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CDC Activities in India

Malaria is reemerging in India. In recent years, India has reported malaria outbreaks leading to deaths. The proportion of malaria cases caused by Plasmodium falciparum has increased, and severe complications of P. vivax malaria have also recently been reported.

Malaria during Pregnancy

Malaria infection during pregnancy can have adverse health consequences for both the mother and her infant. Much more information is known about this problem in sub-Saharan Africa than in other regions of the world. Based on the available information, the World Health Organization (WHO) has recommended safe, effective interventions for pregnant women in areas of high transmission in sub-Saharan Africa: intermittent preventive treatment, insecticide-treated mosquito nets, and case management of malaria illness.

In most of the countries in the South East Asian Region, there are few or no specific data on malaria during pregnancy—which makes it difficult to develop evidence-based policies.

CDC has developed a rapid assessment methodology to assess the burden of the problem of malaria in pregnancy, as well as opportunities to provide interventions, within the existing antenatal care system.

Participants at a course on the rapid assessment of malaria in pregnancy learn how to detect malaria infection in placentas by making transplacental blood smears. The course was held at the Regional Medical Research Center for Tribals (RMRCT - ICMR) in Jabalpur, Madhya Pradesh, India, in April 2004. (Courtesy Dr. Neeru Singh/NIMR)

Malaria Vaccines

The Indian Council of Medical Research has funded scientists from the National Institute of Malaria Research to conduct a multidisciplinary project to study malaria epidemiology, immune responses to malaria, parasite diversity, and vector characteristics in central India (Jabalpur region), in collaboration with the All India Institute of Medical Sciences. The main purpose of this project is to develop a well-characterized site for future malaria vaccine trials in India. This project involves a community-based family cohort study, hospital-based surveillance, and laboratory studies. CDC is providing technical assistance for field investigations and data management and technical support for laboratory investigations.

Neurologic Disorders Associated with Cerebral Malaria

Although recent studies in Africa suggest that severe malaria leads to substantial cognitive impairment and learning disabilities in African children, it is unclear whether similar deficits occur in Asian countries.

CDC, along with investigators from the Morehouse School of Medicine, Atlanta, Georgia, USA, and National Institute of Malaria Research, is participating in a collaborative study funded by the U.S. National Institutes of Health to address this issue. The study, begun in 2004, is being conducted in two health facilities in Madhya Pradesh. Its main goals are to

• Estimate the burden of cerebral malaria–associated neurologic deficits in the Indian population in central India
• Conduct laboratory investigations to understand the role of immunologic and genetic factors associated with neurologic outcomes, which may help identify potential prognostic factors for early recognition of neurologic problems and to better understand the biologic basis for the disease.

As part of this study, a national workshop was conducted in October 2004 in Jabalpur to discuss various aspects of cerebral malaria and its neurological complications. This workshop provided an opportunity to discuss establishing common study methodologies, networking opportunities for investigators, and challenges associated with this research.

A young Indian girl with severe malaria. (Courtesy Dr. Neeru Singh/NIMR)

Molecular Diagnosis and Genetic Markers for Drug Resistance

CDC provides training and technical support for conducting polymerase chain reaction (PCR)–based molecular diagnosis of malaria parasites and for genotyping polymorphisms related to drug resistance markers for the National Institute of Malaria Research /CDC collaborative projects in Jabalpur.

Contact Details

Venkatachalam Udhayakumar, Ph.D.
Malaria Branch, DPD, CCID
Centers for Disease Control and Prevention
4700 Buford Hwy., F-12, Atlanta, GA 30341
tel: 770-488-4047; fax: 770-488-4454
e-mail: VUdhayakumar@cdc.gov

Meghna Desai, M.P.H., Ph.D.
Malaria Branch, DPD, CCID
Centers for Disease Control and Prevention
4700 Buford Hwy., F-22, Atlanta, GA 30341
tel: 770-488-7166; fax: 770-488-4206
e-mail: MDesai@cdc.gov