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Desert malaria “Curse of the Thar Desert” – A unique geographical endemicity of malaria and combating it with modern technology

Introduction: This study focuses on the Malaria endemic in the Thar Desert- The most populated desert in the world. Malarial endemicity in a desert environment is a unique and rare geographical presentation, as malaria is usually common in areas where there is rainfall and water stagnation - like ponds, fields, etc. In this study, we want to highlight the unique clinical presentation, lab findings, and reason behind the existence of malaria in the desert. Most importantly we also would like to share our innovative idea to eliminate breeding sites using Quadcopters and drones. Materials and methods: Study type – Prospective observation study, Study duration – October 2020 to December 2020, Sample size-103 cases, Inclusion criteria – all smear-positive Malaria cases, Exclusion criteria – Cases Referred to higher centers because of complications.Tools used for breeding site identification – Quadcopters and Drones with HD cameras. Since the area to be surveyed was vast (>30km), it was very difficult to do a manual survey in the harsh desert climate. The patients’ demographics, Clinical Presentations, and laboratory parameters were collected systematically in a predesigned format and entered into an excel sheet. The finding of our study was compared with the malaria cases from different parts of the country. Results: All malaria was identified as Plasmodium vivax. The mean age group was 36 years (min-21 and max-56). Clinical features- out of 103 cases, 78% of the patients presented with all 4 symptoms of fever, chills, headache, and bodyache.22% presented with atypical isolated symptoms of abdominal pain, vomiting, myalgia, severe joint pain. 77% of patients had mild hepatosplenomegaly, 7 patients presented with hypotension, and 2 were in sepsis. Lab parameters – 88% of the patients had anemia, of which 5% had severe anemia, 40% had leucopenia while 6% had leucocytosis.87%had thrombocytopenia, out of which 56% had a platelet count less than 50,000/ml. 2% had mild AKI, bilirubin levels were elevated in 53%, and 36% had transaminitis. Using technology, the survey of the entire area was done in 1 week and all the breeding sites were eliminated on the same day of identification and a drastic drop in malaria cases was noted. Conclusion: We conclude that desert malarial presentation of Plasmodium vivax is unique in clinical presentation and lab derangements compared to other malarial cases. Usage of technology like quadcopters and drones for breeding site identification played a major role in curtailing cases drastically in a very short period in an effective way.