Malarial morbidity in tribal communities living in the forest and plain ecotypes of Orissa, India

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Abstract
A detailed epidemiological study of malarial morbidity was carried out in 13 'tribal' villages in the forest or plain ecotypes of Sundargarh district, Orissa, India. Longitudinal and cross-sectional, parasitological surveys were conducted in all the villages, to determine the incidence of malaria and the prevalence of malarial infection. The annual numbers of malaria cases/1000 were much higher in the forest (347.9) than on the plain (61.0). In the forest clinical malaria occurred more frequently in children than in adults but on the plain all age-groups were equally affected. In cross-sectional surveys, 14.1% of the subjects from the forest but only 2.8% of those from the plain were found smear-positive for malarial infection. The prevalences of infection in the forest area were highest in the young children (aged 1-5 years) and gradually declined with increasing age. The highest incidence of Plasmodium falciparum malaria (0.90 episode/person-year) was also recorded in the subjects from the forest who were aged 1-5 years. In the forest and plain communities surveyed, 78.5%-81.5% and 36.0%-52.0% of the children aged 2-9 years had detectable splenomegaly, respectively, indicating that the forest was hyper-endemic and the plain meso-endemic for malaria. Malaria is clearly a major problem among the tribal communities of Sundargarh, causing great morbidity and, consequently, considerable economic losses.