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Women vulnerable to malaria in tea gardens

By Farhana Ahmed
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NORTH LAKHIMPUR, April 24 � As the World Malaria Day is being observed tomorrow, a large number of people belonging to one of the most socio-economically backward communities of Assam � the tea garden workers� community � are afflicted by the disease annually in Lakhimpur district.

The most worrying aspect of this phenomenon in Lakhimpur district is that among these people living along the inter-State border areas of Assam and Arunachal Pradesh on the Himalayan foothills, the percentage of women victims is on the higher side.

A study conducted by an epidemiologist of the District Health Department found that women are more vulnerable to malaria in the tea garden areas of Lakhimpur district. The study, conducted by Jitendra Sarma last year and published in an international journal, reveals that 57 women tested positive among the total 97 detected cases from among 368 samples collected from workers in the Zoihing and Koilamari Tea Estates in Lakhimpur district. The number was more among women between the age group of 11-20 years (16), followed by women between the age group of 1-10 years (15). This is attributed to women�s susceptibility to contract malaria due to decreased immunity during pregnancy and poor financial status that often results in delays to access health interventions.

Besides, a significant number of malaria infections are also found in young children of the same community. The lack of any immunity to malaria is blamed for this alarming rate. The terrain of the two tea gardens studied, the climatic conditions and the managements of the company are responsible for the high prevalence of malaria among the workers� community of this area in Lakhimpur district.

Almost all tea gardens in Lakhimpur district are situated on the fringes of thickly forested foothills of the Himalayas. Excessive rainfall, prolonged rainy season, recurrent waves of flood, forest fringes and hilly terrain are considered vector-friendly and this environment is found in the tea estates of Zoihing and Koilamari.

Stagnant water during the monsoon season also creates a conducive environment for the disease as the Indian Tea Association has reported the presence of 66 per cent Plasmodium falciparum, one of the species of Plasmodium transmitted by the female Anopheles mosquito that causes malaria in humans, in almost all tea gardens on the north bank of the Brahmaputra. Though Anopheles culicifacies (sensu lato), a major vector of malaria on the Indian subcontinent generating 65 per cent of the cases, has developed resistance to dichlorodiphenyltrichloroethane (DDT) and malathion, the coverage of DDT in these two tea gardens has been found to be very poor and inadequate.

Incomplete treatment and lack of sanitation facilities are reported among the people affected by the disease in the two tea gardens. It has also been found that most of the tea garden workers are unaware of the risk of malaria. Further, the movement of �non-immune� tea workers from outside areas to this locality for engagement in work has led to the persistent transmission of malaria in the tea gardens.

It may be recalled that Lakhimpur district witnessed a malaria epidemic in 2006 when more than 200 people died of the disease caused by a falciparum infection.

Assam which has 2.5 per cent of India�s total population, records 5 per cent of the total malaria cases and over 20 per cent of the total malaria deaths in the country. It is one of the major public health problems of Assam since the colonial period and at present, it is estimated that 1,16,30,158 people are living in malaria-prone areas. Among them, 15,147 villages, 2,144 sub-centres and 122 PHCs are identified as having a high malaria risk.

The State Health Department has set up 59 chloroquine-resistant PHCs and cluster PHCs to fight malaria. Lakhimpur district has two PHCs (Nowboicha as Drug Resistant PHC and Boginadi as Cluster PHC/ Bordering Chloroquine Resistant State).

The National Vector Borne Disease Control Programme has recommended rapid tests for the initial diagnosis of the malaria parasite so that clinicians are able to provide proper anti-malarial treatment during the early stage of development and multiplication of the malaria parasite.

As microscopic examination takes a long time for confirmation of the malaria parasite, these rapid malaria tests (RMTs) available in a kit prove to be very useful. Similarly, the distribution of Insecticide-Treated Mosquito Nets (ITN) among the tea garden workers is very vital in tackling the outbreak of the disease.

However, the managements of the two tea gardens in question and the District Health Department are yet to intensify anti-malaria drives for workers even as pre-monsoon rains have been lashing Lakhimpur district since the last four weeks.

It is alleged that the Corporate Social Responsibility (CSR) of the tea company has been zero as far as fighting the annual outbreak of malaria is concerned. The knowledge of local malaria epidemiology in tea gardens is essential in taking up situation-specific disease intervention strategies.

The tea garden workers have relatively limited medical facilities and are at a higher risk to get malaria infection. Special focus is needed for the population in the tea gardens to prevent an impending outbreak of malaria in Lakhimpur district in the coming monsoon season.

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Women vulnerable to malaria in tea gardens

NORTH LAKHIMPUR, April 24 � As the World Malaria Day is being observed tomorrow, a large number of people belonging to one of the most socio-economically backward communities of Assam � the tea garden workers� community � are afflicted by the disease annually in Lakhimpur district.

The most worrying aspect of this phenomenon in Lakhimpur district is that among these people living along the inter-State border areas of Assam and Arunachal Pradesh on the Himalayan foothills, the percentage of women victims is on the higher side.

A study conducted by an epidemiologist of the District Health Department found that women are more vulnerable to malaria in the tea garden areas of Lakhimpur district. The study, conducted by Jitendra Sarma last year and published in an international journal, reveals that 57 women tested positive among the total 97 detected cases from among 368 samples collected from workers in the Zoihing and Koilamari Tea Estates in Lakhimpur district. The number was more among women between the age group of 11-20 years (16), followed by women between the age group of 1-10 years (15). This is attributed to women�s susceptibility to contract malaria due to decreased immunity during pregnancy and poor financial status that often results in delays to access health interventions.

Besides, a significant number of malaria infections are also found in young children of the same community. The lack of any immunity to malaria is blamed for this alarming rate. The terrain of the two tea gardens studied, the climatic conditions and the managements of the company are responsible for the high prevalence of malaria among the workers� community of this area in Lakhimpur district.

Almost all tea gardens in Lakhimpur district are situated on the fringes of thickly forested foothills of the Himalayas. Excessive rainfall, prolonged rainy season, recurrent waves of flood, forest fringes and hilly terrain are considered vector-friendly and this environment is found in the tea estates of Zoihing and Koilamari.

Stagnant water during the monsoon season also creates a conducive environment for the disease as the Indian Tea Association has reported the presence of 66 per cent Plasmodium falciparum, one of the species of Plasmodium transmitted by the female Anopheles mosquito that causes malaria in humans, in almost all tea gardens on the north bank of the Brahmaputra. Though Anopheles culicifacies (sensu lato), a major vector of malaria on the Indian subcontinent generating 65 per cent of the cases, has developed resistance to dichlorodiphenyltrichloroethane (DDT) and malathion, the coverage of DDT in these two tea gardens has been found to be very poor and inadequate.

Incomplete treatment and lack of sanitation facilities are reported among the people affected by the disease in the two tea gardens. It has also been found that most of the tea garden workers are unaware of the risk of malaria. Further, the movement of �non-immune� tea workers from outside areas to this locality for engagement in work has led to the persistent transmission of malaria in the tea gardens.

It may be recalled that Lakhimpur district witnessed a malaria epidemic in 2006 when more than 200 people died of the disease caused by a falciparum infection.

Assam which has 2.5 per cent of India�s total population, records 5 per cent of the total malaria cases and over 20 per cent of the total malaria deaths in the country. It is one of the major public health problems of Assam since the colonial period and at present, it is estimated that 1,16,30,158 people are living in malaria-prone areas. Among them, 15,147 villages, 2,144 sub-centres and 122 PHCs are identified as having a high malaria risk.

The State Health Department has set up 59 chloroquine-resistant PHCs and cluster PHCs to fight malaria. Lakhimpur district has two PHCs (Nowboicha as Drug Resistant PHC and Boginadi as Cluster PHC/ Bordering Chloroquine Resistant State).

The National Vector Borne Disease Control Programme has recommended rapid tests for the initial diagnosis of the malaria parasite so that clinicians are able to provide proper anti-malarial treatment during the early stage of development and multiplication of the malaria parasite.

As microscopic examination takes a long time for confirmation of the malaria parasite, these rapid malaria tests (RMTs) available in a kit prove to be very useful. Similarly, the distribution of Insecticide-Treated Mosquito Nets (ITN) among the tea garden workers is very vital in tackling the outbreak of the disease.

However, the managements of the two tea gardens in question and the District Health Department are yet to intensify anti-malaria drives for workers even as pre-monsoon rains have been lashing Lakhimpur district since the last four weeks.

It is alleged that the Corporate Social Responsibility (CSR) of the tea company has been zero as far as fighting the annual outbreak of malaria is concerned. The knowledge of local malaria epidemiology in tea gardens is essential in taking up situation-specific disease intervention strategies.

The tea garden workers have relatively limited medical facilities and are at a higher risk to get malaria infection. Special focus is needed for the population in the tea gardens to prevent an impending outbreak of malaria in Lakhimpur district in the coming monsoon season.