Hyderabad: The official malaria figures for Hyderabad may significantly understate the actual number of cases in the city. While the public health department reports only 15 cases until August last year and a single case in 2021, private practitioners in areas such as Banjara Hills, Hitech City and Kondapur say they have been treating at least one to five malaria patients every month recently. Across Telangana, malaria incidence has dropped sharply over the past decade—from more than 5,200 cases in 2014 to around 600 in 2022, and 176 cases from January to August this year. Hyderabad’s official numbers show an even steeper decline, falling from 190 cases in 2018 to 81 in 2019, three in 2020 and just one case reported by May 2021. Malaria is mainly detected through microscopy of stained blood smears, considered the gold standard for confirming and identifying Plasmodium species, as well as rapid diagnostic tests (RDTs) that detect parasite antigens from a finger-prick blood sample. Hospitals and district laboratories use microscopy for confirmation, while rural and field settings rely on RDTs. Active fever surveillance is conducted during the monsoon and post-monsoon seasons in high-risk districts such as Adilabad, Komaram Bheem-Asifabad and parts of Khammam. Doctors’ personal experience suggests that rapid tests may not be fully included in official case counts. Dr Aarathi Bellary, a consultant in internal medicine, recalled recently treating a case of cerebral malaria in a patient returning from Africa. “The incidence has decreased, but cases keep coming from time to time,” she said. The patient’s condition was severe, with the patient going into a coma before recovering in 20 days. The state health department maintained that the 176 reported cases are not native but imported from neighbouring states. “These cases are reported mainly in districts such as Asifabad-Komaram Bheem, Kothagudem and Mulugu, where tribal and migrant populations are higher,” said Amar Singh, nodal officer for malaria.Senior consultant Dr Rahul Agarwal, who treated two malaria patients last month, attributed the decline in reported cases to increased public awareness and preventive measures such as mosquito repellents, nets and coils, he explained. Among vector-borne diseases in Hyderabad, dengue continues to have the highest incidence, followed by malaria and leptospirosis. According to Dr Shraddha Sanghani, consultant in internal medicine, dengue poses greater immediate health risks, including organ failure, acute kidney and liver illness and myocarditis. “While the young recover faster, elderly patients are taking longer to recover or are succumbing,” she noted.With no malaria vaccine available yet, doctors emphasise that prevention remains the best defence. However, some experts warn that the apparent decline in malaria cases could partly reflect reduced testing and reporting gaps, making it crucial to maintain vigilance before the disease silently re-emerges.
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