Trends in malaria in Odisha, India—an analysis of the 2003-2013 time-series data from the National Vector Borne Disease Control Program

Background: Although Odisha is the largest contributor to the malaria burden in India, no systematic study has examined its malaria trends. Hence, the spatio-temporal trends in malaria in Odisha were assessed against the backdrop of the various anti-malaria strategies implemented in the state. Methods: Using the district-wise malaria incidence and blood examination data (2003-2013) from the National Vector Borne Disease Control Program, blood examination-adjusted time-trends in malaria incidence were estimated and predicted for 2003-2013 and 2014-2016, respectively. An interrupted time series analysis using segmented regression was conducted to compare the disease trends between the pre (2003-2007) and post-intensification (2009-2013) periods. Key-informant interviews of state stakeholders were used to collect the information on the various anti-malaria strategies adopted in the state. Results: The state annual malaria incidence declined from 10.82/1000 to 5.28/1000 during 2003-2013 (ad...