Mumbai: Downward trend in malaria cases seen in G North ward

Malaria cases are seeing a sharp rise across the city but the numbers are at their lowest point in the past two years at G North ward - which comprises Dadar, Dharavi and Mahim - thanks to a collaborative effort between its health administration, war room and other departments.

War rooms were introduced by the BMC's health department in all 24 wards when the pandemic was at its peak. In February, civic officials announced that the war rooms would also cater to patients with non-communicable diseases. Earlier this month, the health department released a statement where it said that the war rooms would now deal with monsoon ailments.

"We have been attending to patients suffering from a variety of illnesses since the beginning of this year," said the representative from G North's war room. In May and June of last year, the ward reported 40 and 43 malaria cases, respectively. In 2021, during those two months, there were 26 and 31 cases.
Aedes aegypti mosquitoes, which spread dengue, commonly breed indoors in clean stagnant water, while Anopheles mosquitoes can thrive in various sites, including dirty water found outdoors.

The map that the team uses to identify clusters in the area, which comprises Dadar, Dharavi and Mahim

In May and June, the ward reported only 21 and 30 cases of malaria respectively. Dr Balasaheb Kawale, the ward's medical officer of health, said, "G North is at a higher risk, and we mostly see a lot of cases in Dadar and Mahim. Apart from spots where water accumulates during the monsoon, a lot of construction and redevelopment activities take place there."

According to Dr Kawale, BMC officials face numerous hurdles when carrying out pest control activities in high-rise buildings. There were five cases of dengue in May this year, compared to three in 2022 and none in 2021. In June, there were six cases, compared to five last year and none the year before that. "Dharavi reports malaria and dengue cases, and we are able to immediately carry out activities there to prevent it from becoming a cluster, but high-rises present difficulties," he said.

How the war rooms function

The functioning of each war room differs based on the directions given by the medical officer of health, said Kawale. Things were different before he joined.
"It was scattered. Multiple departments were involved in controlling the spread of certain diseases, but they were working individually instead of as a team," said Dr Uzma Sheikh, who has been working in G North ward's war room on a contractual basis.

Along with a social worker and a data entry operator, she handles about 20 calls every day. "Some days, we receive even more calls. We coordinate with the pest control department as well as the disaster management department," she said.

Another medical professional in the war room said, "We receive a list of patients from various public and private facilities. We then map the data to identify clusters more clearly, and the next step is to carry out awareness and pest control activities in those areas. We also coordinate with health posts and HBT clinics."

Private labs send the data, but they are not legally required to do so, Dr Sheikh added. "Very few of them are reluctant, while most simply forget to do it by the end of the day, and some still need training on how to fill out the BMC form that provides us with information about the disease and the patient," she said. The team also follows up with patients to ensure they continue taking their medications.

Furthermore, WhatsApp groups have been created where every pest control activity carried out, after coordination with the war room team, is posted and monitored by Dr Kawale. Malaria cases see a sharp and rapid rise from July till the end of the monsoon. Last year, in July, G North reported 97 malaria cases. "I can safely ensure that the cases this July will not exceed 50 in my ward," Dr Kawale said.

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No. of malaria cases reported in June in ward