Urban Malaria Scheme - Past, Present & Future

Urban Malaria, as a specific problem in India, was first recognized in 1969, after an indepth review of the situation of malaria in India was done by Madhok Committee. However, main malaria vector in urban areas of India is An. stephensi, which was first recognized in early part of the 20 century. Many of the local bodies carrying out antilarval operations earlier failed to continue the same due to paucity of funds. During that time, malaria in urban areas was not considered as a major problem because the epidemics recorded earlier in Bombay, Delhi, Lucknow etc. could immediately be contained. Based on recommendations of Madhok Committee to control malaria in urban areas, the Urban Malaria Scheme (UMS) was launched in the country in 1971–7 2. A large scale migration of population, creation of slum clusters, construction activities and water storage practices have contributed in the establishment of malaria foci. Urban malaria control is therefore based on source reduction, larviciding, minor engineering interventions, legislative measures, building bye laws and limited spraying of indoor residual spray in periurban and jhuggies. Initially 131 towns with a population of > 40,000 and reporting > 2 API were included in the UMS. Later in 1978, due to merger of National Filaria control programme, 206 towns were also brought under vector control support and the preventive measures against malaria vector breeding in clean water as well as filaria vector breeding in polluted water were integrated. Though there has been a well structured separate programme for prevention and control of malaria in urban areas since 1971, the priority attached to it and its implementation has been an issue primarily because it is the responsibility of the local body. Moreover, in recent past, upsurge in cases of Dengue and Chikungunya in urban areas has diverted attention on both disease surveillance and vector control. Coincidently, the vectors of malaria and dengue/ Chikungunya in urban areas breed in clean water and control strategies are same but surveillance with limited resources has affected in assessing the actual magnitude of problem. This has resulted in upsurge in cases and deaths due to malaria in Mumbai during 2010. Historical background and future vision of Urban Malaria Scheme has been discussed in present article.