ntroduction:
Malaria is a life-threatening disease and is widespread in the tropical and subtropical regions mainly around the equator. Malaria is a protozoan disease and transmitted through infected female anopheles mosquitoes. There are five Plasmodium species which can infect human beings namely Plasmodium falciparum (Pf), Plasmodium vivax (Pv), Plasmodium malariae (Pm), Plasmodium ovale (Po) and Plasmodium knowlesi (Pk). In India, Pf and Pv are equally contributing to the malaria burden in the country, but a gradual increase in Pf cases is observed since last five years. According to NVBDCP, around 0.88 million malaria cases were reported in India and amongst them 0.46 million are Pf cases as it is more virulent (NVBDCP 2013). The highest number of malaria cases reported in India were from Odisha (25.6%) followed by Chhattisgarh (13.3%), Jharkhand (11.6%), Madhya Pradesh (8.7%), Gujarat (6.7%), Maharashtra (5.2%), other states (14.3%) and North Eastern states, which contributes 8.3% malaria cases in the country (NVBDCP-2013).
In the past, chloroquine (CQ) was effective for treating nearly all malaria cases. However, CQ resistance of Pf was first reported in Assam, India in 1973 (Sehgal et al.1973) and number of studies until 1977 indicated widespread presence of CQ resistance Pf in Assam, Arunachal Pradesh, Mizoram and Nagaland. Since then drug resistance has been reported from several other parts of the country (Dua et al; 2003, Baruah et al; 2005, Valecha et al; 2009).