A study of the epidemiology of malaria transmission was undertaken in 13 tribal villages located in forest and plain areas of Sundargarh District of Orissa state, India, from January 2001 to December 2003. In forest areas, intense transmission of malaria is attributed to the highly anthropophagic vector Anopheles fluviatilis sibling species S and is complemented by A. culicifacies sibling species C. In plain areas, A. culicifacies sibling species C is responsible for malaria transmission. The entomological inoculation rate in the forest and plain areas was 0.311 and 0.014 infective bites/person/night, respectively, during 2003. Malaria transmission is perennial both in forest and plain areas but is markedly low in the plain area compared with the forest area. Plasmodium falciparum accounted for 85.0% of the total malaria cases during the study period. In forest and plain areas, the number of P. falciparum cases per 1000 population per year was 284.1 and 31.2, respectively, whereas the parasite rate was 14.0% and 1.7%, respectively. In forest areas, clinical malaria occurs more frequently in children aged 0-5 years and declines gradually with increasing age. The study showed that villages in forest and plain areas separated by short geographical distances have distinct epidemiology of malaria transmission.

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During recent years, long-lasting insecticide-treated nets (LLINs) have been developed to overcome the problems of low retreatment rates, washing, and erratic dose of the insecticide resulting in the dilution of efficacy of the conventional insecticide-treated mosquito nets. These nets are treated at factory level with insecticide either incorporated into or coated around fibers. Olyset net, a polyethylene net with 2% permethrin incorporated within fibers, is one type of LLIN. Therefore, these nets were evaluated for their wash resistance and bioefficacy against malaria vectors Anopheles culicifacies Giles and Anopheles fluviatilis James (Diptera: Culicidae) and other nontarget species. Cone bioassay tests produced 100% mortality in these two vector species with 3-min exposure. Results of the bioassays on washed nets showed 100% mortality in An. fluviatilis even after 20 washings, whereas in An. culicifacies 100% mortality up to 11 washings and 80% mortality up to 20 washings were observed. Cone bioassay tests also were performed on nontarget mosquito species Culex quinquefasciatus Say; house fly, Musca domestica L.; American cockroach, Periplaneta americana (L.); head louse, Pediculus humanus capitis De Geer; and bed bug, Cimex lectularius L. with 30-min exposure. Except for bed bugs, 100% mortality was observed in these nontarget species after 24-h recovery period. In bed bugs, only 25% mortality was observed. The density of An. culicifacies and An. fluviatilis was significantly reduced in houses with Olyset nets compared with those with untreated nets or no nets. Thus, it may be concluded that Olyset nets are highly effective against malaria vectors and moderately against other nontarget household insects.

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.

A village-scale trial on the efficacy of mosquito nets treated with a tablet formulation of deltamethrin (K-OTAB) against malaria in comparison to untreated nets or no net was conducted in Sundargarh District of Orissa, India, which is characterized by perennial transmission with Plasmodium falciparum accounting for more than 80% of malaria cases. Three villages with similar topographical and epidemiological situations were selected and randomly assigned to 3 arms of the study: treated net, untreated net, and no net. Distribution of nets, based on a sleeping pattern survey, was carried out to cover 100% of the population in treated-net and untreated-net villages. Longitudinal and cross-sectional surveys were conducted to measure malaria incidence, prevalence, and splenomegaly. Malaria incidence was reduced by 64.3% in the village with treated nets, 45.2% in the village with plain nets, and 21.4% in the control village without nets. Comparison of malaria incidence data after 1 year of intervention showed significant difference between villages with treated net vs. untreated net (P < 0.05) and treated net vs. no net (P < 0.005). The incidence of clinical attack rate due to P. falciparum was significantly lower in the population using treated nets than in those using untreated nets and no nets. However, no age-specific protective efficacy of treated nets or untreated nets was observed. A significant reduction occurred in spleen rate and parasite rate in children aged 2-9 years using treated nets or untreated nets. An overall significant reduction was found in parasite rate in the total population using treated and untreated nets as compared to nonusers.