.02 | 0.02 | 0.01 | 0.02 | 0 | |
| 2018 | 174498 | 3 | 2 | 66 | 8.5 | 0.02 | 0.02 | 0.02 | 0.01 | 0 | |
| 2019 | 181886 | 0 | 0 | 0 | 12.8 | 0 | 0 | 0 | 0 | 0 | |
| 2020 | 185101 | 0 | 0 | 0 | 4.1 | 0 | 0 | 0 | 0 | 0 | |
| 2016–2020 | 892,721 | 18 | 17 | 94 | 7.2 | 0.03 | 0.04 | 0.02 | 0.03 | 0 | |
| Nilambazar | 2016 | 290515 | 28 | 26 | 63 | 4.25 | 0.22 | 0.12 | 0.9 | 0.9 | 1 |
| 2017 | 290515 | 15 | 14 | 93 | 5.36 | 0.1 | 0.04 | 0.05 | 0.04 | 0 | |
| 2018 | 290515 | 7 | 5 | 71 | 5.7 | 0.04 | 0.005 | 0.02 | 0.003 | 0 | |
| 2019 | 276890 | 2 | 2 | 100 | 6.73 | 0.01 | 0 | 0.007 | 0 | 2 | |
| 2020 | 284278 | 0 | 0 | 0 | 3.6 | 0 | 0 | 0 | 0 | 0 | |
| 2016–2020 | 1,432,713 | 52 | 47 | 90 | 5.13 | 0.07 | 0.03 | 0.2 | 0.18 | 3 | |
| R.K. Nagar | 2016 | 349664 | 48 | 32 | 67 | 2.31 | 0.59 | 0.64 | 0.13 | 0.4 | 0 |
| 2017 | 349874 | 14 | 10 | 71 | 2.97 | 0.13 | 0.12 | 0.04 | 0.1 | 0 | |
| 2018 | 349972 | 18 | 13 | 72 | 4.1 | 0.12 | 0.12 | 0.05 | 0.09 | 0 | |
| 2019 | 350024 | 16 | 10 | 62 | 10.62 | 0.04 | 0.03 | 0.04 | 0.02 | 0 | |
| 2020 | 351851 | 0 | 0 | 0 | 5.8 | 0 | 0 | 0 | 0 | 0 | |
| 2016–2020 | 1,751,385 | 96 | 65 | 68 | 5.16 | 0.17 | 0.18 | 0.05 | 0.12 | 0 | |
| Girishganj | 2016 | 260220 | 10 | 9 | 90 | 2.58 | 0.14 | 0.14 | 0.03 | 0.13 | 0 |
| 2017 | 260906 | 4 | 4 | 100 | 3.36 | 0.05 | 0.05 | 0.02 | 0.05 | 0 | |
| 2018 | 261699 | 4 | 4 | 100 | 4.4 | 0.03 | 0.03 | 0.02 | 0.03 | 0 | |
| 2019 | 264758 | 0 | 0 | 0 | 6.57 | 0 | 0 | 0 | 0 | 0 | |
| 2020 | 267388 | 0 | 0 | 0 | 2.3 | 0 | 0 | 0 | 0 | 0 | |
| 2016–2020 | 1,314,971 | 18 | 17 | 94 | 3.84 | 0.04 | 0.04 | 0.01 | 0.04 | 0 | |
| ABER- Annual Blood Examination Rate; TPR total positivity rate; Pf- Plasmodium falciparum; SPR – Slide Positivity Rate; API – Annual Parasite Index; SFR – Slide Falciparum Rate | |||||||||||
The findings of the 20 years study with the aim to investigate the health hazard associated with female anopheles mosquitos in Karimganj district of Assam can be explained below. Malaria cases reported were mainly caused by infection with Plasmodium falciparum and P. vivax. Though P. falciparum accounts for 81% of the malaria cases in the the district but from the survey it is revealed that 41% & 32% cases caused by P. vivax in Patharkandi & R.K. Nagar BPHCs respectively. Hence, P. vivax posing greatest threat in near future. In 2016, total 4 mortality recorded in Assam out of which 2 deaths reported from Karimganj district 1 each from BPHCs- Patharkandi and Nilambazar. In 2019 Assam witnessed 6 mortality of which 2 again reported from Karimganj district under same BPHC Nilambazar. Therefore, BPHC Nilambazar should be under close surveillance. There is also steady decline in SPR with only 4 positive cases & zero mortality in 2020. However, it is also observed that positivity rates are highly dependent on temperature, humidity and rainfall. Favourable temperature range betweem 20-35o & humidity 57–76%. Thus, maximum cases recorded between between April to July. As per last 5years data India documented steep slope in mortality ratre from 331 in 2016 to only 63 in 2020. Similarly, state also recorded decline in cases from 7826 in 2016 to 484 in 2020. Reduction in cases noticed due to untiring efforts by NVBDCP employees and human awareness. Though overall shrinking map of malaria cases in Karimganj district observed, however, given the endemicity of malaria in Assam and India, a thorough investigation need to be carried out to study the emergence of any insecticide resistant mosquito vectors in the area so that an effective control strategy can be made to eliminate malaria and other vector-borne diseases in the district.
Funding: No funding received for completion of this current research work
Data availability statement: The main datasets generated during the current study are not publicly available as those are official data but are available from the corresponding author on reasonable request as the corresponding author is an employee in National Centre for Vector Borne Disease Control, Karimganj -788710 Assam India and other data were cited in the ariticle itself.
Conflict of interest: The Authors of the present paper have no competing interest
Author contribution: Ankita Dey: Writing-Original Draft, Visualisation, Investigation. Debojit Dey: Data collection, investigation and Supervision.
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No competing interests reported.