B.K. Tyagi - Desert Malaria - An Emerging Malaria Paradigm and Its Global Impact On Disease Elimination-Springer (2023)

B. K.
Tyagi
Desert
Malaria
An Emerging Malaria Paradigm and Its
Global Impact on Disease Elimination
Desert Malaria
B. K. Tyagi
Desert Malaria
An Emerging Malaria Paradigm and Its
Global Impact on Disease Elimination
B. K. Tyagi
VIT University
Vellore, India
ISBN 978-981-19-7692-6 ISBN 978-981-19-7693-3 (eBook)

https://doi.org/10.1007/978-981-19-7693-3
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Dedicated to
My parents and teachers who have always
taught me
to follow the principle of work:
Transliteration:
Karmanye vadhika raste, Ma phaleshu
kadachana Ma karma phala he tur bhuh, ma
te sangotsva karmanye
Translation:
You have a right to ‘Karma’ (actions) but
never to any Fruits thereof. You should never
be motivated by the results of your actions,
nor should there be any attachment in not
doing your prescribed activities.
Foreword
Taking cognizance of the World Malaria Report 2021 it looks like malaria will be
knocked off from most parts of world very soon. There are, however, certain
ecotypes where malariated mobile and hard-to-approach populations need special
attention, such as those in the malaria-prone deserts of the world, especially the
Sahara, the Middle East/West Asia, and the Great Indian Thar Desert whose
malariogenic scenario is fast changing under the impact of climate change as well
as anthropization, and can affect the neighbouring regions where successful malaria
elimination campaigns have been in progress. The global data on morbimortality is a
big alert sign in this direction: there were an estimated 241 million cases in 2020,
compared to 227 million cases in 2019, with malaria deaths in 2020 having increased
to 6,27,000 globally—a 12% increase over that in 2019!
After African continent, it is the South-East Asian region, including India which
shoulders the heaviest burden of malaria incidence, that poses the greatest threat of
malaria burden to people in the region which has recently witnessed some countries
having been declared malaria-free by the World Health Organization. India, too, has
made a great progress in reducing the malaria cases and resolutely developed ‘the
National Framework for Malaria Elimination in India 2016–2030’ which will need
to take into consideration with equal alacrity all the various different malaria
ecotypes or paradigms including the distantly malariogenic Thar Desert. Accord-
ingly, the future elimination roadmaps will also need to factor in contemporary
challenges, including the impact of climate change on vector chorogeography,
human migration, rapid urbanization, and expansion of irrigated agriculture.
Leveraging advanced control technologies aided by a robust surveillance system to
intensify malaria elimination, the time seems to be just ripe to tackle malaria; from
grassroot action to holistic policy interventions and effective delivery of services,
without letting emerging malaria paradigms such as, for example, ‘the Desert
Malaria ’ disappear from the sight while executing the ‘National Strategic Plan for
Malaria Elimination’ (2017–22).
During the past one decade India has succeeded in reducing the malaria burden a
great deal (69%). India was also the only high-endemic nation to see a decrease of
17.6% in 2019 compared to 2018. Further, when numbers of malaria cases are
compared between 2019 and 2020 it was revealed that the overall number of malaria
cases recorded in 2020 was 1,57,284 as compared to the number of cases in 2019
vii
viii Foreword
being 2,86,091, which is a year-on-year decrease of approximately 45%. Yet, there

is no reason for ecstatic celebration for there are many challenges ahead, not to
mention the ongoing pandemic which has apparently disrupted other health
programmes across the world, and India is no exception; the reduction in malaria
cases during the past several months could be potentially correlated with the under-
reporting of cases, on one hand, and the inability to timely address ‘mobile and hard
to approach populations’ in regions such as, for example, the arid environments of
the Thar Desert, on the other. Eventually, grassroot action involving as significantly
indiscernible risk as that of the desert malaria is critical to combat a disease like
malaria. Tackling the desert malaria, in addition to holistic policy interventions and
effective delivery of services in endemic areas, would be vital in helping achieve the
goal of a malaria-free India by 2030.
On the global front, due cognizance should be taken of the fact that desert malaria
has immense potential to impact the successful disease elimination campaigns in the
bordering areas/regions or countries, and under the irreversible Climate Change the
situation will only worsen with the expanding geographical reach of the dangerous
invasive mosquito, like Anopheles stephensi, and the parasite, Plasmodium
falciparum. Currently desert environments intervened by Climate Change and
anthropization are becoming conducive to malaria exacerbation.
I wish Prof. B.K. Tyagi’s book, Desert Malaria a great success. The book is an
innovative and unique treatment, and yet so vital for our understanding about the
complexities associated with the malaria elimination in future. I further wish that all
those who are personally or institutionally involved in the drive against malaria, such
as policy makers, programme implementers, disease managers, academicians, and
researchers alike, will find this book a useful reference in their endeavours to
eliminate the disease from the face of the Earth once for all!
Parasitology Department, Universiti Malaya Indra Vythilingam

Kuala Lumpur, Malaysia 28th April, 2022
Preface
The decision to write a book on malaria in deserts, however innovative, exigent, and
thought-provoking, was highly challenging and unconventional. The disease is
inherently associated with water—in variety and abundance—as a prerequisite,
and deserts are but chronically water-deficient, besides other environmental features
generally inimical to the development, growth, and survival of both the Plasmodium
parasites of human malaria and their anopheline mosquito vectors. The fact, how-
ever, is that deserts’ inhospitable and inimical arid environments the world over are
fast transforming under the impact of climate change and/or anthropization, and
becoming home for continued malaria exacerbation and epidemics so much that
antimalaria campaigns elsewhere could be put to danger of reversal by increased
malaria cases. The threat of ‘Desert Malaria’ (Tyagi 1995) is indeed very real.
Therefore, highlighting malariological significance of deserts has proved a path-
breaking endeavour, to say the least! It is, of course, common thinking that deserts
are not the places where malaria exists. If not seriously attended, the ‘Desert Malaria’
may become a good reason to ultimately undermine the global efforts to eliminate
malaria in a timebound manner in the near future.
Globally, according to the World Malaria Report 2021, there were an estimated
241 million cases in 2020, increasing from 227 million in 2019. During the same
time malaria deaths increased by 12% globally in 2020, in comparison to 2019, to an
estimated 6,27,000. For India, the numbers are grim. In 2020, the South-East Asia
Region (SEAR) had 5 million estimated cases. Three countries accounted for 99.7%
of the estimated cases in the region, with India being the largest contributor (82.5%).
India also accounted for 82% of all malaria deaths in the SEAR. Malaria control is a
global issue and the World Health Organization through its member states is
committed to eliminate the disease from the face of the Earth. The WHO Global
Malaria Programme (GMP) is responsible for coordinating WHO's global efforts to
control and eliminate malaria. Its work is guided by the ‘Global Technical Strategy
for Malaria 2016–2030’ adopted by the World Health Assembly in May 2015 and
updated in 2021. As far as the WHO SEA Region, in which India is also included, it
is noteworthy that the island nation of Sri Lanka was recently certified malaria-free
in 2015, and another country Timor-Leste is in the line of WHO Certification for
malaria-free having reported consistently zero malaria cases in 2018 and 2019.
Outside the WHO SEA Region, China was also most recently declared malaria-
ix
x Preface
free in 2021. India has recently prepared a National Strategic Framework of Malaria
Elimination 2016–2030 wherein the northwestern xeric region of the Thar Desert is
also included on the basis of recent experiences. Thus, it is more than crystal clear
that the desert/xeric environments bearing countries with potential for malaria
conflagration, like those in the African Continent and India, face rather greater
challenges to eliminate malaria due largely to a continuous reinforcement of cases
from a less or infrequently surveyed region for reasons apparent. The real potential
of the desert malaria is so far not fully comprehended, and it is doubted if any great
success in eliminating malaria would be achievable without growing au fait in this
crucial ecosystem.
‘Desert Malaria’, a new coinage in the realms of malariology, is an emerging
malaria paradigm, having been reported for the first time in the Thar Desert,
northwestern India. Its global impact on disease elimination carries a unique, yet
most significant epidemiological, value at a time when the malaria endemic countries
across the world are struggling to the skin of their teeth against the man's oldest and
deadliest predator, the mosquito, and the centuries-old infection it transmits,
i.e. malaria, which is woefully neglected in deserts due to their hostile physiography
and inclement environment, on one hand, and, more importantly, the traditional
belief that the desert ecosystem has only very low and unstable potential to exacer-
bate malaria! Generally it is witnessed that countries with endemic malaria invari-
ably lay their entire focus for vector and disease control/elimination on the well-
known epidemiological paradigms such as, for example, tribal malaria, rural malaria,
urban malaria, industrial malaria, irrigation malaria, forest malaria, border malaria,
etc., and the desertic, xeric, and/or arid environments are often neglected epidemio-
logically, albeit high potential for outbreaks conflagratory enough to escalate disease
burden all over again in the neighbouring areas!
Desert environments (including desertic/xeric and arid lands) constitute the most
widespread terrestrial biome on Earth covering about 33% of the land areas of the
world, and are home to over 20% of the world's population. The book brings up the
significance of the emerging new malaria paradigm—The Desert Malaria, in totality,
that is, also by highlighting the significance of both the ‘desert fringe’ and the ‘desert
oasis’. Malariologically, if not appreciated for their epidemiological potential, these
deserts can become difficult habitats for malaria management. The desert malaria is,
therefore, an integral constituent of the global disease epidemiology and control.
The book unfolds the history of malaria vis-à-vis desert ecosystems, followed by
disease exacerbation due to multiple factors chiefly comprising anthropogenic
interference. The book reveals how in recent times increase in trade, transportation
(of all kinds), and migration as well as the cyclic droughts in the world’s xeric
ecosystems, on one hand, and the impending climate change and anthropization, on
the other hand, have led to wide and distant spread of both the vectors and the disease
into the vast stretches of deserts. It also informs on reasons behind the emergence of
the deadly malaria parasite, Plasmodium falciparum, in the desert ecosystem fol-
lowing faulty canalized irrigation. This is for the first time that all the three different
types of disease paradigms, viz., (1) Desert Malaria per se, (2) Desert Oasis Malaria,
Preface xi
and (3) Desert Fringe Malaria, have been treated in one volume, with fundamental
differences in their eco-bio-social impacts in conjunction with malariological signif-
icance. It is hoped that this book, written authoritatively, on Desert Malaria: an
emerging malaria paradigm and its global impact on disease elimination, will add
new knowledge on malaria, and deserts would be given their due share of thinking
about eliminating malaria in India and the world alike.
Vellore, India B. K. Tyagi

30th April, 2022
Acknowledgements
A book on malaria in desert or arid environments may appear quixotic but the reality
is that it is the most burning topic today in the realms of malariological science,
enshrined with a multidisciplinary treatment. My research work on ‘Desert Malaria’,
a theory propounded in 1995, is a fabulous journey of perseverance and application
chronicled in a series of approximately 200 research publications in national and
international journals like The Lancet, Journal of Arid Environments,
Phytomedicine, Indian Journal of Medical Research etc. Many colleagues from
the ICMR-Desert Medicine Research Centre, Jodhpur, Regional Remote Sensing
Centre, Central Arid Zone Research Institute, Arid Forest Research Institute, and
Zoological Survey of India facilitated my malariological explorations in the highly
challenging, and yet so mesmerizing, Thar Desert. To colleagues particularly such
as, for example, Dr S.P. Yadav, Dr K.V. Singh Verma, Dr S.K. Bansal, Dr Raman
Sachdev, Dr Ramnath Takiar, and Dr P.K. Dam I remain ever so indebted for
assisting me in both the laboratory and the field.
For permission to use figures from their publications my heartfelt gratitude goes
to a large number of friends and colleagues particularly Dr Vas Dev, Ex-Scientist 'G',
ICMR-National Institute of Malaria Research, New Delhi, India; Dr Solomon
Kibret, Ecosystem Management, School of Environmental and Rural Science,
University of New England, Armidale NSW 2351, Australia; Dr Marianne Sinka,
Department of Zoology, University of Oxford, Zoology @ Plant Sciences, South
Parks Road, Oxford, OX1 3RB, United Kingdom; Dr Farah Ishtiaq, Principal
Scientist, Tata Institute of Genetics and Society (TIGS), Bangalore, India; Dr
Natacha Protopopoff, Department of Parasitology, Prince Leopold Institute of Trop-
ical Medicine, Antwerp, Belgium; and Prof. Dr S.N. Surendran, Department of
Zoology, Faculty of Science, University of Jaffna, Jaffna, Sri Lanka—who have
all generously permitted in writing. Further, I am also deeply indebted to the
universal policy of organizations like the World Health Organization, Geneva,
Switzerland, to use their material with due acknowledgement which I am respect-
fully doing herewith. They are all duly cited on appropriate legend of the figure(s) or
other places in the book.
Above all, my cordial remembrances with heartfelt thanks go to the world-famous
malariologist and friend, the late Professor Dr Felix P. Amerasinghe of International
Water Management, Colombo, Sri Lanka, who appreciated my malaria research in
xiii
xiv Acknowledgements
the Thar Desert, remarking, ‘Tyagi is best known internationally among malaria and
medical entomology circles for his long years of research into mosquitoes, malaria
and irrigated agriculture in the Thar Desert of Rajasthan, India’. His appreciation
was my motivation for writing this book on ‘Desert Malaria’.
I am extremely grateful to Professor Dr Indra Vythilingam (Parasitology Depart-
ment, University Malaya, Kuala Lumpur, Malaysia) for writing the Foreword in the
book and giving encouragement to me in all my undertakings such as this book.
As always in the past, here too, I wish to thank my wife, Ajita, who gave me full
freedom of time and discussion so that I could put my whole attention to the
accomplishment of this long and meandering journey of characterizing ‘Desert
Malaria’.
Last but not least I duly thank the publisher Springer Nature, specifically the
editorial team for guidance throughout the course of processing this book for
publication.
Contents
1 ‘Desert Malaria’: An Emerging New Paradigm . . . . . . . . . . . . . . . . 1

1.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1.1.1 Definition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
1.1.2 Malaria Symptoms . . . . . . . . . . . . . . . . . . . . . . . . . . 3
1.1.3 Parasites . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
1.1.4 Malaria Vectors . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
1.2 Deserts, Arid Environments, and Malaria . . . . . . . . . . . . . . . . 7
1.3 Ecotypes of Malaria in the Desert Environments . . . . . . . . . . . 9
1.4 Desert-Based Malaria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
1.4.1 The Problem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
1.4.2 Types of Desert-Based Malaria Paradigms . . . . . . . . . 13
2 Global vis-à-vis Desert-Driven Malaria . . . . . . . . . . . . . . . . . . . . . . 19
2.1 Global Malaria Scenario . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
2.2 Desert-Driven Malaria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
2.2.1 Malaria in African Sahara Desert . . . . . . . . . . . . . . . . 20
2.2.2 Malaria in Arabian Peninsula Desert . . . . . . . . . . . . . 21
2.2.3 Malaria in the Middle East/Central and West Asian
Deserts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
2.2.4 Malaria in the Great Indian Thar Desert . . . . . . . . . . . 22
3 World Deserts: Environments and Malaria Potential . . . . . . . . . . . 41
3.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
3.2 Desert Environments, Man, and Malaria . . . . . . . . . . . . . . . . . 42
3.3 Deserts with Potential to Exacerbate Malaria . . . . . . . . . . . . . . 47
3.3.1 Sahara Desert and Malaria . . . . . . . . . . . . . . . . . . . . 49
3.3.2 Arabian Peninsula Desert and Malaria . . . . . . . . . . . . 49
3.3.3 The Great Indian Thar Desert and Malaria . . . . . . . . . 51
4 Desert Water Sources and Vector Adaptation . . . . . . . . . . . . . . . . . 75
4.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
4.2 Traditional Sources of Water in Deserts . . . . . . . . . . . . . . . . . 76
4.2.1 Lakes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
4.2.2 Oases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
xv
xvi Contents
4.2.3 Desert Fringes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80

4.2.4 Springs, Well, and Seasonal Streams . . . . . . . . . . . . . 81
4.2.5 Wadi . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
4.2.6 Fossil Water . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
4.2.7 Mines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
4.2.8 Petro Products . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84
4.2.9 Aquifers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
4.2.10 Canals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
4.2.11 Snowfall in the Sahara Desert: A New and Rare
Source for Water . . . . . . . . . . . . . . . . . . . . . . . . . . . 86
5 ‘TANKA’ and ‘BERI’: The Most Crucial Habitats for Breeding of
Anopheles stephensi and Emergence of “DESERT MALARIA”
in the Thar Desert . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
5.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
5.2 Wetlands and Sources of Potable Water . . . . . . . . . . . . . . . . . 90
5.3 ‘Tanka and ‘Beri’: Most Significant Malariogenic Habitats
in the Thar Desert . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
5.3.1 ‘Tanka’ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
5.3.2 Beri . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
5.4 Microclimates of ‘Tanka’ and ‘Beri’ . . . . . . . . . . . . . . . . . . . . 101
6 Extensive Canalization and Its Impact on Transformation of the
Thar Desert and Malaria Exacerbation . . . . . . . . . . . . . . . . . . . . . . 103
6.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
6.2 Canalized Irrigation in the Sahara Desert . . . . . . . . . . . . . . . . 103
6.2.1 Ziway’s Canalized Irrigation . . . . . . . . . . . . . . . . . . . 103
6.3 Canalized Irrigation in the Thar Desert of India . . . . . . . . . . . . 105
6.3.1 The IGNP Command Area Characteristics
and Malaria Exacerbation . . . . . . . . . . . . . . . . . . . . . 108
6.3.2 Transformation in the Thar’s Physiography . . . . . . . . 109
6.4 Salutogenesis, Canalized Irrigation in Desert Environment,
and Mosquitoes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114
7 Anopheline Fauna and Major Malaria Vectors of Deserts . . . . . . . . 115
7.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
7.2 Deserts’ Most Dangerous Malaria Vectors . . . . . . . . . . . . . . . 116
7.2.1 The Sahara Desert . . . . . . . . . . . . . . . . . . . . . . . . . . 116
7.2.2 The Arabian Peninsula Desert . . . . . . . . . . . . . . . . . . 118
7.2.3 The Middle East/West Asia/Central Asia Deserts . . . . 119
7.2.4 The Great Indian Desert, the Thar Desert . . . . . . . . . . 120
7.3 Bio-Ecology of Anopheline Mosquitoes . . . . . . . . . . . . . . . . . 123
7.4 Dispersal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
7.5 Succession and Replacement of Taxa . . . . . . . . . . . . . . . . . . . 134
7.6 Density of Anopheline Mosquitoes . . . . . . . . . . . . . . . . . . . . . 135
Contents xvii
7.7 Biting Behaviour and Host Preference of the Anopheline

Mosquitoes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138
7.8 Age Structure of Vector Mosquitoes . . . . . . . . . . . . . . . . . . . . 139
7.9 Vector Incrimination Studies . . . . . . . . . . . . . . . . . . . . . . . . . 141
7.10 Major Breeding Habitats of Different Anopheline Species . . . . 141
7.11 Correlation of Canalized Irrigation under National
Five-Year Plan of Economy Development with the Malaria
Escalation in the Thar Desert . . . . . . . . . . . . . . . . . . . . . . . . . 142
7.12 Insecticide Usage in Health and Agricultural Programmes
and Development of Insecticide Resistance in Vector
Species . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145
7.13 Species Complexes in Vectors of the Thar Desert . . . . . . . . . . 146
7.14 Anopheles stephensi-Anopheles culicifacies
Distribution-Based Classification of the Thar Desert . . . . . . . . 146
8 Anophelenization of the Deserts . . . . . . . . . . . . . . . . . . . . . . . . . . . 149
8.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149
8.2 The Phenomenon of Anophelenization . . . . . . . . . . . . . . . . . . 149
8.3 Chorogeography of Anopheline Mosquitoes . . . . . . . . . . . . . . 150
9 Sibling Species Complexes of Malaria Vectors in Major Deserts . . . 157
9.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157
9.2 Species Complexes in Deserts . . . . . . . . . . . . . . . . . . . . . . . . 158
9.2.2 The Middle East/West Asia/Central Asia Deserts . . . . 158
9.2.3 The Thar Desert in India . . . . . . . . . . . . . . . . . . . . . . 160
9.3 The Enigmatic Status of Anopheles stephensi . . . . . . . . . . . . . 165
10 Anopheles stephensi Liston 1901: Origin and Chorogeography—A
New Hypothesis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169
10.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169
10.2 Classification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171
10.3 Etymology of Anopheles stephensi . . . . . . . . . . . . . . . . . . . . . 172
10.4 Distribution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 172
10.5 The New ‘Out of Range’ Occurrence of An. stephensi Since
Early Twenty-First Century . . . . . . . . . . . . . . . . . . . . . . . . . . 173
10.5.1 Gulf Countries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 174
10.5.2 Africa . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 174
10.5.3 Middle East and West Asia . . . . . . . . . . . . . . . . . . . . 174
10.5.4 The Thar Desert . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175
10.6 The Original Desert Mosquito: Anopheles stephensi . . . . . . . . 178
10.7 A New Hypothesis on the Origin and Evolution of Anopheles
stephensi . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179
10.7.1 The Hypothesis Based on the Rule of Reinig
(1938, 1939) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179
xviii Contents
10.7.2 The Basis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179

10.7.3 The Evolution and Migration Pathways of New
Species or Subspecies to Other Regions . . . . . . . . . . . 181
10.7.4 Test of Bergmann’s Rule on the Origin of Anopheles
stephensi . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 184
11 Invasive Vector Species of Malaria in Desert Environments . . . . . . 187
11.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187
11.2 What Makes a Vector Species ‘Invasive’ . . . . . . . . . . . . . . . . 188
11.3 Interplay Between Vector-Pathogen Interaction Dynamics
and the Climate Change . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189
11.4 Invasion of Anopheles stephensi Within India . . . . . . . . . . . . . 191
11.5 Invasion of Anopheles stephensi in Sri Lanka . . . . . . . . . . . . . 192
11.6 Invasion of An. stephensi in West Asia/Middle East . . . . . . . . 193
11.7 Invasion of An. stephensi in Arabian Peninsula . . . . . . . . . . . . 194
11.8 Invasion of An. stephensi in Africa . . . . . . . . . . . . . . . . . . . . . 194
12 Epidemiology of Desert Malaria . . . . . . . . . . . . . . . . . . . . . . . . . . . 197
12.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 197
12.2 Ecological, Biological and Social Aspects of Malaria Disease
in Major Deserts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 198
12.3 Dynamics of Malaria Prevalence in Major Deserts . . . . . . . . . . 198
12.3.2 The Arabian Peninsula . . . . . . . . . . . . . . . . . . . . . . . 205
12.3.3 Middle East/West Asia/Central Asia Deserts . . . . . . . 206
12.3.4 The Thar Desert . . . . . . . . . . . . . . . . . . . . . . . . . . . . 206
12.4 Review of Malaria Situation for Individual District Under the
Thar Desert . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 212
12.5 Possible Factors Responsible for Conflagration of Malaria,
Particularly P. Falciparum-Dominated Malaria . . . . . . . . . . . . 224
12.6 Malaria-Associated Complications or Malaria Syndromes . . . . 228
13 Epidemics of Malaria in Major Deserts . . . . . . . . . . . . . . . . . . . . . . 233
13.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 233
13.2 Malaria Epidemic Modelling . . . . . . . . . . . . . . . . . . . . . . . . . 234
13.2.1 The P. falciparum Infection Model . . . . . . . . . . . . . . 234
13.2.2 The Liverpool Malaria Model (LMM) . . . . . . . . . . . . 235
13.3 Epidemics in Saharan Countries . . . . . . . . . . . . . . . . . . . . . . . 236
13.4 Epidemics in the Thar Desert . . . . . . . . . . . . . . . . . . . . . . . . . 238
13.5 Possible Pathways of Evolution of Malaria Epidemics in the
Thar Desert . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 248
13.6 Early Warning Systems for Epidemic Malaria in the Thar
Desert . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 249
Contents xix
14 Urban Malaria in the Desert . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255

14.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255
14.2 Factors Responsible . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255
14.3 Vectors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 256
14.4 Urban Malaria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 256
14.4.1 Sahara Desert . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 256
14.4.2 Middle East/Central and West Asia . . . . . . . . . . . . . . 257
14.4.3 Thar Desert . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 257
14.4.4 Quarry Mine Malaria . . . . . . . . . . . . . . . . . . . . . . . . 258
14.4.5 Construction Site-Water Storage Pits . . . . . . . . . . . . . 260
14.4.6 Roadside Water Tanks for Cattle/Animal Drinking . . . 261
14.4.7 Overhead Water Tanks . . . . . . . . . . . . . . . . . . . . . . . 261
15 Clinical Scenario of Desert Malaria . . . . . . . . . . . . . . . . . . . . . . . . . 263
15.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 263
15.2 Malaria Clinical Spectrum . . . . . . . . . . . . . . . . . . . . . . . . . . . 264
15.2.1 Symptoms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 264
15.2.2 Splenomegaly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 265
16 Agroeconomical and Eco-Bio-Social Aspects of Malaria
in Deserts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 271
16.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 271
16.2 Agroeconomical and Social Impacts of Malaria: Paradox
about Rice Cultivation in the Irrigated Desert Region and
Malaria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 271
16.3 Health Impact of Malaria . . . . . . . . . . . . . . . . . . . . . . . . . . . . 273
16.4 Knowledge, Attitude and Practice of the Rural Population
about Malaria in the Thar Desert . . . . . . . . . . . . . . . . . . . . . . 280
17 Vector Identification and Malaria Diagnosis in Major Deserts . . . . 285
17.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 285
17.2 Dichotomous Keys for Identification of Vectors of Malaria
in India . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 285
17.2.1 Fourth Instar Larvae of Malaria Vectors . . . . . . . . . . . 286
17.2.2 Adults of Vector Mosquitoes . . . . . . . . . . . . . . . . . . . 291
17.3 Distinctive Taxonomic Characters of the World’s Two Major
Malaria Vectors in Desert Environments, Anopheles stephensi
Liston (1901) and Anopheles arabiensis Patton (1905) . . . . . . . 296
17.3.1 Morphological . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 297
17.3.2 Chromosomal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 297
17.3.3 Polymerase Chain Reaction (PCR) . . . . . . . . . . . . . . . 298
17.4 Parasite Diagnosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 299
17.4.1 Microscopic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 299
17.4.2 Rapid Diagnostic Test . . . . . . . . . . . . . . . . . . . . . . . . 299
17.5 Clinical Diagnosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 299
xx Contents
18 Malaria Immunity in Desert Populations and Development of

Resistance in Parasites against Antimalarials . . . . . . . . . . . . . . . . . 301
18.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 301
18.2 Malaria Endemicity and Immunity Development . . . . . . . . . . . 302
18.3 Biology of Malaria Parasites . . . . . . . . . . . . . . . . . . . . . . . . . 302
18.4 Clinical Symptoms and Treatments . . . . . . . . . . . . . . . . . . . . . 304
18.5 Parasite Resistance against Antimalarials . . . . . . . . . . . . . . . . 304
18.6 Malaria Treatment and Immunity . . . . . . . . . . . . . . . . . . . . . . 306
19 Malaria and Climate Change . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 307
19.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 307
19.2 The Sahara Desert . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 309
19.3 The Thar Desert . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 310
19.3.1 Physical Transformation in the Thar Desert Climate . . . 310
19.3.2 Malariological Transformation in the Thar Desert
Climate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 311
19.4 Where Is the Thar Desert Heading to Malariologically under
Climate Change . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 320
20 Anopheles stephensi: The First Vector to Show an Evolutionary
Response to Rapid Climate Change . . . . . . . . . . . . . . . . . . . . . . . . . 323
20.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 323
20.2 The Principle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 324
20.3 The Basis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 325
20.4 Population, Urbanization, Anthropization and Climate Change
20.5 Urbanization-Driven Climate Change and Effluxes
of Anopheles stephensi from the Thar Desert to In-Country
and Extraterritorial Regions . . . . . . . . . . . . . . . . . . . . . . . . . . 329
20.6 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 331
21 Trans-Border Migration and Malaria in Desert Populations . . . . . . 333
21.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 333
21.2 Human Movement in Search of Fodder for Cattle . . . . . . . . . . 334
21.3 Malaria Transmission across International Borders . . . . . . . . . 334
21.3.1 The Saudi-Yemeni Border . . . . . . . . . . . . . . . . . . . . . 336
21.3.2 The Jordan-Iraq Border . . . . . . . . . . . . . . . . . . . . . . . 336
21.3.3 Malaria Status of Countries Bordering India . . . . . . . . 337
21.3.4 Ethiopia and Sudan . . . . . . . . . . . . . . . . . . . . . . . . . 337
21.3.5 Border Malaria in the Thar Desert . . . . . . . . . . . . . . . 337
22 Malaria Management Including Vector Control in Major
Deserts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 345
22.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 345
22.2 Malaria Control in the Desert . . . . . . . . . . . . . . . . . . . . . . . . . 347
22.2.1 Sahara and Arab Peninsula Deserts . . . . . . . . . . . . . . 347
22.2.2 Malaria Control in the Desert . . . . . . . . . . . . . . . . . . 347
Contents xxi
22.3 Research on Phytochemicals as Repellents against Anopheles

stephensi from the Thar Desert . . . . . . . . . . . . . . . . . . . . . . . . 352
22.4 Role of Community and Future Scenario of Malaria Control
23 Inventions, Innovations and Discoveries in Malaria in Desert
Environments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 355
23.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 355
23.2 Discovery of the First Human Malaria Parasite . . . . . . . . . . . . 355
23.3 Discovery of Entry of Anopheles stephensi in Africa’s Sahara
Desert . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 357
23.4 Discovery of ‘Tanka’ and ‘Beri’ as the Main Breeding Habitats
for Anopheles stephensi in the Thar Desert . . . . . . . . . . . . . . . 357
23.5 Invention of a ‘Tanka Lid’ . . . . . . . . . . . . . . . . . . . . . . . . . . . 358
23.6 Invention of a Mechanical Mosquito Sampler
(Tyagi Sampler) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 358
23.7 Coining a New Classification System of the Thar Desert
Based on the Distribution of Malaria Vectors
(Anopheles stephensi and An. culicifacies) . . . . . . . . . . . . . . . 360
23.8 Hypothesis on the Cradle of Anopheles stephensi in the Thar
Desert . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 361
23.9 Discovery of the Phenomenon of ‘Self-Immobilization’ in
Anopheles stephensi . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 362
23.10 Hypothesis on Anopheles stephensi: A Sibling Species
Complex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 362
23.11 Discovery of Cerebral Malaria Caused by Plasmodium vivax
in Adults . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 362
23.12 New Theory on Epidemics in the Thar Desert . . . . . . . . . . . . . 363
24 Future Implications of Desert Malaria in Global Elimination
Campaign . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 365
24.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 365
24.2 Anthropization and Climate Change: The Major Triggers for
Malaria Exacerbation in the Desert . . . . . . . . . . . . . . . . . . . . . 366
24.3 Excessive Rainfall and Malaria Epidemics in the Thar
Desert . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 368
24.4 Climate Variability: Impact of El Nino Southern Oscillation
on Malaria Conflagration . . . . . . . . . . . . . . . . . . . . . . . . . . . . 369
24.5 The Phenomenon of ‘Inundative Vectorism’ . . . . . . . . . . . . . . 370
24.6 Malaria Control in Deserts . . . . . . . . . . . . . . . . . . . . . . . . . . . 371
25 Conclusion: Will Deserts Transform into Malaria Hotspots
Tomorrow? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 373
Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 381
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 389
‘Desert Malaria’: An Emerging New
Paradigm 1
1.1 Introduction
Malaria is an age-old vector-borne disease that is transmitted to humans by

mosquitoes belonging to the genus Anopheles (Bruce-Chwatt 1985; Sharma et al.
2020). It is numero uno among all the nearly 400 infections transmitted by the
arthropod vectors in terms of morbimortality as well as its social, psychological, and
economic impacts (Tyagi 2003a, b, 2004a, b). It not only affects health but also
emaciates economy, enfeebles communities, and saps off affected nations’ intelli-
gentsia (Sinton 1936; Tyagi 1992a, b; Hay et al. 2004). Malaria’s ferocity in both
time and space is widely regarded to be responsible for changing the course of
human history, for example, deciding the fate of nations in war (e.g., Panama, which
still belonged to Colombia until the late nineteenth century, raged a war for indepen-
dence following which a bitter Civil War erupted between 1900 and 1903 whereafter
it finally won the independence) (Spielman and D’Antonio 2001; Tyagi 2020); for
felling the great leaders (e.g., Alexander the Great, is believed to have succumbed to
the infection by Plasmodium falciparum while returning after the fateful battle
against the Indian King, Porus, in Punjab); for terminating ruthless and much
dreaded invaders on the Indian soil (e.g., Mohammed Bin Tughluk contracted
malaria in 1351 while on a military campaign against rebels and died shortly
thereafter. A similar fate is believed to have meted out to Mahmud Ghaznavi who
invaded and plundered the Indian temples in Somnath and Mathura, and he too died
en route to Ghazni through the Great Indian Thar Desert); for decimating armies
(e.g., malaria, together with Yellow Fever and dengue, is regarded to have taken its
toll on thousands of US soldiers engaged in an ephemeral Cuban independence war
between Spain and the United States of America during the late nineteenth century,
and that death from the disease among American troops was much more common
than death in war per se from bullets); and for indecisive wars (e.g., the infamous and
indecisive US-Vietnam war in the mid-twentieth century, between 1955 and 1975,
during which malaria pitched the foreign troops in dire consequences of the
# The Author(s), under exclusive license to Springer Nature Singapore Pte 1

Ltd. 2023
B. K. Tyagi, Desert Malaria, https://doi.org/10.1007/978-981-19-7693-3_1
2 1 ‘Desert Malaria’: An Emerging New Paradigm
One or more indigenous cases Certified malaria free after 2000

Zero cases in 2018–2019 No malaria
Zero cases in 2019 Not applicable
Zero cases (³3 years) in 2019
Fig. 1.1 World map showing countries with indigenous cases in 2000 and their status by 2019.
Countries with zero indigenous cases over at least the past 3 consecutive years are considered to
have eliminated malaria. In 2019, China and El Salvador reported zero indigenous cases for the
third consecutive year and have applied for WHO certification of malaria elimination; also, the
Islamic Republic of Iran, Malaysia, and Timor-Leste reported zero indigenous cases for the second
time. (Source: WHO 2020, auto-permitted with due acknowledgement in the book)
infection, and even singularly stood responsible for aborting the war with total
withdrawal of the US soldiers from Vietnam).
Malaria is currently vastly limited to tropical and subtropical countries, but more
prominently in Africa, South Asia, and Latin America (Maurice and Pearce 1987;
Greenwood 1999; WHO 2020) (Fig. 1.1). Malaria is a global disease but the poorest
countries of the world have been suffering from it most, with Sub-Saharan African
(SSA) nations bearing the highest burden of both disease prevalence and deaths
(90%), followed by the South-East Asian countries (May 1951; MAP 2020). Though
initially malaria remained predominantly a rural problem, it has recently begun
impacting the urban agglomerations with equally serious repercussions. Interest-
ingly, malaria has recently extended its occurrence even in a least expected, water
scarce and inimical environment such as that of the desert, which is a new paradigm
for malaria as well as a serious issue in our efforts to eliminate malaria globally
(Baeza et al. 2011, 2013; Tyagi 2002).
1.1.1 Definition
Malaria (məˈlɛːrɪə) is defined as an intermittent and remittent infectious disease

caused by protozoan parasites from the Plasmodium family, which is mainly trans-
mitted by the bite of the Anopheles mosquito, besides by way of contaminated
needles or blood transfusion, mostly in tropical and subtropical countries.
1.1 Introduction 3
1.1.2 Malaria Symptoms
Malaria is characterized by high fever, chills, and other flu-like symptoms. The
infection can eventually lead to kidney failure, seizures, confusion, coma, and, in the
worst cases, death. Symptoms of malaria primarily include the classic cycles of high
fever, followed by sweat and finally chills that recur every few days, which may be
joined by nausea and vomiting, abdominal pain, fatigue, rapid breathing, rapid heart
rate, cough, general feeling of discomfort or muscle or joint pain, and headache.
People who fall sick due to malaria usually feel very weak with a high fever and
shaking chills. The sickened people may also experience coughing, vomiting,
diarrhoea, and yellowing (jaundice) of the skin and eyes. On the other hand, those
persons who are affected with severe falciparum-malaria can develop bleeding or
haemorrhagic manifestations, shock, kidney and liver failure, central nervous system
problems, coma, and, if not timely attended medically, even die.
After an infected mosquito bite to a healthy man, signs and symptoms of the
malaria disease typically begin within a few weeks. In some types of malaria
parasites such as Plasmodium vivax, or more particularly P. malariae, however,
the pathogen can lie dormant in the body for months to a year or even more. Among
the many names for malaria are ague, jungle fever, marsh or swamp fever, paludism,
and, in Hindi, ‘durvāta’ (= दरवात) or ‘sheet-jwar’ (शीत-जवर). Indian literature of
yore has several irrefutable references to both malaria and various different types of
mosquitoes involved in the transmission of malaria and other maladies to man
(Satvalekar 1958; Rao 1984; Kaur and Singh 2017; Tyagi 2020).
1.1.3 Parasites
Although there are over 200 species known under the genus Plasmodium March-
iafava and Celli, 1885, and as many as 11 are known to infect humans (Igweh 2012),
only five of the following species of Plasmodium are responsible for human malaria
(Cox Francis 2010), viz.,
1. Plasmodium falciparum (Welch 1897)

2. Plasmodium vivax (Grassi and Feletti 1890)
3. Plasmodium ovale (Stephens 1922)
4. Plasmodium malariae (Feletti and Grassi 1889)
5. Plasmodium knowlesi (Sinton and Mulligan 1932)
Of all these parasites, P. vivax and P. falciparum are more common; the former
being more dominant in Asia and the latter in Africa where it inflicts about 90% of
the population, most of them children below 5 years and pregnant women. Plasmo-
dium falciparum, also known as malignant malaria parasite, differs from the rest of
the parasites mainly in the fact that it affects human brain or nervous system, with
eventual death if not treated medically in time (Guerra et al. 2008). Plasmodium
vivax, too, is dangerous since the benign fever caused by it usually relapses, with
severe complications to follow. Both these malaria forms are, however, treatable
through a range of antimalarials under strict medical advice.
The malaria parasite completes its asexual phase of life cycle in the human host
and sexual phase in the anopheline mosquito. Fundamental details about malariol-
ogy have been explained by Bruce-Chwatt (1985).
To reduce malaria infections, the national health programmes across the world
distribute preventive drugs and insecticide-treated bed nets to protect people from
mosquito bites. Personal, self, or private medication as presumptive treatment
without a proper prescription must be avoided. A reasonably effective vaccine,
RTS,S/AS01 (RTS,S), world’s first malaria vaccine, after being piloted for several
years in a few African countries, is now available for vaccination on a limited scale.
Further, in October 2021, the WHO for the first time recommended the large-scale
use of a malaria vaccine for children living in areas with moderate-to-high malaria
transmission in certain endemic countries in Africa. There is no vaccine for travellers
yet. Therefore, travellers to areas with malaria are advised to take medications to
prevent infection, if exposed. The treatment of malaria is with oral or intravenous
medications, under strict medical care.
1.1.4 Malaria Vectors
Tropical countries are typically characterized by both richness and endemism of the
anopheline taxa, with preponderance of species diversity ever growing toward the
equator (Foley et al. 2007). Therefore the countries like Brazil, Indonesia, Malaysia,
and Thailand surpass others in the species quantum and densities, although Brazil
tops the list of the countries in exhibiting the highest taxonomic output and number
of type locations. Further, countries like Brazil, Australia, the Philippines, Indonesia,
Panama, French Guiana, Malaysia, and Costa Rica do not only boast of the highest
numbers of endemic mosquito species but also the highest densities of total species
and endemic species. Interestingly, 50% of mosquito species occurring worldwide,
i.e., approximately 2000 species, are endemic to these countries. Among all the
nations with highest species densities as well as when compared to the continental
mainland countries of similar size, the island nations have characteristically both the
higher total number of species and higher endemic species. As far as deserts are
concerned, very low number of mosquito species and fragmentary publications have
been brought on record, possibly due to lesser sampling efforts and/or species
abundance. This is probably the reason that the taxonomic output was lowest for
some desertic countries, such as those located in Africa, Arabian Peninsula, and the
Middle East desertic regions; the Thar Desert in the north-western State of Rajasthan
(India) being the only possible exception (Tyagi 2002; Anon. 2006).
Of the nearly 3600 species of mosquitoes worldwide (precisely 3606 extant taxa
of Culicidae as of now on July 6, 2022) in the three subfamilies: Toxorhynchitinae
(Toxorhynchites), Culicinae (Aedes, Culex, Mansonia, Armigeres), and Anophelinae
(Anopheles), there exists a total of 465 formally recognized Anopheles species in
addition to more than 50 unnamed members of species complexes such as Anopheles
1.1 Introduction 5
Fig. 1.2 Zoogeography of vector species for malaria across the world’s different regions. (Source:
Available in public domain at http://www.cdc.gov/malaria/about/biology/mosquitoes/map.html)
culicifacies, An. subpictus, An. fluviatilis, and An. annularis (Sinka 2013; Manguin
2013). Of the many species included in these subfamilies, only a subset of approxi-
mately 70 species have been confirmed to have the capacity to transmit parasites of
human malaria (Service and Townson 2002), and 41 are considered to be primary or
dominant vector species (DVS)/species complexes, capable of transmitting malaria
at a level of major concern to public health (Hay et al. 2010a, b). They are present in
all regions of the world, mostly in the tropics and the subtropics. Maximum vector
species occur in Asia. Region-wise dominant vector species (DVS) are discussed
below (Sinka 2013), albeit actual quantum of potential vector species might be much
higher for each of the regions (Fig. 1.2).
1.1.4.1 The Americas

The American continent nations have the lowest P. falciparum morbidity (PfPR2-
10 ≤ 5%) when compared with the nations of other regions. High quality of vector
control/management throughout the entire region for a long time has been the major
factor behind the decreased morbidity and mortality in the North American nations,
in particular. There are nine dominant vector species in the Americas:
(i) An. albimanus

(ii) An. albitarsis complex
(iii) An. aquasalis
(iv) An. darlingi
(v) An. freeborni
(vi) An. marajoara

(vii) An. nuneztovari complex
(viii) An. pseudopunctipennis
(ix) An. quadrimaculatus complex
1.1.4.2 Africa
Considering Africa’s gargantuan and variable landscape and ecosystem, there is a
corresponding variability in the intensity of malaria transmission (Hay et al. 2000,
2005). The Sub-Saharan region is not only the world’s most malarious area with
highest morbidity and mortality but also the home for highest global P. falciparum-
malaria transmission levels (Fontenille and Simard 2004; Hay et al. 2010a, b).
Anopheles gambiae, the deadliest mosquito on our planet, is a member of the An.
gambiae complex, which also contains other dominant vector species such as An.
arabiensis, An. Merus, and An. melas. In addition, and importantly enough, An.
funestus subgroup consisting of another highly effective vector An. funestus is also
widely found in Africa. It is of course worth mentioning here that An. funestus is
possibly the first species in the subgroup to adapt to make use of humans as a food/
blood source. Still, An. moucheti, a vector much limited in both density and
distribution but highly anthropophilic in nature, and An. nili complex of compara-
tively more widespread species further reinforce the strength of vectors within
Africa. All these vectors, primary or secondary in nature, are highly efficient in
malaria transmission. Their control is equally difficult primarily owing to the yet
unnamed species under complexes, on the one hand, and varying behavioural
attributes, on the other. Following are the more dominant vectors in Africa:
(i) An. arabiensis

(ii) An. funestus
(iii) An. gambiae
(iv) An. melas
(v) An. merus
(vi) An. moucheti
(vii) An. nili complex
1.1.4.3 Asia-Pacific
The Asia-Pacific is one of the most prosperous regions in the world as far as the
biodiversity of vector species, species complexes, and suspected species complexes
is concerned. Many of these species complexes occur sympatrically (i.e., species
occurring in the same geographical range without loss of identity from interbreeding
sympatric species or the taxa occurring between populations that are not geographi-
cally separated sympatric speciation) and manifest a great degree of fluctuation in
behaviour or behavioural plasticity (Sinka et al. 2011). This complexity, and the
taxonomic ambiguity of many of the dominant vector species (DVS) of the region, is
a major contributing factor to the continuing impact of malaria in this area. With
39% of the global malaria burden (estimated clinical cases of P. falciparum malaria
only), southeastern Asia is second only to Africa in suffering with malaria, with
1.2 Deserts, Arid Environments, and Malaria 7
pockets of medium to high endemicity found in Orissa and some of the seven-sister
States in the northeast India, western Myanmar, and the lowlands of New Guinea.
India alone shares 41.9% of the global population at risk of P. vivax transmission
which is quite worrisome.
The Asia-Pacific region harbours 19 DVSs (i.e., 46.4% of totally 41 Dominant
Vector Species recognized globally). Of these at least 10 are now considered as
species complexes. The phenotypic and genotypic complexities of the vector biol-
ogy in the Asian-Pacific region escalates the problems associated with our under-
standing of the vector/disease transmission environment which is integral to control
programmes.
The Asia-Pacific region outnumbers DVSs in all other regions in the world. The
region houses far greater number of species complexes and taxonomic complexities
than anywhere else (vide infra).
(i) An. aconitus

(ii) An. annularis
(iii) An. balabacensis
(iv) An. barbirostris complex
(v) An. culicifacies complex
(vi) An. dirus complex
(vii) An. farauti complex
(viii) An. flavirostris
(ix) An. fluviatilis complex
(x) An. koliensis
(xi) An lesteri
(xii) An. leucospyrus/latens
(xiii) An. maculatus (group)
(xiv) An. minimus complex
(xv) An. punctulatus complex
(xvi) An. sinensis complex
(xvii) An. stephensi
(xviii) An. subpictus complex
(xix) An. sundaicus complex
1.2 Deserts, Arid Environments, and Malaria
Malaria is still the deadliest vector-borne disease of great public health significance
transmitted by infected female Anopheles mosquitoes which breed in aquatic
habitats, stagnant or slowly streaming fresh or salty water which is a prerequisite
for the development of the larval stages (Shayo et al. 2021; Getachew et al. 2020;
Mwakalinga et al. 2018). Therefore, the billion dollar question that springs up
naturally is: “Can malaria occur in the desert environments?” Zahar (1990a, b)
first highlighted the significance of “Desert Fringes” and “Desert Oases” in the
transmission of malaria among local desert populations, and also the neighbouring
areas. Long-term investigations into risk of malaria exacerbation in the light of

extensive canalized irrigation in the Thar Desert by Tyagi (1995a, b,
1996a, b, c, d, e, f, g, 2002, 2003a, b, 2004a, b, 2020, 2021), Tyagi et al. (1995),
and Tyagi and Chaudhary (1997) founded for the first time an irrefutable
malariological significance of the desert ecosystems and their impact on exacerba-
tion of the disease in the neighbouring areas where malaria control campaigns were
in progress and the risk of resurgence of disease transmission occurred.
In general, people associate malaria with the regions where surface water is
abundantly present in some form. However, in addition to surface water, prevalence
of malaria depends mainly on climatic factors such as temperature, humidity, and
rainfall. Factors such as temperature and humidity are particularly critical, though
significance of rainfall cannot be underestimated especially in Desert Fringe areas
where wide epidemics of malaria generally follow heavy downpour. Malaria, partic-
ularly Plasmodium falciparum (a deadly parasite which causes severe malaria)-
malaria, thrives in tropical and subtropical countries because the environment
there is highly favourable for the development of both the vector and the parasite,
implying that (1) Anopheles mosquitoes, which must live for a minimum of 7 days
on an average, can survive and multiply prodigiously, and (2) malaria parasites can
complete their growth cycle in the mosquitoes (“extrinsic incubation period”). It is
noteworthy here that the deadly malaria parasite, Plasmodium falciparum, is unable
to complete its growth cycle in the Anopheles mosquito below 20 °C or 68 °F. On
the other hand, Plasmodium vivax, which is more tolerant of lower ambient
temperatures may be prevalent seasonally in cooler regions. Besides temperature,
humidity and rainfall, factors such as the altitude may also impact transmission. It is
for this reason that malaria is generally not reported in high altitude areas for the
want of any anopheline, leave aside a vector, mosquito. Thus, even within tropical
and subtropical areas, transmission will not occur (1) in colder seasons in some
areas, (2) frozen lands, (3) in deserts (save for the Sahara, the Thar, etc.), and (4) in
many temperate areas, such as western Europe and the United States, economic
development, improved housing conditions, and public health measures through
successful control/elimination programmes have succeeded in interrupting transmis-
sion and thereby eliminating malaria. However, most of these areas, parts of which
existing as buffer zone for both malaria vectors and parasites, have Anopheles
mosquitoes that can transmit malaria, and reintroduction of the disease is a
constant risk.
It is a well-known fact that malaria is more intense and transmitted year-round in
warmer regions closer to the equator, and the most glittering examples to this rule are
(1) the Sub-Sahara Desert where the highest perennial transmission occurs in Africa,
and (2) in parts of Oceania such as Papua New Guinea where following a steady
decline in cases till 2014, the scenario almost catapulted and cases increased over
tenfold from 50,309 in 2014 to 646,648 in 2019. In cooler regions, transmission will
be less intense and more seasonal.
As far as deserts are concerned, one naturally does not associate malaria with a
water-deficient habitat. Common sense dictates that mosquitoes, which breed only in
stagnant and/or slowly flowing ground water, would give arid environments a wide
1.3 Ecotypes of Malaria in the Desert Environments 9
go-by. But that is not the case with some hot deserts in Asia and Africa where
malaria vectors abundantly breed due largely to the long-time impacts of climate
change, anthropization (human-driven environmental changes), and, above all,
canalized irrigation in an attempt to develop agro-economy and general living
standards of the local folks. However, these interventional vicissitudes transformed
deserts into the lands of persistent malaria due mostly to water mismanagement
(Tyagi 2002)! Some deserts present a highly precarious and transitional stage of
evolution such as the Namib where the biological diversity apparently is in a clash of
sea and land, and fog and dust (Barnard 1998).
Deserts constitute a unique ecosystem in our planet, the Earth. Though much of
the various different hot deserts still continue to preserve the antiquitous nature, i.e.,
deficient precipitation, high temperature, low humidity, sand storms, and fauna and
flora with features adapted to hostile xeric conditions, yet at least some of these or
their parts have undergone a major change in their physiography and transformed
into a semiarid environment conducive enough to cultivate new and high-yielding
agriculture due largely to canalized irrigation with a humongous network such as the
world famous Indira Gandhi Nahar Pariyojana (IGNP) running across the Thar
Desert in the northwestern India (Bhandari 1978; Malhotra 1988). Resultantly, in
the Thar Desert, malaria drifted from an autochthonous nature in the penetralium of
the leveed xeric ecosystem to a persistently fulminating epidemic malaria in the
irrigated desert and neighbouring non-desert lands.
1.3 Ecotypes of Malaria in the Desert Environments
Malaria being local and focal in character, control programmes need to stratify their
malaria problem into a number of smaller units, keeping in mind the variability of
malaria. Such stratification may be based on the epidemiology of malaria or on its
determinants such as ecology and disease transmission capacity of vectors (Schapira
and Boutsika 2012a, b). An ecotypic classification comprising eight major malaria
paradigms to categorize typical disease transmission settings was developed by the
World Health Organization around 1990 (WHO 1993a, b), as follows:
1. Malaria of the African Savannah

2. Forest malaria
3. Malaria associated with irrigated malaria
4. Highland fringe malaria
5. Desert fringe and oasis malaria
6. Urban malaria
7. Plains malaria
8. Seashore malaria
Malaria being local and focal infection in nature, the type of ecosystem (e.g.,
physiographically clearly earmarked, in transitional or mixed zones) determines a lot
of its attributions, e.g., distribution over a biogeographical region or even subregion.
Globally malaria is associated with a melange of ecotypes, and the intensity of

occurrence of the disease can be high or low or fluctuating depending on a particular
set of few or all of these ecotypes. The first-hand local information on ecology,
topography, physiography, bio-socio-cultural, anthropic, and health system pro-
cesses, including malaria control, is essential to comprehend the nature of malaria
epidemiology for a specific ecotype or set of ecotypes. Ecotyping malaria is of
paramount significance and needs to be executed in the outset to determine desired
control interventions. Therefore, ecotyping of a malarious area should be done for
early weaving of a framework, rather than used as a shortcut, to supplement available
epidemiological and entomological data so as to assess malaria situations at the local
level, think through the particular risks and opportunities, and reinforce intersectoral
action. Cognizance of these facts implies that several biogeographic regions’ eco-
typic distinctions are not only well defined but also serve as a guiding force for
implementing control campaigns with a certain degree of certitude and success. For
example, forest environments in the Indo-Myanmar, Indo-Malay, and the Neotropics
are, with a few exceptions, associated with much higher malaria risk than in adjacent
areas. Within India, Dev (2022) has recently highlighted high risk of malaria
transmission in the North-East states rife with sylvatic environments where the
vectors are difficult to control, affected populations are difficult to approach, and
the anthropic factors, such as population movements across the state as well as
international borders, also often converge to impose constraints in delivering pri-
mary and/or emergency health care whichever necessary. Another burning example
in India is the emerging urban malaria which is a serious risk, along with rural
malaria intruding deeper into ecosystems hitherto known to be terra incognito for
malaria (e.g., Thar Desert). In Africa, on the other hand, the malaria scenarios
presented by urban agglomerations in both the Sahara Desert (SD) and the
Sub-Saharan Desert (SSD) regions has so far been associated with lower risk.
Urban malaria is, however, more rampart in the savannas south of the Sahara Desert.
While in Africa no specific vector control is defined save for the facultative larval
control on ad hoc basis, in the Indian subcontinent, in contrast, where urban malaria
transmitted by An. stephensi is associated with higher risks than most adjacent rural
areas, malaria vector control is implemented by a well-defined, though not exclusive,
larval control methodology using chemical, biological, and/or environmental
methods. Since all ecotypes do not pose the same set of challenges in controlling
malaria, the field research on malaria and ecology should be interdisciplinary,
especially with geography, and pay more attention to juxtapositions and to anthropic
elements, especially migration (Schapira and Boutsika 2012a, b).
As far as deserts are regarded, three major malaria paradigms exist currently:
(1) Desert Fringe Malaria, (2) Desert Oasis Malaria, and (3) Desert Malaria per
se. Malaria transmission in the desert is dependent on availability of surface water
and associated increase in humidity. Anopheles arabaiensis is the main vector in the
Sahara and the Arabian Peninsula deserts, while in the Great Indian Thar Desert and
the Middle East it is An. stephensi which is the predominant desert species for
malaria transmission. Although, both these vectors are highly adaptable to dry
conditions, An. stephensi has recently invaded many countries which were hitherto
1.4 Desert-Based Malaria 11
a terra incognito for the mosquito (e.g., Sri Lanka and some nations in African
Sahara)! Following are the identified characteristics associated with each of the three
ecotypes:
(i) Desert Fringes—These areas are located on warm low land areas, and experi-
ence abnormally heavy rainfall causing flooding which almost always gives
rise to malaria epidemics.
(ii) Desert Oasis—Malaria in oases is characterized by transmission of malaria
limited to spring and autumn seasons when both temperature and humidity are
suitable, and the transmission usually occurs in abnormal years with very long
periods or heavy rain fall.
(iii) Desert Malaria—This is a very peculiar state of affairs, i.e., ‘The Desert
Malaria’, which has emerged in the traditionally water-deficient arid environ-
ment characterized by two different types of underground water conservation
and/or harvesting processes, i.e., ‘Tanka’ and ‘Beri’—the sole factors behind
indigenous and/or autochthonous round-the-year malaria mediated by An.
stephensi, at the penetralium of the Thar Desert, though at a low ebb. The
‘Desert Malaria’ paradigm was explained for the first time by Tyagi (1995a;
also see Tyagi 2002, 2020) and Tyagi et al. (1995). Thus, the list of malaria
ecotypes earlier offered by the WHO (1993a, b) now extends to nine with the
inclusion of ‘Desert Malaria’. It is emphasized here that arid environments in
the Thar Desert of northwestern India are associated with unstable malaria with
potential for occasional epidemics; the principal and original vector An.
stephensi is difficult to control owing largely to its combined phenotypic and
genotypic plasticity (Chakraborty et al. 2021), and the anthropic factors such as
highly preferred water storage habit due to shortage of water supply which
clearly pose operational constraints (Tyagi and Yadav 1996a, b, c; Tyagi 2002).
1.4 Desert-Based Malaria
1.4.1 The Problem
Since the early times of the Global Malaria Eradication Programme (GMEP), it had
been understood that malaria, unlike several other vector-borne diseases, was essen-
tially a local and focal problem, and a single panacea of “one size fits all” for the
selection of appropriate interventions would not work in all the highly varying
paradigms. A good deal of emphasis was, however, laid on developing a reconnais-
sance of their malaria epidemiology supported with maps on the intensity of parasite
transmission, dominant vectors’ distribution, population settlements, rivers, dams,
and agricultural areas and practices, etc. (WHO 1956; Pampana 1969). Although
national malaria control agencies of different endemic countries independently
followed different plans and developed their own maps and templets without
uniform set of information, the information secured on the basis of the association
between rainfall duration and malaria seasons, altitude, proximity to breeding sites,
and occasionally supported by empirical observations of incidence and prevalence of

malaria provide a solid foundation to frame a roadmap for future action (Gemperli
et al. 2006; Craig et al. 2007). Coupled with this, risk maps prepared in course helped
the national control agencies grow au fait in their knowledge toward malaria
epidemiology and generated important national atlases, with particular context to
malaria cartography across much of Africa and India, to guide disease control
(Languillon 1957; Christophers and Sinton 1926; Covell 1949). When the regional
control agenda shifted from one of preventing infection to treating fevers in the
1970s, the map developing science and effort was brought to back-bench. This is for
this reason that thereafter malaria risk maps were rarely developed for desert regions
and tailored to address national control programme ambitions. The result was as
catastrophic as the devastating resurgence of malaria in India between 1965 and
1976, following a phenomenal success in bringing down the malaria cases below one
million and no death in mid-1960s (Akhtar et al. 1977). However, the eradication
campaign faltered and malaria seemed to have diffused from the less cared low
endemic areas as well as hard to reach populations such as the areas normally arid
(Desert Malaria), semi-arid (Desert Oasis Malaria), or only moderately humid
(Desert Fringe Malaria) which seemed to have played a crucial role in diffusing
with those hyperendemic where control process had been focused. The much
disquieting increase was from over five million in 1976 to ten million in the first
9 months of 1977.
Therefore, malaria associated to desert environments carries a great epidemiolog-
ical significance particularly to retain benefits of disease control in neighbouring
hyperendemic zones or regions since malaria is a focal disease whose epidemiology
is affected by human, vector, parasite, and environment (Ranjha and Sharma 2021).
Deserts being considered generally as regions harbouring low malaria intensity are at
risk of exclusion from the national focus to eliminate the disease with the same force
of attention as practiced in hot malaria zones. However, such negligence might prove
costly soon after achieving success in the hyperendemic and epidemic prone hot
regions as possibly occurred in mid-1960s when India had reported less than one
million cases without any death due to malaria (Sharma and Mehrotra 1986). It is
noteworthy that soon after the spectacular, though ephemeral, success malaria had
resurged with a vengeance and by 1970s hit an unbelievable mark of 10 million
cases with several hundreds of people succumbing to the savagery of the infection.
With this catastrophe a set of new operational constraints also emerged prominent
among which was development of resistance in Anopheles vector species against
insecticides used in antimalaria programme, e.g. DDT, HCH, and malathion, and in
Plasmodium parasites against antimalarials of choice such as chloroquine. That a
low endemic region like the Thar Desert could threaten to generate new malaria
cases across far off states like Punjab, Haryana, Gujarat, Madhya Pradesh, Delhi, and
Uttar Pradesh was not understood and valued significantly until Tyagi (1995a, b) and
Tyagi et al. (1995) exposed its vulnerability to malaria exacerbation with potential to
cyclic epidemics due to irreversible and gargantuan anthropization (human-driven
environmental changes), including an extensive canalized irrigation system—one of
the world’s largest of its kind in a xeric ecosystem, and the changing climate (Bouma
and van der Kaay 1995). All the Desert Malaria ecotypes (i.e., Desert Malaria, Desert
Oasis Malaria, and Desert Fringe Malaria) have been regularly threatening to stall, or
even revert, the progress in eliminating malaria by nations and the world alike. It is,
therefore, important to understand the characteristics of each of these ecotypes
harbouring potential for malaria conflagration.
1.4.2 Types of Desert-Based Malaria Paradigms
To date only three ecotypes of malaria have been identified. Each of these three
ecotypes make a different malaria paradigm being evolved in altogether different
sets of eco-bio-social settings. Each of the ecotype is associated with a kind of
malaria with different intensity and periodicity. Their vector composition is also
more or less specific.
1.4.2.1 Desert Oasis Malaria

The Sahara Desert, lying between Sub-Saharan Africa (where Plasmodium
falciparum malaria is highly endemic and causes major morbimortality) and the
northernmost zone along the Mediterranean Sea (where malaria was eliminated
decades ago, except intermittent exotic cases), is acknowledged as the greatest of
all deserts in the world rife with oases of variety. Desert oases are usually not
considered when one thinks of major malarious areas (Bogreau et al. 2019). In
contrast, oases in the Sahara Desert are the main agro-ecologic environments
suitable for malaria transmission. In fact, oases may offer excellent conditions for
the transmission of malaria in hot deserts where malaria vectors such as An.
arabiensis (in Africa) and the Thar Desert (in India) exist. There are many factors
for malaria transmission in the oases, which is generally low, but the essential
factors, i.e., man, mosquito and parasite always exist. Extrafactorial characteristics
in oases like geographical, climatological and epidemiological conditions, which
differ from other localities, permit malaria to occur in desert oases which are on the
increase in deserts to meet with the ever growing vital needs for human sustenance.
For example, the number of oases in the Adrar region of Mauritania alone grew from
31 in 1984 to 75, which is 140%, in 2012, due mainly to the development of hydro-
agricultural projects. Unfortunately only fragmentary and grossly incomplete infor-
mation is available on oasis malaria in the Sahara, despite the potential risk for
malaria transmission projected by these special water reservoirs in the desert
(Bernabeu et al. 2012; Deida et al. 2019). It has been, therefore, often advocated
that regular monitoring of malaria in the Saharan zone, including in other oases,
should be implemented.
The oases consist of isolated areas of vegetation, normally palm trees, generally
arranged in long, relatively narrow, broken lines with a well-defined orientation, e.g.,
eastwestern direction in Libya’s Fezzan Province oasis in the Sahara Desert. Oases
are generally most thickly inhabited (Goodwin and Paltrinieri 1959). The houses of
the oases, being largely of rural character (i.e., social and economic patterns), are of
two types;
(i) Houses in Large Oases: Therein adobe bricks and palm branches are respec-
tively used to make walls and roof, covered in mud plaster.
(ii) Houses in Outlying Oases: Only palm branches are generally used to construct
these.
Oases occur where the water table is sufficiently near to the surface to support the
growth of date palms, and to permit digging of shallow wells to supply water for
consumption by man and his domestic animals. The wells also supply water for
irrigation of barley, alfalfa, and a few vegetables.
The climate of oases is generally arid with rain falling at rare intervals. As in the
case of Fezzan of Libya where the rainy season is from March to May with variation
in rainfall from 0.5 inch to 4.0 inch over a period of 5 years, it varies in most other
cases of the deserts. The relative humidity ranges from 10 to 45%. Temperature
range is very wide from -9 °C to 55 °C. Oases’ inhabitants, drawn by the better
opportunities of commerce and business, often migrate periodically to the coastal
cities. Many of these oases have been important trade centres, and, though motorable
passages are often noticed currently (four-wheel drive vehicles fitted with special
equipment), the old system of transportation through camel (‘the desert ship’)
caravans is still much in vogue due to their availability round the clock. Some
oases, particularly those celebrating the harvesting season of date palm fruit every
year during June–August in the Sahara Desert, are also the site of increasing tourism
by thousands of Mauritanians. In recent past even long distance movers such as
thousands of migrants from Sub-Saharan Africa on their way to Maghreb countries
(countries in North Africa bordering the Mediterranean Sea) and Europe have been
using these oases as a transit zone.
Evidences from oases in African Sahara and Indian Thar deserts show occurrence
of the two most important human malaria parasites, viz., Plasmodium vivax and
P. falciparum; the latter being more common in approximately 3:1 ratio in the
Sahara Desert’s Libya and 2:3 ratio in the Thar Desert. In a study carried out in
the oasis city in Mauritania, Plasmodium ovale was microscopically detected in
10/154 patients (6.5%), although subsequent PCR results discarded as wrongly
identified instead of P. vivax infections (Deida et al. 2019). Plasmodium malariae,
P. ovale, and P. knowlesi have never been reported from the Thar Desert, although
they are occasionally encountered in the Sahara desert. In the past, incidence of
malaria has not been high and epidemics have been rare. Malaria in the oases would
probably increase if some type of control was not in effect. When the farmers of
oases had abandoned their farms and migrated to other greener areas for the benefit
of their cattle, the abandoned dug wells and other sources of irrigation resulted in an
increase of suitable breeding sources for anopheline mosquitoes and a probable
increase in the transmission of malaria, even epidemics.
The anopheline fauna may differ from oases of one region to those in others.
Thus, while Anopheles multicolor and An. sergenti are prevalent in Libya’s oasis, it
is feared that the deadly desert mosquito, An. arabiensis, possibly along with several
others, might get introduced in Mauritania sheerly on account of the recently
constructed national highway that connects Rachid oasis to Atar. In India the
major malaria vector perennially present is An. stephensi, although other species,
including An. culicifacies and An. subpictus among others, are also present in some
parts of the year (Tyagi 1995a, b, 2002, 2020).
1.4.2.2 Desert Fringe Malaria

Of all the three malaria paradigms or ecotypes known to the world, i.e., desert fringe,
desert oasis and desert per se, the largest surface area is occupied by the desert
fringes which are the home for millions of people around the tropics in Africa, Asia,
and South America. Desert fringes are best known for seasonal and epidemic malaria
under the impact of marginal environmental conditions in which both the develop-
ment of the parasite and the population dynamics of the Anopheles mosquito vector
are favoured (Roy et al. 2015). Due to heavy seasonal rains in the desert fringe areas
both humidity and temperature are almost optimum and good enough to trigger
malaria epidemics in warm semi-arid (desert-fringe) and high altitude (highland-
fringe) epidemic risk areas. As such there is no rainfall in the desert fringe areas for
most part of the year, which, aided by the temperature limit, tends to preclude the
population growth of the vector and the parasite’s development within the vector,
but the sudden onset of climate variability brought about by heavy downpour renders
the ecotype the highest potential to strongly impact disease dynamics.
1.4.2.3 Desert Malaria

‘Desert Malaria’, a new malaria paradigm, originated in the Thar Desert (Tyagi
1995a, b; Tyagi and Chaudhary 1996; Tyagi et al. 1995). The emerging ecotype is of
immense epidemiological significance, especially when focus for control of malaria
is put on high endemic ecotypes in close approximation, both in context with
national malaria elimination campaign and other countries particularly in Middle
East/West Asia, Arabian Peninsula, and the African continent with deserts where
‘Tanka’, etc., exist and either a species like An. stephensi is already occurring there
or has in recent years made incursions to exacerbate malaria situation (Zahar 1985,
1990b; Tyagi 1995a, b, 1996a, b, c, d, e, f, 2002, 2004a, b, 2020; Tyagi et al. 1995;
Sinka et al. 2010, 2012, 2020, Sinka 2013; Manguin 2013).
The Thar Desert is comparatively a young desert. It ranks 20th among deserts in
the world as far as size is concerned and ninth largest hot subtropical desert when
weather conditions dominated by temperature is regarded. During the integrated and
undivided times it was wholly limited within the Indian mainland; however, after the
partition of the country in 1947 about 90% of the Thar Desert is located in India,
while only less than 10% falls in Pakistan. The Thar Desert is about 4.56% of the
total geographic area of India. It originally comprised 11 desert districts which later
increased to 12 in the 1990s. Known for unstable malaria with potential for occa-
sional outbreaks of malaria, the Thar Desert did not have any canal-based irrigation
system nor there was a perennial river, albeit seasonal Ghaggar river which however
disappears halfway into the desert. The only long-time water resources were the
man-made ‘Tanka’ and “Beri’, the underground engineering feats to conserve water
for meeting out vital needs for sustenance as well as limited agriculture, with the help
of seasonal ponds and tube-wells.
Anopheles stephensi, the only desert mosquito specialized to breed in these

underground water storing systems, was adapted to the Thar Desert’s inclement
environment and continued multivoltine life throughout the year. Malaria among
desert folks was P. vivax-dominated, with negligible cases of P. falciparum which
further used to conflagrate during either severe droughts when desert populations
resorted to migration particularly in search of fodder for their cattle and other pet
animals or rare heavy downpours and excessive ground breeding sites were formed.
Till the 1920s there was no canal-based irrigation in the Thar Desert and only An.
stephensi predominated the desert. Three major canal systems came in succession in
the Thar Desert north-southwardly; Gang Canal (Year 1928, with its 1251 km of
distribution system within Sri Ganganagar only, covering 300,000 ha of cultivable
land), Bhakra-Sirhind Feeder canal (Year 1955, having a 1219 km distribution
system irrigating another 300,000 ha of cultivable land), and the Indira Gandhi
canal (previously known as Rajasthan Canal Project, Year 1958; total length
649 km), with first waters flowing only in 1957 and the Canal being fully operative
in 1961), to be expanded in three stages to cover a major part of the arid
environments. It covers 445 km in length and 45 km in width the area of the Thar
Desert in the northwest of Rajasthan. Of all the three canal systems, the Indira
Gandhi Nahar Pariyojana (IGNP) is the most important, embodying nearly
10,000 km network of distributaries, when fully operative (by now its network is
only 547 km). The First Stage was completed as per the time schedule, but the
Second Stage, though largely operative, could be also mostly completed on time; but
it has created major mosquito breeding sites in the form of seepage resulting in vast
swampy areas all along its journey through different desert districts. With the vast
areas of ground breeding sites formed, several new species of mosquitoes some of
them being vectors (An. culicifacies, An. subpictus etc.), also made their entry in the
Thar Desert (Fig. 1.3). It is to be noted here that in spite of massive IGNP in
operation, a major part (80%) of the Thar Desert is still unchanged and is existing
in its original serenity.
Together with An. culicifacies, An. stephensi levied a double impact of disease
transmission on the desert populations, now suffering with a P. falciparum-
dominated malaria (Tyagi and Chaudhary 1996, 1997). After many years of repeated
epidemics, the Thar Desert has partially evolved into a hotbed for malarial inferno,
and a persistent threat to the adjoining non-desert region in the Rajasthan state or the
other hyperendemic states under intensified elimination campaign.
While the unchanged and noncanalized Thar Desert predominantly remains a
home for An. stephensi and P. vivax, the irrigated part of the Thar Desert has been
transformed into a multi-vectorial hotspot for P. falciparum-dominated malaria with
strong potential for disease outbreaks and affecting the lands in the neighbourhood.
This transformation of the Thar Desert from a meagre region of malaria
hypoendemicity to a highly fulminating P. falciparum-dominated ecosystem is an
irreversible one-way journey. This implies that the Thar Desert will continue to
transform and experience more intensified epidemics in future!
Conclusively, the new ecotype, ‘Desert Malaria’, is therefore defined as “a unique
paradigm in the penetralium of desert and/or leveed xeric ecosystem which, in
Fig. 1.3 A graphic representation of unidirectional transformation of the Thar Desert, with “Desert
Malaria” in the offing: (A) The Original Thar Desert with only An. stephensi and P. vivax in
dominance, (B) The triad of canal systems, topped by Indira Gandhi Nahar Pariyojana (IGNP) in
operation, with multi-vector, intensified disease transmission dominated by P. falciparum and
intensified outbreaks, and (C) A vector (An. stephensi + An. culicifacies) chorogeography-based
classification proposed for malaria in the Thar Desert (Source: Dr. B.K. Tyagi, this work original)
contrast to ‘Desert Oasis Malaria’ and ‘Desert Fringe Malaria’ ecotypes that are
solely dependent on monsoon rains, is humanly created, for example, in the Thar
Desert (India) in the first place, as underground water reservoir system either in the
belly of a large dry pond (e.g., ‘Beri’) or dug up burrow pit in the ground as a
gargantuan dome-shaped water-harvesting system (e.g., ‘Tanka’)—breeding invari-
ably the deadly malaria vector, Anopheles stephensi, responsible for low, indigenous
and unstable malaria in the arid environments of the desert with potential for
occasional epidemics—for meeting out man’s daily domestic needs for his own
survival in the hostile environment without a natural water source, for instance, an
oasis, within a radius of tens of kilometres.”
This specific type of paradigm, i.e., Desert Malaria, will be extensively dealt with
in the following chapters of the book.
Global vis-à-vis Desert-Driven Malaria
2
2.1 Global Malaria Scenario
Malaria is amongst the oldest infectious diseases known to man. Currently malaria is
still the most dangerous parasitic disease with the highest morbimortality globally.
The history of malaria in humans is as old as man’s own history. For decades now
malaria has been considered the most dreadful vector-borne disease that puts glob-
ally a massive economic burden (56,200,201 DALYS) (Hay et al. 2017; Breman
et al. 2004; Carter and Mendis 2002). Currently, it is one of the major tropical
diseases adversely affecting the health of the peoples and the economic development
of many developing countries, particularly in sub-Saharan Africa (SSA) and South-
East Asia. Malaria accounts for 300–500 million cases and up to three million deaths
each year throughout the world; of this Africa alone shares more than 90% of the
burden since over 80% of malaria deaths occur in Africa, while less than 15% of the
deaths occur in Asia and Eastern Europe together; in the latter, 8000 cases of
imported malaria are reported every year, the majority of which is due to
P. falciparum. Around 90% of them come from sub-Saharan Africa and are mainly
diagnosed in newly arrived migrants.
Before the dawn of the nineteenth century malaria largely affected rural
environments, but with the turn of the twentieth century increased degree of urbani-
zation and immigration into urban settings have resulted in the formation of new
cities and metropolises with extensive urban areas buffering with those of agricul-
ture, inveigling mosquito vectors like both An. arabiensis and An. gambiae to
maintain malaria transmission with prevalence rates as high as up to 30–40%.
Soon after the discovery of the insecticidal/mosquitocidal properties of the
dichlorodiphenyltrichloroethane (DDT) during the World War II, it became avail-
able as the major plank in the worldwide malaria eradication programmes launched
in the 1950s and resulted in the dramatic decrease in the percentage of the world
population at risk of the disease from 68% in 1946 to 52% in 1975, albeit an increase
in the absolute number of people at risk from 2.1 billion in 1975 to about 3 billion in
2002. Despite several long-term research and control programmes with innovative

Ltd. 2023
20 2 Global vis-à-vis Desert-Driven Malaria
strategies (such as deployment of Long Lasting Impregnated Bed nets, LLINs) the
malaria eradication programme had little success initially in many parts of Africa
south of the Sahara where the number of people at risk of malaria escalated to over
74% (about 600 million) at the end of the twentieth century, although the disease
dramatically declined in prevalence in Asia, particularly in India (Ranjha and
Sharma 2021). Demographic proportions between urban and rural are clearly
favouring a steep increase toward the former and these upward demographic changes
in the urban centres have important implications for malaria control in future,
especially after the invasion of the Asian mosquito vector, An. stephensi—a special-
ist to breed in urban settings, in many Saharan countries in recent past.
2.2 Desert-Driven Malaria
2.2.1 Malaria in African Sahara Desert
Malaria is a major public health threat to the African continent and its control is
critical to achieving the Millennium Development Goals in this region. Although
considerable progress has been made to reduce the malaria burden in sub-Saharan
Africa by introducing control measures such as the provision of insecticide-treated
mosquito nets, indoor residual spraying, and easier access to effective antimalarial
drugs, malaria epidemics continue to occur in many areas including some in the
Sahara region. Populations in epidemic-prone areas have a poorly developed immu-
nity to malaria and the disease remains life-threatening to all age groups in the desert.
The expansive Sahara Desert covers 10 countries fully or partially: Algeria, Chad,
Egypt, Libya, Mali, Mauritania, Morocco, Niger, Sudan, and Tunisia. The Western
Sahara, a Spanish territory earlier and currently annexed to Morocco, is sometimes
considered the eleventh nation. Many of these are already free from malaria and the
World Health Organization has certified these countries as free from malaria at
present (Algeria in 2019, Libya in 2012, Morocco in 2010, Tunisia in 2012). Malaria
has been rampant in Africa south of the Sahara Desert; out of the global estimate of
229 million malaria cases in 2019, about 95% of the burden was shared by
29 sub-Saharan African region countries; majority (51%) being accounted for by
only 5 countries, namely, Nigeria (27%), the Democratic Republic of the Congo
(12%), Uganda (5%), Mozambique (4%), and Niger (3%). This propensity for
hyperendemicity by the Sub-Saharan countries is due largely to preponderance of
the major malaria vectors such as An. gambiae, An. arabiensis, and An. funestus. As
far as the Saharan region is concerned, An. arabiensis has invaded some of these
nations in the past and recently An. stephensi has also crossed over from Middle
East, or from the Thar Desert directly via trade, and established in a few countries in
the African Sahara, in both rural and urban centres.
Some countries such as Ethiopia are not covered fully by any desert, but they still
have some part of their land engulfed by the xeric environment of a desert. In case of
landlocked Ethiopia, the Danakil Desert (situated in the Afar Triangle, stretching
across 136,956 sq. km) swamps a major part of land in north-east Ethiopia, bordering
2.2 Desert-Driven Malaria 21
southern Eritrea and north-western Djibouti. Anopheles arabiensis, a member of the

An. gambiae species complex, is the major malaria vector widely distributed in
Ethiopia, besides the secondary vectors of malaria with limited distribution, viz., An.
funestus, An. pharoensis, and An. nili.
2.2.2 Malaria in Arabian Peninsula Desert
The largest expanse (80%) of desert is spanning Saudi Arabia, and the desert also
extends into neighbouring portions of southern Iraq, southern Jordan, central Qatar,
most of the Abu Dhabi emirate in the United Arab Emirates (UAE), western Oman,
and north-eastern Yemen. Some of these countries like Qatar (central region)
(in 2012) and United Arab Emirates (UAE in 2007) were already certified malaria-
free by the World Health Organization. The Arabian Peninsula is largely free from
malaria, although in past the transmission of malaria was governed by the diversity
of dominant vectors and extreme aridity. However, in view of the possible presence
of a few dominant vectors it is likely that malaria transmission, though limited,
occurred across populated areas of most of the present day territories of Saudi
Arabia, Kuwait, Qatar, United Arab Emirates (UAE), Bahrain, Oman, and Yemen
at the turn of the last century (Snow et al. 2013). Campaigns to eliminate malaria
were undertaken in the peninsular region countries since the 1940s but were met
with varying degrees of success for next three decades, shrinking malaria transmis-
sion across the peninsula. After the 1990s epidemics all the desert national
governments began pondering over a unified action throughout the peninsula,
which took shape in course of the present global resolve for malaria eradication,
and launched a collaborative malaria-free initiative in 2005. Even though this
initiative did not succeed completely in eradicating malaria from the peninsula, it
helped in further shrinking the malaria risk map. Currently, only Saudi Arabia and
Yemen, with the latter contributing to over 98% of the clinical burden, manifest
locally acquired clinical cases of malaria.
2.2.3 Malaria in the Middle East/Central and West Asian Deserts
Most of the Middle East region countries (by conventional political definition, the
countries in the Middle East are Cyprus, Iran, Iraq, Israel, Jordan, Lebanon, the State
of Palestine (West Bank and Gaza Strip), Syria, and the Asian part of Turkey) are
malaria-free, as no indigenous cases of infection have been described in recent years.
However, imported cases of malaria continue to occur in some of these countries
(Al-Awadhi et al. 2021). Large expatriate population originating from malaria
endemic countries and/or migrant workforce being employed in Middle East region
countries and beyond are considered as a source of influx of imported cases.
2.2.4 Malaria in the Great Indian Thar Desert
Since the trend of malaria prevalence in the Thar Desert cannot be fully
comprehended in totality without having an understanding of malaria scenario in
the country and the state of Rajasthan, it is considered opportune to shed some light
first on malaria in India and Rajasthan State. Covell (1927b) critically reviewed the
data on transmission of malaria by different species of Anopheles in India, with
notes on distribution, habits, and breeding places. Covell (1928) also deeply
investigated malaria in Bombay, which set an example for controlling malaria in
other fast evolving metropolises under the threat of malaria.
2.2.4.1 Brief History of Malaria in India

Malaria has been known to the natives in the country as one of the most devastating
diseases for centuries and many Ayurvedic remedies have been prescribed to get rid
of these intermittent fevers. In the modern world of science, however, it was only
towards the end of the nineteenth century, following the epoch-making discovery of
malaria being transmitted by the anopheline mosquitoes (Ross 1897), that great
scientific interest was generated in both studying the epidemiology and control as
well as transmission dynamics of the disease (Hehir 1927). Many important pieces of
taxonomic literature on malaria vector species, both larvae and adults, were pro-
duced in the late first and early second half of the twentieth century, notably by
Christophers (1933), Puri (1949, 1955, 1960), Wattal (1963), Wattal and Kalra
(1961), Rao (1984), and Tyagi et al. (2012, 2014). Indian history of malaria control
has been exemplary to the whole world nations with malaria endemicity. Most of the
major milestones in the journey of malaria control in India are presented in Table 2.1.
Before malaria control programme was launched in India in 1953, nearly 100 mil-
lion people suffered from the disease annually and close to one million people died
every year (Sharma 1986a, b; Sharma and Mehrotra 1986; Tyagi 1994a). The latter
figure clearly appears to be a gross underestimate since during frequent epidemics so
common in the country during those days the overall number would have been much
higher and the number of deaths indirectly or directly resulted from malaria had
exceeded two million in 1931 (Sinton 1935). Besides, malaria affected the national
as well as individual development as economic losses of the order of Rs. 2936
million per year were forced on India (Ramaiah 1980).
Physiographically India is a highly heterogenous country encompassing within its
limits a large range of ecosystems, from thousands of kilometers of coastline in the
peninsula, spanning plateau in the humongous midland, highlands in north-east as
well as central and southern India, dense forests of Eastern and Western Ghats to the
sprawling Great Indian Thar Desert in the north-west. Owing to vast ecosystem and
environment differences in these topographically varying habitats, generally the
mosquito fauna and the malaria vectors, together with malaria endemicity, too
differed a great deal. Therefore, epidemiological scenario of malaria differs from
state to state, region to region, and ecosystem to ecosystem, and therefore the data of
a given area cannot represent the situation in different regions or ecosystems.
Although malaria in India is at present drastically controlled (Lal et al. 2000),
Table 2.1 The milestones in malaria control programme in India (Adapted from free Wikipedia)
Year/period Event
Prior to 1940 No organized national malaria control programme
Prior to 1953 Malaria cases estimated to be >75 million with 1 million deaths annually
1953 National Malaria Control Programme launched
1958 National Malaria Eradication Programme launched
1966 Cases reduced to less than 0.1 million with nil death
Early 1970s Resurgence of malaria
1971 Urban Malaria Scheme launched
1976 Malaria cases escalated to 6.46, highest in post-DDT era
1977 Modified Plan of Operation (MPO) policy formulated and circulated
1984–1998 Annual incidence reported within 2–3 million cases
1995 Malaria Action Programme
1997 World Bank assisted Enhanced Malaria Control Project (EMCP)
2005 Global Fund assisted Intensified Malaria Control Project (IMCP)
2006 ACT introduced in areas showing chloroquine resistant Falciparum-malaria
2008 Revised NVBDCP Drug Policy, extending ACT policy to high risk Pf districts
2009 World Bank assisted Project on Malaria Control and Kala-azar Elimination,
LLIN introduced
2009 Artemisinin monotherapy banned in the country
2010 Revised NVBDCO Drug Policy 2010, extending ACT to all Pf cases; Global
Fund (Rd. 9) assisted Intensified Malaria Control Project (IMCP- II)
2016 National Framework for Malaria Elimination (NFME) 2016–2030
Fig. 2.1 Annual malariometric information (P. falciparum, P. vivax and deaths) in India between
1964 and 2014. (Source: National Vector Borne Disease Control Programme, in public domain)
there is a trend towards increasing proportion of Plasmodium falciparum cases than

that in the past (Fig. 2.1). There is also a report from central India showing increase
in the proportion of P. falciparum malaria cases (Singh et al. 2000). Correspond-
ingly, Tyagi and Chaudhary (1997) have demonstrated a rising trend of
P. falciparum in the Thar Desert.
Table 2.2 Magnitude of malaria problem in India during pre-eradication period and thereafter
(Source: Tyagi 2002)
No. of % of
malaria population
cases per with No. of
year malaria per deaths
Period of disease eradication Year Population (in million) year per year
Pre-eradication (estimates 1947 344.11 75.0 21.8 800,000
based on surveys)
During eradication: lowest 1965 487.0 0.1001 0.02 Nil
incidence (after 7 years of (-99.806)
eradication operations)
During eradication: highest 1976 613.0 6.4 1.04 59
incidence (after 18 years of (-91.46)
eradication operation,
immediately after the MPO
was enacted)
During Modified Plan of 1981 657.74 2.70 0.41 170
Operation (after 5 years of (-96.97)
MPO-NMEP initiative)
After creation of P. falciparum 1986 737.71 1.79 0.24 323
(-97.61)
Containment Programme 1991 808.10 1.81 0.22 421
(-97.58)
One year before Enhanced 1994 861.73 2.51 0.29 1122
Malaria Control Project (-96.65)
In Table 2.2 is presented the magnitude of malaria problem during pre- and post-
eradication periods with a view to assess, on the one hand, the grim situation caused
by malaria before an organized malaria control campaign, the National Malaria
Control Programme (NMCP), was initiated in 1953 and to acquaint with the
discernible successes and failures in the ensuing decades with a vengeful comeback
of malaria, on the other.
Encouraged by the stupendous success of the NMCP, the Government of India
stepped up goals and functions of National Malaria Control Programme and it was
transformed into National Malaria Eradication Programme (NMEP) in 1958. Soon
thereafter malaria cases were reduced to less than 0.1 million in 1965, without single
death, and it appeared that malaria would be wiped off from India before very long. It
is noteworthy here that decline in cases was in case of P. vivax and not in
P. falciparum. Due to utter failure to sustain the success achieved, within the next
10 years malaria epidemics were widespread and the disease, recording the highest
ever number of malaria cases (6.47 million) by 1976, invaded even those areas
which were earlier unknown for malaria transmission or were once freed from its
scourges. Subsequently, during the 1980s and the early 1990s, following a series of
critical reviews of the malaria eradication programmes, the malaria incidence was
brought down to less than two million in 1995, as reported by the National Malaria
Eradication Programme (NMEP). More stringent policies and strategies to reduce
Table 2.3 Countrywide epidemiological situation in India (1995–2020) (Source: National Vector
Borne Disease Control Programme in public domain)
Population Total malaria P. falciparum Deaths due
Year (in ‘000) cases (million) cases (million) Pf % API to malaria
1995 888,143 2.93 1.14 38.84 3.29 1151
1996 872,906 3.04 1.18 38.86 3.48 1010
1997 884,719 2.66 1.01 37.87 3.01 879
1998 910,884 2.22 1.03 46.35 2.44 664
1999 948,656 2.28 1.14 49.96 2.41 1048
2000 970,275 2.03 1.05 51.54 2.09 932
2001 984,579 2.09 1.01 48.20 2.12 1005
2002 1,013,942 1.84 0.90 48.74 1.82 973
2003 1,027,157 1.87 0.86 45.85 1.82 1006
2004 1,040,939 1.92 0.89 46.47 1.84 949
2005 1,082,882 1.82 0.81 44.32 1.68 963
2006 1,072,713 1.79 0.84 47.08 1.66 1707
2007 1,087,582 1.51 0.74 49.11 1.39 1311
2008 1,119,624 1.53 0.77 50.81 1.36 1055
2009 1,150,113 1.56 0.84 53.72 1.36 1144
2010 1,167,360 1.60 0.83 52.12 1.37 1018
2011 1,194,901 1.31 0.67 50.74 1.10 754
2012 1,211,580 1.06 0.53 49.98 0.88 519
2013 1,221,640 0.88 0.46 52.61 0.72 440
2014 1,234,995 1.10 0.72 65.55 0.89 562
2015 1,265,173 1.17 0.78 66.61 0.92 384
2016 1,283,303 1.09 0.71 65.53 0.85 331
2017 1,315,092 0.84 0.53 62.70 0.64 194
2018 1,337,617 0.43 0.21 48.19 0.32 96
2019 1,349,006 0.34 0.16 46.36 0.25 77
2020 1,372,316 0.19 0.12 63.84 0.14 93
malaria burden were subsequently followed up and by 2020 the incidence is brought
to an appreciable low of 0.19 million (Table 2.3, Fig. 2.2).
Ironically, the malaria incidence and deaths reported by NMEP were based on the
parasitologically proved cases, thus excluded a large number of asymptomatic
carriers and/or those who approached other medicinal systems for cure of disease
or even resorted to self-medication. As earlier emphasized by the in-depth evaluation
of the Modified Plan of Operation (MPO) (NMEP 1985), both morbidity and
mortality were apparently underestimated. While the NMEP reported 2.5–3 million
malaria cases and about 1000 malarial deaths annually, the WHO South East Asia
Regional Office put the estimates to 15 million malaria cases (nearly 6 times) and
19,500 deaths due to malaria (Sharma 1999). Therefore, it appears safer to assume
that the malaria incidence reported offers at most the disease trend and not its true
incidence, knowledge of which, for logical reasons, is inevitably indispensable for
effective implementation of malaria control in the country.
Fig. 2.2 depicts that the cases have consistently declined from 2.09 million to 0.19 million during
2001 to 2020. Similarly Pf cases have declined from 1.0 to 0.12 million cases during the same
period. Less than 2000 deaths were reported during all the years within this period with a peak in
2006 when an epidemic was reported in NE States. The country SPR has declined from 2.31 to 0.19
and SFR has declined from 1.11 in 2001 to 0.12 in 2020. This indicates declining overall
endemicity of malaria in the country. (Source: National Vector Borne Disease Control Programme,
in public domain)
It can be seen from the above table that although the present epidemiological
situation is nowhere near that of 1931, 1947, or 1976, there is nevertheless no room
for complacence in view of the rising trend of P. falciparum proportion and heavy
mortality in many parts of the country as well as a range of several strategic and
operational constraints (Fig. 2.2).
Malaria control in India is presently hampered mainly by two reasons: (1) devel-
opment of drug resistance in malarial parasites, and (2) development of resistance in
malaria vectors. Plasmodium vivax and P. falciparum are the dominant species in
India, with the former responsible for 60–65% cases and the latter for 35–40% cases
(Sharma 1999). Among the six major vector species prevalent in India, An.
culicifacies, the main transmitter of rural and peri-urban malaria in the peninsular
India, is alone responsible for 65% malaria and 55% P. falciparum annually. This
mosquito is resistant to DDT and HCH all over the country, and to malathion in
Maharashtra, Gujarat, and certain other States. Anopheles stephensi transmits nearly
12% malaria cases in the country, mostly in the urban and industrial areas. This
species, too, has developed multiple resistance against various insecticides, many of
which are however used as larvicides. Yet, another vector species, An. fluviatilis,
which like the above two species is common in Rajasthan, transmits 15% of total
malaria cases and 30% P. falciparum in the country.
The strategy of malaria control in India has been to cause interruption in the
disease transmission by spraying residual insecticides in the rural areas (351.8
million population) and by source reduction and larviciding urban areas (62.1
million population) (Dev 2020). Because most of the primary malaria vectors in
India are endophilic and/or endophagic in behaviour, indoor residual spraying of
insecticides in the rural areas and anti-larval operations in the urban set-ups have
been the major means to control malaria in the country. Led by widespread use of
DDT in controlling vector population, now largely jeopardized owing to develop-
ment of resistance in vector mosquitoes, other insecticides like HCH (later banned in
1997), malathion, and certain synthetic pyrethroids such as cyfluthrin, deltamethrin,
and lambda-Cyhalothrin have also been selectively employed in the control of
malaria, although spray targets were rarely achieved due to logistic and operational
constraints.
Major anti-malaria activities launched in India since independence can be
summed up briefly as follows:
(i) National Malaria Control Programme (NMCP): It was launched in 1953 with
comprehensive indoor residual spray of DDT. By 1957, 165.7 million people
were effectively protected.
(ii) National Malaria Eradication Programme (NMEP): The success achieved
under the NMCP was so spectacular and encouraging that the Government of
India launched National Malaria Eradication Programme, in 1958, with the
objective of eradicating the disease from the country (Mehta 1962; Sharma
1967; NMEP - A brief review for professional colleagues. Rajasthan Med J 7:
43-47.NMEP 1985)). This brought down malaria cases to 0.1 million and no
deaths due to malaria were reported in the country in 1965. The euphoria of
victory, however, proved to be ephemeral as malaria incidence began to
escalate in the late sixties owing to multiple factors comprising financial,
logistic, administrative and technical constraints, on the one hand, and a
feeling of complacency due to a near victory over the disease in the country,
on the other. Consequently, malaria resurged with a vengeance and reached its
peak in 1976, when about 6.47 million cases of malaria were recorded in the
country.
The NMEP originally began as a completely centrally sponsored health
programme and, till 1979, the entire expenditure on malaria control through-
out the country was borne by the Centre. Thereafter, the programme was
implemented on a 50:50 cost sharing basis with the States, with the exception
of the seven north-eastern States which, from December 1994 onwards, were
brought under 100% Central assistance as a special case. All other States in
the country, while meeting out the entire operational costs for malaria control
as their part of the cost sharing, continued to receive 50% of the costs from the
Centre in the form of required equipment and material. The Indian Govern-
ment spends nearly Rs. 350 crores on malaria control annually. Additionally,
the World Bank also recently provided a sum of Rs. 1075 crores for 5 years for
the Enhanced Malaria Control Programme.
(iii) Modified Plan of Operation (MPO): The successes and failures under the
NMEP were reviewed in depth and a Modified Plan of Operation was
introduced in the year 1977 with three main objectives: (1) prevention of
deaths due to malaria, (2) reduction of morbidity due to malaria, and (3) main-
tenance of industrial and green revolution due to freedom from malaria as well
as retention of achievement gained so far. Under the MPO a new strategy was
adopted from eradication of malaria to the containment of the disease in the
country, i.e., prevention of death and reduction in morbidity due to malaria.
As a strategy under this Plan areas with 2 Annual Parasite Incidence (API) or
more were earmarked for regular rounds of spray. Surveillance activities in the
whole country were decentralized to Primary Health Centres (PHC) along
with laboratory services. People’s participation was solicited by involving
volunteers in the distribution of antimalarials through Drug Distribution
Centres (DDC) and Fever Treatment Depots (FTD). Malaria control in
urban areas (>40,000 population) is carried out under the Urban Malaria
Scheme (UMS) of the NMEP, launched in 1971–1972. This led to significant
reduction in malaria incidence in the country to a level of around two million
cases by 1987 for nearly one decade. Since 1994, however, focal outbreaks of
malaria have been continuously reported from different parts of country,
particularly the north-eastern States and the Thar Desert region in Rajasthan
State in the north-west India. This unwarranted situation resulted in resur-
gence of malaria, generally pronounced by P. falciparum dominance, as well
as deaths due to malaria in the country.
(iv) Plasmodium falciparum Containment Programme (PfCP): The P. falciparum
problem attained new dimensions when a focus of chloroquine resistant strain
was discovered in Assam in 1973. Subsequently, new foci of chloroquine
resistance were traced in different north-eastern States, Orissa, Madhya
Pradesh, Maharashtra, Rajasthan, etc. This situation led to the creation of
PfCP in 1977 to tackle the rising threat of P. falciparum.
(v) Malaria Action Programme Based on Expert Committee Report - 1995: An
expert committee that took cognizance of the fact of availability of appropriate
technologies for control of malaria in different epidemiological situations or
paradigms in the country attributed the various setbacks in malaria eradication
programme, particularly recurrence of periodic epidemics and high mortality,
to various different imminent factors like the administrative indifference, the
organizational weakness, the low prioritization to malaria under the health
services and apathy of middle-level and peripheral workers in the states.
Accordingly, the Expert Committee recommended intensification of malaria
control activities throughout the country with focus on high risk areas through
an integrated malaria control strategy, with the following mentioned
components: (1) Early case detection and prompt treatment, (2) Selective
vector control, (3) Promotion of personal protection methods, (4) Early detec-
tion and containment of epidemics, (5) Information, education and communi-
cation towards personal prevention and community participation, and
(6) Institutional and management capacity building, trained manpower devel-

opment, and efficient management information system.
(vi) Enhanced Malaria Control Project (EMCP): It was launched in September
1997 with the help of World Bank assistance and covered, in addition to
19 towns in 10 States, 62.2 million high risk tribal population living in
100 districts and 1045 PHCs of the seven major States, viz., Andhra Pradesh,
Bihar, Gujarat, Madhya Pradesh, Maharashtra, Orissa, and Rajasthan. These
PHCs, with a tribal population of more than 25%, had contributed 65.5%
malaria cases and 78.6% P. falciparum cases in 1997. The benefits of the
programme are conceived to reach other malaria endemic areas as well since
the strengthening of the components of the Information, Education and
Communication (IEC), trained manpower development and Management
Information System (MIS) covers the whole country.
(vii) Roll Back Malaria (RBM): In January 1998 the World Health Organization
proposed Roll Back Malaria initiative taking into consideration large-scale
morbidity and mortality due to malaria in developing countries and also
observing the changing epidemiological scenario, and the experience of the
past control efforts. The basic concepts of the RBM initiative are not different
from the existing control strategy in India, but it lays more emphasis on social
mobilization, intersectoral collaboration, effective partnerships, strengthening
of Primary Health Care, investment in development of effective methods of
control, shaping of existing tools by operational research and it is expected
that this will result in sustained reduction in disease burden by the year 2010
(Alnwick 2000).
(viii) National Anti-Malaria Programme (NAMP): Eradication concept was
changed to Anti-Malaria Programme and, thus, the programme was once
again renamed as National Anti-Malaria Programme (NAMP).
(ix) National Vector Borne Disease Control Programme (NVBDCP): The vertical
anti-malaria control programme transformed into a horizontal one with the
establishment of a wide spectrum National Vector Borne Disease Control
programme (NVBDCP) in 2003 for synchronizing efforts to control/eliminate
six vector-borne diseases. It was erected as an umbrella programme for
prevention and control of malaria and other vector-borne diseases viz., Lym-
phatic Filariasis, Kala-azar, Japanese Encephalitis, Chikungunya, and Dengue
with special focus on the vulnerable groups of the society namely, children,
women, scheduled castes (SC), and scheduled tribes (ST).
(x) The Global Fund to Fight AIDS, Tuberculosis, and Malaria (GFATM): It is an
international financing and partnership organization that aims to “attract,
leverage and invest additional resources to end the epidemics of HIV/AIDS,
tuberculosis and malaria” to support attainment of the Sustainable Develop-
ment Goals established by the United Nations. Founded in 2005 it aims to
extend support and additional inputs in 106 districts of 10 states.
(xi) World Bank Assisted Project on Malaria Control & Kala Azar Elimination
(2008)
(xii) National Framework for Malaria Elimination (2016–2030) & Integrated

Vector Management (IVM) 2016 were launched to provide a roadmap to
eliminate malaria from India (Nema et al. 2020).
(xiii) Operational Manual for Malaria Elimination: It was launched in 2016.
(xiv) National Strategic Plan (2017–2022) for Malaria Elimination by 2030: It was
launched in 2017.
(xv) Mosquito & Other Vector Control Response (MVCR): It was launched
in 2020.
(xvi) National Centre for Vector Borne Diseases Control (NCVBDC): The long-
standing Directorate of NVBDCP was recently rechristened as National
Centre for Vector Borne Diseases Control (NCVBDC) in 2021.
2.2.4.2 Malaria Situation in Rajasthan State

Contrary to the common belief that Rajasthan State being largely a desert area
embodies but a little chance of persistent malaria in the State, there exists certain
areas with considerable patches of hyper-endemicity which for known reasons had
been experiencing incessant episodes of focal and/or widespread epidemics involv-
ing huge morbidity and deaths (Tyagi 1994a, 1995a; Shukla et al. 1995; Anon. 2001;
Bose 2004). However, the overall impression of the state has been that of a
non-problematic area with few focal outbreaks here and there (Sharma 1986a, b;
Anon. 1987a). In Rajasthan, the morbidity and mortality trends due to communica-
ble diseases including malaria were highlighted by Chandra (1981). Based on
malaria endemicity, Sharma et al. (1996a, b) have classified Rajasthan being covered
under following two zones;
(i) Zone or Stratum II, signifying moderately refractory areas with high epidemic
potential (i.e., eastern plains and southern forested and mountainous districts of
Rajasthan State), and
(ii) Zone III, signifying nonrefractory areas with moderate to high epidemic poten-
tial (i.e., western and northern districts of Rajasthan State, including whole of
the Thar Desert).
It is interesting to note that in last nearly two decades the physiography of the
Thar Desert, in particular, has undergone such a major change that the zoning of the
region needs a re-characterization for its epidemiological potential (Tyagi 1995a,
1996a, b, c, d, e, f). Under prevailing grim circumstances, the malaria transmission
dynamics in Rajasthan State particularly the Thar Desert region requires a serious
thinking to be able to device appropriate control methodologies (Tyagi and
Chaudhary 1996, 1997; Sharma et al. 1996a, b; Sharma 1996a, b, 1998, 1999). A
careful review of the malariometric data reveals it all (Table 2.4).
To understand the dynamics of malaria prevalence over the years in Rajasthan
and the impact of ‘Desert Malaria’ on its malaria prevalence, it is considered
worthwhile to briefly organize the entire richness of malaria research in three periods
of time, as follows:
Table 2.4 Malariometric data for Rajasthan state (1961–2000) (Source: Tyagi 2002)
Population Blood slides Blood slides Positive Pf
Year (×000) collected examined cases cases % Pf ABER API SPR SFR Deaths
1961 17,562 669,202 595,176 8494 3266 38.45 3.39 0.48 1.43 0.55 0
1962 18,785 943,159 1,082,815 3210 508 15.85 5.76 0.17 0.30 0.05 0
1963 19,048 1,779,180 1,743,916 3813 1210 31.73 9.16 0.20 0.22 0.77 0
1964 20,917 2,200,707 2,184,182 3164 826 26.10 10.44 0.15 0.14 0.04 0
1965 22,001 2,212,563 2,183,592 2872 348 12.11 9.92 0.13 0.13 0.02 0
2.2 Desert-Driven Malaria
1966 22,454 1,863,401 1,857,961 9680 532 5.29 8.27 0.43 0.52 0.03 0
1967 23,040 1,772,313 1,763,870 23,898 1221 5.10 7.66 1.04 1.35 0.07 0
1968 23,850 1,661,789 1,659,286 14,999 923 6.15 6.96 0.63 0.90 0.06 0
1969 24,670 1,485,220 1,471,587 15,487 1158 7.47 5.97 0.63 1.05 0.08 0
1970 25,320 1,741,741 1,736,028 79,788 4985 6.24 6.86 3.15 4.60 0.29 0
1971 25,850 2,184,134 2,174,281 109,773 8064 7.34 8.41 4.25 5.05 0.37 0
1972 26,510 5,037,069 2,215,322 82,517 8470 10.26 8.36 3.11 3.72 0.38 0
1973 26,715 2,233,100 2,162,576 118,012 16,451 13.94 8.09 4.42 5.46 0.76 0
1974 27,560 2,694,698 2,688,624 177,596 13,663 7.69 9.76 6.44 6.61 0.51 0
1975 27,560 3,186,044 3,062,207 354,567 31,304 8.82 11.11 12.87 11.58 1.02 0
1976 28,031 3,578,216 3,572,281 412,776 24,163 5.85 12.74 14.73 11.55 0.68 0
1977 29,104 3,318,120 3,318,120 231,862 12,445 5.36 11.40 7.97 6.99 0.38 0
1978 29,670 3,260,421 3,226,710 154.549 8612 5.57 10.88 5.21 4.79 0.27 0
1979 31,092 3,515,605 3,515,605 83,394 4670 5.59 11.31 2.68 2.37 0.13 0
1980 31,594 4,208,295 4,208,295 96,118 15,871 16.51 13.32 3.04 2.28 0.38 0
1981 32,491 3,992,445 3,991,672 100,694 14,752 14.65 12.29 3.10 2.52 0.37 0
1982 33,113 3,284,810 3,284,810 75,320 12,296 16.32 9.92 2.27 2.29 0.37 0
1983 33,583 3,161,396 3,161,396 115,177 35,462 30.78 9.41 3.43 3.64 1.12 0
1984 34,124 2,901,731 2,901,731 101,955 20,443 20.05 8.50 2.99 3.51 0.70 0
1985 34,655 3,037,182 3,037,182 67,040 12,643 18.86 8.76 1.93 2.21 0.42 4
31
(continued)
Table 2.4 (continued)
32
Population Blood slides Blood slides Positive Pf

Year (×000) collected examined cases cases % Pf ABER API SPR SFR Deaths
1986 34,897 2,941,659 2,941,659 54,618 13,890 25.43 8.43 1.57 1.86 0.47 2
1987 35,378 3,219,363 3,219,363 65,523 13,942 21.28 9.10 1.85 2.04 0.43 0
1988 35,457 3,493,559 3,493,559 104,109 29,189 28.04 9.85 2.94 2.98 0.84 2
1989 35,683 3,074,207 3,074,207 112,316 24,072 21.43 8.62 3.15 3.65 0.78 1
1990 35,854 3,567,539 3,567,539 114,689 32,500 28.34 9.95 3.20 3.21 0.91 65
1991 43,881 3,179,925 3,179,925 77,573 16,097 20.75 7.25 1.77 2.44 0.51 10
1992 43,880 3,833,880 3,833,880 121,499 41,513 34.17 8.74 2.77 3.17 1.08 55
1993 44,005 3,644,944 3,644,944 107,797 26,387 24.48 8.73 2.44 2.96 0.72 19
1994 44,005 4,855,841 4,855,841 241,255 94,020 38.97 11.04 5.48 4.97 1.94 452
1995 44,005 5,181,432 5,181,432 350,780 45,212 12.58 11.77 7.97 6.76 0.87 45
1996 44,005 6,591,873 6,591,873 300,547 72,780 24.21 14.97 6.82 4.55 1.0 0
1997 44,005 6,000,745 6,000,745 272,670 19,742 7.24 13.63 6.19 4.54 0.32 0
1998 44,005 4,977,977 4,977,977 76,438 10,030 13.12 11.31 1.73 1.53 0.20 0
2
1999 45,159 5,223,301 5,223,301 53,154 5857 11.02 11.57 1.18 1.02 0.11 0
2000 44,006 4,969,259 4,969,259 35,973 3425 9.52 11.29 0.82 0.72 0.07 10
Global vis-à-vis Desert-Driven Malaria
Malaria Situation During Pre-1966 Period

One of the earliest scientifically documented reports on malaria from Rajasthan had
been by Green (1911), following which many an important but isolated
malariological reporting was brought on record which mostly related to the south-
eastern Rajasthan being the stronghold for nearly all the epidemiological and
entomological investigations in the pre-independence period, although a few reports
from the Thar Desert also existed (cf. Christophers 1933; Macdonald 1931; Jaswant
Singh 1933). It is interesting to note that because of its strategic location in the midst
of desert and non-desert or plain regions in the State, Jodhpur, a desert township in
the Thar Desert, also aptly referred to as the Rajasthan’s Gateway to the Great Indian
Thar Desert, was selected as one of the earliest trials with DDT in controlling malaria
vectors in the country in the late 1940s.
There is ample evidence to show that malaria endemicity was of a very low order
by the early 1950s, which however gradually accentuated in the ensuing years. The
infant parasite rate (IPR), child parasite rate (CPR), and child spleen rate (CSR) are
considered good indicators to comprehend the level of endemicity in a community,
and when the same are analyzed for the period 1953–1954 to 1956–1957 in both the
insecticide sprayed and unsprayed areas in Rajasthan, a steady increase in these rates
could be noticed (Table 2.5).
The funding situation in the state had been quite satisfactory, considering that
most malaria cases appeared from the forested and mountainous Udaipur zone and
the non-desert north-eastern areas under Jaipur and Kota zones. At a time when the
incidence of malaria from various districts had begun to show an escalating trend
around the mid-1980s, the budget allocation was also regularly increased (e.g., from
Rs. 106.63 million in 1986–1987 to Rs. 127.41 million in 1988–1989). According to
a recent report the State Government has spent about Rs. 31.5 million in 2001, which
included the World Bank assistance of more than Rs. 15 million for Jodhpur zone
(Anon. 2001). Much before the Thar Desert began to generate more hyper-endemic
patches, the plains have always been liable to periodic epidemics that occurred
almost every year, culminating into a severe epidemic every 6 or 7 years, e.g.,
Bharatpur district where child spleen and parasite rates were reported to be about
45% and 50%, respectively, with high adult spleen rates. In the flood-prone lower
reaches of the Thar Desert malaria remained confined mainly to Barmer and Jalore
districts, e.g., Sanchore tehsil in Jalore district was one such area where in 1954 and
Table 2.5 Infant parasite rate (IPR), child parasite rate (CPR), and child spleen rate (CSR) in
insecticide sprayed (A) and unsprayed (B) areas of Rajasthan for period 1953–1954 to 1956–1957.
Year
1953–1954 1954–1955 1955–1956 1956–1957
Rates (%) A B A B A B A B
IPR 0 0 0.5 – 0.8 0.4 0 –
CPR 1.3 – 1.0 0 1.2 3.6 2.9 35.7
CSR 4.8 – 4.3 19.8 16.9 42.0 12.1 41.4
1956 the child spleen, adult spleen, and the child parasite rates were up to 50–100%,
25–70%, and 25%, respectively. Both Plasmodium vivax and P. falciparum were
detected adequately, though P. malariae occurred rarely. However, in the last few
decades, the Thar Desert has emerged malariologically as a singularly most impor-
tant ecosystem and the vastly acknowledged factor attributable to the change in the
desert malaria situation has been associated with the water management from the
threesome of the Gang canal, the Bhakra-Sirhind feeder canal, and the Indira Gandhi
canal systems—a subject that will be discussed in great detail in the following pages
in this book.
In the hilly and forested Udaipur area malaria was always endemic with hyperen-
demic patches, often with average spleen rate being close to 50%.
(a) Season of Malaria: Generally high malaria transmission season starts after the
monsoon in July and lasts up to November/December, although in certain areas
(like Bharatpur district) two peaks of transmission of malignant malaria were
noted each in July–November and February–March. In the hilly areas of
Udaipur zone the transmission is always much longer due to persistent presence
of the vector, An. fluviatilis.
(b) Anopheline Fauna: A total of 15 species were reported to be present in
Rajasthan (Anon. 1976), although Puri (1955, 1960) had enlisted a total of
16 species from Rajasthan. Of these species, An. culicifacies and An. fluviatilis
were incriminated as the main vectors of malaria in plain and hilly regions,
respectively, with sporozoite rates about 0.39% and 2.08% in the corresponding
regions. Anopheles stephensi was suspected a vector of malaria in urban
areas only.
(c) Susceptibility Status of Vector Species against Insecticides: Both An.
culicifacies and An. stephensi were confirmed to have developed resistance
against DDT. Moderate to high resistance to DDT by An. culicifacies was
found in 11 units, high level of insecticide resistance (i.e., mortality between
7–21% in 1–2 h exposure to DDT) was determined in Pratapgarh, Banswara,
Udaipur, Dungarpur, Sirohi, Bharatpur, etc. Anopheles stephensi moderately
resistant to DDT was confirmed in nine subunits comprising Ajmer, Barmer,
Sojat, Bikaner, Nagaur, Jodhpur, Pali, Sanchore, and Jaipur, while high resis-
tance level of An. stephensi was determined in Nagaur, Khetri, and Neem ka
Thana.
Malaria Situation During 1967–1976

(a) Malaria Prevalence. Since 1966 the epidemiological situation in the Rajasthan
State had changed with malaria cases gradually increasing year by year, partic-
ularly the P. falciparum infection, thus threatening the life of people. During this
period, a definite shift in Rajasthan’s malaria scenario was visible, and when
compared to certain other problematic states, the malaria incidence (1973–1975)
had apparently increased constantly with much bigger margin over each of the
receding year (Table 2.6). Thus, while there occurred an increase of 50.5% in
Table 2.6 Comparison of malaria cases in Rajasthan state with those of other malariologically
major problematic states (Source: Tyagi 2002)
Positive cases % of increase/ % of increase/
decrease for 1974 decrease for 1975
State/UT 1973 1974 1975 over 1973 over 1974
Andhra 94,400 142,430 111,807 +50.9 -21.5
Pradesh
Assam 37,918 49,684 49,182 +31.1 +89.6
Bihar 39,989 82,299 98,776 +105.8 +20.0
Gujarat 437,292 570,799 758,344 +30.5 +32.9
Haryana 103,777 243,543 506,465 +121.9 +107.9
Karnataka 78,443 163,343 332,257 +108.2 +103.4
Madhya 262,780 437,774 676,593 +65.1 +55.9
Pradesh
Nagaland 2823 3108 2710 +10.1 -12.8
Orissa 189,767 292,225 267,359 +53.9 -8.5
Punjab 166,846 230,274 279,150 +38.4 +21.2
Rajasthan 133,097 177,596 355,635 +50.5 +94.7
Tamil Nadu 5869 14,236 87,708 +142.6 +516.1
Uttar 52,052 120,110 359,824 +265.2 +89.3
Pradesh
West 12,433 18,938 37,090 +52.3 +95.8
Bengal
1974 over 1973, the increase was 94.7% for 1975 over 1974 in Rajasthan being
one of the four states in the country exhibiting an increase of over 90%.
(b) Anopheline fauna. Anopheles culicifacies was the main vector in all plain
regions of Rajasthan, the sporozoite rate being about 0.3%. The relative density
of An. culicifacies tended to increase following the monsoon during August,
September, and October. Anopheles culicifacies and An. fluviatilis were both
confirmed to transmit malaria in the hilly and forested areas under Udaipur
region, with sporozoite rates of An. fluviatilis being around 2.08%. Anopheles
stephensi was strongly “suspected” to be a vector in the desert area of Barmer,
Jodhpur, and Bikaner where its density increased during March and April, and
again in August.
Anopheles culicifacies is generally oriented for feeding between 9 and 11 p.m. but
was sometimes found to continue feeding up to 1 a.m., as observed in Jodhpur. On
the contrary, An. stephensi preferred to feed between 4 and 6 am. The anthropophilic
indices recorded for both these vector species are tabulated below for comprehension
of their blood meal preferences (Table 2.7).
It is evident from the above tabled information that while An. culicifacies was the
most significant vector in vast areas of the State, An. stephensi appeared equally
important as a vector especially in the desert district of Jodhpur and even some other
plain areas.
Table 2.7 Anthropophilic indices (Al) for An. culicifacies and An. stephensi recorded in different
places in Rajasthan (nd = not done) (Source: Tyagi 2002)
Name of places AI for An. culicifacies Al for An. stephensi
Jodhpur 25.4% 25.2%
Jaipur nd 24.4%
Bundi 12.0% 23.1%
Kota 16.8% 12.9%
Pratapgarh 14.8% nd
Ambamata ka khera 20.0% nd
Udaipur 34.0% nd
One of the important developments in the malaria control operations through

vector control was of ULV (Ultra Low Volume) space spray with 10 or 15 days
interval which the Government of India, with the aid of World Health Organization,
undertook for the first time in India with effect from April 1973 to December 1974 in
Jodhpur. The pilot project was initiated in the Soorsagar site in Jodhpur covering
about 2–3 km2 area having persistent malaria transmission and vector resistance to
DDT. The space spray with ULV was found very effective in reducing the vector
density immediately after the spray. Particularly when applied with a 10-day inter-
val, the ULV space spray reduced the density of both An. culicifacies and An.
stephensi to very low levels and also brought down the malaria cases from 1222
cases in 1973 to 569 cases in 1974. However, as the experiment could not be
sustained the vector density rebuilt itself soon after the spray.

This is perhaps the most critical period for Rajasthan, full of events that culminated
in recurrence of a series of epidemics, particularly in the Thar Desert region, causing
immense morbidity and heavy mortality year after year (Tyagi and Chaudhary
1997). After 1975–1976, it occurred for the first time in the known history of malaria
of Rajasthan that the malaria cases exceeded 0.3 million mark, although no death
was reported in the 1970s. When compared with the base morbidity results for 1961
(8494 positive cases), it was amazing to know that overall number of positive cases
in the State had increased to 350,780 in 1995 (41-fold increase), while the targeted
population increased only 2.5 times during the same period. While the slide positiv-
ity rate (SPR) had significantly increased from 1.43 in 1961 to 5.07 in 1994 (3.5-fold
increase), the slide P. falciparum rate (SFR) had also increased as many folds only,
from 0.55 to 1.95.
However, the increase in either the SPR or the SFR was not steady and, therefore,
no definite trend could be noticed. The maximum SPR was recorded in 1976, with
several epidemics in non-desert parts of the State (Sharma 1986a, b; Tyagi 1994a).
From the mid-1980s onwards, however, the trend had become clearer and both the
SPR and SFR had steadily increased. In fact, the highest ever SFR had been recorded
in 1994—the year when the State as well as the Thar Desert region experienced the
maximum deaths due to malaria in their entire history. The annual parasite incidence
Fig. 2.3 Histograms showing total P. falciparum cases (×1000) total malaria cases (×1000) and
deaths from malaria in Rajasthan between 1990 and 1995. (Source: Tyagi 2002)
(API) also showed a steady increase from 0.48 to 1.76. The state of disease
prevalence, including death toll, in the State between 1990 and 1994 is depicted in
Fig. 2.3.

Extensive control measures undertaken all over the State reduced the incidence
steadily from 1995 onwards, and in 2000 the malaria cases were just 10% of what
was reported for 1995. However, after a fall initially, P. falciparum proportion is
stabilized around 10% which is a serious concern to disease managers and disease
control implementers. Furthermore, once again heavy mortality was reported in
2000, although in 1999, too, some deaths could have possibly occurred during an
epidemic in Jaisalmer. It is noteworthy that malaria outbreaks struck in western
Rajasthan during the 3 consecutive years of 1999, 2000, and 2001, of which at least
first 2 years were confirmed as drought years, while 2001 had a good rainfall. A
sudden roll back of malaria cases in 2001 (total positives 1,29,233; P. falciparum
17,405) from a rather less vexing figure of 2000 (total positives 35,973;
P. falciparum 3425) has once again alerted for possible epidemics in future (Anon
2002a, b, c, d). The period thereafter up till 2020 has been full of upheavals
witnessing several major and minor outbreaks.
Malaria Situation in the Great Indian Thar Desert

(a) Background: Even though the Thar Desert has been reporting outbreaks of
malaria infrequently and in a patchy manner, mostly in Sri Ganganagar,
Bikaner, and Jodhpur districts, the xeric region was never considered a major
player in engendering malaria in the country; in fact, the Thar Desert was
regarded as a region with hypoendemic and unstable malaria with potential for
occasional outbreaks! The changing scenario of disease endemicity in the Thar
Desert, however, caught the attention of Indian Council of Medical Research,
and at the behest of Prof. V. Ramalingaswamy, Director General, ICMR, New
Delhi, a “National Seminar on Deserts, Man and Health” (Anon. 1981) was
organized by the S.M.S. Medical College, Jaipur, as a major attempt to under-
stand in-depth the desert-based maladies among humans. Deliberations in this
seminar, especially on vector-borne diseases including malaria, not only led to
the inevitable necessity of establishment of the ICMR-Desert Medicine
Research Centre in Jodhpur, but also analyzed for posterity the impending
impacts of climate change and anthropization particularly the development of
Indira Gandhi Nahar Pariyojana (IGNP) on both the infectious/communicable
and non-infection/non-communicable diseases in desert communities. The real
significance of the changing physiography of the Thar Desert on emergence of
malaria, particularly Plasmodium falciparum-dominated malaria, was brought
to light after long-term investigations by Tyagi (1995a, b, 1996a, b, c, d, e, f, g,
2002, 2003a, b, 2020), Tyagi and Chaudhary (1996, 1997), and Tyagi
et al. (1995).
(b) Advent of Canalized Irrigation and Transformation of Desert Physiography:
The Thar Desert region in north-western Rajasthan does not remain any longer a
mere hypoendemic area with precarious potential for infrequent and sporadic
focal malaria outbreaks (Tyagi 1992a, b, 1995a; Akhtar and McMichael 1996).
On the contrary, the Thar Desert has recently emerged as one of the more
potential hot-beds in the country for recurrent Plasmodium falciparum-
dominated epidemics, particularly in the areas under the Indira Gandhi Nahar
Pariyojana (IGNP). Recent experience in the Thar desert of western Rajasthan,
India, does not support the view that canal-irrigated desert zones are at low risk
of malaria outbreaks. Following an epidemic in this region in 1994, increased
vector species—their density and vectorism, and a drastic change in meteoro-
logical factors and irrigation practices were postulated as the causes (Tyagi
1995a, b; Tyagi and Chaudhary 1997). One of the particular debates has focused
on whether populations living in irrigated arid zones remain prone to malaria
epidemics, or whether endemicity ensues (as in the more irrigated, heavier
rainfall—but more socioeconomically favoured—Punjab State) (Akhtar and
McMichael 1996)?
(c) Emergence of Plasmodium falciparum-Dominated Malaria and the ‘Thar Des-
ert Model’: Under the continuing dynamic xeric environmental circumstances,
together with increased quantum of vectors, vectorism, and vectorization, high
human mobility and migration during droughts, expanding urbanization, and
climate change, the Thar Desert’s malariology is also shifting from low
endemic, unstable, and occasional malaria epidemics to potentially more
epidemic-prone and Plasmodium falciparum-dominated malaria in the canal-
irrigated Thar Desert (Tyagi 2003a, b). It is to be noted here that more than
two-third of the Thar Desert is still devoid of canalized irrigation system despite
the three major canal-based irrigation systems in the desert. Conclusively, The
Thar Desert can be safely acknowledged as an effective model to understand a
correlation between changes in a xeric environment, brought about mainly by
extensive canalization, and escalation in P. falciparum-dominated malaria inci-
dence as well as more or less ‘yearly cyclic’ epidemics. The ‘Thar Malaria
Model’ is good also in further understanding how an effective, or otherwise,

water management can have a bearing on the vector composition, vectorial
capacity, and prospective mosquito nuisance in a region that was virtually a
terra incognito for several of these mosquito species till a few decades ago.
Milestones on Malaria Research in the Thar Desert

The whole subject of malaria in the Great Indian Thar Desert will be discussed in
extenso in the following chapters. However, major achievements in malaria research
and anti-malaria activities in the Thar Desert are chronologically presented below
with a view to acknowledge, on the one hand, the real malaria potential of the Thar
Desert region and, on the other, the future challenges awaiting indefatigable
malariologists/medical entomologists to decipher the enigmatic ‘Desert Malaria’.
The Thar Desert in north-western India has a long history of malaria (Tyagi
2002). The sun-baked arid environments of the Thar Desert are a far cry from the
aquatic habitats in which mosquitoes generally breed and complete half of their life
cycle. Yet, even in the driest and dustiest part of India mosquitoes can still manage to
survive under quaint conditions and emerge to feed on human blood and transmit the
deadly malaria disease. Although malaria research in the Thar Desert is nearly a
century old, nevertheless, more active malariological investigations have been
initiated rather recently since the late 1980s. Many of these research activities
have gone a long way in making better our understanding about ‘Desert Malaria’
and showing a need to make use of more useful modern tools such as those based on
molecular biology and genetic engineering to further enrich our knowledge on the
subject and the means to control the disease. In Table 2.8 are presented some of the
major milestone research activities.
Table 2.8 Milestones in the malaria research in the Thar Desert

Year/
period Event
1933 For the first time, the Thar Desert region’s anopheline fauna were described in
detail by Christophers (1933), in his magnum opus on ‘Family Culicidae: Tribe
Anophelini’ in the classic ‘Fauna of British India’ series
1948– One of the earliest trials with the DDT as an indoor residual adulticide for
1949 controlling malaria vectors was made in Jodhpur
1955– Puri (1955, 1960) described in great detail the larval identification keys of Indian
1960 anophelines, some of which referred to the Thar Desert fauna, too
1962 Wattal and Kalra (1961) described comprehensively the identification keys based
on adult characteristics for the Indian anophelines, some of which occurred in the
Thar Desert as well
1980s– Dr D. Kochar and his group made important investigations on malaria and
1990s discovered that Plasmodium vivax could be also associated with neurological
complications
1989– For the first time in the Thar Desert, Anopheles culicifacies was incriminated with
1990 the malarial parasite in Sri Ganganagar, and its distribution with canalized
irrigation was demonstrated during the course of a long-term entomological
investigation (Tyagi and Verma 1991)
1990– For the first time, Anopheles stephensi was incriminated with the malarial parasite
1991 from the interior of the rural Thar Desert. Its predominance in the xeric
environments was demonstrated and its exclusive breeding in the household
underground water reservoir, ‘tanka’ and ‘beri’, both carrying tremendous
malariological significance in the desert ecosystem, was brought on record with the
coining of a new malariological paradigm, “the Desert Malaria” (Tyagi 1995a,
1998a, b; Tyagi and Yadav 1996a)
1990 March 22, an indigenous mosquito sampler was developed by Dr. B.K. Tyagi,
which was registered with the National Research Development Corporation, New
Delhi for seeking PATENT by the Indian Council of Medical Research, New
Delhi, in 1996
1995 In acknowledgement of repeated malaria epidemics in the Thar Desert, influencing
the overall malaria scenario in the Rajasthan State, as well as strong malaria
research potential at the Desert Medicine Research Centre, Jodhpur (established in
1984), malaria was identified as a major thrust research area at the DMRC. This
mandate was once again reinforced with greater emphasis in 1999
1995– Various kinds of factors underlying emergence of malaria epidemics in the Thar
1996 Desert region were clearly outlined and defined (Tyagi 1995a, b, 1996a)
1997 A clear-cut correlation between P. falciparum-dominated malaria conflagration in
the Thar Desert and the management of canal irrigation water was established
(Tyagi and Chaudhary 1997)
1999 A ‘tanka lid’ was developed by Dr. B.K. Tyagi for effective control of vector (An.
stephensi) breeding in this malariologically very important household and
community-based water reservoir, and the technology handed over to the District
Collector in Jaisalmer
World Deserts: Environments and Malaria
Potential 3
3.1 Introduction
The word ‘desert’ is derived from the ecclesiastical Latin dēsertum, meaning an
abandoned place (Ezcurra et al. 2006). A desert naturally paints kind of a picture in
the human mind that exhibits a grossly inimical environment for humans and animal
populations to live in under generally soaring temperatures, very low humidity, and
scanty precipitation, to say the least. All deserts are, however, not characterized with
such critically extreme attributions and, particularly when there are cold deserts as
well. It is interesting to know that about 33% of the Earth’s land surface is arid or
semi-arid, both ‘hot’ and ‘cold’ types. The latter includes much of the polar regions,
where little precipitation occurs, and which are sometimes called polar deserts or
‘cold deserts’ due to extreme weather conditions. Characteristically, as a rule, ‘cold
deserts’ are free from malaria. Therefore, it is rather difficult and complex to attempt
to judge some correlation between aridity and sparse population dynamics including
the living conditions, socio-culture, agriculture practices, and technologies. There-
fore, in the outset itself, it considered opportune and of paramount importance to
foremost clear beforehand the term ‘desert’ particularly in its relation to malaria.
Before the dawn of the twentieth century, desert was often used in the sense of
‘unpopulated area’, without specific reference to aridity; but today the word is most
often used in its climate-science sense as an area of low precipitation. Accordingly, a
desert is a barren area of landscape where little precipitation occurs and, conse-
quently, living conditions are hostile for plant and animal life with abysmal diversity
whatsoever (Sher et al. 2004). Deserts generally receive less than 250 mm (10 in) of
precipitation each year, though it may vary a great deal in reference to a given desert.
As a rule, all hot deserts in the world exhibit very low evapotranspiration which may
be close to zero. Semi-deserts (when clad in grass, these are known as steppes),
buffer zones, or the desert fringe areas are regions which receive relatively much
higher precipitation generally ranging between 250 and 500 mm. The lack of
vegetation exposes the unprotected surface of the ground to the processes of
denudation (Bhandari 1978).

Ltd. 2023
42 3 World Deserts: Environments and Malaria Potential
Even though there are close to 100 deserts, small and big, and hot and cold, across
the globe, nevertheless less than only a dozen of them are large enough with
characteristic arid environment that generally attract human attention for their
malariogenic potential (Table 3.1, Fig. 3.1). While the Sahara desert is the largest
hot desert in the world (9.2 million km2 covering a total of 8% of the earth’s land
area; and the third largest overall after the Antarctica and the Arctic), the Namib
Desert is believed to be the oldest desert (55 million years) (Barnard 1998), and the
Aralkum Desert, lying to the south and east of what remains of the Eastern Basin
Aral Sea in Uzbekistan and Kazakhstan, is currently the youngest desert in the world
since it has appeared in 1960 on the seabed once occupied by the Aral Sea. The
Atacama Desert, forming part of the arid Pacific fringe of South America, is one of
the driest regions in the world. The Thar Desert in the north-west India is peculiar
owing to its massive canalized irrigation system called Indira Gandhi Nahar
Pariyojana (IGNP), complemented by two others, namely, the Gang Canal and the
Bhakra-Sirhind Canal, and regarded as one of the world’s most gigantic projects of
its kind in a desert ecosystem (app. 10,000 km) that has not only partially
transformed the desert’s physio-demography in favour of annual cyclic malaria
epidemics in recent decades, on one hand, but also proved it to be the first model
of malaria in arid environments. ‘One usually does not associate malaria with a
desert environment. Common sense dictates that mosquitoes, that breed only in
stagnant water, would give arid, water-scarce spaces such as a desert a wide go-by.
But that is not the case in the Thar desert. Rajasthan, India, is also the land of
persistent desert malaria. The Thar Desert has a unique ecosystem. But over the last
two decades, its physiography has undergone a major change. What precisely
changed? And what is the relation between this change and the transformation of
malaria from an occasional to a persistent, endemic disease? The startling
answer is: extensive canalisation! Though these projects were set up with good
intentions—they would provide a fillip to irrigation, allow more crops to be grown,
and solve the water problem of the region—they also brought with them swarms of
mosquitoes. Drastic changes began to occur in the ecosystem: increase in the water
table, water logging, and a change in the rainfall pattern along with relative
humidity were observed’ (DownToEarth 2003).
3.2 Desert Environments, Man, and Malaria
There are many theories about the origination of the hot deserts and one of these
ascribe weathering processes being the reason behind the desert formation. The
weathering process is characterized by the large variations in temperature between
day and night which put strains on the rocks and consequently break them in pieces
(Mann 1978). Scanty precipitation is another feature of the desert, although occa-
sional downpours happen in certain areas that can result in flash floods such as those
in the Thar Desert during 1988, 1990, and 1994 (Tyagi 2002). When rain falls on hot
rocks, they shatter them into smaller strands, and rubble strewn over the desert floor
are further eroded by the wind. This fast billowing wind in the desert gathers up fine
3.2 Desert Environments, Man, and Malaria 43
Table 3.1 A complete list of hot deserts of the world

S. No. Country Deserts
1 Afghanistan Dasht-e Khash, Dasht-e Leili, Dasht-e Margo, Dasht-e Naomid,
Ragistan Desert
2 Algeria Erg Chebbi, Erg Chech, Grand Erg Occidental, Tademait
3 Argentina Salar de Arizaro, Monte Desert, Patagonian Desert, Salinas Grandes
4 Australia Great Victoria Desert, Great Sandy Desert, Tanami Desert, Simpson
Desert, Gibson Desert, Little Sandy Desert, Strzelecki Desert, Sturt
Stony Desert, Tirari Desert, Pedirka Desert
5 Bahrain Sakhir
6 Botswana Kalahari Desert
7 Bulgaria Pobiti Kamani
8 Colombia Guajira-barranquilla Xeric Scrub, La Guejira Desert, Tatacoa Desert
9 Chile Atacamara Desert, Lomas, Patagonian Desert, Sechura Desert
10 China Gobi Desert, Badain Jaran Desert, Dzungaria, Gurbantunggut
Desert, Hami Desert, Kumtag Desert, Lop Desert, Mu Us Sandyland,
Ordos Desert, Shapotou District, Taklamakan Desert, Tengger
Desert
11 Kyrgzstan Betpak-Dala, Muyunkum Desert
12 Egypt Blue Desert, Eastern Desert, Great Sand Desert, Libyan Desert,
Qattara Depression, Sinai Desert, Wadi El Hitan, Wadi El Natrun,
Western Desert
13 Eritrea Danakil Depression, Eastern Desert
14 Ethiopia Danakil Depression, Eastern Desert
15 Greece Pachies Ammoudies of Lemnos
16 India Thar Desert, Cold Desert
17 Iran Dashte-e Kavir, Dasht-e Lut, Dasht-e Naomid, Kavir National Park,
Maranjab Desert, Petregan Playa, Polond Desert
18 Iraq Arabian Desert, Syrian Desert
19 Israel Negev, Judaean Desert, Negev, Zin Desert
20 Italy Acona Desert
21 Jordan Arabian Desert, Syrian Desert
22 Kazakhstan Aral Karakum Desert, Aralkum Desert, Betpak-Dala, Central Asian
Nrothern Desert, Karagiye, Karakum Desert, Kasakh Semi-Desert,
Kyzylkum Desert, Muyunkum Desert, Ryn Desert, Saryesik-Atyrau
Desert
23 Kenya Chalbi Desert, Nyiri Desert
24 Libya Calanshio Sand Sea, Calansho Desert, Great Sand Sea, Idehan Ubari,
Libyan Desert, Murzuq Desert, Rebiana Sand Sea, Tadart Acacus
25 Mexico Chihuahuan Desert, Gran Desierto de Altar, Sonoran Desert
26 Mongolia Gobi Desert, Dzungaria, Khongoryn Els, Flaming Cliffs, Khongoryn
Els
27 Namibia Kalahari Desert, Namib Desert
28 New Zealand Maniototo, Rangipo Desert
29 Niger Erg of Bilma, Talak, Ténéré
30 Oman Arabian Desert, Empty Quarter, Gulf of Oman Desert and Semi-
Desert, Jiddat al-Harasis, Umm al Samim, Wahiba Sands
(continued)

S. No. Country Deserts
31 Pakistan Thar Desert, Bhakkar Tehsil, Cholistan Desert, Cold Desert,
Hazarganji-Chiltan National Park, Hingol National Park, Indus
Valley Desert, Kachho, Kharan Desert, Thal Desert, Thar Desert
32 Peru Garua, Lomas, Sechura Desert
33 Poland Bledow Desert
34 Saudi Arabia Ad-Dahna Desert, An Nafud, Arabian Desert, Arabian Peninsula
Costal Fog Desert, Empty Quarter, Red Sand
35 Senegal Ferlo Desert, Lompoul Desert
36 Serbia Deliblato Sands
37 South Africa Kalahari Desert, Karoo, Namib Desert, Richtersveld
38 Spain Bardenas Reales, Cabo de Gata-Nijar Natural park, Monegros
Desert, Tabernas Desert
39 Sudan Bayuda Desert, Eastern Desert, Libyan Desert, Nubian Desert
40 Syria Syrian Desert
41 Turkmenistan Karakum Desert, Kyzylkum Desert
42 United Arab Al Khatim Desert, Arabian Desert, Empty Quarter
Emirates
43 United States Chihuahuan Desert, Mojave Desert, Yuma Desert, Lechuguilla
Desert, Sonoran Desert, Painted Desert, Tonopah Desert, Tule
Desert, Amargosa Desert, Eastern California, Great Basin Desert,
High Desert, Low Desert, Old Plank Road, Yuha Desert, Owyhee
Desert, Yp Desert, Black Rock Desert, Smoke Creek Desert, Alvord
Desert, Tamaulipan Mezquital, Bonneville Salt Flats, Escalante
Desert, Great basin Desert, Great Salt Lake Desert, Sevier Desert
44 Uzbekistan Aralkum Desert, Central Asian Northern Desert, Karakum Desert,
Kyzylkum Desert, Mirzacho
45 Venezuela Guajira-Barranquilla Xeric Scrub, la Guarjira Desert, Medanos de
Coro National Park
46 Yemen Arabian Desert, Arabian Peninsula Coastal Fog Desert, Empty
Quarter, Ramlat al-Sab’atayn
particles of sand and dust, which can remain airborne for extended periods and if
densely matrixed can cause the formation of sand storms or dust storms. Further any
solid object in their path such as the embedded rocks in the desert are smoothed
down by the striking of wind-blown sand grains and are abraded on the surface, and
the wind sorts sand into uniform deposits, but sometimes the finely grained sand
particles end up as overlaying sheets of sand or are piled high in billowing sand
dunes or levees. But all deserts, though maintaining xeric environments throughout,
are not sandy but are flat, stony plains commonly known as desert pavements. Still,
beyond the sandy and rock-hard flat deserts, at times a desert may imbibe other
desert features such as rock outcrops, exposed bedrock, and clays once deposited by
flowing water. When occasional rainfall occurs, the gushing floodwater may run
down along the hard surfaced rocky payments and get collected as temporary lakes
in the deeper cavities emerged in the whole process of desert formation. After
3.2 Desert Environments, Man, and Malaria 45
Fig. 3.1 A global distribution of the desert areas according to their Aridity index. Deserts
distribution throughout the land surface, making up 33% of the total land area. The map indicates
the most famous deserts in each continent, the Mojave, Sonoran, and Chihuahua Desert in North
America and the Atacama Desert in South America. The largest deserts in the world are the Sahara
desert in North Africa, along with the Kalahari and Namibia deserts in the southern parts of Africa.
In the Middle East, the Negev and the Arabian Peninsula Deserts. In East Asia, the Thar Desert
(90%) in North India and (10%) in parts of Pakistan, and in west Asia the Lut Desert, while the Gobi
and Taklamakan Deserts cover North China and a large part of Mongolia. In Australia, Great Sandy
and Gibson Deserts are shown. The map classifies the deserts based on the global Aridity index
(AI), which is defined as the numerical indicator of the degree of climatic dryness in a specific
location. The map shows the hyper-arid zones in bright yellow, semi-arid zones in orange, and arid
zones in brown. (Source: Available free online at: http://wad.jrc.ec.europa.eu)
evaporation of water from lakes salt pans, such as the Sambhar Lake in the outskirts
of the Thar Desert, are formed. Generally deserts may harbour a variety of water
sources aplenty in the form of springs and seepages from aquifers. Where these are
found, oases can occur, attracting ‘Desert Oasis Malaria’ such as in the Phalodi
Tehsil area in the Thar Desert.
Desert plants and animals possess special adaptations to sustain in the hard-to-
survive environment. From outside plants appear to be sturdy, sparsely branched,
cuticle-clad, and spiny with small or no leaves to deter herbivory. During occasional
rains some annual plants germinate, bloom, and die in the course of a few weeks after
rainfall such as swan grass, Lasiurus scindicus (Poaceae), found in the dry parts of
Jaisalmer, Barmer, and Bikaner in the Thar Desert, while other perennial plants such
as Prosopis cineraria (Fabaceae) survive for years in dry soil conditions of the Thar
Desert in India, besides arid portions of Afghanistan, Behrain, Iran, Oman, and
Pakistan. Animals likewise are few in species diversity; while invertebrates like
arthropods e.g., dung beetle (Scarabaeidae) and vertebrates like reptiles, e.g., desert
lizard or Sara hardwickii (Agamidae) are poikilothermic (i.e., animals whose body
temperature varies considerably and more or less in regard with the temperature of
their environment) and suitably adapted to desertic conditions. As far as mosquitoes
are concerned, Anopheles stephensi, is an extraordinary example of desert adaptabil-

ity; it is the only anopheline mosquito in the Thar desert which can live throughout
the year beating the extreme temperature ranges (0 °C in winter to 50 °C in summer)
(Tyagi 2002). Desert animals efficiently conserve water extracting most of it from
their food and concentrating their urine.
Desertification is a continuous process and is on the increase in many continents
of the world. For millennia the growing human and cattle populations, with their
vital needs in decline, have been constantly forcing nomadic people to quest for
more space to settle in the vast, yet inhospitable, expanses of the desert environments
and the less inimical surrounding semi-arid lands. Oases, being the major source of
water and abysmal agriculture, have not only provided opportunities for a comfort-
able settlement of life but also grazing and fodder for their flocks and herds of
milching, transport, and nutritive significance. Some nations, realizing early that
oases may not suffice for a prosperous development of people in the desert, worked
out to bring in canalized water from other places with surplus sources in the
Himalaya to the desert and upscaled farming with the fresh aid of irrigation. The
birth of Indira Gandhi Nahar Pariyojana (IGNP) in the Thar Desert, western India,
being the one such project of its kind aiming to convert the barren land into verdure
and upgrade people’s GDP (Gross Domestic Product), is a glittering example in the
world. Presently three major canal systems exist in the Thar desert (Gang Canal,
Bhakra-Sirhind Canal, and Indira Gandhi Nahar Pariyojana). This Herculean task of
bringing Himalayan waters to the Thar desert, with an investment of INR 1161
crores (at 1990 level) has resulted in growing irrigation-intensive crops such as
sugarcane, mustard, groundnut, wheat, and of course paddy. Paddy is mostly grown
in Sri Ganganagar, Bikaner, and Sikar districts. The production of paddy in Sri
Ganganagar district alone, the most irrigated among all desert districts, has topped
the list in the whole State of Rajasthan. Nomadism and, during severe droughts,
regular migration of the local folks in search of food and fodder for their pets across
the desert limits and beyond to other areas or countries have ushered in many trade
routes across deserts. Some mineral extraction also takes place in deserts, and the
uninterrupted sunlight gives potential for the capture of large quantities of solar
energy.
Depending upon nature, deserts are categorized under (i) hot, (ii) cold, (iii)
semiarid, or (iv) coastal head. Some of the hot deserts, being heartlands for malaria
conflagration, are invariably characterized by high temperatures in summer; greater
evaporation than precipitation by high temperatures, strong winds, and lack of cloud
cover; considerable variation in the occurrence of precipitation, its intensity, and
distribution; and low humidity. Winter temperatures vary considerably between
different deserts and are often related to the location of the desert on the continental
landmass and the latitude. Daily variations in temperature can be as great as 22 °C
(40 °F) or more, with heat loss by radiation at night being increased by the clear
skies. However, such factors as the temperature, humidity, rate of evaporation and
evapotranspiration, and the moisture storage capacity of the ground have a marked
effect on the degree of aridity and the plant and animal life that can be sustained.
Rain falling in the cold season may be more effective at promoting plant growth, and
3.3 Deserts with Potential to Exacerbate Malaria 47
defining the boundaries of deserts and the semiarid regions that surround them on the
grounds of precipitation alone is problematic.
Excluding cold (or temperate) deserts in view of any malaria history ever, the hot
deserts based on precipitation alone fall under the following four different
categories: (i) Hyperarid Deserts: characterized by <25 mm/year of rainfall (Afri-
can Sahara desert). These regions are free from malaria, (ii) Arid Deserts: They
receive rainfall between 25 and 200 mm/year (e.g., the Great Indian Thar Desert).
Malaria is not only established in some parts but due to the new vector mosquitoes
intruded with man-made developmental activities, particularly agro-irrigation,
severe cyclic outbreaks of malaria have intensified, (iii) Semiarid Deserts: Rainfall
here is between 200 and 500 mm per year. They share some characteristics of a true
desert and are usually located at the edge of the desert per se. Not only rainfall is
higher in this category of desert but even vegetation and humidity surpass. These
regions feature a semi-arid climate and are less extreme than regular deserts [e.g.,
The Tabernas Desert (and some of the Spanish Plateau), the Sahel, the Eurasian
Steppe, most of Central Asia, the Western US, most of Northern Mexico, portions of
South America (especially in Argentina), and the Australian Outback], and (iv)
Coastal Deserts: They are mostly found on the western edges of continental land
masses in regions where cold currents approach the land or cold water upwellings
rise from the ocean depths. These regions have low temperatures and very low
rainfall (e.g., the Atacama Desert, and those in Namibia, Chile, southern and Baja
California, Western Australia, the Arabian Peninsula and Horn of Africa, and the
western fringes of the Sahara). These are generally not carrying malaria, although
exceptions to this do exist, and in the recent past malaria scenario has been fast
changing, such as in Djibouti in the Horn of Africa. North Africa refers to the region
of the African continent north of the Sahara desert. The desert fringe is gradually
meeting the coastline in the north harbouring countries, e.g., Algeria, the Canary
Islands (Spain), Egypt, Libya, Morocco, and Tunisia. This region is characterized by
fertile coastal areas and a desert hinterland, and of course, plenty of malaria.
3.3 Deserts with Potential to Exacerbate Malaria
Malaria occurs in hot deserts. Hot deserts, which are classifiable on the basis of either
quantum of precipitation, the temperature, the causes of desertification or even by
their geographical location, have both precipitation and temperature that are the two
main environmental factors to trigger malaria. In the vast stretches of Sahara and
Arabian Peninsula where long years of high temperature (app. 50 °C) and near
absolute absence of precipitation is a common observation, malaria is almost entirely
unnoticed, albeit exceptions such as the Thar Desert in India where malaria exists
due to underground water storage habits in ‘Tanka’ and ‘Beri’ suited for the breeding
of Anopheles stephensi. Desert oases may also contribute to the prevalence of
malaria in the leveed desert superbly adapted for breeding by one of the world’s
deadliest vectors, An. arabiensis (Fig. 3.2).
Fig. 3.2 Ambient temperature ranges at which vector mosquitoes and malaria parasites (P. vivax
and P. falciparum) can optimally survive in the former body
As a rule, an inexorable melange of three factors (the epidemiological triad), i.e.,

the parasite, the intermediate vector host such as the anopheline mosquito, and the
recipient human host in whom occurs the pathological impact, are inevitably indis-
pensable to effect a vector-borne disease, provided the commensurate interactions
have a favourable environment to be executed successfully. The desert environment
generally wanting in water sources is regarded unsuitable for malaria prevalence;
however, certain intrinsic desertic attributions make a desert highly susceptible to
malaria conflagration transforming a non-endemic or at best highly low and unstable
malaria ecosystem, to a fulminating hyperendemic zone with cyclic epidemics
(Fig. 3.3). Major deserts with malaria potential are discussed here.
Fig. 3.3 Epidemiological

triad of vector-borne diseases
3.3.1 Sahara Desert and Malaria
The Sahara, measuring approximately 4800 km from east to west and between 1288
and 1931 km from north to south, with a total area spanning over 8,600,000 km2 that
literally fills nearly all of northern Africa, is the largest hot desert in the world, and
the third largest desert behind Antarctica and the Arctic, which are both cold deserts.
Arguably one of the harshest environments on Earth, it is strategically surrounded on
the west by the Atlantic Ocean, on the east by the Red Sea, on the north by the
Mediterranean Sea and the on the south by the Sahel Savannah—the expansive
heartland of malaria. In size it takes nearly a third of the whole African continent,
measuring about the size of the United States (including Alaska and Hawaii) or
whole of the South America’s largest nation, Brazil. The name Sahara for the desert
is derived from the Arabic word ṣaḥrā, meaning ‘desert.’ The Sahara desert is home
to 10 African countries: Algeria, Chad, Egypt, Libya, Mali, Mauritania, Morocco,
Niger, Sudan, and Tunisia (Fig. 3.4).
3.3.2 Arabian Peninsula Desert and Malaria
The Arabian Desert, located in the northeast of Africa and stretching from Yemen to
the Persian Gulf and Oman to Jordan and Iraq, is a vast desert wilderness in Western
Asia occupying most of the Arabian Peninsula, with an area of 2,330,000 km2,
which makes it the fifth largest desert in the world, and the largest in Asia. At its
centre is Ar-Rub’al-Khali (The Empty Quarter), one of the largest continuous bodies
of sand in the world. The peninsula’s seven constituent countries are (clockwise
north to south) Kuwait, Bahrain, Qatar, and the United Arab Emirates (UAE) on the
east, Oman on the south-east, Yemen on the south, and Saudi Arabia at the centre.
Saudi Arabia is the largest of these countries by both area and population. The
Arabian Peninsula is surrounded by the Red Sea to the west and south-west, with the
Persian Gulf located to the north. The Peninsula consists of a range of deserts,
Fig. 3.4 The Sahara desert with countries covered. (Source: Free Wikipedia)
Fig. 3.5 The Arabian Peninsula Desert with countries covered.(Source: Free Wikipedia)
Fig. 3.6 The Arabian Peninsula Desert in all its vast, continuous, and expansive glory. (Source:
Dr. B.K. Tyagi, personal archive)
mountains, marshy coastlines, oases, and a central plateau called the Najd, which has
fertile valleys (Figs. 3.5 and 3.6).
3.3.3 The Great Indian Thar Desert and Malaria
Environment plays a very important role in regulating the biology of both the vector
mosquitoes and the malaria parasites. One of the main reasons why in distant past
malaria, if at all present, has been existing only at a very low ebb was the extremely
inhospitable and arid nature of the Thar Desert, rendering the region a rather
inconducive habitat for the disease (Fig. 3.7). It is, therefore, worthwhile, to know
in this context about the environment of the Thar Desert as it existed before and after
the canal-based irrigation-related developmental activities were initiated (cf. also
Chap. 6).
Climatically classified as arid plains, the project area endured intense heat with
very strong wind currents during summer, when very high temperature up to 45–50 °
C was observed. The average maximum temperature was about 42 °C. The coldest
month was January, when the average minimum temperature was 6 °C. Rarely
though, strong winds or gales (on a mean monthly of 27.2 km/hour in June),
generally from south west to north east, caused wind erosion on a large scale
allowing, among other events, also the canal sedimentation. The rainy season lasts
for a very short period between mid-July to first week of September. The mean
Fig. 3.7 A panoramic bird’s eye-view of the location of the Thar Desert region between the
irrigated lands of the Indus and Sutlej river systems and the western edge of the Aravalli Hills; about
90% of the Thar Desert Region falls in India
annual rainfall varies between less than 100 mm near Tannot in north-west Jaisalmer
district and 360 mm near Churu. The variability of annual rainfall is about 40%
around Churu—Anupgarh area and increases to more than 90% west of Sam—
Asutar area. Most of the rain hails as heavy showers, otherwise the weather remains
dry. The annual mean potential evapotranspiration varies between 1825 mm in Sri
Ganganagar to 2530 mm in Jaisalmer district. The native sub-soil water level in the
IGNP area remains around 60–100 meters below ground level.
In both the distant and near past, severe droughts and famines continued to engulf
the region. The famines of 1860–61, 1867–68, 1869–70, 1886–87, 1899–1900,
1920, 1938–39 and 1939–40 took heavy toll of human and cattle lives. The great
famine of 1783 depopulated area. The epidemics and famines that followed forced
the starving population to migrate across the neighbouring States of Haryana,
Gujarat, etc. Famines occurred on regular basis in the project area and the region
remained most thinly populated. The population density of the project area varied
between 1.5 per km2 in Jaisalmer district to 16 per km2 in Bikaner district, against an
average population density of 48 per, km2 in Rajasthan State and 112 per km2 of
India recorded in 1951. Due to availability of irrigation water from the river Sutlej in
Fig. 3.8 Extent of the three major canal systems in the Thar Desert region in Rajasthan, embodying
12 districts (Source: Tyagi 2003a, b)
the year 1928, the population of Sri Ganganagar district had risen from merely 15 per
km2 to 127 per km2 in 1991.
The Great Indian Thar Desert region [lying between 27.4695° N, 70.6217° E,
with an area over 238,254 km2 (of this app. 90% in India and about 85% in
Rajasthan, i.e., 62% of the total land of the State) and harbouring a population of
16.6 million people (40% of the population in the State; density 83 persons/sq. km, at
the 2011 Census level] stretches between the irrigated lands of the Indus and Sutlej
river systems on the west and the western edge of the Aravalli Hills on the east
(Figs. 3.8, 3.9 and 3.10). There are altogether 12 administrative districts in the
Rajasthan State’s Thar Desert region which is the most populated desert in the
world (cf. Malhotra 1988; Anonymous 1994a). The Thar Desert has two obvious
environments brought about by the intersection by the seasonal Luni river; a vast
stretch of sand dunes or levee-draped sand mounds in the north and an expansive
Fig. 3.9 Eleven* desert districts (those encircled had severe malaria epidemic history) in the Thar
Desert region in Rajasthan and the extent of the three major canal systems. (Note: *actually 12 since
Sri Ganganagar having been split into two resulting in the creation of an additional desert district,
Hanumangarh, in 1994.) (Source: Tyagi and Chaudhary 1997)
basin rimmed by flat-topped hills of sandstone and limestone in the south. The
annual ambient temperature varies between -4 °C and 50 °C, while the average
precipitation, which was until recently about 250 mm, has since 1990 been about
350–400 mm.
(i). Topography and Physiography
Rajasthan State, which roughly lies in the area bounded by 23°–30° North
latitudes and 69°–78° East longitudes bracing Pakistan on its West, Gujarat and a
part of Madhya Pradesh on its south, rest of Madhya Pradesh and Uttar Pradesh on
its east, and Punjab and Haryana on its north, experiences generally a very dry
extreme climate. The Great Indian Thar Desert of which a huge area falls in the
north-western region of Rajasthan presents one of the most xeric environments in the
Fig. 3.10 Development of irrigation coverage in the Thar Desert since the first Five Yearly
Planning in 1951. Gang canal system; Bhakra canal system; Indira Gandhi canal system.
(Source: Tyagi and Chaudhary 1997)
country. The geographical limits of the Thar Desert region, forming West Rajasthan,
formerly called as Marwar, is sterile, sandy, and inhospitable. In the State of
Rajasthan, it forms the whole of the West Rajasthan—Sind frontier, extending
from the edge of the Rann of Kutch beyond the Luni river northward. The only
important river in the Thar Desert is the Luni or salt river (also locally known as
Lonavari or Lavanavari, referring to the river’s saltish nature).
(ii). Evolutionary Hypothesis for the Thar Desert
There are several theories for the origin and evolution of the Thar Desert.
Although the Thar Desert ranks as the 18th largest hot desert in the world, it is
nonetheless one of the youngest deserts still in the process of transformation (Warren
et al. 1996). According to one school of thought the Thar Desert is believed have
come into existence between 4000 BC and 1000 BC (Krishnan 1952), although
another concept based on palynological evidence advocates that the development of
the desert set in during late Cretaceous (Lucose 1972). Prior to this a well-knit
riverine system existed. However, in the ensuing passage of time a series of events
took place, such as the deterioration of climate and land physiography, the rise of the
Himalaya, lowering of the Aravalli mountain ranges, the diversion and disappear-
ance of three classical rivers (the Yamuna, the Saraswati, and the Ghaggar) and
consequently the decrease in the underground water-table, which possibly caused
increased aridity in the area (Wadia 1960). Presumably agriculture was introduced in
the region from the Middle East through Baluchistan and Sind, but likely the practice
of agriculture originated in the times of Mohenjo Daro-Harappa civilization at the
banks of Indus (=Sindhu) river in old-time India, about 3300 BCE to 1300 BCE.
(iii). Climate
The climate of the Thar Desert is, generally speaking, of the tropical desert type
with arid hot environment. The year in the Thar Desert may be divided into four
seasons: (i) the winter season from November to March is followed by
(ii) pre-monsoon season from April to June, (iii) the period from July to middle of
September constitutes the south-west monsoon season, and (iv) the period from the
latter half of September to October forms the post-monsoon period. While in the rest
of the State the period from November to March is generally very unpleasant due to
biting cold, in the Thar Desert region the severe cold-wave period lasts only for
1 month or so involving December and January at the most. In the summer months
from April to June, weather is very dry and inhospitable. Monsoon is often erratic
and inadequate in the desert and the humidity is ephemeral.
(iv). Atmospheric Sea Level Pressure and Winds
As far as the Thar Desert is concerned, in principle, and the Rajasthan State, in
general, the atmospheric pressure systematically varies on seasonal basis, with a
maximum in the winter (January) and a minimum in the monsoon season (July)
(Table 3.2). The pressure gradient over the State generally remains weak except
during the late summer and monsoon season. During winter, the higher pressure is
built up towards the north. In April, the pressure tends to decrease from west to east.
Accordingly, the winds are light and mainly for north-west to north in January, but
turn gradually anticlockwise, and are replaced by light north-westerly to westerly
winds in April. With the advance of summer, the pressure gradient increases
correspondingly, and the winds south to south-west also strengthen reaching their
maximum strength in July. There the pressure decreases in July from west/south-
west to east/northeast and correspondingly the winds move mainly from west to
south-west. As the monsoon intensifies, winds become more and more westerly.
October is the month of transition, with the weakest pressure gradient. From October
onwards, the changeover of the pressure and wind pattern commences.
(v). Temperature
Day temperatures are more or less uniform over the plains except during winter
and monsoon when temperatures increase southwards and north-westwards, respec-
tively. In general, the night minimum temperature is lower in higher latitude except
during the south-west monsoon when it is more or less uniform (Table 3.3).
May is the hottest month with mean maximum temperature at 41 °C in the plains
of the desert. The highest temperature recorded at an individual station in the plains
was 50.0 °C at Sri Ganganagar on June 14, 1934 which is about 8 °C higher than the
normal of the warmest month. January is the coldest month in the Thar Desert. On
such occasions minimum temperatures below the freezing point can be registered at
a few stations in the northern parts of the desert. The lowest temperature ever
recorded at an individual plain desert station was -5.9 °C at Jaisalmer on 12 January,
1967 which was nearly 13.8 °C below the normal for the coldest months.
Table 3.2 Mean wind speed (kph) in the Thar Desert region
Months
District Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Annual
Barmer 7.6 7.5 9.1 10.6 12.9 14.2 12.4 10.6 9.5 7.2 5.3 6.4 9.5
Bikaner 4.6 5.1 6.5 7.3 10.1 13.3 12.8 11.0 9.4 5.3 3.5 3.7 7.7
Sri Ganganagar 4.0 5.0 6.4 6.8 8.0 10.7 9.6 8.0 6.2 4.7 3.3 3.4 6.3
Jaisalmer 8.6 8.2 10.9 12.7 18.3 27.2 24.8 21.7 16.1 8.5 5.5 6.5 14.1
Jodhpur 8.9 8.8 9.8 10.2 15.0 18.5 16.6 12.9 10.6 6.6 5.8 7.3 10.9
Source: Tyagi (2002)
57
58
Table 3.3 Mean maximum and minimum temperatures (°C)

Months
District Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Annual
Barmer Max 24.7 28.6 33.9 38.9 41.9 40.3 36.1 33.8 35.3 36.0 31.5 27.0 34.0
Min 10.2 13.3 18.7 24.1 26.8 27.3 26.3 25.1 24.5 21.7 15.9 12.1 22.2
Bikaner Max 22.3 26.1 31.8 37.6 42.0 41.7 38.9 36.1 36.6 35.3 30.3 24.7 33.6
Min 5.0 8.2 14.4 20.8 27.2 29.3 28.0 26.6 25.2 18.6 10.0 5.6 18.2
Sri Ganga- Max 20.5 24.1 29.6 36.3 41.5 42.1 38.8 37.3 36.6 35.0 29.4 23.3 32.9
nagar Min 4.7 7.5 11.1 18.2 24.0 28.0 28.1 26.9 24.1 17.0 8.9 5.5 17.0
Jaisalmer Max 23.6 28.2 32.6 37.8 41.6 41.4 37.7 35.9 36.3 36.1 31.1 26.0 34.0
Min 7.9 10.6 16.9 21.4 25.8 27.3 26.5 25.5 24.5 20.1 13.0 8.9 19.0
Jodhpur Max 24.6 27.9 33.3 38.3 41.6 40.1 35.7 33.2 34.7 35.7 31.4 26.7 33.6
Min 9.5 12.0 17.1 22.4 27.3 28.5 26.8 25.2 24.1 19.6 13.9 10.7 19.8
3 World Deserts: Environments and Malaria Potential
Table 3.4 Number of depressions and thunderstorms affecting the Thar Desert region compared to
that in the State of Rajasthan during 1891–1970
Number of events in the Number of events in % of events in the
Month Thar Desert Rajasthan State Thar Desert
January 1 1 100.0
February – –
March – – –
April 1 1 100.0
May 1 1 100.0
June 8 14 57.14
July 15 39 38.46
August 24 49 48.97
September 18 50 36.0
October 1 5 20.0
November – – –
December – – –
TOTAL 69 160 43.12
Both the minimum and maximum temperatures rise rapidly from February
onwards till May. The increase in maximum temperature in the period from January
to May ranges from 14 °C to 19 °C at individual stations. From the beginning of June
to the end of July the maximum temperature falls by about 4 °C to 7 °C whereas the
minimum temperature falls only by about 4 °C from June to September. In
September, a slight rise in the maximum temperature is experienced due to increased
insolation. The night temperatures fall rapidly after September while the day
temperatures follow the same trend after October and both attain lowest values by
January. The fall in minimum and maximum temperatures is about 14 °C–20 °C and
8 °C–17 °C, respectively, during these periods.
July and August are the months recording smallest diurnal range of temperature
(about 8 °C–9 °C) in the Thar Desert. The diurnal range increases rapidly after the
withdrawal of monsoon. During the period from November to May the diurnal range
is of the order of 15 °C to 18 °C, being greater in November.
(vi). Humidity
The relative humidity is generally very low during the hot and dry periods of the
year. However, it is relatively higher during the period from June to September. The
relative humidity is about 46% in June rising to a little less than 70% during August
in the Thar Desert. The diurnal variations in relative humidity are least during
monsoon season, being higher in the Thar desert as compared to that of the
non-desert areas in the Rajasthan State.
The relative humidity is least during summer afternoons when it becomes about
15–34%, making the summer very dry and hot. On the other hand, the diurnal
variation is highest during the winter period of November to March.
(vii). Thunderstorms and Dust-Storms
Convective activity is essential for occurrence of thunderstorms and dust-storms

(Table 3.4). Thunderstorms become pronounced in the summer due to excessive
ground heating. When the moisture is insufficient in the atmosphere dry thunderstorms
or dust-storms occur. The maximum number of thunderstorms, however, occur with
the onset of the monsoon current, while dust-storms are mainly restricted to the
summer months of March–June. The average number of days of thunderstorms during
the monsoon season is 6.4, the maximum being in July. The average annual number of
thunderstorms in the Thar Desert is 14 (approximately 33% of the total thunder
activities in the State). In the winter months there is sometimes thunder activities
accompanied by hail in association with western disturbances. Thunder activity is
minimum in the months of November and December in the Thar Desert.
(viii). Cyclonic Storms and Depressions
The cyclonic storms which can really make an impact in the Thar Desert region
originate in the Arabian Sea, but even so most of these weaken before making any
catastrophic effect. During the period 1891–2000, only two such storms originating
over the Arabian Sea affected the Thar Desert region, the latest and the more
destructive in nature was observed in 1998, the former one in May while the latter
in June (Table 3.4). In association with such oceanic disturbances, heavy to very
heavy rains occur over the area under its impact. But, these cyclonic storms and
depressions hardly have any long-term effect on the weather in the desert. During the
period 1891–1970, only two storms, one in 1917 and the other in 1956, originating
over the Arabian Sea affected the weather of the Thar Desert region.
(ix). Cloudiness and Bright Sunshine
The intensity of cloudiness or bright sunshine in the environment may affect the
biology of vector mosquitoes (Table 3.5). The period of October to May is cloudless
or lightly clouded. The part of the period from January to March being more clouded.
However, afternoons are comparatively more clouded than the forenoons in this
period. In April and May the sky remains cloudless or lightly clouded making about
1–1.5 Oktas of the sky covered during evenings. During monsoon season (July to
September) the sky is heavily clouded particularly during July and August, when a
little less than 5 Oktas of skies are covered with clouds. On an average in each of
these 2 months, the sky remains covered for more than 5 days per month and clear on
7 days in the Thar Desert. During October, cloudiness decreases to a great extent
over the entire State, but more pronouncedly so in the Thar desert.
(x). Rainfall
It is one of the most important climatic factors that is supposed to affect both the
epidemiology of malaria and the biology of its vector species (Table 3.6) (Akhtar
and McMichael 1996).
Table 3.5 Mean number of hours of bright sunshine per day as recorded in Jodhpur (Thar Desert region) and Jaipur (non-desert region) in Rajasthan State
Months
Station Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Annual
Jodhpur 9.0 9.6 9.0 10.0 10.4 9.5 6.7 6.4 8.3 10.0 9.8 9.3 8.2
Jaipur 8.6 9.3 8.9 9.3 9.1 7.1 4.6 4.6 7.3 9.6 9.7 8.9 8.1
61
62
Table 3.6 Percentage departure of monsoon season rainfall (June to September). (Departures are with respect to normal rainfall, i.e., the long period average
value of monsoon season rainfall over west Rajasthan which is of the order of 28 cm)
Year % Departure Year % Departure Year % Departure Year % Departure Year % Departure
1901 -53 1921 -20 1941 -19 1961 +40 1981 -30
1902 -31 1922 -11 1942 +16 1962 -07 1982 -36
1903 +12 1923 -04 1943 +10 1963 -35 1983 +66
1904 -51 1924 +0.4 1944 +87 1964 +22 1984 -17
1905 -59 1925 -32 1945 +28 1965 -23 1985 -44
1906 -16 1926 +56 1946 -18 1966 -14 1986 -43
1907 +19 1927 +16 1947 -05 1967 +02 1987 -67
1908 +112 1928 -04 1948 -23 1968 -45 1988 -20
1909 +40 1929 +10 1949 -15 1969 -54 1989 -23
1910 +11 1030 -03 1950 +09 1970 +33 1990 +63
1911 -63 1931 +40 1951 -43 1971 -13 1991 -38
1912 -02 1932 -03 1952 +04 1972 -27 1992 +62
1913 -27 1933 +27 1953 +10 1973 +56 1993 +21
1914 +02 1934 +19 1954 -13 1974 -42 1994 +67
1915 -72 1935 -12 1955 +31 1975 +96 1995 +51
1916 +45 1936 -10 1956 +29 1976 +63 1996 +49
1917 +139 1937 -06 1957 -21 1977 +66 1997 +43
1918 -76 1938 -29 1958 -05 1978 +43 1998 -01
1919 +03 1939 -59 1959 +22 1979 -14 1999 -24
1920 -28 1940 -02 1960 -16 1980 -27 2000 -22
The total rainfall in the Rajasthan State varies from 14 cm over the extreme north-
western parts of the Thar desert to 95 cm over the south-eastern parts of the
non-desert plains. The south-west monsoon is the principal rainy season when the
State receives 75–85% of its total rainfall. In Table 3.6 is given percentage departure
of monsoon season rainfall, whereas mean rainfall data for some of the desert
districts in the Thar Desert are offered in Table 2.6. As far as the Thar Desert region
is concerned, Pali and Jalore districts on the west of Ararvalli hills receive maximum
amount of rain. Other districts in the north/north-west like Bikaner, Sri Ganganagar,
and Jaisalmer receive annual rainfall of 26.0 cm, 25.2 cm, and 14.1 cm, respectively;
annual rainfall over Jaisalmer district being the lowest. The mean annual rainfall in
the Thar Desert is about 31.7 cm (about 32% of the total mean annual rainfall in the
State) (Table 3.7).
The south-west monsoon approaches the State of Rajasthan by the end of June
and the Thar Desert in the first week of July. Both July and August are the rainiest
months, each accounting for about 30% of the annual rainfall in the desert region. In
each of these months there are 2–7 rainy days (with daily rainfall of at least 2.5 mm)
in the Thar Desert. The south-west monsoon begins to withdraw from the north-
western parts of the Thar Desert around first September. During winter the Thar
Desert receives 1.7 cm of rainfall, which although small in amount, is of great
significance for the traditional agriculture.
(xi). Rainfall Variability: Vagaries and Excessiveness of Rainfall
Co-efficient of variation of annual rainfall is more than 80% for some of the desert
districts like Barmer and Jaisalmer, which is twice that in the non-desert areas. Rain
pattern in the Thar Desert region has always been very sceptical and erratic. The
periods 1901–05 and 1906–10 stand unique as both fairly deficient and excessive
rainfall occurred in these 5-year periods alternately. The period 1901–05 had
become marked for 4 years of drought out of which one year was of severe drought
in the desert area. On the other hand, the period 1906–10 had three consecutive years
of excessive rainfall and not registered any drought condition in the Thar region.
Excessive rain is conveniently defined as the rainfall of 125% or more of the normal.
The probability of occurrence of heavy rain of 125% or more of the normal over the
Thar desert region is about 18%, i.e., 9 times in 50 years in the long run.
In Table 3.8 is given the district-wise years of excessive rainfall in increasing
order of number of such years with the highest percentage of annual rainfall and the
year in which it occurred.
It becomes more than obvious from the above table that, during the period under
consideration, the desert districts recorded excessive rainfall in 32 years the maxi-
mum amount being 351% of normal annual rainfall in year 1917 for the Jaisalmer
district. Churu, Barmer, and Nagaur had 8, 11, and 12 years and the other districts
had 13 years of such rainfall. In 1917, all the desert districts except Jalore received
maximum amount of rainfall and hence the Thar region registered maximum amount
of rainfall in the above year. Successive years of excessive rainfall are shown against
64
Table 3.7 Mean rainfall (mm) in some of the selected desert districts in the Thar Desert
Months
District Jan. Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Annual
Barmer 2.8 3.6 2.5 1.6 6.6 19.4 87.3 112.1 33.7 3.6 0.6 1.1 275.9
Bikaner 3.6 6.2 4.1 4.3 9.9 24.9 74.9 91.2 30.8 5.5 0.9 3.3 259.6
Churu 8.6 6.6 5.3 4.2 9.9 34.8 101.0 95.2 49.4 5.2 1.2 4.1 325.5
Sri Ganga Nagar 9.7 9.8 6.8 5.3 5.5 27.4 77.4 73.1 31.4 3.2 0.3 3.8 253.7
Jalore 2.9 4.5 1.9 1.6 5.5 39.5 151.7 155.2 50.3 6.2 0.8 1.5 421.6
Jaisalmer 1.6 3.7 1.3 1.2 2.7 8.4 48.0 60.9 11.4 0.8 0.5 0.4 140.9
Jodhpur 3.9 5.3 3.7 2.8 9.3 30.9 97.5 119.3 44.9 4.8 1.1 1.8 325.3
Nagaur 5.7 5.5 5.0 3.5 11.8 35.2 128.8 126.6 50.8 5.6 1.1 3.8 383.4
Pali 3.5 4.7 2.1 2.0 10.9 41.6 144.8 182.4 70.9 6.5 1.5 1.3 472.2
Sikar 12.2 7.8 7.3 5.0 12.2 46.5 150.8 142.3 63.7 5.9 2.1 5.1 460.9
Jhunjunun 11.1 9.4 8.3 5.4 13.5 48.4 141.3 125.7 65.8 8.5 1.9 5.2 444.5
Table 3.8 District-wise years of excessive rainfall with highest percentage of annual rainfall and
the year in which it occurred during the first half of the twentieth century
Affected The year with highest %
desert districts Years of excessive rainfall age of annual rainfall
Churu 1908, 1909, 1917, 1926, 1942, 1944, 1945, 1950 1917–285%
Barmer 1907, 1908, 1909, 1913, 1916, 1917, 1921, 1926, 1917–285%
1927, 1931, 1944
Nagaur 1903, 1908, 1909, 1916, 1917, 1924, 1926, 1929, 1917–251%
1940, 1942, 1943, 1945
Bikaner 1907, 1908, 1909, 1916, 1917, 1928, 1931, 1933, 1917–293%
1936, 1937, 1941,1942, 1950
Sri 1908, 1909, 1914, 1917, 1923, 1926, 1930, 1933, 1917–219%
Ganganagar 1942, 1944, 1945, 1948, 1950
Jalore 1907, 1908, 1909, 1917, 1919, 1926, 1927, 1931, 1944–228%
1933, 1937, 1941, 1944, 1945
Jaisalmer 1906, 1908, 1909, 1914, 1916, 1917, 1923, 1926, 1917–351%
1929, 1931, 1933, 1937, 1944
Jodhpur 1908, 1909, 1916, 1917, 1924, 1926, 1927, 1931, 1917–288%
1933, 1934, 1943, 1944, 1945
Pali 1907, 1908, 1910, 1916, 1917, 1926, 1927, 1931, 1917–250%
1933, 1934,
Table 3.9 Desert districts Desert District Successive years of excessive rainfall
with successive years of
Barmer 1907–09, 1916–27, 1926–27
excessive rainfall
Bikaner 1907–09, 1916–17, 1936–37,1941–42
Churu 1908–09, 1944–45
Sri Ganganagar 1908–09, 1944–45
Jalore 1907–09, 1926–27,1944–45
Jaisalmer 1908–09, 1916–17
Jodhpur 1908–09, 1916–17, 1933–34,1943–45
Nagaur 1908–09,1916-17,1942–43
Pali 1907–08, 1926–27, 1933–34, 1943–44
each district in the Table 3.9 below. It will be interesting to note here that some of
these years coincided with the El Nino Southern Oscillation (ENSO) event years.
Each of the districts of Barmer, Bikaner, Jalore, and Jodhpur experienced exces-
sive rainfall in three consecutive years only once and also the first three districts
mentioned above received such rainfall in the same three consecutive years, namely
1907, 1908, and 1909. According to one estimate, the heaviest rainfall on record at
any district for one day in the Thar Desert region was 511.8 mm at Sanchor (Jalore
district) on 16th September, 1893.
Table 3.10 Desert District No. of drought spells

districts with numbers of
Barmer 18
droughts
Bikaner 16
Churu 11
Sri Ganganagar 11
Jalore 17
Jaisalmer 16
Jodhpur 14
Nagaur 13
(xii). Droughts
Drought is meteorologically defined as a situation when annual rainfall over the

area or place is less than 75% of the normal. However, if rainfall deficit is between
25 and 50% it is then classified as ‘moderate drought’ and when it is more than 50%
the event is called ‘severe drought’. ‘Drought areas’ are those where frequency of
drought as defined above is 20% of the years examined. At the same time, ‘chroni-
cally drought-affected areas’ are those areas having drought condition for more than
40% of the years under consideration. The severity of drought not only depends
upon the order of rainfall deficiency in a single year, but also upon continued
occurrence of deficient rain in successive years, even though the deficiency in
each such successive year may not be as high as in single year.
Although the droughts continue to ravish the Thar Desert even in the recent years,
these are reduced in frequency a great deal, apparently, in view of the substantial
metamorphosis of the Thar ecology due the extensive canalization in north-western
areas, particularly under the Indira Gandhi Nahar Pariyojana, in the second half of
the last century. The last two spells, being amongst the worst droughts in the history,
have been those during 1987 and 1998–2000). It will be beneficial to review the
situation from 1901 to 1950 to comprehend a change in the physiology of the desert
over a period of years highly conducive for both malaria vectors’ propagation and
the disease prevalence. All the districts in the Thar Desert region have repeatedly
experienced spells of drought as presented in the Table 3.10.
Droughts in the Thar desert often hailed in successive years (i.e., the district
rainfall less than 75% of the annual rainfall in each year) during the 50-year period
1901–1950 as given in the Table 3.11.
The years 1901 and 1939 experienced widespread drought affecting invariably all
desert districts. The probability of occurrence of drought, moderate drought, and
severe drought for the whole Thar Desert is 14%, i.e., 7 times in 50 years, 10% i.e.,
once in 10 years, and 4%, i.e., once in 25 years, respectively, in the long run.
Table 3.11 Successive droughts in the Thar Desert districts

Period of successive droughts Affected desert districts
1901–02 Barmer, Bikaner, Jalore, Jodhpur, Nagaur, Pali
1904–05 Barmer, Jalore, Jaisalmer, Jodhpur, Pali
1905–06 Nagaur
1911–12 Bikaner
1920–21 Sri Ganganagar
1920–22 Churu
1935–36 Jalore
1936–37 Barmer
1938–39 Bikaner, Churu, Sri Ganganagar, Jaisalmer, Jodhpur, Nagaur
1939–40 Jalore
1946–48 Jaisalmer
1948–49 Jalore
(xiii). Malaria in the Thar Desert
After maintaining a less pernicious profile during the late 1970s and 1980s,
malaria has resurged with a vengeance in some States in addition to developing
new disease foci in hitherto less malarious areas in India. Excellent control work by
the National Malaria Eradication Programme (NMEP), launched in 1958, signifi-
cantly decreased the incidence of the disease in the country from about ten million
cases in 1976 to two million in 1991 (Sharma 1986a, b; Tyagi 1994a). The success
under the NMEP can be gauged simply from the fact that by 1966 the total malaria
cases were reduced to the lowest ever figure of less than one million without a single
death (Sharma and Mehrotra 1986). So far as Rajasthan State is concerned, most of
the 30 districts, including the then 11 desert districts (Sri Ganganagar, Bikaner,
Churu, Nagaur, Jodhpur, Barmer, Jaisalmer, Pali, Jhunjunu, Sikar, and Jalore), have
hitherto been considered to have low and variable endemicities of malaria with
potential for sporadic outbreaks of the disease (Anonymous 1987a). However, since
the 1960s malaria has increased in the State to reach epidemic proportions in some
regions, particularly the Thar (Fig. 3.8). It appears that, coupled with many other
factors, the mismanagement of the widespread developmental activities of canal-
based irrigation is possibly the single most pressing reason for not only repeated
outbreaks but also exacerbation of malaria in the Thar Desert.
Three major canal systems have been introduced into the desert regions of
Rajasthan, the Gang canal, the Bhakra Sirhind feeder canal, and the Indira Gandhi
canal, running over 10,000 km in length. Consequently, the physiography of the land
has changed a great deal in its soil composition, landscape, potential for water
retention, and climate. As a result, some areas, especially those in the vicinity of
the canalized irrigation, have become perennial breeding sites for vectors and are
regularly experiencing outbreaks of malaria, particularly that caused by Plasmodium
falciparum. Periodic malaria epidemics between 1983 and 1994 claiming hundreds
of deaths are ample proof of the changing pattern of the disease epidemiology in the
Thar Desert region. It is to be emphasized here that all these epidemics were
characterized by a high P. falciparum incidence, which was insignificantly
represented in all earlier instances of malaria outbreaks without a single death,
such as during the mid-1970s.
(a) Topographic and Climatic Oscillations Under the Impact of Extensive

Canalization:
As shown in Fig. 3.8, three major canal systems exist in the Thar Desert region
today (Anonymous 1994a, b). The first was the Gang canal project which became
fully operative in 1928, with its 1251 km distribution system in Sri Ganganagar
district only. Along with the Bikaner canal feeder, it provides water to about 65% of
the 300,000 ha of cultivable land. The Bhakra-Sirhind canal project, with its
1219 km long distribution system, was started in 1955 to utilize a further
300,000 ha of cultivable land. The most important of all the canal systems is the
Indira Gandhi Nahar Pariyojana project (IGNP), which is one of the world’s largest
projects of its kind in the desert. It was started in 1958, and the irrigation of part of
the area began in 1961. The project, when completed, will include a 649-km long
main canal (of which 445 km is in the Thar Desert) and over 9000 km of
distributaries (Anonymous 1987b). Although only two of the three stages envisaged
are completed by now, the main canal including feeder and 5500 km of distributaries
is already irrigating 950,000 ha of land (approximately 50% of the irrigated area that
is planned). The irrigation potential of all these canal systems during each Five
Yearly Plan commencing from 1951 is shown in Fig. 3.10. This Herculean task,
bringing Himalaya’s water to the Thar Desert, aims at transforming vast stretches of
western desert terrain into blossom. As a result, the annual agriculture production
from the newly irrigated land now exceeds Rs. 6500 million (Anonymous 1994b).
While several irrigation-intensive crops, such as sugarcane, mustard, groundnut,
etc., have been established in some of the canalized desert districts, the production of
rice in Sri Ganganagar district, the most irrigated among all desert districts, has
topped the list in the whole State. Rice cultivation has often been associated with
malaria transmission (Russell and Rao 1940; Rao 1984; Dossou-yovo et al. 1994),
although Sharma et al. (1994) have found a negative correlation between rice
cultivation and the annual parasite incidence (API) in most States and Union
Territories on a nationwide survey.
Beside the surplus irrigation water that accumulates on irrigated land, vast areas
along the course of the Indira Gandhi main canal have been engulfed by seepage
water from the irrigation canals on a perennial basis. An estimated 8600 ha in the
Nalibed area, Sri Ganganagar district, is permanently inundated under the IGNP
Stage I by the Ghaggar river floodwater while 1000 ha is converted into marshy land
due to waterlogging and excessive seepage from the canal in Stage II (Anonymous
1992). Supply of canal water to the desert region over several decades has caused a
rise of the water table and water-holding potential of the soil, and a plentiful growth
of vegetation, particularly hydrophytic weeds. Such extensive breeding grounds are
Fig. 3.11 Comparison of slide positivity rate (SPR; and slide falciparum rate (SFR; in
Rajasthan from 1961 to 1991 (at 5-yearly intervals) and in 1994. (Source: Tyagi and Chaudhary
1997)
the preferred sites of many anophelines including An. culicifacies, the most serious
vector of malaria in the whole Indian subcontinent.
(b) Dynamics of Plasmodium Parasites:
The position regarding endemic malaria in Rajasthan, especially in the Thar

Desert where P. falciparum is rampant across the entire region, has changed a
great deal over the past few decades (Hehir 1927; Sharma 1986a, b; Tyagi 1994a).
The overall number of positive cases in the State has increased 27 times, from 8494
cases in 1961 to 229,772 cases in 1994, while the targeted population has increased
only 2.5 times during the same period. From Fig. 3.11 it is obvious also that while
the slide positivity rate (SPR) (the number of blood slides found with Plasmodium
parasites as a percentage of those examined) has significantly increased from 1.43 to
1961 to 5.07 in 1994 (3.5-fold increase), the slide falciparum rate (SFR) (the number
of blood slides found with Plasmodium falciparum as a percentage of those exam-
ined) has also increased as much, from 0.55 to 1.95. However, the increase in either
the SPR or the SFR was not steady and, therefore, no definite trend can be noticed.
The maximum SPR was recorded in 1976, with several epidemics in non-desert parts
of the State (Sharma 1986a, b; Tyagi 1994a). From the mid-1980s onwards, how-
ever, the trend has become clear and both the SPR and the SFR have steadily
increased. In fact, the highest ever SFR has been recorded in 1994. To demonstrate
the trend in the prevalence of P. falciparum against slide positive rate, moving
averages (%) are plotted in Fig. 3.12. The annual parasite incidence (API) (the
number of parasite-positive blood slides per thousand population) also showed a
Fig. 3.12 Comparison of moving averages of % P. falciparum cases and % positive cases (SPR
+) in Rajasthan. (Source: Tyagi 2002)
Fig. 3.13 Diagram depicting total P. falciparum cases (× 1000) , total of malaria cases (× 1000)
, and deaths from malaria in Rajasthan between 1990 and 1994. (Source: Tyagi 2002)
steady increase from 0.48 to 1.76. The state of disease prevalence, including death
toll, in the State between 1990 and 1994 is depicted in Fig. 3.13.
Before malaria epidemics began to occur regularly in the desert region in the
mid-1980s onwards, most of the positive cases were reported from the hyperendemic
hilly and forested terrain of Udaipur in the southern part of Rajasthan (Sharma
1986a, b).
Fig. 3.14 Comparison of annual parasite incidence (API) in the desert and non-desert
districts of Rajasthan between 1979 and 1994. Note the appreciable rise in API in desert districts
from mid-1980s onwards. (Source: Tyagi 2002)
Thus, while in 1986 the Udaipur zone had contributed 44.1% positive cases and
67.7% P. falciparum cases as against 24.4% positives and 11.6% P. falciparum
cases in the desert region (Anonymous 1987a, b), in 1994 only 14.1% positives
(P. falciparum 26.6%) hailed from the Udaipur zone compared to 53.3% positives
from the desert districts with a whopping 62.5% P. falciparum cases (Anonymous
1995). Amongst 11 desert districts, Barmer is the most malarious contributing 31.3%
positive cases and 35.8% P. falciparum cases (Tyagi et al. 1995). In Fig. 3.14 a
comparison of annual parasite incidence in desert and non-desert districts in the State
is presented for the period 1979–1994 which indicates a definite increase in the
desert districts.
For the application of malaria control, the 11 desert districts are organized in three
zones: Jodhpur zone (Jodhpur, Pali, Jaisalmer, Barmer, and Jalore districts), Bikaner
zone (Sri Ganganagar, Bikaner, Churu, and Nagaur districts), and Jaipur zone (Sikar
and Jhunjunu districts). Recent malaria epidemics have affected most of the Jodhpur
and Bikaner zonal districts. In the Bikaner zone, data for Sri Ganganagar district
(1976–1986) show that the SPR initially declined from 13.48 in 1976 to 0.84 in
1982, whereafter, following an epidemic, it advanced to 4.91 in 1984. However, the
percentage of P. falciparum exhibits an increase from 2.49 in 1976 to 6.83 in 1986,
with inter alia a steep increase to 43.39 in 1983. In the Jodhpur zone, on the other
hand, percent P. falciparum shows a marked escalation in at least three of the five
districts during 1981, 1986, and 1991 (Fig. 3.13).
When the data of Jodhpur zonal districts at these three points of time are pooled
and compared with those of Sri Ganganagar district and the State, it becomes evident
that the SPR has steadily increased in the Jodhpur zone districts, while in Sri
Ganganagar and in Rajasthan it is down or unchanged in 1991 against the base
year 1981. On the other hand, the % P. falciparum in the Jodhpur zone districts, after
being slightly down in 1986, shows a significant increase in 1991, but in both Sri
Ganganagar and Rajasthan it is down in 1991 after significantly increasing in 1986
against that in 1981. However, in all the three categories, the % P. falciparum is
much higher in 1991 than in 1981.
In conclusion, it is clear that changes in % P. falciparum over the years have come
about regardless of SPR. Therefore, in a region such as the Thar Desert, %
P. falciparum is a rather significant factor in determining the severity of the
magnitude of fatal infection or future epidemic.
(c) New Foci of Plasmodium falciparum and Its Pathways in the Thar Desert:
Out of the three physiographic zones described earlier, the IGNP command area
seems to correlate with the flare up of malaria in the desert. In Fig. 3.14 the annual
parasite incidence and % P. falciparum are presented to relate the two parameters to
each other and to the period of availability of canal water for irrigation in the four
desert districts under the IGNP command area. Generally, it would appear that more
malaria cases occurred in the early 1970s. However, it is significant to note an
appreciable decline in malaria cases since 1977 on the one hand, and a significant
rise in % P. falciparum with different magnitudes soon after that, on the other.
Ironically, in Jaisalmer, and to some extent in Jodhpur, both annual parasite inci-
dence and % P. falciparum are showing an increasing trend since the early 1990s,
clearly coinciding with the period of canalized irrigation and implying that a likely
outbreak is foreseeable in the near future.
Four major outbreaks involving markedly high representation of P. falciparum
will corroborate this hypothesis. Sri Ganganagar, the first of the desert districts to
receive canalized water for irrigation, experienced a major P. falciparum-dominated
outbreak of the disease for the first time in 1983 with 4925 positive cases, of which
43.4% were P. falciparum cases. In spite of the fact that in 1983 API was but second
lowest during the last few years, the malaria outbreak in the Nalibed area in
Hanumangarh Tehsil of the district caused high morbidity and some deaths. Two
primary health centres (PHCs), Sangaria and Pilibanga, which were most severely
affected, had jointly contributed 72.2% of the total positive cases in the district
during the epidemic. It is noteworthy that since 1987 the % P. falciparum has been
constantly increasing while conversely the API has been keeping a low ebb.
In 1990 Barmer district was severely struck by an epidemic claiming several
lives. A total of 19,322 positive cases (P. falciparum 66%), which was 2.5 times
higher than reported in the preceding year, were recorded (Mathur et al. 1992).
During late 1992 and early 1993 an epidemic broke out simultaneously in several
districts, i.e. Bikaner (Bajju and Kolayat PHCs), Jodhpur (Baap and Phalodi PHCs)
and Jaisalmer (Pokaran and Nachna PHCs). In a survey carried out in two desert
villages near the Indira Gandhi canal, Madassar and Awai, during early 1993, the
SPR was as high as 85.0 and the P. falciparum proportion as 88% (Tyagi et al.
1994). In Jaisalmer district alone a total of 2128 positive cases (P. falciparum 73.6%)
were reported during the epidemic as against a combined total 1809 cases
(P. falciparum 27.6%) in the two preceding years (1990 and 1991). In mid-1994,
malaria broke out once again, particularly in Barmer, Jaisalmer and Jodhpur districts,
and this was the worst epidemic in the history of the desert, taking as many as
452 lives in Rajasthan State alone. Plasmodium falciparum accounted for over 60%
of cases in the desert and was considered as the main cause of death (Anonymous
1994a, b, c; Tyagi et al. 1995).
Taking cognizance of the chronological development of various epidemics since
1983 as well as their foci in the desert region, it appears that P. falciparum-
dominated malaria epidemics have advanced from northern-most Sri Ganganagar
district to the western and southern districts in the interior of the Thar Desert, more or
less along the course of the Indira Gandhi canal.
(d) The Thar Desert Classified on the Basis of Malaria
The Thar Desert is a highly complex ecosystem which is under constant stress of
metamorphosis. Consequently, from time to time several classifications have been
offered for its physiography, based on soil types, rainfall, flora and fauna, and riverine
systems (Gupta 1975; Singhvi and Kar 1992). On the other hand, Heron (1938), like
Blanford (1876), described the tract lying north-west of the Aravalli Hills as sandy,
poorly watered, and sterile. At present, the Thar Desert has a different look, particu-
larly so in the north-western part where the three canals’ network exists, and, therefore,
a new classification based on availability of canal based-irrigation was recently
proposed by Tyagi (1996a, d; Tyagi and Chaudhary 1997). Malariologically, too,
this system of classification, as mentioned hereunder, is agreeable.
Accordingly, the whole Thar Desert can be classified in three areas, namely,
(1) the IGNP command area, which includes the upper reaches of the Marusthali
desert (i.e., Jaisalmer northwards including also Jodhpur, Bikaner, and Sri
Ganganagar/Hanumangarh districts), which are receiving canal water. This area is
presently characteristically dominated jointly by An. Stephensi and An. Culicifacies.
Also, this area particularly the tract under progress of canal construction activities is
a highly P. falciparum-dominated malarious area, often experiencing focal
outbreaks of the disease. This area covers only 11% of the entire Thar Desert falling
in Rajasthan, (2) the IGNP non-command area, which includes districts at the eastern
fringe forming a part of the desert peneplains, namely Churu, Jhunjunun, Nagaur and
Sikar. These districts are not yet appreciably supplied with canals, hence largely
desertic in nature. Unarguably, this is an area dominated almost entirely by An.
Stephensi. Malaria prevails in this part of desert but at a low intensity and is
characteristically P. vivax-dominated. This area occupies most of the Thar Desert,
78.4%, and (3) the non-IGNP area, which largely falls in the Luni river basin and is
invariably flood-prone following heavy monsoon rains in the catchment area of the
river in the Aravalli hills. This comprises Barmer, Pali, and Jalore districts, of which
at present, at least, only Barmer is envisaged in the IGNP third phase of construction
but still has to wait for several years. Anopheles culicifacies circumstantially
outnumbers all other taxa, and is often responsible for high transmission of disease
following heavy monsoon in the area. This area is but 10.6% of the Thar Desert.
Desert Water Sources and Vector
Adaptation 4
4.1 Introduction
Water in desert is synonymous to the survival of man. The very existence of animal
and plant life in deserts depends on the presence of water, grossly abysmal though,
earning it a befitting sobriquet, “Water is a desert’s gold” or, more philosophically,
“Like water in the desert is wisdom to the soul.” Water is considered rarest of the rare
commodity in the desert, and in the Thar Desert, where water is regarded as a source
of wealth that is more precious than gold, even marriages of young girls are settled
by assuring first about the availability of water in the prospective groom’s village or
hamlet. In other words, life in the desert is a “continuous struggle” and is but mere
nought without the water source. And now the same water, when mismanaged, is the
inexorable source of this malicious disease, malaria! One of the most dangerous
transmitters of Plasmodium parasites to humans is the mosquito, Anopheles
stephensi, equipped with special attributions to adapt to inimical xeric environments,
on the one hand, and high propensity toward feeding on human blood and potential
to transmit copiously both P. falciparum and P. vivax in the desert, on the other.
Deserts are characterized, in principle, with very low (<60 mm), occasional, and
erratic rains, extreme temperatures (sub-zero or close to zero on lower side while
beyond 50 °C on the upper side), and often violently billowing desert storms which
carry the sand a great distance. The Sahara desert has rarely experienced blitzkrieg
torrential rains and the resultant flood like situations during which time the normally
dry stream channels, called arroyos or wadis, are rapidly filled making these habitats
dangerous for breeding of vector mosquitoes such as An. gambiae (the deadliest
amongst all mosquitoes of the world), An. arabiensis, and An. funestus. Rain and
snow from adjacent highlands also cause water running down in such short-lived
streams which get filled with a slurry of mud and commonly transport considerable
quantities of sediment or detritus for a few days—a condition where, nature permit-
ted, a desert specialist mosquito like An. arabiensis may choose to breed. In some
cases of deserts like Egypt and Mali, some well-known voluminous and ‘exotic’
rivers like Nile, Senegal and Niger cross deserts deriving their water from outside the

Ltd. 2023
76 4 Desert Water Sources and Vector Adaptation
desert. These rivers finally carry on through deserts and deliver the entire collected
sediment en route the sea. In the Thar Desert in India, a seasonal Ghaggar river
enters into the Thar Desert but gets evaporated in course during hot summer months.
In contrast to this, a mighty irrigation canal system named Indira Gandhi Nahar
Pariyojana (IGNP) traverses through the Thar Desert with a huge network of
distributaries measuring 10,000 km on perennial basis. The water into the trio of
Gang Canal, Bhakra-Sirhind Feeder Canal and Indira Gandhi Canal originate in
Punjab (India) from Chenab and Tawi rivers. This has converted a part of the Thar
Desert into agriculturally advanced habitat, full of verdant environment. Irrigation
schemes, particularly in the virgin desert ecosystems, have been regarded for the
increase in malaria transmission due mainly to poor canal water management.
(Kibret et al. 2014; Tyagi 2002). Uncharacteristically, sometimes even deserts
experience events of snowfall, for example, the African Sahara desert had a massive
snow fall on 19 January 2022.
4.2 Traditional Sources of Water in Deserts
4.2.1 Lakes
Lakes are few in desert but a major source of water for meeting day-to-day needs and
minimal agriculture. As a matter fact desert lakes generally exist either in the basin of
the highlands receiving its meltwater or at the periphery of deserts where rainfall or
interior drainage basins is sufficient. Generally, as a rule, such desert lakes are
shallow, temporary, salty, and stretch over several kilometers due to a low bottom
gradient and wind stress. On drying these lakes form playa, a melange of clay, silt, or
sand encrusted with salt, sometimes representing relic lakes of the Ice Age about
12,000 years ago (e.g., 52,000 km2 Bonneville lake), which are aplenty as salt crust
or hardpans in North American deserts. The biggest salt marsh/lake in India, and the
world alike, is the Great Rann of Kutch (or Rann of Kutch seasonal salt marsh;
7500 km2) in the Thar Desert in the Kutch District of Gujarat State. The salt marsh of
Rann of Kutch, notwithstanding an intolerable soil and water conditions, abundantly
breed mosquitoes of variety including An. aconitus, An. nigerrimus,
An. pulcherrimus, and An. sundaicus (Singh et al. 1985). Earlier, however, even
An. barbirostris was recorded, possibly alluding to a change in faunal composition
due to climate change so closely demonstrable in the evolution of arid land forms,
the playas and/or salt marshes, from a wetter past.
4.2.2 Oases
Desert oases may offer excellent conditions for the transmission of malaria, given the
kind of demography, trade avenues, social connectivity with oases, etc. in its
approximation. There are many factors for malaria transmission in the oases,
where though of low intensity the disease is almost perennial since the essential
4.2 Traditional Sources of Water in Deserts 77
Fig. 4.1 (a–c) Some of the important malariogenic oases (Source: Free Wikipedia)
factors of man, mosquito and parasite are always existing. Extrafactorial

characteristics in oases like geographical, climatological, and epidemiological
conditions, which differ from other localities, prompt malaria to occur in desert
oases.
Oases (singular oasis, derived from Egyptian ‘wah’, implying “fertile place in the
desert”), usually ringed by steep sandstone escarpments, are a natural or man-made
artificial development of water stored in concavities such as vast depression or
fissures in a plateau of all measures and forms to keep them moistened by springs,
wells, or irrigation, with generally high water table in the surrounding lands due to
long-time water collection, good quality water due to constant recharging, and richly
vegetated on banks and in vicinity to provide shade for both permanent habitation
and cropping. They are often of all sizes; small, medium, and large. Many a times
they are quite big and spanning over several scores of kilometres covering a great
deal of villages’ requirements.
A typical oasis is highly rich in ores of the soil, keeping the surrounding lands
highly fertile, with many wells formed around due to groundwater almost
approximating the surface (Fig. 4.1).
Generally palm trees are observed growing around the well-lined oases, in long,
relatively narrow, broken lines with a well-defined orientation, e.g., east-western
direction in Libya’s Fezzan oasis in the Sahara desert. Oases are generally most
thickly inhabited. The houses of the oases, being largely of rural character (i.e.,
social and economic patterns), are of two types. In the larger oases they are
constructed of adobe brick with a roof of palm branches covered with sand. In the
outlying oases they are generally constructed of palm branches. They occur where
the water table is sufficiently near to the surface to support the growth of date palms,
and to permit digging of shallow wells to supply water for consumption by humans
and their domestic animals. The wells also supply water for irrigation of barley,
alfalfa, and a few vegetables.
The climate of areas of oases is generally arid with rain falling at rare intervals. As
in the case of Fezzan of Libya where the rainy season is from March to May with
variation in rainfall from 0.5 to 4.0 in. over a period of 5 year period, it varies in most
other cases of the deserts. The relative humidity ranges from 10 to 45%. Temperature
range is very wide from -9 °C to 55 °C. Oases’ inhabitants, drawn by the better
opportunities of commerce and business, often migrate periodically to the coastal
cities. Many of these oases have been important trade centres, and, though motorable
passages have been often noticed currently (four-wheel drive vehicles fitted with
special equipment), the old system of transportation through camel (‘the desert ship’)
caravans is still much in vogue due to their availability round the clock and low cost
of management.
Evidence from oases in African Sahara and Indian Thar deserts show occurrence
of the two most important human malaria parasites, viz., Plasmodium falciparum
and P. vivax; the former being more common in approximately 3:1 ratio in the
Sahara Desert and 2:3 ratio in the Thar Desert. Plasmodium malariae, P. ovale, and
P. knowlesi have never been reported from the Thar Desert, although they are
occasionally encountered in the Sahara desert. In the past, incidence of malaria has
not been high and epidemics have been rare in the Sahara desert but in the Thar
Desert their prominence was outstanding. Malaria in the oases would probably
increase if some type of control was not in effect. When the farmers of oases
would abandon their farms and migrated to other greener areas for the benefit of
their cattle, the abandoned dug wells and other sources of irrigation result in an
increase of suitable breeding sources for anopheline mosquitoes and a probable
increase in the transmission of malaria, even epidemics.
The Khorezm oasis has been the site of some of the most extensive irrigation
works in Inner Eurasia over the last 3000 years (Lewis 1966; Mukhamdejanov 1994;
Brite 2016). This irrigation has emerged time and again despite the volatility of
Khorezm’s water regime and a historical tendency for its canal systems to fail. There
are multifaceted reasons for the tenacity of this irrigation, in which the social context
has played a central role, helping to shape local people’s decisions to irrigate, and
leading them to develop different kinds of systems throughout history. The Khorezm
oasis is located in the Amu Darya delta, one of the most changeable deltas in the
world (Asarin et al. 2010). With very little rainfall to carve permanent drainage
patterns, its terrain is flat and smooth, leaving few topographic features in place to
direct water flow in any particular direction. As a result, natural re-channelling of the
delta’s streams occurs repeatedly as sediments accumulate, and as water volume
fluctuates due to evaporation loss and the seasonal inundation cycles of the river.
These dynamics determine flow patterns across the delta, which can change
Fig. 4.2 Inner Eurasia’s desert oases. (Source: Brite 2016)
dramatically and often abruptly. Artificial irrigation diverts water out into the desert
and exposes it to additional evaporation loss, further accelerating these effects and
changing both the direction and volume of water flows in the network.
Asia’s arid interior is home to several well-watered zones, known as the desert
oases, where humans have practiced artificial irrigation for the last 7000 years
(Fig. 4.2).
The Thar Desert’s oasis town, Phalodi, is located at the edge of the desert. It is a
wonderland by itself. The town, 160 km from Jaisalmer, is on the long-standing
historical Arab-Marwar-Sindh trading route (Ashima and Sheth 2005). In the olden
times, before the Karachi port opened an alternative quicker route, for over 400 years
this was a busy trading outpost. It is a place of money and mystery. It was here that a
massive sandstorm is said to have buried the treasures of Humayun who was fleeing
from Sher Shah Suri. The oasis is located at Khichan, a small habitat. The oasis, like
the rest of the topography, is a shallow pan with sand dunes of modest height
surrounding it. The oasis is a home to thousands of cranes, the migratory birds
from Europe and Russia, and one of the smallest of the crane family. This is the
magic of the desert (Fig. 4.3).
The anopheline fauna may differ from oases of one region to those in others.
While in Libia’s oases these are Anopheles multicolor and An. sergenti, in India the
major malaria vector perennially present is An. stephensi, although other species are
also present in some parts of the year.
Fig. 4.3 (a, b) The Khichan oasis at Phalodi, and (c) A ‘nadi’ at Khetusar village at the edge of the
Thar Desert, Western Rajasthan (India) (Source: a and b—Free Wikipedia, c—Dr. B.K. Tyagi’s
personal archive)
4.2.3 Desert Fringes
Desert fringes are more commonly associated with large malaria outbreaks
(Fig. 4.4). Since their strategic location is such that the rainfall and temperature are
two of the major factors which trigger malaria epidemics in warm semi-arid (desert-
fringe) epidemic risk areas. Desert fringes, the buffer zone between waling desert
and the non-desert area, often are a mosaic of microclimates. Small hollows support
vegetation that picks up heat from the hot winds and protects the land from the
Fig. 4.4 Some of the desert fringe areas belonging to different deserts. (Source: a, b—Free
Wikipedia; c, d—Recreational avenues created at the Thar Desert fringe point at Sam, Jaisalmer
district, western Rajasthan (India) (Source: Dr. B.K. Tyagi: personal archive)
prevailing winds. After rainfall, the vegetated areas are distinctly cooler than the
surroundings. Deserts advance erratically, forming patches on their borders. At the
borders, desert fringe areas support greater biodiversity largely due to heavy rainfall
at times and less detrimental temperature.
Jaisalmer district’s Sam is at the northwestern fringe of the Thar Desert region
and is currently bustling in tourism, tented accommodation, and several different
recreational avenues including the camel safari in the desert. At the same time, the
whole of Jaisalmer district is notoriously known for malaria epidemics year
after year.
4.2.4 Springs, Well, and Seasonal Streams
Deserts have fewer springs and wells. These are either rain-dependent or rarely
ground-borne run-off water from foothills and mountain ranges (Fig. 4.5). Some of
the springs and natural wells are watered from the underground sources through a
capillary action, bringing up water in the water passage from the water table below.
The well-water needs to be treated adequately before making it drinkable for
humans. At times, when the groundwater is far below the surface, giant drill
machines are used to dig deep wells and pumps to bring water up.
Fig. 4.5 (a) A deep well near Jodhpur (India) in the Thar Desert, and (b) a village well. (Source:
Dr. B.K. Tyagi, pers. archive)
For desert places with little or no rain at all there rivers come to the rescue of man,
but such instances are fewer only, e.g., Ghaggar river originating outside the Thar
Desert. Other popular examples of rivers providing water to some parts of deserts are
the Nile River in Egypt and the Sudan, the Tigris and Euphrates rivers in Iraq and
Syria, and the Indus River in Pakistan.
4.2.5 Wadi
Ghaggar in the Thar Desert, being a seasonal river which remains dry for most part
of the year, save for the monsoon months (July–September) during which time a lot
of vegetation grows around, is a good example of wadi.
4.2.6 Fossil Water
Water from excessive torrential rainfall, rivers, and freshwater lakes which has been
trapped underground in aquifers between rocks for ages is generally referred to as
“fossilized” water. This type of water is extracted in a way the petroleum products
like oil is drilled out from under earth or sea. It has been demonstrated in the Thar
Desert with the help of satellite imaging that there are lots of underground sites of
‘fossilized water” in the pathway of the now disappeared Saraswati river of yore
traversing through a once tropical forest. The “fossilized water” has been also found
in Cholistan (Pakistan side of the Thar Desert) (Geyh and Ploethner 2008).
4.2.7 Mines
Deserts are completely barren when their enormous, almost infinite, ores-related
treasure is taken into consideration. Many a country’s deserts, such as those in the
United States, Chile, Peru, and Iran, are rich in copper, whereas that in Australia and
the United States lead in iron, lead, zinc, gold, silver, and uranium deposits ores.
Turkey desert boasts of chromite. The Sonoran Desert near Ajo in Arizona is famous
for yielding a huge copper deposit about (750,000 m2). The copper ore mined here is
in a bed that averages 150 m in thickness. Similarly, alluvial fan deposits and playa
evaporites are present in considerable quantum in the deserts of the Green River
Formation of Colorado, Wyoming, and Utah (USA). Deserts are also highly rich in
precious non-metallic minerals such as beryllium, mica, lithium, clays, pumice,
sodium carbonate, sulphate, borate, nitrate, lithium, bromine, iodine, calcium, and
strontium compounds. Needless to emphasize, even economically significant
deposits of trona, a major source of sodium compounds, and thick layers of oil
shale are created in the arid environments.
An open-pit mine in the Thar Desert in India is very rich in natural minerals, ores,
and petroleum products resources. It is also richly endowed with non-metallic
Fig. 4.6 Quarry-mining in the desert fringe town of Soorsagar in Jodhpur (India) (Source: Dr. B.-
K. Tyagi, pers. archive)
minerals and a variety of building stones like sandstone and limestone. It is also the
leading producer of asbestos, soapstone, gypsum, felspar, calcite, etc. Bikaner,
Nagaur, and Barmer have good deposits of lignite, bentonite, quartz, and silica
(Anon. 1994a, b).
Extensive and deep quarry-mining in the famous Soorsagar has already resulted
into gargantuan excavations in about 1000 km2 area on the outskirts of Jodhpur,
which have been filled up with the rainwater and or the run-off from their catchment
areas for several decades (Fig. 4.6). These quarry-mined lands in the Thar Desert
have now inevitably become preferred breeding grounds for several kinds of vector
mosquitoes such as An. stephensi, An. subpictus, An. culicifacies, and An. annularis
(Fig. 4.6).
4.2.8 Petro Products
Contrary to the popular belief that oil reservoirs were extensively formed in shallow
marine environments, the arid and semiarid deserts also boast of being reservoirs to
some of the more productive petroleum areas on Earth, in addition to metallic and
non-metallic ores, and the biggest such resources are present in the regions of Africa
and the Mid-east. Recently huge deposits of petroleum has been confirmed under
the belly of the Thar Desert, too (so far 38 oil and gas blocks have been discovered in
the Barmer-Sanchor basin). India’s largest ground oil reservoir was discovered in the
Mangla oil field at Barmer in 2005.
4.2.9 Aquifers
Aquifers are underground layers of porous rock that contain water extending over
vast area (Fig. 4.7). While shallow aquifers may dry out soon (and can be
replenished on the advent of rains though it takes a long time for it to be replenished),
deep aquifers sustain for a very long time and do not require any replenishment.
These aquifers are a good source of water 100 times more in quantum than that in
lakes and rivers—enough to support billions of people for centuries.
4.2.10 Canals
Perhaps the world’s best example of canalized irrigation in an arid and desertic
environment is the Indira Gandhi Nahar Pariyojana (IGNP), complemented by two
other systems, namely, the Gang Canal and the Bhakra-Sirhind Feeder Canal
systems, running with their distributaries well over 10,000 km across the nearly
200,000 km2 of the Thar.
Till the end of the first quarter of the twentieth century the Thar Desert was a
highly barren, unproductive, inimical, and inhospitable region, characterized by high
temperatures, very low (50 mm) and erratic rainfall, very low humidity, low human
density (<10 persons/km2), and the only source for water being the ‘Tanka’, and
‘Beri’, besides a few nadis, etc. Realizing the difficulties of the local folks of the
Thar Desert, the Government of India planned to draw a triad of three major
irrigation canal systems in the parts of the Thar Desert falling in the line of the
Fig. 4.7 Anatomy and physiology of aquifers (Source: Free Wikipedia)

natural gradient created by the age-old, and now extinct, the Saraswati river (The
Gang Canal in the 1920s, The Bhakra-Sirhind Canal, and the most important of all
Indira Gandhi Canal System or the famous Indira Gandhi Nehar Pariyojana) in the
1950s and 1960s. These irrigation canal systems aimed to (1) provide irrigation for
enriching the Thar with agriculturally high yields of old desert crops and, at the same
time, initiating new crop practices with an objective to appreciably upscale GDP
(Gross Development Product) of a local person, and (2) to provide drinking water to
a large population in the desert to sustain good health for them. Although these
canalized irrigation projects positively metamorphosed the economy of the desert
folks, they also carried vector-borne diseases to the desert, the worst of all being
malaria. The three canals together brought drastic changes for worse into the
physiography of the Thar Desert (e.g., increase in the water table, water logging,
and a change in the rainfall pattern along with relative humidity) as far as distribution
of malaria vectors is concerned. The year 1990 was crucial when the Thar was hit by
a major epidemic, recording about 48 deaths, followed by another even more severe
epidemic 1994 when the morbimortality due to malaria had smashed all the records
in past. Canalization apart, lack of malaria-related immunity among villagers, and
the development of resistance in mosquito species against insecticides and in
malarial parasites against drugs further aggravated the epidemic (DownToEarth
2003).
In Pakistan the Chashma Canal, flowing more than 1000 km between Indus River
and the Suleiman Mountains, has helped transform a vast expanse of barren land into
green farmland where profitable crops like rice and sugarcane can be cultivated, but
not without fighting against the onslaught of the deadly malaria, particularly
falciparum-malaria. The canal, built with financial support from the Asian Develop-
ment Bank, was a life changer for communities living along its banks from the
Chashma Barrage to Taunsa. Malaria is rampant in Pakistan’s smaller desert region
with milder P. vivax, during August when there are two seasonal peaks, and
potentially deadly P. falciparum, during October, both transmitted mainly by An.
stephensi but also An. culicifacies in the irrigated areas.
4.2.11 Snowfall in the Sahara Desert: A New and Rare Source

for Water
Snow and ice are unusual in desert regions but not completely unknown. Both the
Sahara and Saudi Arabia deserts experienced de novo snowfall after a gap of almost
40 years (Fig. 4.8).
Ice-blanketed dunes is a rare phenomenon in the world’s largest and hottest
desert, Sahara, where temperatures can soar as high as 58 °C. Yet, Ain Sefra, a
town in Algeria in the northern Sahara and better known as the Gateway to the
Desert (3000 ft MSL), witnessed snow for the fifth time in 42 years as temperatures
dropped far below zero; the other years have been 2021, 2018, 2017, and 1979.
Interestingly, the Asir region of Saudi Arabia also had its first snowfall in half a
century last January, 2021. Moreover, the snow has hit elsewhere in the desert
Fig. 4.8 Snow and ice in the town of Ain Sefra in northwestern Algeria on 19 January 2022 within
the Sahara desert region (Source: Free Wikipedia)
kingdom in recent years, in April. As if this is not enough, the Thar Desert is known
to have experienced hailstorms multiple times since 1988. In village Kanasar, near
Phalodi Tehsil of Jodhpur District, children apparently ran indoors thinking this was
some kind of stone-pelting, although with milkish round balls which ultimately
disappeared by turning into water!
‘TANKA’ and ‘BERI’: The Most Crucial
Habitats for Breeding of Anopheles 5
stephensi and Emergence of “DESERT
MALARIA” in the Thar Desert
5.1 Introduction
Desert and water—these two words stand clearly far apart, and yet they are so
intimately interlinked when we embark on malaria which is constantly growing its
tentacles through none other than the arid environments of deserts. Even though
water in deserts is but abysmally present through limited sources, malaria, on the
other hand, is intensifying in many parts of deserts largely because of (1) changes in
physiography through anthropogenic interventions in the name of developmental
activities, (2) climate and environment change-driven impact on temperature in some
parts of the world’s desert (e.g., a decline in temperature by 0.03 °C has been
recorded in the Indira Gandhi Nahar Pariyojana (IGNP) command areas in the
Thar Desert during past nearly half century, (3) the desert specialist vector species,
Anopheles stephensi, has adapted to breed outside its age-old breeding habitats,
‘Tanka’ and ‘Beri, now in the vast stretches of seepage water from either the main
irrigation canal or open stagnant or slowly running water from Ghaggar river or the
smaller irrigation channels, and (4) entry of new and sometimes more virulent
vectors such as An. culicifacies along with the canal water from hyperendemic
areas outside the desert. Since the groundwater is moderately to highly saline over
a large area in Barmer district of the area in the Thar Desert region (76%), with total
dissolved solids (TDS) ranging from 1500 to 10,000 ppm, people depend entirely on
the rainwater harvesting (RWH) as small ponds (Nadis and Khadins), which are very
few and scattered far off in between, and underground Tanka and Beri which exist in
close vicinity and contain odourless, clean water usable for both drinking and/or
agriculture. In the Thar Desert, particularly in the western, north-western and
southern parts where sand dunes, interdunal plains, and undulating sandy plains
are dominant, the people, by and large, reside in scattered settlements called Dhani.
Each Dhani possesses at least one Tanka.

Ltd. 2023
90 5 ‘TANKA’ and ‘BERI’: The Most Crucial Habitats for. . .
5.2 Wetlands and Sources of Potable Water
The Thar Desert has been a region with fewer varieties and quantum of the wetlands.
In nature, there are two rivers, namely the Ghaggar river and the Luni river, that
make their presence felt more or less during the monsoon season only, although the
latter is flowing perennially with very little water in it. The Ghaggar river water is
systematically allowed to escape through escape structures and collected into large-
sized lake-like surface reservoirs that abound in Hanumagarh district. The Luni river
often exacerbates into heavy deluge during the monsoon and its flooding waters
engulf large areas in Pali, Jodhpur, and, particularly, Barmer districts. After the
monsoon is gone, the flood water recedes leaving behind large sheets of water
standing for weeks or sometimes months. Thus, both these rivers essentially give
birth to certain amount of differently sized wetlands that are favourable sites for
breeding of the malaria vector mosquito, An. culicifacies, and in certain situations
also An. stephensi. In addition to river-based and canal-based water reservoirs, there
are also certain age-old traditional reservoirs invariably maintained in the rural Thar
Desert such as the recharge well, Tanka, Beri, Baori, Nadi, Khadin, and Talab
(Chatterji et al. 1985) (Fig. 5.1). Even though open groundwater reservoirs like
Talabs had a precedence over the dates of origin of both ‘Tanka’ and ‘Beri’—the
underground water reservoirs—they were venerable to exposure to hot and dry
weather conditions. Such groundwater sources actually tended to dry out soon,
and would be recharged only when the next rainfall will oblige them.
Both nadi and khadins are large surface reservoirs and are generally free from any
anopheline breeding. On the other hand, tanka and beri require special mention as
both these man-made water reservoirs have been confirmed to support both breeding
and resting of An. stephensi (Tyagi 1992a, b; Tyagi and Yadav 1996a). These are
Fig. 5.1 A Talab located at the periphery of a village in the Thar Desert. Note drying of the source
of water. (Source: Dr. B.K. Tyagi, personal archive)
5.3 ‘Tanka and ‘Beri’: Most Significant Malariogenic Habitats in the. . . 91
very special man-made structures to store potable water and have so far been
observed only in the rural Thar Desert, the ‘Tankas’ are existing in some of the
desert nations of Middle East being an integral part of rural life in the xeric
ecosystem. Both these structures are never charged on their own from underground
drainage, and have to essentially depend on infrequent and scanty rain water (e.g., in
case of both ‘tanka’ and ‘beri) or man’s own efforts to fetch water for storage (e.g.,
in case of ‘tanka’). The number of domestic underground ‘tanka’ is seen less in those
areas in the Thar Desert where adequate canal water and/or bore-well water has been
made plentiful, for instance, in Sri Ganganagar and Hanumangarh districts
(Table 5.1).
It is understandable from this table that the ‘tanka’ are indeed a major source of
storing water in the Thar villages despite availability of the conduit-drawn canal
water, but they also serve as a major source of breeding of the malaria vector, An.
stephensi, to help sustain malaria transmission in the desert.
5.3 ‘Tanka and ‘Beri’: Most Significant Malariogenic Habitats

in the Thar Desert
Under such extreme inhospitable arid environments as that of the Thar Desert, where
transportation in many areas is still through camel cart, and, at best, safari-like
motorable roads exist in the penetralium of the desert, it is inconceivable that
organized and costly water supply schemes will be a feasible proposition to fully
meet the drinking water requirements of the human and livestock populations, albeit
a great deal of desert villages having been provided by the conduit water under the
IGNP scheme. Therefore, for centuries the local desert folks have been harvesting
rainwater or fetching water from distant sources to store water in Nadis, Tankas, and
Beris of which the latter two are known sites for breeding of the desert specialist, An.
stephensi. Such water harvesting systems adopted for centuries provide convenient,
moderately clean, and sweet water for drinking by the inhabitants, and preclude the
unnecessary compulsions to venture for exploring sources of water under the
scorching sun.
5.3.1 ‘Tanka’
Both ‘Tanka’ and ‘Beri’ are the most sustainable and exhibitive designs for
harvesting rainwater by the desert folk-artisans, to store large quantum of water in
good condition underground for a long period of time (Fig. 5.2). These were possibly
the first interior subterranean designs—a extraordinary marvel of brilliant engineer-
ing feat, in the whole world’s underground water storage technology in deserts
several hundred years ago. The first reference of ‘Tanka’ construction comes from
1520 A.D. in the Marwar then ruled by Rao Jodhaji, although the first known
construction of tanka in this region was in village Vadi ka Melan during the year
1607 A.D. made by Raja Sursinghji. It was, however, during the great famine of
Table 5.1 Distribution of different types of tanka (A = Domestic underground tanka; B = Domes-
tic camel-cart mounted tanka; C = Village community bore-well fed tanka; D = Village community
tanka assembly in the outskirts of the village) and beri in 32 villages distributed in Sri Ganganagar,
Jodhpur and Jaisalmer districts (single ‘+’ sign indicates presence of tanka, while double ‘++’
shows positivity for An. stephensi breeding) (Source: Tyagi 2002)
Tanka
District Villages A B C D Beri
Sri Ganganagar Kamarani - + + - -
Jambhar - + + - -
Sherekan - + + - -
Masani - + + - -
Salemgarh - + + - -
Tibbi ++ + + - -
Talwada Jheel - + + -
Tandurwali - + + - -
Basir - + - - -
Saliwala - + - - -
Udaipura + + - - -
Harsingpur + + - - -
Maler ++ + + - -
Lalgarhi ++ - - - -
Sangeeta + - - - -
Jodhpur Khetusar + - - - ++
Deedasari + - - - -
Dholia + - - - -
Mokheri + ++ - - -
Kuslava + - - - -
Dayankor + - - - -
Bhed ++ - - - -
Mandala + - - - -
Kanasar + - + ++ -
Noore ki Dhani + - - - -
Jaisalmer Madassar + + + - -
Awai + + + - -
Chennu + + - - -
Seuva - + + - -
Raimala + + + - -
Raghawa + + + - -
Sadhana + + + - ++
1895–1896 that hundreds of ‘Tanka’, both individual and community-

commissioned, sprang up in virtually every village. Outside India, ‘tanka, is histori-
cally extant in some Middle East countries as well as, in a much advanced form, in
Indonesia in the South-East Asian Region (Winarto 1982).
Fig. 5.2 A representative diagram of the anatomy of ‘Tanka’. (Source: B.K. Tyagi’s original
drawing)
5.3.1.1 Benefits of Tanka

The singular most important benefit offered to villagers for the rainwater harvesting
in tankas is their unchallenged, yet democratically harmonious, private ownership
both individual and community-based (Vangani et al. 1988).
While, on the one hand, each house in the Thar Desert invariably has a ‘Tanka’
facility to meet with the inhabitants’ requirements (human drinking, kitchen work,
cloth-washing, and animal drinking), the community-based tankas, on the other
hand, are made to meet out mostly the emergency needs of humans and animals.
A community Tanka can be either (1) a single, voluminous well-like structure
regularly refilled with water from another source mostly a tube-well nearby, or
(2) it can be a cohort of tens of dome-shaped structures made at the periphery of
the village. These are generally the water reserves to be used only when all other
sources of water have already exhausted. Considering the inimical and inhospitable
environment of the desert, Tanka instantly offers a large number of advantages on a
sustained basis such as the following:
(i) The orderly use of water

(ii) Close proximity to Tanka saves time
(iii) In deserts, traditionally these are women who fetch water to carry out all
domestic chores and to feed animals. Their burden of several hours of labour
of walking afoot for miles (almost daily >25–20 km) is virtually cut to
nought, and instead they can utilize the same time in caring about their
families and other essential activities.
(iv) Tanka is a great relief to elderly people, too, who would otherwise be
unnecessarily bothered relentlessly.
(v) Clean Tanka water is a guarantee to good health and improves the living
standard of the people of an area poor in groundwater resources.
(vi) Odourless Tanka water attracts consumers in terms of taste, cleanliness,

quality, etc.
(vii) Availability of water in Tanka at a stone’s throw improves self-reliance
among rural folks.
(viii) Since Tanka water is occasionally used to develop minimum agriculture, this
also stabilizes self-reliance and even rural employment.
(ix) In emergency Tanka, both individual family-owned and community-based,
offers a valuable alternative when the bore wells are dried out or fuel runs out.
(x) Tanka water is totally free at both individual family-owned and the
community-owned levels, hence highly economical and hassle-free.
5.3.1.2 Present Status of Tankas

The origin of Tanka in the Thar desert was an altogether indigenous invention by the
local folk-minds nearly five centuries ago. Since then it has undergone several
changes, to suit the requirements of the local communities. The Rajasthan State
Government has begun many schemes to ensure that each house in a village or
Dhani (hamlet) has access to a household Tanka, and there is enough water stored in
each tanka to fulfil villagers’ needs. Therefore, as far as possible, the government in
collaboration with non-governmental organizations has encouraged for building a
huge tube-well in the centre of each village so that recharging of Tanka is maintained
uninterruptedly, with or without any rainfall or even conduit-run water to the village.
With the availability of water through canals, channels, or conduits under Indira
Gandhi Nahar Pariyojana (IGNP), the desert village communities today are at much
ease of their access to drinking water but, as the government has been promoting
rainwater harvesting at all levels, villagers continue to keep Tankas and use them
regularly.
All Tankas are built so as to harness rainwater, however, occasional and scanty,
and bigger the catchment area the greater is the likelihood of the runoff gushing in to
the reservoir. When The rainfall is normal all Tankas get filled up to the brim ((Anon.
1971). All entry points in the Tanka are covered, loosely though, with twigs or linen
so as to prevent sand-dust to get way in. A mosquito like An. stephensi is, however,
able to make the use of Tanka water as its favourite breeding and resting site.
5.3.1.3 Size of Tanka and Construction Materials

Tankas may be built in different shapes and sizes depending on whether these are
built for each family in a village or Dhani, a community-owned Tanka at the centre
of the village, or a cluster of scores of Tankas at the outskirts of the village and to be
used for water only during emergency.
(a) House-Owned Tanka: This kind of Tanka is built on individual household

and/or dhani-basis. They are essentially pucca, built with pond silt, murrum
(the disintegration of rock, i.e., fragments of rock), wood-coal ash, gravel, etc.
and finally cement-plastered atop. Size may vary from 3 to 4.25 m in both width
and depth, and shape is generally circular in the form of a dome, but can be
squarish, with wall and floor in 9 mm of diameter which is strong enough to
Fig. 5.3 (a) An in-house ‘pucca’ (cemented) ‘Tanka’. (Source: Dr. B.K. Tyagi, personal archive)
and (b) A modern, well-designed tanka (Source: Free Wikipedia)
withstand any cracks or water absorption. Only a small part (app. 60 cm) of the
structure protrudes above the ground, mainly equipped with the main hole or
mouth at the tip of the Tanka. The top lid may be squarish, and having a flat
metal or wood plate to close it securely. This kind of mud/lime plastering may
last for about 5 years (Fig. 5.3).
(b) Village-Owned Tube-Well-Aided Community Tanka: This is almost invariably a
solitary Tanka in a village’s centre meant for use for the entire village commu-
nity. Size is nearly double to that of the household Tanka and shape is more or
less dome-like, with wall and floor plastered in cement concrete over a base
structure of stone reinforced with lime or cement. The part protruding or exposed
above the ground can be exceeding anything beyond 30–40 cm, so that if one
wants to pail out some water he or she will have to climb 3–4 steps of the stair.
Fig. 5.4 A village-owned and tube-well-aided community Tanka built by the government with
people’s help in the centre of the village (Source: Dr. B.K. Tyagi, personal archive)
The round or squarish opening at the top is essentially closed with the help of a
metallic plate set tight on a metallic frame. Such Tankas may last for longer
period of time (10–15 years) (Fig. 5.4).
(c) Community Tankas on the Outskirts of Village: These are always plurally
present, in large cohorts on the outskirts of the village, and located in such a
concave land that during a rainfall all the water naturally find a gradient to run to
these structures provided with an orifice to allow runoff water enter the Tanka.
They are constructed at some distance from each other as each of them has its
own catchment area so to say. The top lid is normally covered with loose plant-
twigs or the cloth-peace, but hardly ever a permanent metallic lid is secured to
shut it. As a result, An. stephensi breeds profusely in these structures throughout
the year.
This aggregation of Tankas is characterized by the availability of spare land

around it and connecting suitably with its catchment area which may vary from
about 20 m2 to 2 ha depending on the expected runoff along the cleaned and
smoothened land with a gradient of 3–4% slope towards the tanka, and developed
by reinforcing the path with pond silt, murrum (the disintegration of rock, i.e.,
fragments of rock), wood-coal ash, gravel, etc.
Unfortunately, Community tankas have generally failed through poor workman-
ship, lack of ownership responsibility, and high costs. These may be weathered in
course of time giving way to breeding of An. stephensi (Figs. 5.5 and 5.6).
Fig. 5.5 (a) Tankas at the periphery of a village in the Thar Desert, and (b) a damaged Tanka
which was found breeding An. stephensi
5.3.1.4 Volume of Water per Tanka Required

Before reaching a conclusion as to how much water should be available in a Tanka it
is inevitably necessitated to calculate properly the comprehensive human and pets’
needs in a year. The following factors are considerable:
Fig. 5.6 Different types of ‘Tanka’: (a, b) Archetypal in the periphery of Kanasar village in
Phalodi Tehsil in Jodhpur district (Rajasthan, India), (c) a deserted, uncared, and top-damaged
archetypal ‘Tanka’ breeding An. stephensi
(i) A family with five members will need per person 6 l of water per day in the
Desert. In addition, a group of associated cattle including (minimum) one camel
and a couple of goats will need 20 l a day. The total need per day thus comes to
50 l day-1, and 1500 l in a month, and 18,000 or safely rounded off to 20,000 l.
(ii) A family will need per week at least has 50 l of water for kitchen, cloth
washing, house cleaning, etc. This makes a total of 200 l week-1 or
2400 l year-1.
(iii) Considering more consumption during summer months, further 1500 l may be
required additionally per year.
(iv) Still, to meet certain exigencies and watering to a few plants in proximity will
require further 1500 l year-1.
Therefore, keeping all the above estimates, a house-owned Tanka should be so

voluminously built so as to have a minimum of 25,400 l of water. However nearly
half of the water is always kept as a reserve in the Tanka to keep it alive, the actual
quantum of water needed per Tanka should be 40,000 to 50,000 l. In other words, a
tanka with 8–9 feet height, and with the same measurements for length and width,
will be sufficient to store this quantum of water for meeting the needs of all the
inhabitants for one full year (Doelhomid 1982; Winarto 1982; Molvaer 1982).
(v) Suitable Design of Tanka: A tanka is usually circular or rectangular in shape.

The circular tanka is the most economical form of the structure and is found to be
more stable as the pressure exerted by water is uniform radial pressure in all
directions in the diametrical plane at right angle to the curved surface.
The successful installation of a tanka depends on the selection of site, particularly

the catchment characteristics such as size, shape, topography, soil type, vegetation,
etc. The size of the catchment selected, or artificially prepared should produce
adequate runoff to meet the storage requirement of the tanka and at the same time
it should cause minimum soil loss. Experience indicates that a 2 ha catchment,
having 2–3% slope, on gravelly or heavy textured soil free from vegetation, is
generally sufficient for a tanka of 200 m3 capacity (Prajapati et al. 1973). However,
the size of the catchment area depends on dependable rainfall.
5.3.2 Beri
Beris are percolation wells traditionally used to catch rainwater and store it. A beri is
essentially a pitcher-shaped shallow well. It is about half a metre wide at the top and
3–4 m wide at the bottom. The spot is strategically selected so that the percolated
rainwater gets channelized towards the well. While setting up a beri, people stop
digging once they encounter a layer of clay or gypsum. These layers prevent further
percolation of the stored rainwater, while the narrow mouth prevents loss through
evaporation. Beris can hold up to 500,000 l of water, sufficient to meet the needs of
Fig. 5.7 (a) A cluster of Beris in the village Khetusar in the Thar Desert, and (b) mouth of a beri
used to fetch water through a chorded pail. (Source: Dr. B.K. Tyagi, pers. archive)
10 families for a year. Khidrat village originally had 34 beris, but now they have
grown to 155. Village Khetusar is famous for its beris (Fig. 5.7).
People build raised concrete platform and cover it with a slab to prevent dust and
surface runoff contamination. All it takes is two bags of cement, sand, a lid and
2 months of labour. Dug to meet drinking water needs of the family, a beri holds
enough water to irrigate a farm with millets, pulses, watermelon, and cucumber.
Depending on the size and structure, a Beri costs between Rs 3000 and Rs 15,000.
When calculated, the cost of beri water comes to less than a paisa per litre. About
90 per cent families of the Khidrat village drink Beri water.
5.4 Microclimates of ‘Tanka’ and ‘Beri’ 101
Fig. 5.8 Anatomy of a Beri (Source: B.K. Tyagi’s original drawing)
Table 5.2 Chemical anal- Property Quantity measured

ysis of the tanka water from
Salinity 0.180655 ppt
Mandla and Bhed villages
in Jodhpur district (Source: Hardness 144 g l-1
Tyagi and Yadav 1996a) pH 6.74
Nitrate 6.993 μg
Phosphate 5.60403 μg l-1
Ammonia 80 mg l-1
Carbon dioxide 8 ppm
Oxygen content 38 ml l-1
To minimize the wastage of water, small wells known as Beri or Kui, are
constructed near a water leaking tank. At Bikaner, Jaisalmer, and Jodhpur beris
are found in large numbers. Its mouth is covered by strips and mostly they remain
kuchcha or uncemented. Beris are normally 5–12 m deep. Six or ten beris when
constructed together constitute a ‘Paar’ system (Fig. 5.8). Rainwater harvested
through Paar technique is known as Patali Paani.
5.4 Microclimates of ‘Tanka’ and ‘Beri’
Both ‘Tanka’ and ‘Beri’ maintain more or less the same temperature throughout the
year despite enormous degree of variations in the ambient temperature. On average,
the temperature of an adequately protected and covered tanka stays about 26 ± 2 °C.
Tyagi and Yadav (1996a) have analyzed the tanka water wherein occasional An.
stephensi breeding was also observed in a slightly acidic nature of water (Table 5.2).
However, the water chemical profile may depend largely on the source of water:
(1) pond, (2) canal, (3) deep-well, (bore-well), and finally (4) rainwater. Also, if the
water was long standing in the ‘Tanka’ it might then collect some turbidity. Presence
or absence of An. stephensi in the ‘Tanka’ depended much on its purity; the purer the
water, the more is the likelihood of presence of larvae of the vector. The ‘Tanka’ also
has an advantage for being partially exposed to sunlight, which can also enter the
‘Tanka’ through loosely fitted lid on the top of the reservoir. This provides the
necessary warmth within the ‘Tanka’ for the mosquito to rest a while after
emergence.
Above information on the water quality of ‘tanka’ further reinforces to a large
extent the great adaptive prowess of An. stephensi to ‘tanka’ breeding in the Thar
Desert environment.
Extensive Canalization and Its Impact
on Transformation of the Thar Desert 6
and Malaria Exacerbation
6.1 Introduction
Of all the major malaria producing water sources in the desert, whether natural (e.g.,
Desert Oases, Desert Fringes) or man-made (irrigational canals from rivers outside
the range of the desert), extensive canal-based irrigation in the desert has created a
more monumental impact in the virgin lands of deserts, hitherto terra incognito for
malaria and vectors of the disease, than any other type. Over the years some very
significant large-scale irrigation projects have been undertaken in the Sahara Desert
in Africa and the Thar Desert in India and elsewhere, mainly to irrigate barren fields
and compensate other vital needs such as drinking. (Roy 1983; Kibret et al. 2014;
Tyagi 1997a, b, 1998a, b, 2002, 2022). Irrigation schemes have resulted in
intensified malaria transmission due only to poor canal water management (Russell
1938). Therefore, when not properly executed with multi-departmental coordination,
irrigation schemes have often been blamed for the increase in malaria in many parts
of the world, including deserts, although, the fact is that proper water management
could appreciably help reduce vector abundance and malaria transmission in the
irrigated villages, thereby mitigating malaria around irrigation schemes.
6.2 Canalized Irrigation in the Sahara Desert
6.2.1 Ziway’s Canalized Irrigation
Ziway area (8° 00’N, 38o40’E; 1650 msl) is located 165 km south of Addis Ababa,
the capital of Ethiopia, and has a semi-arid environment. It receives annual rainfall
between 700 and 800 mm; in two peaks, the main rains from June to September and
short rains in April and May. The mean annual temperature is 20 °C. Some 205 sq.
km area of the Ziway area practices irrigation with the only source of water from
Lake Ziway, located 10–15 km from the irrigated farmland. The water is pumped
using three engine-operated pumps feeding three primary earthly canals. The overall
Ltd. 2023
104 6 Extensive Canalization and Its Impact on Transformation of the Thar. . .
irrigated area extends to some 65 ha of land, mainly producing maize, corn, and
onions.
Malaria is endemic in the Ziway’s irrigated area (Kibret et al. 2014). Anopheline
mosquitoes (Anopheles arabiensis, An. pharoensis, An. coustani, and An. funestus)
bred in almost all kinds of potential breeding surface water sources available such as
irrigation canals, canal leakage pools (i.e., pools formed from leaking main canals),
irrigated field paddies (water-logging in the field due to over-irrigation and poor
drainage canals), mud-brick-making pits, rain pools, and other man-made pools,
such as water-holding wells. Adult mosquitoes were sampled both outdoors and
indoors. All the four species collected in larval breeding sites were also present in
adult collections. Anopheles arabiensis, which fed predominantly on human-blood
with high HBI both in the irrigated (80%) and non-irrigated villages (73%), was
predominantly represented in both irrigated and non-irrigated villages (Fig. 6.1).
Plasmodium falciparum sporozoites were detected in An. arabiensis (1.67%) and
An. pharoensis (0.81%) specimens from the irrigated villages, while only one An.
arabiensis (0.43%) was found to be positive for malaria sporozoites in the
non-irrigated villages. Thus, it was apparent that malaria was intensified with the
canalized irrigation waters. Also, a strong positive correlation between canal water
releases and larval/adult vector densities clearly indicated the potential of using canal
water management for malaria vector control around irrigation schemes (Mutero
et al. 2000).
Fig. 6.1 Monthly malaria incidence (cases per 1000 population) in the irrigated and non-irrigated
villages in the Ziway area, Ethiopia, in 2010. (Source: Kibret et al. 2014)
6.3 Canalized Irrigation in the Thar Desert of India 105
6.3 Canalized Irrigation in the Thar Desert of India
Despite appreciable reduction in nationally determined cases of malaria, outbreaks

of disease keep on surfacing in the country, including the Thar Desert region in the
western Rajasthan State. The Thar Desert is currently suffering from the impact of
repeated annual epidemics during the past four decades. Nearly all malaria
epidemics in the Thar Desert have come about with the progression of canal-
irrigation work, particularly the massive Indira Gandhi Nahar Pariyojana (IGNP).
Therefore, the Thar Desert provides an excellent model for understanding the
underlying factors responsible for the exacerbation of malaria, pathways of evolu-
tion of the epidemics, succession in anopheline fauna, changes in the vector breeding
and feeding preferences, and, most importantly, the possible repercussions of mis-
management of irrigation systems.
Interestingly, before the initiation of canalized irrigation only Anopheles
stephensi, breeding exclusively in household and community-based underground
water reservoirs, the Tanka and the Beri, and transmitting malaria at a low level, was
prevalent in the interior of the Thar Desert. Since the 1980s, extensive irrigation
from three different canal systems has altered the desert physiography, vector
preponderance, distribution, and vectorial capacity, whilst triggering the emergence
of Plasmodium falciparum-dominated malaria in the virgin levees of the Thar
Desert. The major objective of bringing the Himalayan waters to the xeric environ-
ment of the Thar was to transform it into verdure through growing irrigation-
intensive crops like paddy, groundnut, cotton, mustard, wheat, and sugarcane,
besides providing drinking water to the desert dwellers. The change in crop pattern,
retention of high surface moisture, and excessive canalization rife with mismanage-
ment of irrigation water have attracted several anophelines, including Anopheles
culicifacies, which were earlier unknown in the desert. It is noteworthy here that An.
culicifacies is credited with about 65% of malaria cases in the country (Sharma and
Mehrotra 1986). Thus, An. culicifacies has penetrated into the interior of the Thar
Desert, along with irrigation and is now established in vast areas covered by the
IGNP project (Fig. 6.2). The distribution of P. falciparum-dominated malaria in the
Thar Desert is more or less synchronous with the spread of IGNP-related irrigated
agriculture and of A. culicifacies
As shown in Fig. 6.3, three major canal systems exist in the Thar Desert region
today (Anon. 1992). Ironically, these canal systems which breathed life into the
deserted lands of the Thar in course of time also became the major reasons for
inveigling more dangerous malaria mosquitoes into its interior parts, till then a terra
incognito for such mosquitoes, by way of creating conditions most conducive to
their breeding and propagation, and which, in turn, under prevailing situations at the
source of work spots or other such conditions, triggered off transmission of malaria
parasites at a frequency never experienced earlier in the Thar Desert. Therefore,
growing au fait on the extent of distribution and working of the various canal
systems drawn in the Thar Desert is of utmost importance.
All the three major canals, i.e., Gang Canal, Bhakra-Sirhind Feeder Canal, and
Indira Gandhi Canal, commence from the point of confluence of rivers Beas and
Fig. 6.2 Indira Gandhi Canal through the Thar Desert: (a) A cleaned canal in the beginning of
entry in the Thar Desert, and (b) a highly vegetated (Eichornia crassipes) and uncleaned canal soon
later, with seepage through canal embankments and unwanted marshy land formed on both sides
(Source: B.K. Tyagi, personal archive)
Fig. 6.3 Index plan of Indira Gandhi Canal Project (showing also Gang Canal and Bhakra – Sir
Hind Feeder Canal) (Source Tyagi 1995a, b)
Sutlej in Punjab, about 100 km north of the State of Rajasthan’s Sri Ganganagar
(desert) district. First, it was the Gang Canal project which was implemented and
became fully operative in 1928. It commanded within Sri Ganganagar district only,
and with its 1251 km distribution system it provides irrigation to nearly two-third of
the 1000,000 sq. km. of cultivable land. Secondly, after the successful venture of the
Gang Canal to convert the northern tip of the Thar Desert into a verdure, it was the
Bhakra-Sirhind Canal project which started operating in 1955. The canal runs for
about 100 km in Sri Ganganagar, and its 1219 km-long distribution system further
provides irrigation to nearly 1000,000 sq. km. of cultivable land. Thirdly, because
most of the Thar Desert still continued to remain without the provision of the
irrigation as well as drinking water, the most important of all the canal systems,
the Indira Gandhi Nahar Pariyojana (IGNP) was introduced to the Thar Desert in
1958 and the first waters began to flow in 1961. The Indira Gandhi Canal (originally,
Rajasthan Canal, and renamed in 1984) starts at the Harike Barrage near Harike, a
few kilometres downriver from the confluence of the Satluj and Beas rivers in Punjab
(India), and terminates in irrigation facilities in the Thar Desert. The canal first enters
Haryana state from Punjab near Lohgarh village, and then runs through the western
part of the Sirsa district before entering the Thar Desert near Kharakhera village in
the Tibbi tehsil of the erstwhile Sri Ganganagar district, now in the newly founded
Hanumangarh district. The canal traverses 7 of the 12 desert districts, viz.,
Sriganganagar, Hanumangarh, Churu, Bikaner, Jodhpur, Jaisalmer, and Barmer.
The multi-purpose IGNP project, including 445 km of the main canal Desert and
over 9000 km of distributaries is in the Thar, was designed to be completed in three
phases. The main canal was planned to be 43 m wide at the top and 35 m wide at the
bottom with a water depth of 6.4 m. The canal was scheduled to be completed by
1971. Unfortunately, the whole project has taken far too long a time completing by
and large only two of the three stages envisaged; the main canal including feeder and
5500 km of distributaries is but irrigating 950,000 ha of land (approximately half of
the irrigated area that is planned). The IGNP has nevertheless infused a new life in
the Thar Desert, and, besides, improving the daily income of the local communities,
transformed the leveed lands of the xeric Thar into a verdant region with a range of
new agricultural produce such as paddy (Tyagi and Yadav 1996c, 1998, 2000).
6.3.1 The IGNP Command Area Characteristics and Malaria

Exacerbation
The Indira Gandhi Nahar Pariyojana (IGNP), conceived in 1948, was sanctioned In
July, 1957, at an estimated costing of Rs. 666.7 million. The project construction
work commenced in March, 1958. The project now envisages to provide irrigation
facility to 18,69,000 ha of land spreading in six desert districts of Sri Ganganagar,
Bikaner, Jaisalmer, Jodhpur, Barmer, and Churu, and utilizes 9362 Mcum of waters
from Ravi and Beas rivers. About 504,000 ha land is being currently envisaged to be
irrigated by lifting waters up to a static height of 60 metres.
The IGNP lies in the famous Thar Desert of Rajasthan State, India along the
international border with Pakistan. The main Indira Gandhi canal travels more or less
along the course of the vanished Saraswati river, across the truly desertic conditions
full of high mountains of sand dunes which occupy 24.3% of the Thar Desert. The
IGNP command area is devoid of natural drainage except the river Ghaggar flowing
through Hanumangarh and Sri Ganganagar districts and a small stream called Kakni
in Jaisalmer district. The Ghaggar river rises in the slopes of the Siwalik hills and
after traversing Patiala and Hissar districts in Punjab and Haryana States, enters
Rajasthan from northeast in Hanumangarh district. The river flows with little or no
waters down Hanumangarh town.
6.3.2 Transformation in the Thar’s Physiography
Ramakrishana and Rao (1991) have widely dealt with the subject of climatic features
of the Indira Gandhi Canal region in western Rajasthan, whereas Rao (1996)
critically reviewed the variability in climate in the irrigated tracts of Indira Gandhi
Nahar Pariyojana in the Thar Desert.
(i). Rise of Water Table and Waterlogging.
An estimated 8600 ha in the Nalibed area, Sri Ganganagar/Hanumangarh district,

is permanently inundated under the IGNP Stage I by the Ghaggar river floodwater,
while 1000 ha is converted into marshy land due to waterlogging and excessive
seepage from the canal in Stage II (Anon. 1992a,b). Supply of canal water to the
desert region over several decades has caused a rise of the water table and water-
holding potential of the soil, and a plentiful growth of vegetation, particularly
hydrophytic weeds. The IGNP has substantially changed the ground water hydrol-
ogy in the command area. Before the project, in the year 1952, the ground water table
in stage-l was observed between 40–51 metre below ground level (mbgl). Compared
to this, in 1973, the water level was observed between 9.00 to 32.00 mbgl.
(ii). Rainfall, Air Temperature, and Relative Humidity Changes.
Pant and Hingane (1988) studied trends in rainfall and temperature during
1901–1982, covering the north-western Rajasthan, and showed an increasing trend
in mean annual rainfall (141.3 mm per 100 years.) and a decreasing trend in air
temperature (-0.52 °C for 100 years), which contradicts the conclusion of
Winstanley (1973a, b). One of the most reliable studies on the meteorological
parameters of a desert district, Sri Ganganagar, was made by Ramakrishana and
Rao (1991) who found an increase in the mean decadal rainfall in the district, which
had been subjected to canal-based irrigation for a considerable period. Even more
recently, Sikka and Kulshrestha (2001), have attempted to draw relationship
between climate and health, including vector-borne diseases, especially malaria. A
recent compilation of percentage departure of monsoon season rainfall (June to
September) for the period 1901–2000 over west Rajasthan by Dr. S.M. Kulshrestha,
Former Director General of the Indian Meteorological Department (pers. comm.)
depicts how significantly the drift has been over past the 100 years.
The Gang canal and IG canal projects aimed to utilize 7.59 MAF of water from
Ravi-Beas duo to irrigate a 1.143 mill-ha area. In Ganganagar, Bikaner, and
Jaisalmer districts, approximately 708,775 ha, 37,022 ha, and 84 ha of land, respec-
tively, have been put under irrigation (Roy 1983). The impact of irrigation in
Rajasthan is seen from the vegetational and micro-climatic changes that have
occurred in the region. Sri Ganganagar receives an annual rainfall of 243 mm. The
annual rainfall of Sri Ganganagar showed an increasing trend, at the rate of
1029 mm/year, during the period 1926–1993.
The decade-wise mean annual rainfall shows that the increase in rainfall was high
during the last four decades, the period of intense irrigation in the region, Even in
periods of drought faced by western Rajasthan, Ganganagar has received adequate
rainfall for crop production, which is attributed to the increased moisture through
irrigation imposed for long periods in the region. On average, climatic droughts
prevailed in the region once every 5 years (22% chance) during 1926–1993. The
mean annual rainfall of Bikaner is 286 mm with a coefficient of variation of 48%.
The region experienced droughts once every 3 years (38% chance).
The rainfall (annual) at Bikaner showed an overall decreasing trend at a rate of
0.147 mm/year during 1926–1993, which is forcibly attributable to consecutive
droughts which occurred after 1961. The latest straight string of droughts has been
in the years 1998–2000. Likewise, Jaisalmer is understood to receive a mean annual
rainfall of 185 mm with a coefficient of variation of 64%. The rainfall has until
recently been erratic and poorly distributed with droughts occurring once every
4 years (24% chance). However, the overall trend in annual rainfall at Jaisalmer
which remained the same during 1901–1993 seems to be shifting towards an
escalation in recent years.
As to the air temperature, in a recent study, Rao (1996) established a general
decreasing trend in the ambient temperature of 0.039 °C/year at Sri Ganganagar,
0.023 °C/year at Bikaner, and 0.009 °C/year at Jaisalmer. With regard to relative
humidity in the Thar Desert, he recorded 5–10% higher humidity measurements in
cropped surfaces at 1 m height in the irrigated villages compared to the unirrigated
cropped surfaces. This highlights the fact that the amount of canal water available in
the desert region can influence atmospheric humidity.
These observations sufficiently indicate a shift in the abiotic characteristics of the
Thar Desert under the IGNP command area as compared to that in the typical
desertic environs.
(iii). Crop Pattern.
Years of sustained canal-water supply to the Thar desert area has changed is
cropping pattern a great deal. Till the turn of the first half of the century. Sorghum or
Jowar (Sorghum vulgare), bajra or pearl millet (Pennisetum typhoides), moth
(P. aconiifolius), moong (P. radiatus), guar (Cyamopsis psaraliodes), etc. were
the main desert crops completely dependent on the regular monsoon-fed rains.
However, with the advent of extensive canal irrigation in the 1960s, some irrigation
intensive crops have been introduced in the Thar, particularly in Sri Ganganagar
district. Consequently, crops like cotton, wheat, mustard, groundnut, and, in partic-
ular, paddy are grown extensively in Sri Ganganagar district, and the process is
continuously extending to other districts downstream the Indira Gandhi canal. Sri
Ganganagar district, where paddy cultivation was introduced in the mid-1970s, had
paddy cultivation on about 6600 ha land with a yield of 27.50 t/ha. A decade later,
however, the paddy cultivation increased to 7199–10,391 ha of land, with a yield of
3.77 t/ha. The paddy cultivation is amongst the top ten crops grown in Sri
Ganganagar district. The initiation of paddy cultivation in the 1970s and enormous
paddy output during the mid-1980s assume great significance from the fact that it
was during this period of 1975 and 1983–85, respectively, when Sri Ganganagar
district had experienced the first ever focal outbreak of malaria (Tyagi and Yadav
1998).
(i) Ground Water Quality.
Analysis of native ground water in the project area indicates mineralized

characteristics. It is generally saline having Ec more than 8000 micro-siemens/cm
at 25 °C. It is sometimes as high as 100,000 micro-siemens/cm. The general Ec
varies from 275 to 36,500 micro-siemens/cm and specific conductance varies from
200 to 19,000 ppm. Chloride and fluoride contents are also of very high order
ranging from 14 to 22,500 ppm and 38 ppm, respectively. In addition, a fresh
water cushion seemed to have been formed over the saline native ground water
mainly due to recharge from different sources. The exploitable fresh ground water
zones are mainly restricted in the Ghaggar bed and in the vicinity of main canal and
distribution system. Water quality of upper layer, up to 20 to 30 m, is fresh
(Ec = 2000 micro siemens/cm) in Ghaggar plain area. However in traditional deep
wells water quality varies between 20,000 to 40,000 micro-siemens/cm. In the low
lying locations under the IGNP where pockets of stagnant water have developed, the
chemical analysis shows considerable deterioration in chemical quality. The Ec is as
high as 100,000 micro-siemens/cm.
(ii) Soil Property and Salinity Effects.
The project has two main soil groups, viz., flood plain soils and erosion soils. The
flood plain soils are deep and calcareous. They are highly stratified and extremely
variable within short distances. Their water holding capacity in good. These soils
were generally saline-alkaline (sodiac) in varying degrees before introduction of
irrigation. The Aeolian soils cover sandy plains, parts of the inter-dunal flats and the
high dunes. They are generally deep, coarse- textured, calcareous, of low fertility,
highly susceptible to wind erosion, and excessively permeable. These soils are
occasionally undertaken by calcareous hard pan at shallow depth.
(iii) Land Irrigability and Productivity.
The pre-IGNP Aeolian soils were coarse-textured and had low fertility. Now, in
the IGNP area the texture, fertility, and irrigability of soils have substantially
improved as indicated in the increase of crop yields over the time.
(iv) Canal Sedimentation.
A recent study indicates that between RD 243 to 1120 the rate of deposition of silt
and wind-blown sand in main canal alone is 0.212 Mcum/year. Infestation of canal
with weeds has further complicated the problem.
(v) Demography and Human Behaviour.
One of the most significant factors that is responsible for augmenting and
intensifying malaria prevalence in a conceptually hypoendemic malarious area like
the Thar Desert is the population movement across the State border to other
hyperendemic States. Such migrants pick up parasite infection, possibly
P. falciparum, and in some cases drug-resistant one, and on return to the native
place in Rajasthan, mostly the Thar Desert, help the vector population to disseminate
the parasite among other non-immune populations. Epidemics caused in this way
often result in heavy mortality. In the That Desert the displacement of human
population is principally associated with the cattle migration in search of fodder
during recurrent droughts. The Thar Desert being a rain deficit area can offer fodder
for livestock only during monsoon and the cattle breeders do not find enough pasture
lands to graze their livestock. Under these adverse circumstances, the cattle and
sheep breeders are forced to migrate across the State border, in most cases, in search
of sufficient grazing ground. Table 6.1 presents an account of the States to which the
cattle and sheep breeders migrate for grazing their animals.
(vi) Cattle Population.
Type and quantum of cattle population associating with human population play a
significant role in the transmission dynamics of malaria (Rao 1984). To become
gravid, female mosquitoes need a blood meal which they take by vigorously biting
on cattle and other animals inhabiting human settlements, as well as humans. In
general, easy accessibility to any preferred type of cattle for feeding will drive more
mosquito species zoophilic, hence inducing only a chance feeding on human blood.
It can be noted from the Table 6.2 that although sheep and goat population together
far exceeds that of any other type of animal, the cattle population which is generally
preferred by malaria vectors is less than half the human population in the Thar
Desert.
Table 6.1 States to which the cattle and sheep breeders migrate for grazing their animals
Animal From district of origin of movement in the To the destination State across the
type Thar Desert border
Cattle Jaisalmer, Barmer, Jodhpur, Nagaur, Gujarat, Madhya Pradesh, Haryana,
Churu, Pali, Jalore Punjab
Sheep Bikaner, Jaisalmer, Barmer, Jodhpur, Uttar Pradesh, Gujarat, Madhya
Nagaur, Churu, Pali, Jalore Pradesh, Haryana, Punjab
Camel Jaisalmer, Bikaner, Barmer Haryana, Punjab
Table 6.2 District-wise population (in Lakhs) of milch and non-milch animals during 1992
Milch animals Non-milch animals
District Cows Buffaloes Horses & Ponies Donkeys Pigs Dogs Camel Sheep Goat
Barmer 3.71 0.55 0.01 0.42 0.02 0.71 1.24 9.40 16.22
Bikaner 4.55 0.72 – 0.13 0.02 0.54 0.58 9.53 4.54
Churu 2.62 1.47 – 0.07 0.01 0.40 0.83 5.24 6.64
Sri Ganganagar 6.76 5.69 0.01 0.06 0.10 1.55 1.07 4.95 4.57
Jaisalmer 0.94 – – 0.13 – 0.09 0.30 3.83 2.93
6.3 Canalized Irrigation in the Thar Desert of India
Jalore 2.66 2.16 0.01 0.07 0.03 0.69 0.18 6.33 5.46
Jhunjunun 1.13 2.50 0.01 0.03 0.03 0.27 0.33 2.18 4.44
Jodhpur 4.89 1.37 – 0.08 0.01 0.80 0 50 11.39 9.54
Nagaur 4.95 2.97 0.01 0.06 0.10 0.94 0.36 10.67 8.92
Pali 4.24 2.26 0.01 0.09 0.10 0.56 0.16 13.77 6.65
Sikar 2.14 3.28 0.01 0.02 0.06 0.20 0.29 3.11 6.30
113
6.4 Salutogenesis, Canalized Irrigation in Desert Environment,

and Mosquitoes
Desert environments are not only inimical to biodiversity but a continuous challenge
to a successful survival of human being including demographic structure and
dynamics (e.g., fertility and migration patterns), nutritional status, social and orga-
nizational values, morbidity profile, infectious, chronic, genetic psychological
disorders, man’s adaptation to extreme environments including work capacity heat
tolerance (desert worthiness), solar reaction and photosensitivity reactions, water
electrolyte metabolism and hormonal regulation, Vitamin A deficiency and
corresponding night blindness, urolithiasis, summer diarrhoea in children, fluorosis,
respiratory diseases especially chronic bronchitis, drug addiction, and vector-borne
diseases atop which is the life-threatening malaria transmitted by Anopheles
mosquitoes (Anon. 1981). With respect to peculiarities of medical non-infective
diseases in the indigenous inhabitants of the African Sahara Desert, a highly useful
and detailed information was given by Trowell (1960).
Since deserts are conventionally regarded as waste, uninhabited, and uncultivated
lands, hardly ever the desert human population attracted attention from the
governments and other global organization. After, however, mega-irrigation and
other development projects were launched in some of the deserts to improve
agriculture, economy, and health, the xeric ecosystems were in part transformed
into verdure. Wherever the canalized irrigation water was not properly managed it
became the crux of the problem of heavy malaria infernos and the resultant enor-
mous morbimortality due largely to anthropization (Tyagi 1995a, b, 2002).
Anopheline Fauna and Major Malaria
Vectors of Deserts 7
7.1 Introduction
There are close to 4000 mosquito species in the world, of which over 400 are
Anopheles (Tyagi et al. 2015). Different deserts of the world are essentially
characterized by, more or less, but not exclusive, a group of specific, yet preponder-
ant, malaria vectors which are highly adapted to xeric environments, such as
Anopheles stephensi in Asia and the Middle East deserts, and An. arabiensis in the
Arabian Peninsula and the Sahara deserts. Both these vector mosquitoes tolerate
drier environments and are, therefore, absent from the sylvatic environments. Ironi-
cally, very little is known about the desert malaria vectors’ biology and distribution.
Both these vector species present a higher inclination for human blood and suscepti-
bility toward Plasmodium falciparum and P. vivax. Anopheles stephensi mysorensis
strain has been demonstrated to possess high competency for Plasmodium vivax.
Additionally, presence of inhibitory carbohydrates in An. stephensi mysorensis and
their role in blocking sporogonic cycle in Plasmodium vivax has been also recorded
(Basseri et al. 2008).
Among all the various different types of mosquitoes in the world, only Anopheles
mosquitoes (comprising 465 formally recognized species and > 50 unnamed
members of species complexes), there too a small portion (approx. 70 species),
carry the potential to transmit human malarial protozoa, though only five Plasmo-
dium species, i.e., P. falciparum, P. vivax, P. malariae, P. ovale, and P. knowlesi can
result into malaria in humans (Bruce-Chwatt 1985; Service and Townson 2002;
Harbach 2011; Sinka et al. 2012; Tyagi et al. 2015). However, globally only
41 species are regarded as primary vectors or dominant vector species/species
complexes (DVS), which have the capability to transmit human malaria at a level
of major concern to public health (Hay et al. 2009, 2010a, b; Sinka 2013) (Fig.7.1).
On a global front, several attempts had been made to map the major malaria
vectors in the beginning of the twentieth century when malaria control campaigns
had just begun (May 1951; MacDonald 1957, MacDonald et al. 1968). Recently,
Kiszewski et al. (2004), in consideration of developing a malaria transmission
Ltd. 2023
116 7 Anopheline Fauna and Major Malaria Vectors of Deserts
Fig. 7.1 Map showing the global distribution of 34 DVS. (s.l.: sensu lato, meaning ‘in the broad
sense’ referring to species complex (Source: Sinka 2013)
‘stability’ map, brought out a global distribution map for the major malaria vectors.
More recently Sinka (2013) and Sinka et al. (2010, 2011, 2012), after careful
consideration of the zoogeography-based vector species map of May (1951) and
the 12 zones-based malaria epidemiology maps by MacDonald et al. (1968)
incorporating broad climatic ranges and physical land features, as well as consider-
ation of the known distribution of the major anopheline vectors at the time, have
crafted a series of updated maps for the major vector species/species complexes
across various continents that visualize the malaria problem more objectively.
Recently Sinka et al. (2012) simplified these distribution maps of the major malaria
vector based on ‘dominant vector species’ (DVS) (Table 7.1; Fig. 7.2).
7.2 Deserts’ Most Dangerous Malaria Vectors
7.2.1 The Sahara Desert
Three species (i.e., An. gambiae s.s., An. arabiensis, and An. funestus s.s.) out of the
seven dominant vector species (DVS) carry highest transmission of epidemiological
significance in Africa. The former two species are both members of the complex An.
gambiae s.l. which contains five other sibling species (An. melas, An. merus,
An. quadriannulatus A and B, and An. bwambae). Anopheles funestus s.s. is a
member of the An. funestus s.l. complex that comprises at least 11 sibling species
(An. funestus Giles, An. vaneedeni Gillies and Coetzee, An. rivulorum Leeson, An.
7.2 Deserts’ Most Dangerous Malaria Vectors 117
Table 7.1 Major inventories on Indian anophelines

Number of species described
Year Authors India Rajasthan Thar Desert
1912 Anonymous 3 – –
1916 Anonymous 3 – –
1931 Covell 38 4 4
1933 Christophers 43 (excluding 8 varieties) 4 4
1955 Puri 38 12 5
1960 Puri 39 13 5
1984 Rao 51 – –
1996 Nagpal & Sharma 58 – –
1961 Wattal & Kalra 36 – –
1996 Tyagi – 16 10
2004, 2002 Tyagi – 18 12
2015, 2020 Tyagi et al. 63 – –
Source: B.K. Tyagi, This work
An. freeborni, An . pseudopunctipennis*,

21.95% An. quadrimaculatus*, An. albimanus, An. albitarsis*,
An. aquasalis, An. darlingi, An. marajoara, An. nuneztovari*
An. barbirostris*,
*
An. lesteri,
An. sinensis,
An. aconitus†‡,
An. annularis‡,
An. balabacensis,
An. culicifacies*,
An. dirus*,
An. farauti*,
An. atroparvus
46.34% An. flavirostris,
An. abranchiae,
An. fluviatilis*,
An. koliensis, An. messeae,
An. sacharovi, 14.63%
An. eucosphyrus,
An. maculatus group, An. ergentii,)
An. minimus*, An. superpictus
An. punctulatus*,
An. stephensi,
An. subpictus *†‡,
An. sundaicus*
An. arabiensis, An. funestus
An. gambiae, An. melas‡ 17.07%
An. merus‡, An. moucheti‡,
An. nili*‡
Fig. 7.2 A total of 41 dominant vector species (DVS) and species complex presence points across
four major regions in the world (*Species complex: Americas 4, Africa, Asia 9; {Not included in
multi-species maps: Asia 2; {Not included in global map: Africa 4, Asia 3; see also Fig. 7.1)
rivulorum-like, An. leesoni Evans, An. confusus Evans and Leeson, An. parensis
Gillies, An. brucei Service, An. aruni Sobti, An. fuscivenosus Leeson, and an Asian
member An. fluviatilis James.
The three main malaria vectors have adapted to specific ecological niches with
possible overlaps (Sinka et al. 2012), yet An. gambiae and An. arabiensis appear to
be relatively highly influenced by the anthropogenic (human) activities. Conse-
quently their distribution and prevalence are subject to seasonal and spatial
vicissitudes brought about by humans. For instance in Mali, generally An. gambiae
is sampled in higher frequencies compared to An. arabiensis from samples collected
in different ecological settings. This implies that the frequencies of An. gambiae are
the highest in Southern Sudan savanna zones, while those of An. arabiensis are very
low in Sudan savanna zones (~7%) but increase from these zones toward Northern
Sudan savanna where they can reach 20%. The highest frequencies of An. arabiensis
are observed in the Northern drier zones where they could reach 60% (Ndiath et al.
2015). In fact, the frequencies of An. arabiensis increase with increasing aridity
showing a cline (Adelman 2015). Another important mosquito, Anopheles multi-
color is known to be present in the arid areas of Africa north of the Sahara Desert,
especially in oases. Until recently, its presence in Mauritania was not reported, and
was for the first time recorded for its presence in Nouakchott, the capital of
Mauritania (Lemrabott et al. 2020). The larvae of An. multicolor, together with
those of An. arabiensis, the major malaria vector in the city, were found thriving in
highly saline surface water collections.
Quite often the desert specialist, An. arabiensis, is compared with An. gambiae
which is rather more widely spread in the Sub-Saharan Region in Africa. Anopheles
arabiensis¸ whose distribution may overlap with that of An. gambiae in the
Sub-Saharan Region, is best adapted to dry environments, in addition to parched
lands of savannahs and sparse woodland, but also forested areas influenced by recent
anthropization. Even though An. arabiensis readily breeds in the paddy fields
(reasons for which are not yet clear; Sinka et al. 2010), both tend to breed in a
similar fashion, choosing as larval habitats generally small, temporary, sunlit, clear,
and shallow fresh water pools, although An. arabiensis has an edge over An.
gambiae in utilizing a greater variety of locations, including slow flowing, partially
shaded streams, and a variety of large and small natural and man-made habitats.
Anopheles arabiensis can profusely breed both in the brackish water and, under
stress, the polluted urban drain water. Notwithstanding higher epidemiological
significance of An. gambiae in the overall African continent, in general, and the
Sub-Saharan Region, in particular, yet An. arabiensis, due to its high behavioural
plasticity is a dangerous vector to be reckoned with particularly in arid
environments. The mosquito cleverly avoids indoor residual spray (IRS) exhibiting,
besides a zoophilic, exophagic, and exophilic behaviour, ‘avoidance’ (deterrence
from a sprayed surface) depending on the type of insecticide used. The mosquito has
a wide range of feeding and resting patterns, depending on the geographical location.
7.2.2 The Arabian Peninsula Desert
Little, fragmentary, and isolated information was available on the mosquito fauna of
the Arabian Peninsula, with virtually nothing known about mosquitoes in the central
and northern regions of the peninsula prior to 1956, and the first ever updated and
annotated inventory comprising a total of 18 anophelines (out of a total of 49 mos-
quito species) was offered in 2019 for the Kingdom of Saudi Arabia, the largest of all
nations in the peninsula (Alahmed et al. 2019) (vide infra):
1. An. (Anopheles) coustani Laveran, 1900

2. An. (Anopheles) tenebrosus Dönitz, 1902
3. An. (Cellia) arabiensis Patton, 1905
4. An. (Cellia) azaniae Bailly-Choumara, 1960
5. An. (Cellia) cinereus Teobald, 1901
6. An. (Cellia) culicifacies Giles, 1901 (s.l.)
7. An. (Cellia) dthali Patton, 1905
8. An. (Cellia) fuviatilis James, 1902 (s.l.)
9. An. (Cellia) multicolor Cambouliu, 1902
10. An. (Cellia) pharoensis Teobald, 1901
11. An. (Cellia) pretoriensis (Teobald, 1903)
12. An. (Cellia) pulcherrimus Teobald, 1901
13. An. (Cellia) rhodesiensis rupicolus Lewis, 1937
14. An. (Cellia) sergentii (Teobald, 1907)
15. An. (Cellia) stephensi Liston, 1901
16. An. (Cellia) subpictus Grassi, 1899 (s.l.)
17. An. (Cellia) superpictus Grassi, 1899
18. An. (Cellia) turkhudi Liston, 1901
Anopheles sergentii, referred to as the ‘desert malaria vector’, is the most

ubiquitous dominant vector among all the primary vectors across the region, viz.,
An. sergentii, An. stephensi, An. arabiensis, An. superpictus, and An. culicifacies.
Additionally, there are ‘secondary’ vectors (An. claviger, An. d’thali, An. fluviatilis,
and An. pulcherrimus) as well playing less important roles.
7.2.3 The Middle East/West Asia/Central Asia Deserts
The Middle East Region has approximation to mosquito faunal elements of the
European Region abounding in An. atroparvus, An. labranchiae, An. messeae, and
An. sacharovi. The two species, however, of enormous importance in the Middle
East Region are An. sergentii and An. superpictus.
Deep inside deserts where oases are the major breeding habitats, it is decisively
Anopheles sergentii, best known as the ‘oasis vector’ or the ‘desert malaria vector’,
which is widely distributed in the oases-rich Saharan belt in northern Africa and the
Middle East, largely due to its adaptability in harsh conditions, ability to survive at
high temperatures, and withstand the extreme climate vicissitudes (Beier et al. 1986;
Farid 1958). The mosquito specializes in breeding in a spectrum of habitats includ-
ing streams, seepages, canals, irrigation channels, springs, rice fields, and most other
non-polluted, shallow sites that contain fresh water with a slow current, slight shade,
and emergent vegetation or algae. Presence of algae in breeding sites seems to be a
major factor to attract An. sergentii (Sinka et al. 2010). Like An. arabiensis in Africa
and An. sundaicus in India, An. sergentii too can lay eggs in brackish habitats.
Ostensibly An. sergentii, although preferably a zoophilic species for which reason
limiting transmission of oasis malaria in Egypt, and also in Morocco, nevertheless
opportunistically bites on humans and animals simultaneously. It may rest both

indoors (endophilic) and outdoors (exophilic). The behaviour of An. sergentii limits
largely to zoophily, and though still present yet its anthropothic index is low.
Anopheles sergentii is more abundant but its low human aggressiveness and its
zoophilic behaviour does not attribute to this species an important vectorial capacity
(Faraj et al. 2009). Human biting was related to local animal stabling practices which
had a common space for both humans and animals. Animals’ proximity to humans
during night determined if the mosquito bit more on animals and less on humans.
Still those females which were collected resting in human dwellings exhibited more
of the human blood in their stomach. Anopheles sergentii is also apparently both
exophagic and exophilic. In Israel An. sergentii seems to have recently developed
deterrent behaviour against DDT and turned more of an ‘exophilic strain’, hence
encountered with fewer adults indoors resting places where they once thrived in the
past, despite the local abundance of larvae. Anopheles sergentii can overwinter as
both adult females and larvae, although no details regarding hibernation, blood
feeding, and oviposition could be found.
The second species of enormous epidemiological significance in Middle East is
Anopheles superpictus. This vector is widely prevalent in Mediterranean across to
central and south-western Asia. There is a school of thought which recognizes at
least three genotypes, namely, X, Y, and Z, in Iran alone, raising the likelihood of a
species complex under An. superpictus which is gaining impressive weight, with
eight junior synonyms already in existence.
Like An. sergentii, the females of An. superpictus too feed on both humans and
animals. In any case An. superpictus is regarded as an unusually dangerous vector
mosquito. Although generally understood to be an exophagic mosquito, An.
superpictus has been frequently sampled indoors (Severini et al. 2004; Oshaghi
et al. 2007).
In addition to An. sergentii and An. superpictus, the Thar Desert/Asian malaria
vector An. stephensi is also a vector to reckon with. Herrel et al. (2001) conducted
extensive investigation on the different kinds of breeding habitats and behaviour of
Anopheles mosquitoes in irrigated areas of south Punjab (Pakistan), in the
neighbourhood of desert where An. stephensi is predominantly existing.
7.2.4 The Great Indian Desert, the Thar Desert
Until about two decades from now, the Thar Desert was hardly considered a fruitful
biotope for investigation into the anopheline mosquitoes of interest to malariologists,
and most of other ecotypes in the country were thoroughly investigated for about
half-a-dozen vectors of malaria (Fig. 7.3). This was due essentially to a very low
prevalence of malaria and without any epidemic in the region. In the wake of such
knowledge about malaria, no significant anopheline survey was ever made in the
interior parts of the Thar Desert, and the fewer studies then directed on the subject
have been from around the townships. Also, medical entomologists got more
attracted to the forested and mountainous districts of the Udaipur zone in southern
Fig. 7.3 Distribution spectrum of malaria vector species in India (Source: Dev 2020)
Rajasthan, being highly malarious. It is not surprising, therefore, that in the early
days nearly all the major faunal surveys in the State were organized in the Udaipur
zone districts only.
(i). Pre-1980 Anopheline Surveys of the Thar Desert
Although, the first ever account of Indian anophelines was presented on a ‘wall
map’ in 1912 by the Central Malaria Bureau, at Kasauli (subsequently transformed
first into Malaria Institute of India and, finally, the National Institute of Communi-
cable Diseases, Delhi), it became possible only in the late 1920s when for the first
time four anopheline species from the then Rajaputana State were put on record
(Covell 1927a). Later in his magnum opus on ‘Family Culicidae: Tribe Anophelini’
in the classic ‘Fauna of British India’ series, now largely out of date, Christophers
(1933) described in detail the taxonomy and bionomics of these four species, viz.,
An. stephensi, An. culicifacies, An. annularis, and An. subpictus, which were stated
to be occurring in at least a few desert districts as well. The total number of taxa in
the State was first raised to 7 and subsequently to 16 (Puri 1955), without any change
in the strength of the desert fauna. According to Puri (1960), most of the 16 anophe-
line species were restricted to the two southern forested districts, Sirohi and Udaipur,
contributing 56% of the total fauna from the State, while the Thar Desert had a
meagre share of seven (44%) species from 5 of the then 11 desert districts. Wattal
and Kalra (1961) offered a comprehensive taxonomic key, also State-wise, for the
adults of anopheline mosquitoes known to be occurring in India till then.
Table 7.2 District-wise distribution of anophelines

District Species collected References
Sri An. culicifacies, An. stephensi, Tyagi and Verma (1991)
Ganganagar An. subpictus, An. vagus,
An. annularis, An. nigerrimus,
An. splendidus
Hanumangarh An. culicifacies, An. stephensi, Tyagi and Verma (1991)
An. subpictus, An. vagus,
An. splendidus
Bikaner An. culicifacies, An. stephensi, MacDonald (1931), Anonymous
An. subpictus, An. vagus, (1976)
An. splendidus, An. barbirostris
Jhunjunun Not surveyed –
Churu Not surveyed –
Sikar Not surveyed –
Jaisalmer An. culicifacies, An. stephensi, Tyagi (1994e, 1995a, 1996e), Tyagi
An. subpictus, An. vagus, et al. (1994, 1995), Tyagi and Yadav
An. annularis, An. nigerrimus, (2001a)
An. splendidus, An. d’thali
Barmer An. culicifacies, An. stephensi Mathur et al. (1992)
Nagaur Not surveyed –
Jodhpur An. culicifacies, An. stephensi, Ramnath et al. (1995), Tyagi and
An. subpictus, An. annularis Yadav (2001a)
Pali Not surveyed –
Jalore Not surveyed –
Source: Tyagi (2003a)
Interestingly, though Rao (1984) extensively dealt with the Indian anophelines, no
mention was however made to either the Rajasthan State or the Thar Desert while
discussing the regional distribution of the taxa (Table 7.1).
(ii). Post-1980 Anopheline Surveys
Very extensive and well-organized entomological surveys were conducted by the

author in Sri Ganganagar district during 1988–1990, and as a result 2 more species,
An. nigerrimus (new to Sri Ganganagar) and An. splendidus (new to Rajasthan
State), collected out of a total of 7 species in that district, were added to the list of
anophelines from the Thar Desert raising the total to 9 (52.9%), with one addition to
the faunal strength of the State (Tyagi and Verma 1991). Long-term entomological
expeditions in Jaisalmer district, currently under the immediate impact of IGNP,
during 1991–1994 by the author yielded the presence of An. d’thali, new to
Rajasthan, elevating the fauna from the Thar to 10 (55.6%), and in the State to
18 (34.6% of the total anophelines recorded from India) (Tyagi 1994e). Subse-
quently, An. barbirostris from Bikaner and An. fluviatilis from Jaisalmer have also
been recorded making the latest inventory shooting to 12 (66.6% of the total taxa
7.3 Bio-Ecology of Anopheline Mosquitoes 123
enlisted from Rajasthan). It is comprehensible from the distribution of taxa in each

district, as given in Table 7.2, that there stands a good possibility of discovering
more new records from the Thar Desert, particularly the unexplored and/or less
explored north-eastern and southern desert districts in the future.
7.3 Bio-Ecology of Anopheline Mosquitoes
Compared to malaria prevalence in the Sub-Saharan Africa (SSA), the disease is far
less intense, both in morbidity and mortality, in the Indian subcontinent, teeming
with an overwhelming population which is naturally at higher risk of contracting
malaria, though (Manguin 2013). Fortunately most of the areas in the subcontinent
dwell with low endemicity (<5% prevalence) or areas of unstable malaria transmis-
sion such as the Thar Desert in the north-western region where the disease is not
endemic throughout the arid ecosystem, and this could be one simple reason for low
level of infection to the inhabitants. Yet, wherever malaria is existing
hyperendemically the risk of contracting disease is always higher irrespective of
presence of P. falciparum or P. vivax. This scenario is best exemplified in India
where a few States like Orissa, and North-East States abound in P. falciparum where
a smaller proportion of population living there, are at risk of much higher levels of
falciparum malaria (>40% prevalence), possibly equalling the levels of risk found in
sub-Saharan Africa. In Orissa a few districts like Koraput, Kalahandi, and Malkangri
exhibit P. falciparum infection as high as 90%.
Various aspects of bio-ecology have been studied for the Thar Desert’s Anophe-
les mosquitoes which offer a good insight into the specific behaviour of each species
(vide infra), which is important from malaria point of view.
(a) Anopheles stephensi Liston, 1901
This is one of the most important vectors in India, next only to An. culicifacies,
contributing individually around 20% of the total malaria transmission in India
(Sharma and Mehrotra 1986; Tyagi 1992a). It has a very wide distribution in the
Indian mainland, Iran, and the Middle East, along with rather recent invasion by this
species in Sri Lanka and a few Northeast African countries (Rao 1984). It is
considered as the most significant vector in and around urban areas (Neogi and
Sen 1962; Nair and Samnotra 1967), but its variety, mysorensis carries transmission
in the rural areas as well (Viswanathan 1950). Tyagi et al. (1991) have discussed the
status of the desert population akin to An. stephensi s.s and suggested occurrence of a
possibly different taxon, which is highly adapted to the xeric environment of the
Thar Desert. The hypothesis is strengthened from the observations of Subbarao et al.
(1987) who, based on a nationwide survey of data, opined for the existence of an
‘intermediate’ form besides the type form and the variety mysorensis, but designated
all these merely as ‘ecological variants’. Very recently, however, molecular
approaches have helped to show that the type and the variety mysorensis have no
variation in their sequencing of the ribosomal DNA internal transcribed spacer
2 (ITS2) and domain-3 (D3) loci based on 70 samples of mosquitoes collected from
three different regions of India. They concluded that the type and variety mysorensis
forms of An. stephensi exhibit identical nucleotide sequences at their ITS2 and D3
loci (Alam et al. 2008).
Anopheles stephensi larvae exhibit a great degree of behavioural adaptability and
plasticity to breed and develop in virtually every conceivable freshwater stagnant
water source in urban environments, making use of artificial containers such as
domestic wells, overhead water tanks, room coolers, cisterns and roof gutters, and in
water bodies in construction sites and other industrial localities, and bringing malaria
transmission not only into densely populated Indian metropolises such as Delhi and
Chennai but also the emerging towns and cities like Jodhpur in the Thar Desert,
north-western India (Tyagi et al. 2000). Anopheles stephensi, being a dynamic
species, though can comfortability breed indoors, nevertheless tend to prodigiously
breed in greater numbers outdoors. In India, the subspecies mysorensis, adapted to
breed typically in rural environments, is found abundantly in stone pots and earth-
enware containers (Fig. 7.4). The vector, like other anophelines, is always in quest of
fresh water, yet specializing to breed only in water stored in any kind of natural or
man-made container – an attribution which defines a strong characteristic of the
species’ biology. Tyagi (1994f) observed thanatosis or death feigning behaviour in
the larvae of An. stephensi, a trait that helps the vector species survive successfully in
the ‘Tanka’ and ‘Beri’. Conclusively, it was generally observed that the desert
specimens were relatively larger in size.
Verma and Tyagi (1991) reported on mite (Arrenurus sp.) infestation of Anophe-
les stephensi in the desert villages of Rajasthan. This infestation is a result of
mosquito’s insular habit of breeding in container waters like that of ‘Tanka; which
in many instances is not properly stoppered or covered atop by a lid. Some scientists
have advocated using the water mites as a biological tool for control of vector
mosquitoes. Biswas et al. (1980) drew inconclusively an association of Arrenurus
spp. mite infection to anopheline mosquitoes with nulliparity.
Anopheles stephensi is a desert species and eminently predominates its popula-
tional density in the Thar Desert, characterized by the presence of stupendous
number of ‘Tanka’ and ‘Beri’. However, with the constant influx of another serious
vector, An. culicifacies, due to canalized irrigation and the consequent climate
change, the desert vector of malaria is appreciably replaced by the intruder (Fig. 7.5).
Anopheles stephensi, a prominent Indian species found widely across the sub-
continent, and beyond (extending from the Arabian Peninsula, through Iran and Iraq,
across to Bangladesh, southern China, Myanmar, and Thailand), is a highly conten-
tious and debatable species whose taxonomic status, despite availability of molecu-
lar evidences, is still unresolved under the Neocellia Series. It is typically described
as an endophilic and endophagic species despite a tendency to bite outdoors during
warmer months when people are more active outdoors. Host availability seems to be
a driver to a variable anthropophily for this species. In urban areas there appears to be
a greater tendency for biting humans and, therefore, an increased risk of malaria
transmission. This species rests primarily in temporary or poorly constructed human
and animal shelters rather than brick structures (Fig. 7.6). Outdoor blood-feeding
Fig. 7.4 (a-d). Various kinds of breeding habitats of Anopheles stephensi in the rural Thar Desert
ecosystem (a, b) a household ‘Tanka’, (c) a cemented water tank for animals’ drinking, and (c) an
earthen pitcher and an urn. (Source: Dr. B.K. Tyagi, personal archive)
Fig. 7.5 Dominance of (a) An. stephensi in desert environments of Pilibanga Primary Health
Centre (Sri Ganganagar District) and of (b) An. culicifacies in Sangaria being highly irrigated
Primary Health Centre (Hanumangarh District) (Source: B.K. Tyagi, personal archive)
activity varies seasonally, with females feeding later in the night during the summer
months compared to the winter months. However, indoor biting frequencies of An.
stephensi appear to show no marked seasonal variation during different months of
the year. Anopheles stephensi, which is inherently associated with the arid
environments in all the world’s selective deserts, particularly the Thar Desert
where it has additionally adapted to associate all year round with the canal-irrigated
open water stagnation in villages, but generally in low densities when compared to
that of An. culicifacies and An. subpictus, the other two vectors in the Thar Desert. In
urban areas, An. stephensi is found throughout the year, but is most abundant in the
summer months (between June and August), which coincides with the peak period of
malaria transmission.
Anopheles stephensi has a great history to narrate one of the greatest discoveries
in medical science, when Sir Dr. Ronald Ross, a British Indian Medical Officer
serving in Secunderabad military unit in India, decoded the malaria cycle by
establishing an irrefutable relationship between malaria parasite and the anopheline
mosquito, presumably An. stephensi only. Soon thereafter the mosquito was repeat-
edly incriminated with the malaria parasite in Mumbai (1911), Madras (1938),
Ahmedabad (1943), and Broach (1967). In India, An. stephensi ranks next only to
An. culicifacies and An. fluviatilis in the intensity of malaria transmission. While
both the latter taxa are species complexes, the status of An. stephensi is still
continuing to be enigmatic, albeit recognition of three different subspecies, varieties
or forms, identifiable on the basis of differences in the numbers of ridges of egg
floats and other measurements, viz., ‘typical’ (i.e., An. stephensi stephensi Liston
1901), ‘mysorensis’ (Sweet and Rao 1937), and ‘intermediate’ (Subbarao et al.
1987). While the type form is an efficient vector of urban malaria throughout
India, the ‘mysorensis’ form is restricted to areas in central and south India, and,
due to being highly zoophilic in nature, has a relatively weak vectorial capacity. In
contrast, it is a strong vector in Iran where recently extensive molecular
investigations have been carried out on its vectorial potential, with sporozoite rates
Fig. 7.6 (a) A typical cattle-shed in the Thar Desert where Anopheles stephensi bites on cattle and
rests on mud walls and, (b) roof hangings. (Source: Dr. B.K. Tyagi, personal archive)
from southern Iran have been reported to range from 0.5 to 47% (Sinka et al. 2011).
The intermediate form is typically found in rural villages and peri-urban areas, but
very little is known about its vector status. Interestingly, none of these definition fits
into the vector species, An. stephensi, occurring in the vast stretches of the Thar
Desert (Tyagi et al. 1991; Tyagi 2017, 2018).
(b) Anopheles culicifacies Giles, 1921
Anopheles culicifacies was singularly regarded the most dangerous vector before
the discovery of its being a complex of several sibling species (A, B, C, D and E); the
Species A having been discovered first in 1986 (Green and Miles 1980). An.
culicifacies complex has a very wide range in the Indian subcontinent and beyond,
extending across large areas of Vietnam, Cambodia, Lao PDR, Sri Lanka, Nepal,
India, and southern China in the Southeast Asia and reaching as far as Yemen in the
Middle East, and the Kingdom of Saudi Arabia in the Arabian Peninsula as well as in
small areas of Eritrea in the Horn of Africa, through Pakistan. Among all these
nations, however, India, Sri Lanka and Iran are the main countries where extensive
ecological, biological, sociological, control, and molecular investigations have been
conducted on An. culicifacies. As far as India is concerned, all the five species of the
complex (A,B,C,D and E) occur in the country, but only four, except species B
(a staunch zoophilic species), are considered vectors. Species E being highly
anthropophilic and endophilic in nature, is a particularly efficient vector of both
P. falciparum and P. vivax in southern India and Sri Lanka (Sriwichai et al. 2016;
Surendran et al. 2003).
Anopheles culicifacies is undoubtedly the most serious vector of malaria in the
Indian Sub-continent, being responsible for as high as 65% of the entire transmission
load in the country. It has very wide distribution and within the Indian limits it occurs
in the entire mainland, including Rameswaram island, but not either in Andaman
islands or the Lakshadweep islands (Rao 1984). It is often associated with the
irrigation and has also been reported to occur in semi-arid areas receiving irrigation
facilities (Tyagi 1994b; Tyagi and Verma 1991; Tyagi and Yadav 1996c; Tyagi and
Chaudhary 1997), and is considered the main transmitter of focal outbreaks (Mathur
et al. 1992; Tyagi et al. 1994, 1995). It is highly plastic in nature and adapts to new
geographic situations very swiftly. Anopheles culicifacies is considered a “complex”
of five sibling species designated as A, B, C, D and E (Subbarao and Sharma 1997;
Subbarao et al. 1987, 1988, 1999), of which only first three are described to occur in
the Thar Desert. While sibling species A, C and D are generally vectorial in nature, B
is either not transmitting or does so at a low level only.
Anopheles culicifacies has a predilection for a vast range of open surface stag-
nant, slowly running irrigation channels and even swampy habitat waters (Fig. 7.7),
and has been found breeding along with other several anopheline species
(c) Anopheles subpictus Grassi, 1899
Typically a monsoon species An. subpictus complex has a distribution ranging

from north-eastern Pakistan, across India, Sri Lanka, Bangladesh, Myanmar,
Thailand and along coastal regions of southern Cambodia, Vietnam and coastal
areas of Malaysia, Indonesia, Timor-Leste, Papua New Guinea and extending as far
east as the Solomon Islands. Wherever occurring, however, it simply outnumbers all
other species, and in the Thar Desert briefly up to November. It is normally
considered a vector of secondary importance, but has also been incriminated in
Fig. 7.7 (a-d) An irrigation channel breeding An. culicifacies; (a, b) Shallow water collections in
the Ghaggar riverbed in the Hanumangarh district, and (c, d) Sampling of An. culicifacies by the
author in irrigation channels in Sri Ganganagar district. (Source: Dr. B.K. Tyagi, personal archive)
recent years from the Thar Desert (Tyagi 1996g; Tyagi and Yadav 2001a). Tyagi
et al. (1992, 1994) demonstrated its recurrence with the monsoon rains throughout
the desert region. However, so far it is an enigma as to what happens to this species
when it disappears with the onset of winter and again appears with the slightest
precipitation. Interestingly, elsewhere in India it has also been identified to be a
“complex” of four species, designated as A, B, C and D. While one of these breeds in
brackish waters along the eastern coastal region, others are essentially freshwater
breeders. It is not known if the species available in the Thar is A, B, C or D? It is
noteworthy that the saltwater breeding species has been reported to be more vectorial
in nature. In this background, it is very important to correlate the incriminated sibling
species with the breeding water types which occur in both saline and fresh forms in
the Thar Desert region.
The Subpictus Complex, comprising two subspecies, viz., An. s. subpictus—a
brackish water habitats-breeder, and An. s. indefinitus—primarily a fresh-water
species (Reid 1966), is classified under the Pyretophorus Series (Sinka et al.
2011). The egg phenotypes have suggested that An. subpictus may be a complex
consisting of two or more sibling species (Rattanarithikul et al. 1996).
Currently An. subpictus is considered a complex of four sibling species (A, B, C,
and D) (Reid 1966; Suguna 1982; Suguna et al. 1994). While species B is the only
brackish water breeder restricted to coastal habitats (Suguna et al. 1994;
Abhayawardan et al. 1996; Reuben et al. 1984), the remaining three species, A, C,
Fig. 7.8 (a–d) Various different kinds of breeding sites of Anopheles subpictus in the Thar Desert:
(a) heavily weeded shallow water habitat, formed as a result of seepage from the Indira Gandhi
Canal in Jaisalmer district, and breeding several malaria vectors including An. culicifacies, An.
subpictus, An. annularis, and even An. stephensi, (b) A tube-well, (c) a hand-pump, and (d) waste
water from a hand-pump. (Source: Dr. B.K. Tyagi, personal archive)
and D, prefer fresh-water sites including riverine pools and rice fields (Suguna et al.
1994), although species A too was reported breeding in brackish-water coastal
habitats (Abhayawardana et al. 1996). Tyagi (2002) studied a vast range of breeding
sites of An. subpictus in the Thar and found the species breeding in all kinds of open-
surface stagnant and slowly flowing water, with some turbidity (Fig. 7.8). Surendran
et al. (2010) studied the molecular biology of An. subpictus species Band and
analyzed its rDNA from larval and adult specimens, doubting it to be An. subpictus
at all, but indeed An. sundaicus. The species complex is only known from limited
areas of India, Sri Lanka, the Philippines, and Thailand.
Larvae of the Subpictus Complex are found in both clear and turbid waters but
have been reported from highly polluted habitats including sites contaminated with
organic waste such as waste stabilization ponds, street pools, and drains. Habitats
may be exposed and sunlit and larvae are frequently associated with floating algae or
other vegetation. Natural larval habitats for members of the complex include
lagoons, shallow ponds, marshes, slow-flowing rivers, natural pools and margins
of small streams, but the species are also highly associated with rice fields and
irrigation schemes, specifically in the earlier stages of rice cultivation. Larvae have
also been collected from small, artificial containers, including intra-domestic earthen
pots, tanks, and barrels.
Members of the Subpictus Complex are generally zoophilic; however, species B

will readily bite humans.
(d) Anopheles vagus Donitz, 1902
This is a rather uncommon species generally found and confused with An.
subpictus. However, it can be readily distinguished on the basis of palpal banding
pattern as well as basal humeral markings at the costa of the wing. Tyagi and Verma
1991and Tyagi et al. (1992, 1994) have recorded the species from most of the north-
western desert districts.
(e) Anopheles annularis Van der Wulp, 1884
Like An. culicifacies this species is also very common in most parts of the Indian
mainland, although unlike the former it is a strong vector of malaria in eastern States.
Being a zoophilic species, it generally has a strong correlation with the cattle
population. In the desert it has spread through most areas wherever waterlogging
has taken place as it breeds in such sites with plenty of vegetation. It is, therefore,
significant to ponder on the distribution of An. annularis and the seepage water
released from the canals in the desert.
Anopheles annularis, a malaria vector of considerable significance in Nepal and
Sri Lanka in India (Rao 1984), is assigned to the Neocellia Series. A typical South
Asian species its zoogeography spans from Afghanistan eastward through areas of
Pakistan, India, Nepal, Sri Lanka, Bangladesh, Myanmar, southern China, Taiwan,
Thailand, Cambodia, Malaysia, Indonesia, Timor-Leste, Vietnam, and the
Philippines. The vector is generally zoophilic, but given the opportunity of humans
surpassing cattle may intensely transmit malaria and cause epidemics as witnessed in
the Narayanganj District of Bangladesh where a P. vivax epidemic broke out in a
village with hardly any cattle.
Anopheles annularis is regarded a complex of two sibling species, A and B,
diagnosed primarily on the basis of ovarian polytene chromosomes’ differences in
the banding patterns and conclusively reconfirmed through PCR-restriction fragment
length polymorphism (PCR-RFLP) assays based on endonuclease restriction sites in
the ITS2 and D3 regions of rDNA. In India they are either occurring sympatrically
(e.g., in the Shahjahanpur and Ghaziabad Districts in Uttar Pradesh) or solitarily
(e.g. in Haryana, Orissa, and Rajasthan States, and in Assam where alone it (species
A) is a vector. The vector is having a strong association with agroecosystem and
riverine environments with plenty of vegetation where the larvae are typically found
in clean, still water bodies with abundant vegetation, especially ponds, swamps, and
rice fields (Fig. 7.6a).
(f) Anopheles nigerrimus Giles, 1900
This is a widely distributed species in the rice growing countries of Southeast

Asia. In the Thar Desert region, so far it has been recorded from Sri Ganganagar,
Bikaner, and Jaisalmer only. This species is observed to breed in the boggish habitats
under the impact of seepage water from the Indira Gandhi canal. Although it has
been incriminated with malarial parasites elsewhere in the Southeast Asia, this
species has never been incriminated in the Thar and has also never been considered
a vector of any significance in the country.
(g) Anopheles d’thali Patton, 1905
This species is but rarely collected from within the Indian limits. It has been
recorded from Jaisalmer in Rajasthan and the Rann of Kutch area in Gujarat (Tyagi,
1996b,d). It is not a vector in India, but is a very serious vector in the Suez Canal area
in the Middle East (Zahar 1990a, b).
(h) Anopheles splendidus Koidzumi, 1920
This is recorded only from the districts currently under extensive canalization
such as Sri Ganganagar and is of academic interest only.
(i) Anopheles barbirostris van der Wulp, 1884
It is an uncommon species appearing invariably after the monsoon, preferring to

breed in the well’s water, but never in the ‘tanka’ or ‘beri’. So far it has seen
collected from Bikaner district.
Belonging to medically important and taxonomically complex Barbirostris Group
of Oriental origin, the malaria vector is widely distributed in the Indian mainland and
some of the Southeast Asian countries, where, save for other nations in the region
including India, it is an important vector for the Brugian filariasis as well. Anopheles
barbirostris likes to feed outdoors on bovine blood, sometimes throughout night as
seen in the peninsular Malaysia near the Thai border, but adults are found resting
indoors as well.
Anopheles barbirostris is a complex of nearly half a dozen sibling species (three
to five) as alluded by the sequence data for the COI mtDNA gene and the ITS2
rDNA locus, as well as electrophoretic profiles of salivary gland proteins, although
the exact number is not known yet. An. barbirostris is identified as a potential vector
of malaria in the northern Sumatra.
Larvae of An. barbirostris is, as a rule, a swamp breeder and prefers to breed in
water sources with some vegetation. It is typically found in deep fresh water that is
still or slow moving such as sunlit to moderately shaded ground-water bodies like
wells, river and stream margins and pools, ditches, moats, lakes, permanent and
temporary ground pools, rice fields, wells, canals, marshes, rock pools, ponds,
springs, swamps and animal footprints, and paddy fields, with even high level of
organic pollution.
7.4 Dispersal 133
(j) Anopheles fluviatilis James, 1902
Anopheles fluviatilis is principally a species that is found in the mountains and

sub-mountainous fast running streams among sylvatic environments such as, the
Udaipur Zone in the Aravalli Hills, adjacent to the Thar Desert. The forest loving
species was found completely wanting in a forest-denuded area in Orissa (India),
whereas, in contrast, in the forested area An. fluviatilis ‘S’ was represented by 98% of
the sample collected; the remaining 2% was species ‘T’. More recently, however,
this species was reportedly collected from Jaisalmer district (see Tyagi 2002). Its
zoogeography stretches typically from south-western Asia including Iran,
Afghanistan, and Pakistan to southern Asia including India, Nepal, Bangladesh,
and Myanmar.
Anopheles fluviatilis, a sibling species complex of three yet to be taxonomically
named taxa, S, T, and U (there is a fourth one, species V, too, awaiting confirmation)
within the Funestus Group of the Myzomyia Series (Sinka et al. 2011) has been
studied both behaviourally and ecologically mostly in India and Iran. In India
species S, being anthropophilic (biting activity begins around 19:00 h and peaks
between 20:00 h and 21:00 h, but may also occur throughout the night until dawn
without an apparent peak) and endophilic, is a strong vector for malaria; the other
two, both T and U, being zoophilic, are either weak or secondary vectors, with an
exception of species T which is regarded a strong vector for malaria in Pakistan,
Nepal, and Iran.
7.4 Dispersal
Flight and dispersal characteristics of anopheline mosquitoes are considered an

important component in malaria epidemiology, but these properties for the Indian
anophelines are quite meagrely investigated (cf. Rao 1984), and in the Thar Desert
no planned and organized studies supported with mark-release-recapture
experiments on vectors were ever undertaken. However, based on the detection of
adults at points from the nearest larval sources the author has made some
observations on the flight range of some important vector species in the desert
such as An. culicifacies, An. stephensi, and An. subpictus. The flight range of these
mosquitoes nevertheless greatly varied in the canal-irrigated or unirrigated tanka-
dependent villages. The flight range of An. culicifacies in certain villages like
Khetusar in Phalodi tehsil, Jodhpur district was measured to be about 6–8 km
which is comparatively much higher than the maximum so far reported (2.8 km)
for the species in southern India (Russel et al. 1944), although in Pakistan the flight
range was determined as high as 5.2 km (De Burca 1939). In Dholia village in
Phalodi tehsil, Anopheles subpictus which is completely absent in the interior parts
of the Thar Desert between December and May suddenly appears with the mounting
up of the moisture in the xeric environs. Its maximum flight has been determined to
be about 28 km, since the nearest breeding place, the seepage water collections from
the main Indira Gandhi canal, being in abundance there. Anopheles stephensi
certainly has much shorter flight range due to its synanthropic habit in the Thar
Desert villages.
7.5 Succession and Replacement of Taxa
Even though some of the most significant works on the faunal resources in the Thar
Desert did not enlist anophelines (e.g., Pruthi and Bhatia 1952; Jairajpuri 1991),
clearly undermining the significance of these medically important insects, a few of
the celebrated malariologists of that time adequately brought on record the
bio-economical significance of several different mosquito species (e.g., Macdonald
1931; Jaswant Singh 1933). Chronologically, An. stephensi, which is a desert species
(Zahar 1990a, b) and seemingly existed in the Thar Desert for centuries, is the oldest
anopheline species transmitting malaria at a low intensity, though. Considering the
fact that An. stephensi is the most dominating species in the Thar Desert, it is
interesting to notice a systematic erosion of its main domain by another very
important malaria vector, An. culicifacies, introduced in the interior parts of the
Thar Desert along with the canal-based irrigation. As a result, in Sri Ganganagar, An.
culicifacies (97.93%) has totally dominated the species composition in the irrigated
villages as compared to those villages which do not receive canal-based irrigation
but boast of the predominance of An. stephensi (87.3%) (Tyagi and Verma 1991)
(Fig. 7.7). In Jaisalmer district, where the main Indira Gandhi canal with its IGNP
has subsequently provided irrigation to a large north-western area, the situation of
replacement of domination of An. stephensi seems to have sufficiently advanced. In
contrast to this, a large north-western part of Jodhpur district which until recently
remained largely dependent on ‘tanka’ or bore-wells is highly xeric in nature and
predominantly harbours An. stephensi, albeit very low density in comparison to that
in the irrigated villages.
Still, the phenomenon of succession and replacement of the oldest anopheline
taxon (An. stephensi) in the Thar Desert by a newly introduced species
(An. culicifacies) was demonstrated in a recently canal-irrigated Jodhpur district,
notwithstanding in a very small part. A group of ten villages in Phalodi, Shergarh,
and Osiyan tehsils, all characterized by the exclusive presence of the ‘tanka’, were
studied between 1991 and 1993 for the transmission dynamics of An. stephensi and it
was discovered that An. culicifacies had begun to establish in this area as well,
although An. stephensi continued to prevail as the most dominant species (72.79%),
followed by An. subpictus (26.04%) and An. culicifacies (1.15%).
It is comprehensible from the above data that there is a definite course of ushering
of An. culicifacies in the Thar Desert, more or less along with the canal irrigation,
whereas An. stephensi, whose distribution in the desert is synonymous to the
presence of ‘tanka’ and/or ‘beri’, is being systematically replaced in domination
within the species composition by the former more plastic and adaptive species.
7.6 Density of Anopheline Mosquitoes 135
7.6 Density of Anopheline Mosquitoes
Anopheles stephensi is unquestionably the most adapted and successful species in

the Thar Desert environment, although An. culicifacies, a relatively new entrant in
the interior of the desert, has fast spread over a large area more or less synonymous to
the expansion of the IGNP. Both these species, along with An. subpictus,
An. annularis (An. fuliginosus), and An. pulcherrimus, were reported from the
urban limits of Bikaner township (Macdonald 1931). Ramnath et al. (1995),
summarizing the data from a base line survey conducted during 1986–87 in three
districts, including two from the Thar Desert (e.g., Jodhpur and Bikaner), reported
the highest density of An. subpictus as 1.2 PMH in Jodhpur district in the rainy
season, along with 1.0 PMH) of An. stephensi, but none in the summer, however.
Both these species occurred in peak densities in the dawn hours. An. stephensi was
found to be in fairly good density at a temperature range of 30–40°C. In Bikaner
district, besides above two species, also An. annularis and An. culicifacies were
sampled, with An. stephensi topping the density (range 1–36.4 PMH), followed by
An. subpictus (range 0.2–4.4 PMH), An. annularis (0.1–1.0 PMH) and An.
culicifacies (0.2 PMH). Anopheles stephensi was sampled more or less uniformly
during all the three seasons (average range 6.4 PMH in monsoon to 9.5 PMH in
winter), followed by An. subpictus (average range 1.1 PMH in winter to 1.6 PMH in
monsoon). Anopheles culicifacies was characteristically restricted to only monsoon
season. Although, An. stephensi was sampled in more or less comparable densities
during dawn (8.74 PMH) and dusk (6.80 PMH), nevertheless, its feeding peak
periods could not be determined, just like in case of An. culicifacies. Interestingly,
An. stephensi was collected more from the hanging objects (19.2 PMH) than the
different kinds of plastered walls and roofs. On the contrary, An. culicifacies (12.0
PMH) preferred mud-plastered surfaces than the other materials.
In another study carried out in two irrigated and two unirrigated villages under
Jaisalmer and Jodhpur districts, Tyagi and Yadav (2001a) encountered very interest-
ing observation on vector density. A total of eight anopheline species were sampled
from all the types of collection. The relative density, expressed as the number of
females collected by one man during a 1 h period, is graphically presented in
Fig. 7.9. The average density per man-hour of An. stephensi (17)1; range
0.0–47.2) was the highest, with maximum density in April and minimum in January.
Another important vector, An. culicifacies, (average pmh 3.3; range 0.0–14.1)
showed maximum density during the monsoon months of July–September. Anophe-
les subpictus rose in density with the onset of the monsoon in late June due to the
existence of rainwater-fed surface breeding habitats, and remained abundant until
December (average pmh 11.6; range 9.7–33.1). Anopheles stephensi was conspicu-
ous by its constant presence in unirrigated villages despite extremes of ambient
temperature (average pmh 7.0; range 0.0–18.7). In these villages An. subpictus also
occurred in low densities between August and December (average pmh 1.1; range
0.0–7.0), but A. culicifacies was characteristically absent throughout.
Tyagi and Verma (1991) made a 2-year study on the anophelines in two sets of
physiographically different situations, viz. the irrigated Sangaria PHC villages (now
Fig. 7.9 Comparison of relative density (per man-hour) amongst three vector species, namely, An.
culicifacies, An. stephensi, and An. subpictus in desert (unirrigated; histograms) and non-desert
(irrigated; line graphs) villages in Jodhpur and Jaisalmer districts, during respectively (1993–1994)
[An. stephensi ; An. culicifacies , An. subpictus, , An. stephensi , An. culicifacies ,
An. subpictus ] (Source: Tyagi and Yadav 2001a)
Table 7.3 Comparison of Total number of females collected (%)

relative abundance of
Species Irrigated villages Unirrigated villages
females of different anoph-
eline species sampled dur- An. stephensi 1223 (29.6) 430 (10.4)
ing dawn hours from An. culicifacies 658(15.9) 0.0
irrigated villages of An. subpictus 1085 (26.2) 55 (1.1)
Jaisalmer and unirrigated An. annularis 493(11.9) 0.0
villages of Jodhpur
An. nigerrimus 52 (1.2) 0.0
Other species 146 (3.5) 0.0
in Hanumangarh district) and the unirrigated Pilibanga PHC villages of Sri

Ganganagar district, during December 1988 – November 1990, and recorded several
very interesting observations (Table 7.3). Overall, An. subpictus (56.09%)
outnumbered all other species including An. culicifacies (27.43%) and An. stephensi
(14.4%). Distribution of major vector species showed that An. culicifacies occurred
predominantly in the villages with canal irrigation (97.93%), whereas An. stephensi
was recorded in greater abundance in the unirrigated desert villages (87.3%).
Anopheles subpictus showed a trend similar to An. culicifacies, although occurred
mostly in the monsoon season. Both An. culicifacies (84.38%) and An. subpictus
(56.83%) strongly preferred to rest more in the cattle-shed, whereas An. stephensi
(53.29%) showed only a marginal preference for resting in the cattle-shed. Of the
various adult sampling procedures employed, the indoor resting collection yielded
the maximum numbers of female individuals (97.92%), indicating strong endophilic
habits of all An. stephensi, An. culicifacies, and An. subpictus. The per man-hour
density (PMH) for An. culicifacies and An. subpictus maintained a low ebb during
winter (1.84, 1.06) and summer seasons (1.09, 0.19), but built high densities during
7.6 Density of Anopheline Mosquitoes 137
Table 7.4 Per man-hour District An. culicifacies An. stephensi An. annularis
density of malaria vectors
Jaisalmer 2.7 7.4 0.0
in four districts in the Thar
Desert during 1994 Barmer 15.2 6.1 1.5
Jodhpur 8.3 11.7 0.5
Bikaner 2.5 6.0 0.0
Pali 4.0 5.2 0.0
monsoon season (3.98, 11.5). This observation is a pointer to the fact that both these
species are highly dependent on conducive range of ambient temperature and the
relative humidity.
However, in case of An. stephensi the seasonal variation did not seem to affect its
subsistence as it occurred throughout the year (range 0.19–3.37 PMH; average 1.63
PMH). Bansal (1998) and Bansal and Singh (1993) have later also corroborated
these observations on anopheline species composition and density in Bikaner district
where An. stephensi was the only species prevalent throughout the year and nearly
dominated the anopheline faunal composition (33.3%), along with An. subpictus
(34.7%), followed by An. culicifacies (18.0%), An. annularis (12.1%), An.
pulcherrimus (1.1), and An. barbirostris (0.8%). Sharma et al. (1995) presented
the relative density profile of the two major malaria vectors, An. stephensi and An.
culicifacies in six desert districts, which are in conformity of Tyagi and
Verma (1991).
Similar results on relative density of different vectors were reported in another
study in five Thar Desert districts during the epidemic of 1994 (Sharma et al. 1995).
Presence of An. culicifacies in all the epidemic hit districts particularly Jaisalmer,
albeit higher density of An. stephensi, is of interest (Table 7.4).
Tyagi and Yadav (2001a, b) had conducted a detailed 4-year long entomological
investigation (November 1992–October 1996) on vector composition and preva-
lence in two irrigated villages of Jaisalmer district (Madassar and Awai) and unirri-
gated villages of Jodhpur (Kanasar and Khetusar) (cf. Fig. 7.7). A total of eight
anophelines were sampled from all types of collection, of which An. stephensi
(38.8%) was found to be most numerous. Save for An. stephensi, all other species
exhibit tremendous amount of variation in the relative density. The average density
per man-hour of An. stephensi (17.1; range 0.0–47.2) was the highest, with maxi-
mum density in April and minimum in January. On the other hand, An. culicifacies
(average pmh 3.3; range 0.0–14.1) showed minimum density during monsoon
months of July–September. Anopheles subpictus rose in density with the onset of
monsoon in late June due to the existence of rain-fed surface breeding habitats, and
remained abundant until December (average pmh 11.6; range 9.7–33.1). Anopheles
stephensi was conspicuous by its constant presence in unirrigated villages despite
extremes of ambient temperature (average pmh 7.0; range 0.0–18.7). In these
villages, An. subpictus also occurred in low densities between August and December
(average pmh 1.1; range 0.0–7.0), but An. culicifacies was characteristically absent
throughout (Table 7.5).
Table 7.5 Quantum of female mosquitoes (%) from indoor collection and the relative densities of
various anophelines sampled in the irrigated and unirrigated villages of Jaisalmer and Jodhpur
districts, respectively
Irrigated villages Unirrigated villages
Species Total (%) PMH density Total (%) PMH density
An. stephensi 1223 (33.4) 23.8 430 (88.6) 8.1
An. culicifacies 658 (17.9) 13.5 0 (0.0) 0.0
An. subpictus 1085 (29.8) 22.6 55(11.4) 1.1
An. annularis 493 (13.5) 10.2 0 (0.0) 0.0
An. nigerrimus 52 (1.4) 1.0 0 (0.0) 0.0
Other species (including An. vagus, 146 (4.0) 2.8 0 (0.0) 0.0
An. splendidus and An. d’thali)
7.7 Biting Behaviour and Host Preference of the Anopheline

Mosquitoes
Preferred biting times and sites for the different anopheline vector mosquitoes
against a given host are considered significant to the transmission dynamics of the
disease because this manifests the intensity of exposure of the community to biting
and their ability to protect themselves through different prophylactic means, besides
specific control measures to be adopted.
Tyagi and Verma (1991) were the first to investigate the feeding preference of
different anopheline species in Sri Ganganagar district, although the sample size was
too small to drive any concrete conclusion. In northern Jaisalmer a site of summit of
three districts, viz., Jaisalmer, Jodhpur, and Bikaner, and recently brought under
IGNP, Tyagi and Yadav (2001a) demonstrated a preference for biting on a human
host (52.2%) by An. stephensi as compared to An. culicifacies which fed more on the
cattle (73.2%) (Table 7.6).
Orientation of the vectors for feeding has also been studied during all-night
human-bait collections by Tyagi and Yadav (2001a) in the irrigated villages under
the IGNP command, and both An. stephensi and An. culicifacies exhibited two
peaks, one early in the night and the other just before the dawn (Fig. 7.7). Anopheles
culicifacies oriented earlier than An. stephensi and stayed in higher densities until
just before dawn. Anopheles nigerrimus was collected in large numbers in vicinity of
the main Indira Gandhi canal in the early hours of the night only and was apparently
Table 7.6 Anopheline Number of females collected

species collected simulta-
Species Man (%) Cattle (%)
neously from man and cat-
tle to show anthropophily/ An. stephensi 151 (52.2) 138 (47.8)
zoophily of five of the eight An. culicifacies 78 (26.8) 213(73.2)
anophelines prevalent in An. annularis 2 (3.7) 51 (96.3)
Jaisalmer district An. subpictus 11 (4.8) 215 (95.2)
An. nigerrimus 71 (98.6) 1 (1.4)
7.8 Age Structure of Vector Mosquitoes 139
attracted to the flash lights. Blood meal identification indicated to a greater prefer-
ence of An. stephensi for human blood (58.2%) compared to that of either An.
culicifacies (23.4%) or An. subpictus (13.4%). In view of the fast aggression of the
interior parts of the desert by An. culicifacies and steady succession of the various
taxa in the areas being brought under irrigation, in future it would be worthwhile to
investigate these behavioural characteristics in different physiographic situations in
both wet and dry seasons in the Thar Desert. It would be also very interesting and
useful for designing appropriate control measures in the Thar Desert if specific
sibling species particularly under An. culicifacies complex transmitting malaria
could be determined with reference to their differential blood feeding habits. The
same is also true for An. stephensi and An. subpictus (Tyagi 1996f), although the
former has so far not been shown to have any sibling species. Both An. culicifacies
and An. stephensi have been reported to be frequently feeding both indoors and
outdoors in the Thar Desert, although the former species certainly bites outdoors
more than the latter (Tyagi and Verma 1991). This is possibly explained due to
outdoor sleeping habits of the rural people due to generally excessively hotter
climate indoors, although women with their infants prefer to sleep indoors in the
central open area of the house. Both An. stephensi (81.42%) and An. culicifacies
(95.5%) preferred resting more indoors than outdoors (Tyagi and Yadav 2001a). The
same is true for An. subpictus resting predominantly indoors.
7.8 Age Structure of Vector Mosquitoes
The physiological age structure of mosquitoes is significant in initially assuming

their vectorial importance. That is, the older a mosquito lives the more it has the
likelihood to allow the extrinsic cycle of the malarial parasite to complete in its body,
hence maintaining transmission in nature. The physiological age of a vector popula-
tion is generally assessed by determining parous rates, i.e., the proportion of females
that have oviposited previously, and are thus likely to be in a position to transmit
disease. Tyagi and Verma (1991) have studied the parity rates for seven anophelines
including An. stephensi and An. culicifacies in 10 irrigated and 6 unirrigated villages
of Sri Ganganagar district, while Tyagi (1994a), in a 2-year long study (1990–1992)
on the ecology and malaria transmission potential of An. stephensi in 10 unirrigated
or dry villages in Jodhpur district, found out its parous rate as high as 94.65%. Tyagi
and Yadav (2001a) determined parity rates and endophilic behaviour of eight
species, with above two vectors included, from two irrigated villages in Jaisalmer
district and two unirrigated villages in Jodhpur district (Table 7.7). The parous rate
for An. stephensi was 83.41% as to 74.42% of An. culicifacies, 66% of An. annularis
and 56.84% of An. subpictus.
This clearly shows supremacy of both An. stephensi and An. culicifacies as good
vectors, although while the latter species, along with An. annularis, could be found
parous up to Stage III, An. stephensi alone reached Stage IV. Values for other
anopheline mosquitoes ranged from 27 to 72.85%, except An. d’thali (100.0%)
which could not go beyond Stage II. It is noteworthy that An. d’thali, which has
140
7
Table 7.7 Abdominal condition and parity status in eight anophelines from Jaisalmer and Jodhpur districts in the Thar Desert
Abdominal condition No. of parous females
Species No. of females collected indoors UF FF HF SG G No. of females dissected NP PI PII PIII PIV
An. stephensi 1653 282 951 209 115 96 591 98 100 317 65 11
An. culicifacies 658 107 416 60 45 30 305 78 131 89 7 0
An. annularis 493 73 247 92 52 29 100 33 45 20 2 0
An. subpictus 1140 238 626 152 70 54 95 41 42 12 0 0
Other species 194 29 86 33 26 20 128 55 64 8 1 0
Anopheline Fauna and Major Malaria Vectors of Deserts
7.10 Major Breeding Habitats of Different Anopheline Species 141
recently been reported from both the Thar Desert in Rajasthan State and the Rann of
Kutch in Gujarat State, is a serious vector of malaria in areas close to Suez canal in
the Middle East (Zahar 1990a, b), although in India it has never been incriminated.
Both An. stephensi and An. culicifacies showed nearly the same sense of strong
endophilic nature.
7.9 Vector Incrimination Studies
Of the 12 anophelines recorded in the Thar Desert, 3 species, viz., An. stephensi,
An. culicifacies, and An. subpictus, have been incriminated with malarial parasites
(Tyagi and Verma 1991; Tyagi 1996f; Tyagi and Yadav 2001a). Although An.
culicifacies was already confirmed transmitting malaria in the lower southern
reaches of the Thar Desert, it could be found parasitized from a northern desert
district for the first time in Sri Ganganagar district (Tyagi and Verma 1991), who
dissected 203 females belonging to five anophelines but found only one female An.
culicifacies from Masani village in Sangaria PHC (now in Hanumangarh district)
parasitized with the oocyst stage of the parasite. In a pilot investigation during the
1994 epidemic in the Thar Desert, An. culicifacies was again incriminated with the
infection rate value, 3.8%. Tyagi (1992a, 1995b, 1996a) documented scientifically
for the first time involvement of An. stephensi (infection rate 0.43%) in the interior
Thar Desert villages of northern Jodhpur district as well as the quarry mine areas
near Jodhpur township. In two groups of villages in isolated ecological conditions of
northern Jaisalmer, Tyagi 1996f and Tyagi and Yadav (2001a) performed dissection
on 2625 females belonging to eight species and found 0.37% An. stephensi, 0.10%
An. culicifacies, and 0.22% An. subpictus infective in the irrigated villages, as
compared to only An. stephensi (infectivity rate 0.98%) in the unirrigated villages
(Table 7.8).
7.10 Major Breeding Habitats of Different Anopheline Species
Both Christophers (1933) and Puri (1955, 1960) have informed on the different
breeding sites of various anophelines from the Thar Desert. MacDonald (1931)
described several breeding places for An. stephensi like stone lined tanks, earthen
Table 7.8 Results of dissections of salivary glands and gut for incrimination with the malarial
parasite
No. SG + G+ No. SG + G+
Species dissected ve ve Total dissected ve ve Total
An. Stephensi 850 3 0 3 102 1 1 2
An. culicifacies 938 1 6 7 0 0 0 0
An. subpictus 451 1 1 2 284 0 1 1
SG = Salivary Glands; G = Gut
tanks, collections of water at the bottom runs beside wells, reservoirs beside wells,
rainwater cisterns, and ornamental water. In some of these breeding places, An.
subpictus also bred. Tyagi and Verma (1991) studied the breeding of as many as
seven anopheline species in irrigated and unirrigated villages of Sri Ganganagar
district and found that while An. culicifacies bred profusely in a number of habitats in
the irrigated villages, An. stephensi exclusively restricted to the ‘tanka’ in the
unirrigated villages, though it bred also in the canal-borne seepage and stagnated
water collections in the Ghaggar river basin. The breeding index (Bl) of An.
stephensi in ‘tanka’ in Sri Ganganagar district is 0.01 (Tyagi and Verma 1991)
which is comparatively far less that in Jodhpur (0.99) or even to certain other types
of open surface breeding habitats like seepage water collections (0.23) and the flood
waters (0.56) in Sri Ganganagar district. An. subpictus preferred to breed in the
surface water sites generally formed following the monsoon or overflow of the river
and/or canal waters, whereas An. annularis essentially bred in heavily vegetated rain
pools, mostly developed near the main Indira Gandhi canal. Verma et al. (1991) have
made similar observations in Bikaner.
7.11 Correlation of Canalized Irrigation under National

Five-Year Plan of Economy Development with the Malaria
Escalation in the Thar Desert
From malaria point of view the Thar Desert in north-western Rajasthan State has in
recent years emerged out as a unique paradigm (Tyagi 1992a, 1995a; Tyagi and
Chaudhary 1997). Till recently the region was popularly regarded as a unproblem-
atic area with mostly hypoendemic malaria patches and potential for unpredictable
focal outbreaks of the disease (Sharma 1986a, b; Sharma 1999). In a way the Thar
Desert was nearly a terra incognito for high malaria intensity, especially
P. falciparum-dominated malaria, in the interior part of the desert. Malaria scenario
changed quickly with the onset of the canal-based irrigation of the region particularly
under the Indira Gandhi Nahar Pariyojana (IGNP), one of the world’s largest
canalized irrigation systems in a xeric environment. The problem related clearly
with the water management associated with the IGNP in the Thar (Herrel et al.
2001). In Fig. 7.10, a correlation between annual parasite incidence (API) and %
P. falciparum (+) as well as their relationship to the year canal water became
available for irrigation in Sri Ganganagar, Bikaner, Jaisalmer and Jodhpur
districts- the most troublesome districts from the point of view of malaria
epidemics-is presented.
It is noteworthy that while the API was apparently high in the- mid-1970s, it
lowered steadily from 1977 onwards. On the contrary, % P. falciparum that was
negligible before the mid-1970s showed a remarkable escalation from nearly 1979
onwards. Various irrigation methods related to malaria transmission have been
described by Singh and Puri (1951). Of these, the perennial irrigation system is
considered to have the most adverse influence on malaria incidence, although this
may not become apparent until the system has been in operation for a number of
7.11 Correlation of Canalized Irrigation under National Five-Year Plan. . . 143
Fig. 7.10 Comparison of annual parasite incidence (API; ■) and % P. falciparum (+) as well as
their relationship to the year canal water became available for irrigation (arrow) in Sri Ganganagar,
Bikaner, Jaisalmer, and Jodhpur districts. Note that while the API was apparently high in the
mid-1970s, it lowered steadily from 1977 onwards. On the contrary, % P. falciparum that was
negligible before the mid-1970s showed a remarkable escalation from nearly 1979 onwards
(Source: Tyagi 2003a)
years, and it is especially liable to occur where no provision is made for adequate
drainage. Percolation through embankments markedly raises the subsoil water level
in the surrounding territory leading to the formation of ‘waterlogging’ in vast areas.
This condition is invariably associated with hyperendemic malaria since the vector
mosquitoes, such as An. culicifacies, breed there prodigiously and build up a dense
adult population. Russell (1938), therefore, has emphasized that it is not irrigation
per se, but defective and untidy irrigation which is responsible for vector prolifera-
tion and spread of malaria (Table 7.9).
The Thar Desert now enjoys an appreciably large number of anopheline
mosquitoes, including serious vectors like An. culicifacies and An. stephensi,
many of which did not occur earlier within the precincts of the Thar Desert
(Table 7.9).
This has clearly indicated towards a change in the climate and physiography of
the Thar Desert as evidenced by the fact that in the truly desertic environment (nearly
79%) of the Thar, the mosquito An. stephensi, chronologically the oldest vector in
the desert and best adapted to breed in ‘tanka’ and ‘beri’ for its successful survival, is
still the most dominant species. In the canal-irrigated areas, on the other hand, clearly
Table 7.9 Chronological relationship between anopheline fauna, malaria prevalence, and extent of
canal irrigation in the Thar Desert
Number of Irrigation
vector species Malaria casesa (in hax106)
Period Primary Secondary Pv Pf (%)
Pre-1930 1b – – – –
1930–34 1 – – – 0.24
1935–39 1 4 – – 0.24
1940–44 1 4 – – 0.24
1945–49 1 5 – – 0.24
1950–54 1 5 – – 0.24
1955–59 1 5 – – 0.32
1960–64 1 5 – – 0.37
1965–69 1 5 – – 0.71
1970–74 2 5 – – 0.84
1975–79 2 5 639,754 21,649 (4.9) 1.22
1980–84 2 5 98,242 12,422 (12.6) 1.23
1985–89 2 5 110,746 16,533 (14.9) 1.33
1990–94 3 6 368,208 106,963 (29.0) 2.17
1995–2000 3 9 2,45,960 30,077 (10.9) 2.17
a
In all the 11 desert districts organized surveillance began simultaneously only from early 1970s.
b
An. stephensi; although unrecorded, circumstantial evidence points to its occurrence in the interior
desert areas.
Pv = Plasmodium vivax; Pf = Plasmodium falciparum
An. culicifacies, unarguably the most serious vector of malaria in India, is in the
process of establishing dominance. In course of these developments, totally in
consonance with the progress of the various planned Stages (I-III) of the IGNP in
the Thar Desert, P. Falciparum cases also fulminated resulting often in focal and/or
widespread epidemics in the desert population during past several years. Suddenly,
the Thar Desert has become a hot-bed for malaria conflagration on year by year
basis, as epidemics could not be prevented in the absence of any fool-proof
forecasting mechanism.
In order to determine the factors responsible for exacerbating malaria in the Thar
Desert, particularly emergence of epidemics, Tyagi (1996a), Tyagi and Chaudhary
(1997), and Tyagi and Yadav (2001a, b) have put forth several arguments and
attempted to draw a comprehensible correlation between IGNP related water man-
agement and the rise in malaria incidence in the Thar Desert.
In fact the Thar Desert now provides a good model to understand the relationship
between the changing xeric environment and malaria escalation with varying
intensities, particularly outbreaks of the disease, but also the change in anopheline
mosquito fauna, succession of various taxa, the breeding and blood-feeding habits of
vector mosquitoes, vectorial potential of different species, and how water and
environment management can help reduce the disease burden in a newly canal-
irrigated desert ecosystem.
7.12 Insecticide Usage in Health and Agricultural Programmes and Development. . . 145
7.12 Insecticide Usage in Health and Agricultural Programmes

and Development of Insecticide Resistance in Vector
Species
Since the early 1970s when malaria surveillance work had started in Sri Ganganagar
district, mainly the DDT (50% and 75% water dispersible powder) was used in the
indoor spraying of houses to control malaria vectors. However, during emergent
periods malathion and deltamethrin were also employed in border villages. While
the coverage of spraying by the DDT ranged from 61–82.5% (average 62%) of all
houses, with HCH the coverage ranged between 63.1 and 84.9% (average 79.5%).
The DDT was invariably sprayed in two rounds as compared to normal 2–3 rounds
of the HCH. Incessant usage of DDT, in particular, made the targeted vector
mosquito populations resistant to it. Sharma et al. (1995) reviewed the susceptibility
status of important malaria vectors, An. culicifacies and An. stephensi, against
various different residual insecticides in vogue and concluded that An. culicifacies
had developed resistance more strongly than An. stephensi (Table 7.10).
Sharma et al. (1995) also pointed out similar results for Jaisalmer district where
susceptibility status of these vectors ranged between 20–30% following 24 hrs of
exposure to DDT 4% and dieldrin 0.4% impregnated papers. Bansal & Singh (2001)
determined LC50 (0.0046 mg/l) and LC90 (0.104 mg/l) for An. stephensi against
temephos and certain other insecticides otherwise used as an adulticide and found
that the lethal concentrations were quite higher than prescribed doses to effect
desired amount of mortality. Singh and Bansal (2001) determined the resistance
status of An. stephensi, An. culicifacies, An. subpictus, and An. annularis from
Barmer, Bikaner, and Pali districts against DDT and dieldrin and found them tolerant
to the insecticides (mortality <80%), but almost completely susceptible to
fenitrothion and permethrin (mortalities >98%) and moderately resistant to mala-
thion and propoxur (mortalities 80–98%). They suspected development of cross-
resistance to insecticides in some vectors at least.
Table 7.10 Laboratory evaluation of susceptibility status of An. culicifacies and An. stephensi to
different adulticides in selected desert districts in Rajasthan
Insecticides Mortality (%) in An. Mortality (%) in An.
District used culicifacies stephensi
Bikaner DDT 4% 19.3% –
Sri Ganganagar DDT 4% 6.6% –
Dieldrin 0.4% 5.0% –
Jodhpur DDT 4% 10.0% 40.0%
Dieldrin 0.4% 25.0% 35.0%
Barmer DDT 4% 40.0% 32.0%
Table 7.11 Malaria vectors with species complexes in the Thar Desert
No. of Nomenclature Sibling species
sibling assigned to sibling Sibling species found in the Thar
Species species species found in India Desert
An. culicifacies 5 A,B, C,D and E All A, B and C
An. fluviatialis 3 S,T and U All Not known yet
An. subpictus 4 A, B, C and D All Not known yet
An. annularis 2 A and B All Not known yet
7.13 Species Complexes in Vectors of the Thar Desert
As far as the Thar Desert is concerned, sibling species have been confirmed to be
occurring in An. culicifacies, An. subpictus and An. fluviatilis (Table 7.11). Anophe-
les stephensi does not possess any species complex.
Anopheles culicifacies complex comprising five species (A, B, C, D, and E) is the
most important group in which except species C, all are vectors. It is now confirmed
that species A, which is a vector, occurs prodigiously in the canal- irrigated areas
(Subbarao et al. 1999). From the point of view of distribution of sibling species in
different vector species complexes, the Rajasthan State is stratified in Division I and
II. The north-eastern districts of the Thar Desert like Sri Ganganagar, Hanumangarh,
Churu, Jhununu, and a part of Bikaner and Sikar are classified into Division I, which
is characterized to harbour species A in the irrigated areas. The remaining districts in
the Thar Desert are grouped into Division II where species B and C are most
common. Therefore, it is suggested that areas with species A and C need be
thoroughly monitored for various behavioural characteristics to help design the
control strategies more purposefully.
As regards An. annularis, An. subpictus, and An. fluviatilis still nothing is
determined about the sibling species prevailing in the Thar Desert, and this presents
a new pathway for future research.
7.14 Anopheles stephensi-Anopheles culicifacies

Distribution-Based Classification of the Thar Desert
Soon after the introduction of the three major canal systems, viz., Gang Canal,
Bhakra-Sirhind Feeder Canal, and Indira Gandhi Canal (with a gargantuan
10,000 km network of distributaries as Indira Gandhi Nahar Pariyojana, IGNP), in
the Thar Desert, the anopheline fauna was also immensely impacted in expanding
distribution. Due to perennial flow of canal waters, irrigation channels, and increase
in surface water and water-logged lands, not only had several new mosquitoes made
entry in the Thar Desert, but also the vector species, too, changed their breeding
behaviour. The most startling change in behaviour was noticed in An. stephensi,
which, in addition to its ‘container breeding speciality’, also tended to breed in
7.14 Anopheles stephensi-Anopheles culicifacies Distribution-Based. . . 147
Fig. 7.11 A new classification of the Thar Desert based on distribution of the two major malaria
vectors, Anopheles stephensi and Anopheles culicifacies (Tyagi 2002)
surface water of variety, more or less in association with An. culicifacies (Tyagi et al.
1997; Tyagi 2002). By the mid-1990s the distributional limits were almost
formalized in view of the maximum canalized irrigation water supply to the Thar
Desert.
Based on this information, Tyagi (2002) had proposed a new classification of the
Thar Desert based on presence of the two major malaria vectors, An. stephensi and
An. culicifacies, either alone or in combination (Fig. 7.11).
Anophelenization of the Deserts
8
8.1 Introduction
For millions of years mosquitoes, including anophelines, have been inhabiting

countries and/or zones in the tropical and subtropical regions. This process of
species’ chorogeography, however, appears to have occurred slowly and in
steps—from tropical (warmer temperature) to subtropical (less warmer temperature)
parts, ecosystems, and especially high altitudes, or even colder Arctic region and
the Greenland. As exemplified by the currently sole mosquito-free spot on the
Earth, Iceland, it can be assumed that similar non-mosquito ecosystems or habitats
were in existence in remote past at various different points of time. This implied
that each of such non-mosquito lands was first invaded by a few mosquitoes, which
in course of time adapted to new conditions and subsequently colonized there.
Exactly the same phenomenon has occurred in case of Anopheles mosquitoes
(‘Anophelenization’) which more or less dispersed to far-flung areas with human
migration in search of new sources of food and fodder, and still possibly carrying the
malarial parasites.
8.2 The Phenomenon of Anophelenization
The phenomenon of Anophelenization is an important chorogeographic and evolu-

tionary process, and is common to both vector and non-vector species; in case of the
former, the term applicable more specifically is ‘Vectorization’. The phenomenon of
‘Anophelenization’ is different from that of ‘Anophelism’ (Rao 1984; Fantini 1994)
in which case several Anopheles species exist in a territory sans the presence of
malaria—a phenomenon which is both an ecological and epidemiological puzzle
(Fantini 1994). ‘Anophelenization’, a new coinage by the author in the realms of
malariology, is a phenomenon where a given area or region, originally a terra
incognito for a given Anopheles species, is first gradually frequented by the invasive
species, then established and finally populated enormously (Fig. 8.1). The
Ltd. 2023
150 8 Anophelenization of the Deserts
Fig. 8.1 Schematic presentation of the ‘Anophelinization’ phenomenon: (a) an Anopheles species
(red), vector or non-vector, enters a new territory already housing other species (black); (b) the
invasive species slowly adapts new territory/environment and populates and expands distribution
together with other native species, and, finally (c) the invasive species populates copiously over a
vast stretch and manifests its stupendous presence in the new/invaded territory. (Source:
B.K. Tyagi, this work)
best examples in modern time include Anopheles stephensi, the most important
invasive malaria vector in both urban and rural agglomerations, particularly arid
environments in the African Sahara Desert.
In modern context of chorogeography of Anopheles or for that matter any
mosquito species, it is difficult to believe a country without mosquitoes. But, yes,
this is demystified by the fact that a European country called Iceland is the only
nation in the world where no mosquito exists, although in the Iceland’s
neighbourhood countries like Norway, Denmark, Scotland, and even Greenland
mosquitoes exist in plenty—which only adds to the mystery.
8.3 Chorogeography of Anopheline Mosquitoes
The global climate change seems to have been playing a key role in deciding the
geographic range of mosquitoes, in the present context the Anopheles. Availability
of water, from the resourceful ground or precipitation, besides commensurate ambi-
ent temperature, is the key factor for mosquito presence, and this invaluable source is
either wanting or at best scarcer and even ephemeral in the critically arid
environments, the deserts. Recent snowfall in Ain Sefra, a town in Algeria in the
northern African Sahara in January 2022, the record fifth time during past four
decades only in one place, in addition some others in both Africa and Arabian
Peninsula, has prompted many scientists to proclaim that during the next 1500 years
the Sahara would be likely transformed into a verdant environment.
A desert like the Thar Desert in north-western India makes a classical example of
the possible ‘Anophelenization’. Historically, several thousand years ago, and
8.3 Chorogeography of Anopheline Mosquitoes 151
Fig. 8.2 Tributaries of the Vedic Saraswati flowing through the Thar Desert. Paleochannel view.
(Source: Free Wikipedia)
possibly before the birth of the present day’s Thar Desert, a perennial river,
Saraswati, was flowing across the region, as evidenced by soil attributes, together
with fossilized fauna and flora (the natural north-southern land gradient as well as
plentiful molluscan shells are a testimony to this fact). Ghaggar river, too, was
flowing through the region but later dried partly and, currently, ends up in the
Thar Desert. In the passage of time the mighty and sprawling Thar Desert rose and
the river dried. Some experts consider the Thar Desert to have emerged nearly
10,000 years ago, while others maintain that aridity started in this region much
earlier. Remote sensing techniques amply demonstrate that Late Quaternary climatic
changes and neotectonics have played a significant role in modifying the drainage
courses of the region, and a large number of palaeochannels exist. These
palaeochannels of the Sarasvati river (6000–3000 BC) coincide with the bed of
present day Ghaggar and give gargantuan evidence that the Sutlej river along with
the Yamuna river once flowed into the present Ghaggar riverbed (Fig. 8.2). It has
been postulated that the Sutlej was the main tributary of the Ghaggar and that
subsequently the tectonic movements might have forced the Sutlej westward and
the Yamuna eastward, causing the Ghaggar to dry up.
The Thar Desert, also known as the Great Indian Desert, encompasses
92,000 km2 of rolling sand dunes mostly in the north-western Indian state of
Rajasthan (90%) and in the eastern Pakistan (10%). Small portions of the desert
also extend into the Indian states of Haryana, Punjab, and Gujarat. The Thar Desert is
defined by a series of natural borders, including the Aravalli Mountain Range to the
southeast and the Punjab plain in the north and north-east. To the west, lies the Indus
plain, and to the south, the Rann of Kutch. The geographic isolation of the Thar
Desert by mountain ranges and plains contributes significantly to the weather

patterns that shape its distinctive, hot, dry environment. The environment around
the Thar effectively absorbs all the rain that is carried in the monsoon clouds before
the clouds can reach the desert. The resulting monsoon winds in the desert are hot
and dry, and the desert does not share in the wet season experienced in surrounding
terrains. Perpetually rolling sand dunes is the most remarkable feature of the Thar
Desert, the 18th largest desert land. It is undoubtedly the most inhospitable
ecoregion in the Indo-Pacific region.
The Indus/Sindhu Valley settlements (one of the oldest Civilizations in the
world), beside the Sindhu river close to the Thar Desert, existed about 8000 years
ago, as determined through carbon dating techniques on animal remains and pottery
fragments. This clearly implies that the Thar Desert was at that time a complete
wasteland without any trace of humans. The Thar Desert, virtually wanting in any
surface water source or precipitation, was also entirely inhospitable to human and
cattle living, thereby rendering no support of any kind for any vector breeding and/or
establishment. It was the Thar Desert sans any mosquito, then.
Subsequently, in the course of evolution of human civilization from the cradle of
Indus/Sindhu Civilization, it appears that some humans together with their cattle
(mostly camels) cruised toward (desert fringe) and through the Thar Desert, in search
of safe and resourceful niche. Those who settled in the vast stretches of the desert
toiled hard to engineer their way to quest water or harvest water from whatever little
precipitation came their way. This is how some of the man’s oldest ‘water potting’
means, ‘Beri’ and ‘Tanka’, in that order, came into being—to conserve water for all
kinds of vital use, and for survival of both man and animals in the harshest
environments. This desert dwelling human behaviour was the first example under
the Sun.
On the other hand, because of human mobility and their innovative water storing
behaviour in the Thar Desert, a mosquito—an anopheline—also evolved
synanthropically, to hideously match, and yet so brilliantly, the human behaviour
relating water storage, for its own survival. It was An. stephensi, a specialist
pot-water breeder. Here it is noteworthy to mention that the general term pot-water
is being used in specific reference to ‘Beri’ and ‘Tanka’- the earliest of the under-
ground water-conservation innovations by the desert dwellers. Later, as humans
expanded their distribution across the plains of India’s mainland and, with the time
passing and the human population exploding and congregating into a fast growing
new phenomenon of establishment of towns, large cities, and megapolises with
mostly multi-storied skyscrapers, etc. touched new heights, An. stephensi also kept
pace with the anthropization and dynamically adapted to invariably every kind of
water-storing behaviour of man. The ability of the larval stages of An. stephensi to
develop in urban areas, making use of artificial containers such as domestic wells,
cement tanks, overhead water tanks, room coolers, cisterns and roof gutters, and in
water bodies in construction sites and other industrial localities, brings malaria
transmission into densely populated areas including the major cities of India such
as Delhi. The only condition applied is that water must be more or less fresh, without
Table 8.1 Degree of Reflex Immobilization (RI) or thanatosis exhibited and time taken for
keeping submerged by the various instars of Anopheles stephensi
Time taken for submergence in seconds (3 replicates)
Average Standard Deviation Variance Reflex Immobilization
Instar time (SD) (ϰ2) (RI)
1st 0.35 1.01 1.01 Low
2nd 1.17 0.53 0.29 Low
3rd 2.26 0.53 0.29 Medium
4th 5.5 1.63 2.66 Highly pronounced
Pupa 1.12 1.98 3.93 Absent
any pollution and vegetation or even decaying organic matter. This specific character
made An. stephensi relate to the human behaviour rather more strongly.
Anopheles stephensi is the only malaria vector in the world which is so strongly
adapted to freshwater potting/reserving systems whether a shallow cement tank or a
well as deep as 40–50 ft. and as narrow as 3 ft. In the Thar Desert the species has
been observed to overwinter; while reserve a good amount of fat bodies to support
supply of energy through a short but inimical weather and low temperature. Also,
An. stephensi is the first mosquito species in which the phenomenon of reflex
immobilization (RI) or thanatosis (death-feigning behaviour)—a defence mecha-
nism which many animal species, both vertebrate and invertebrate, exhibit to thwart
attention of their predators (Edmunds 1974; Corbet 1962; Tyagi 1994a, b, c, d, e, f, g, h).
All larval instars exhibited some degree of the RI, although fourth instar manifested
the highest; pupae ranked among the lowest (Table 8.1). The only other mosquito in
which reflex immobilization has been reported is again an anopheline mosquito (An.
subpictus), though in adults sampled in the Serula forests along the Tapti river in
southern Gujarat, unlike that in the Thar Desert’s An. stephensi in which the RI was
observed in the aquatic stages (Tyagi 1984).
Thanatosis and reflex immobilization do not mean quite the same but both
attribute to the state of immobilization of the living organism being ‘disturbed’ or
‘attempted for a prey by another superior organism, thus feigning thanatosis as a
defensive mechanism to deceive momentarily the predator for a rather lifeless object
and escape the danger of predation. The larvae of An. stephensi are adapted to dive
deeper in the well-like underground water storing practices, such as ‘Beri’ and
‘Tanka’ in the Thar Desert, and remain submerged for a long period (Rao 1984;
Tyagi 1994a, b, c, d, e, f, g; Tyagi and Verma 1991; Tyagi 1992a, b; Tyagi et al.
1992). While the trait related to feigning death or thanatosis provides a successful
defensive mechanism to safeguard against physical assault or predation, the attribu-
tion to remain submerged for a long time is certainly an advantageous adaptation
commensurate with the interspecific competition for food and space within a limited
space of ‘Beri’ and/or ‘Tanka’, in particular. This also enabled An. stephensi larvae
to take advantage to devour while submerged, in addition to when coming to surface
(Tyagi 1994f). Interestingly pupae did not show any inkling of reflex
immobilization.
It is noteworthy here that the Thar Desert, besides being the most inhospitable
ecoregion in the Indo-Pacific region, is the world’s most populated desert
(>80 persons/sq. km). This implies that An. stephensi breeding man-made ‘Beris’
and ‘Tankas’ abound in thousands in the overall span of nearly 96,000 sq. km. Thus
Anopheles stephensi became the original and foremost anopheline mosquito which
must have evolved and established in the Thar desert. Since the human dwellings
and cattle-sheds, if at all existing, are approximated the mosquito invariably feed
with freedom on both man and animals. Since the ‘Beris’ and ‘Tankas’ are generally
loosely covered at the lid, the mosquito has all the freedom to enter, breed and
populate in these desertic reservoirs. Its preponderance in the Thar Desert has
become a phenomenon of ‘Anophelenization.’
As we will see elsewhere in the book, with the advent of a massive canalization—
a combination of three canals, viz., the Gang Canal, Bhakra-Sirhind Feeder Canal,
and Indira Gandhi Canal—in the Thar Desert, anophelines such as An. culisifacies
and An. subpictus which entered the penetralium of the desert’s arid environment
also anophelenized, albeit breeding in altogether different surface water sources
(Table 8.2).
Though in the mainland peninsular India An. stephensi has been existing in all the
five States of Karnataka, Telangana, Andhra Pradesh, Tamil Nadu, and Kerala,
nonetheless its entry in Kerala State has been confirmed rather recently (Sharma
and Hamzakoya 2001). Soon afterwards the vector seems to have entered the
Lakshadweep Archipelago during early 1990 and since then gained a permanent
foothold on these islands due to the availability of a large number of community and
rain-harvesting cement storage tanks. It is noteworthy that malaria was already
reported in Lakshadweep islands two decades ago (Roy et al. 1978). These
developments also threaten the northern islands of Maldives which are about
90 km south of Lakshadweep, where water storage practices are identical (Sharma
and Hamzakoya 2001).
Table 8.2 Possible evolutionary correlation between the anopheline fauna, malaria incidence, and
the extent of canal irrigation in the Thar desert
Number and names of anopheline mosquitoes
Vector species Non-vector species
Period No. Name No. Name
Pre-1930 1 An. stephensi – –
to
10,000 yrs
1930– 1 An. stephensi – –
1934
1935– 2 An. stephensi, An. 4 An. subpictus, An. annularis, An. vagus, An.
1939 culicifacies splendidus
1944 culicifacies splendidus
1949 culicifacies splendidus, An. barbirostris
1955– 2 An. stephensi, 5 An. subpictus, An. annularis, An. vagus,
1959 An. culicifacies An. splendidus,An. barbirostris
1990– 3 An. stephensi, An. 6 An. annularis, An. subpictusc, An. vagus,
1994 culicifacies, An. An. splendidus, An. nigerrimus, An.
fluviatilis barbirostris
1995– 3 An. stephensi, An. 9 An. annularis, An. subpictus, An. vagus, An.
2021 culicifacies, An. splendidus, An. nigerrimus, An.
fluviatilis pulcherrimus, An. d’thali, An. barbirostris
(a) Until the late 1980s An. culicifacies was recorded only from desert fringe urban areas, e.g.,
Bikaner; (b) An. fluviatilis is yet to be incriminated with malaria parasites in the Thar Desert, though
it is a very efficient vector in southern Rajasthan; (c) An. subpictus is rarely incriminated in the Thar
Desert
Sibling Species Complexes of Malaria
Vectors in Major Deserts 9
9.1 Introduction
A species complex is primarily a taxonomic phenomenon of immense evolutionary

importance, which is fairly common among arthropods, and carries additionally a
great epidemiological significance in context with vector-borne diseases such as
malaria. In Culicidae, when a mosquito species consists of a group of closely related
species which are morphologically nearly indistinguishable and may share the same
ecological niche (sympatry), but not interbreeding among themselves at all, it is
referred to as a species complex. Correct identification of such complexes among
dominant vector species (DVS; Sinka et al. 2010, 2011, 2012, 2020; Sinka 2013),
with their zoogeography mapped and behavioural differences against insecticides
deployed in the indoor residual spraying (IRS) recorded, help the vector control
campaigners to design malaria control efforts effectively without losing sight on the
vectors’ bionomics and epidemiological importance. A species complex differs
strikingly from a mere species which is a group of individuals that are morphologi-
cally, geographically, and ecologically alike but are reproductively isolated from
such another group (e.g. subspecies, populations). The complexity of species
complexes can be understood from the fact that within a specific group such as
Anopheles gambiae in Africa and An. culicifacies in India, there are both the deadly
vectors (primary vectors) and less efficient vectors (secondary vectors) or species
without any transmission potential. This implies that it is of paramount importance to
know beforehand undertaking a control measure in an endemic or outbreak-hit area
as to which species in the complex is primary, secondary, or carry no importance
epidemiologically. Malaria endemic deserts of the world house some of the species
of a complex that derives a great deal of epidemiological significance due to their
differential transmission potential, e.g. Anopheles arabiensis in the Sahara Desert
(Africa) and An. culicifacies in the Thar Desert (India).
Mosquito systematics and phylogeny are often complicated by the excessive
nature of species complexes, more specifically under the genus Anopheles. By an
estimate there could be more than 50 species complexes under Anopheles which is
Ltd. 2023
158 9 Sibling Species Complexes of Malaria Vectors in Major Deserts
represented by 465 formally recognized species throughout the world (Sinka 2013).
Of these, about six dozen species (70#) are vectors of some measure while 41 are
confirmed primary vectors of malaria transmission.
9.2 Species Complexes in Deserts
Some of these species complexes have extended into the deserts, although no
complete species complex is specifically limited to the arid environments of the
deserts.
Anopheles arabiensis is a member of the An. gambiae complex, which is most

common in Africa south of Sahara (Sinka 2013). It is also a major vector, perhaps
along with An. quadriannulatus, in the Sahara Desert. There is a suspicion that a new
species sympatric with An. quadriannulatus exists in Ethiopia, but until more
evidences are brought on record it has been designated as An. quadriannulatus ‘B’
(Hunt et al. 1998). As far as deserts are concerned, following vector mosquito
species complexes needs careful attention. Anopheles sergentii is a species complex
in Africa and Middle East, hence described under the latter below.
9.2.2 The Middle East/West Asia/Central Asia Deserts
Anopheles sergentii, a dominant vector, is associated with oases, hence deriving the
sobriquet, ‘oasis vector’. Due to its ability to cope with the extreme climates across
this region and specific propensity to breed in the oases, Anopheles sergentii has
become the most important ‘desert malaria vector’ whose distribution is synchro-
nous to the distribution of oases across the Saharan belt in northern Africa and into
the Middle East (Fig. 9.1). Besides oases, the vector can breed in a large selection of
habitats including streams, seepages, canals, irrigation channels, springs, rice fields,
and most other non-polluted, shallow sites that contain fresh water, but also some-
times brackish habitats, with a slow current, slight shade (exceptionally in full
sunlight), and emergent vegetation or algae—the latter being the only characteristic
common to all larval habitats of this species.
An. sergentii, principally a zoophilic species, is still an important malaria vector.
The mosquito has been found uncharacteristically feeding on humans and/or animals
both indoors and outdoors, and, therefore, its exo-/endophilic and exo-/endophagic
status is unclear. Like An. stephensi in the Thar Desert (Tyagi 2002), An. sergentii
can also tide over extremely low temperature (overwinter) as both adult females and
larvae, in the desert environment of the African Sahara, the Arabian Peninsula, and
the Middle East/West Asia.
9.2 Species Complexes in Deserts 159
Fig. 9.1 Distribution of Anopheles sergentii in Africa, Arabian Peninsula, and Middle East/West
Asia (Source: Free Wikipedia)
As a “desert malaria vector” Anopheles sergentii prominently represents the

northern Africa, the Mediterranean basin, and the Middle East (viz., Albania,
Algeria, Bulgaria, Burkina Faso, Cameroon, Chad, Côte d’Ivoire, Djibouti, Egypt,
Eritrea, Ethiopia, Greece, Guinea, Iran, Iraq, Israel (and Gaza Strip & West Bank),
Italy (includes Sicily), Jordan, Libya, Kenya, Mali, Morocco, Pakistan, Portugal,
Saudi Arabia, Senegal, Spain (including Canary Islands), Somalia, South Sudan,
Sudan, Tunisia, United Arab Emirates (UAE), and Yemen). Anopheles sergentii is
found from Algeria and as far south in Africa as Kenya and Cameroon, northeast to
Italy, Greece and Albania, and southeast to Pakistan.
Anopheles sergentii comprises two valid subspecies: (1) An. sergentii sergentii
described from Algeria and (2) An. sergentii macmahoni Evans described from
Kenya. Anopheles sergentii macmahoni appears limited to the sub-Saharan belt of
Africa. The subspecies macmahoni has one synonym—An. barkhuusi Giaquinto-
Mira, described from Ethiopia. These two taxa are placed in the Demeilloni Group
(Myzomyia Series) along with six others—An. carteri Evans & de Meillon, An.
demeilloni Evans, An. freetownensis Evans, An. garnhami Edwards, An. keniensis
Evans, and An. lloreti Gil Collado.
9.2.3 The Thar Desert in India
There are as many as six Anopheles species in India which are complexes of sibling
species, of which four occur in the Thar Desert (Table 9.1). These complexes carry
immense epidemiological significance since some of these are vectors, which only
need to be targeted for controlling.
Some of these are annotated below:
1. Anopheles culicifacies Giles
Anopheles culicifacies, which also has its cradle in the central India, is the most
important vector responsible for more than 65% of malaria cases in the country
particularly in the rural environments. The species, despite its wide distribution in
the Indian subcontinent (Nepal, India, Pakistan and Sri Lanka), in addition to several
Southeast Asian countries (e.g., Vietnam, Cambodia, Lao PDR and southern China),
and extending on the other hand as far as Yemen in the Middle East as well as Eritrea
in the Horn of Africa (Sinka et al. 2011), has been extensively investigated in India
Table 9.1 Sibling species complexes of Anopheles mosquitoes in India

No. of Species of Sibling species in
sibling complex complexes duly named
Species species Designated species in India taxonomically
An. 5 A,B,C,D and E A,B,C,D –
culicifacies and E
An. 4 S,T,U and V S,T and U –
fluviatilis
An. 4 A,B,C and D A and B –
subpictus
An. 2 A and B A and B –
annularis
An. dirus 7 A,B,C,D,E and F, as well as D and E Species A = An. dirus s.
a duly named species, plus s.,
another species though an Species B = An. cracens,
incertae sedis. Species C = An. scanloni
Species D = An. baimai
Species E = An. elegans
Species F = An.
nemophilous and An.
takasagoensis
(additionally, a cryptic
Species tentatively
designated as An. aff.
Takasagoensis)
An. 4 An. sundaicus s.s. An. An. sundaicus s.s., An.
sundaicus sundaicus spiroticus (formerly
s.s. species A), An.
sundaicus species D and
An. sundaicus species E.
and Sri Lanka (Surendran et al. 2000; Jude et al. 2010; Subbarao 1988; Subbarao and
Sharma 1997; Amerasinghe et al. 1999; Barik et al. 2009). Save for the Species B
(which is a highly zoophilic species, hence a non-vector; Subbarao 1988;
Vatandoost et al. 2004; Dev 2020), all others are vectors with some degree of
potential to transmit malaria, but Species E, owing to its highly anthropophilic and
endophilic behaviour, is singularly the most virulent of all vector species to transmit
with equal prowess the parasites, P. vivax and P. falciparum (Subbarao et al. 1988;
Sharma 1998; Kar et al. 1999; Surendran et al. 2003). These cytospecies are best
identifiable and distinguishable from each other through cytotaxonomic methods
(Figs. 9.2 and 9.3).
These five sibling species overlap each other in distribution in different
proportions and a clear understanding of whether a vector or two among them is
predominantly prevalent is to be inevitably determined to understand the intensity of
malaria transmission, on the one hand, and to bring about effective vector control, on
the other (Fig. 9.4).
As far as the Thar Desert is concerned, species A and B have been diagnosed
there. Both these species overlap each other in large areas and there is hardly any
area which is species-specific. As a result, controlling the vector species in the
complex through indoor residual spraying is often very challenging (Fig. 9.5).
2. Anopheles fluviatilis Species Complex
A dangerous vector for malaria contributing approximately 12–15% of all the

annually reported cases, An. fluviatilis is next only to An. culicifacies in intensity of
malaria transmission in India, with Species ‘S’ being the vector due to its strong
anthropophilic and endophilic behaviour (Fig. 9.6). Anopheles fluviatilis s.l. is
distributed widely in the sylvatic-cum-mountainous regions and foothill areas of
India, Nepal, Bangladesh, and Myanmar and certain southwestern Asia nations like
Iran, Pakistan, and Afghanistan.
India and Iran are the only two countries where the biology, distribution, dynam-
ics of orientation for feeding, and ecology of the An. fluviatilis complex have been
extensively studied. Adapted to breed in fast flowing mountain rivulets, An.
fluviatilis still can abundantly breed in wide-ranging man-made habitats such as
irrigation canals, borrow pits, domestic wells, tanks, and gutters as well as natural
sites such as stream margins and rock pools in terai area in the foothills of northern
States of India as well as the Eastern and Western Ghat regions, where the larvae of
this complex are associated with fast-flowing water in streams or river margins.
Apparently, the species prefers fresh water sites in comparison to brackish water
habitats.
3. An. subpictus
Anopheles subpictus Grassi s.l. is a primary (Malaysia, Indonesia) or a secondary

malaria vector (India, Sri Lanka) in different Southeast Asian countries; in Sri Lanka
it is secondary to Anopheles culicifacies Giles s.l.
X chromosome
ab
+a +b
b b b
a
a a b
a
Chromosome arm 2
1 1 1
+g +h i1 +h g1 +h
1 1
+g h1
1
+i i1
h1
h1 h1
h1
h1
h1 h1
h1
i1
g1
g1 i1 g1
g1
g1 g1
i1
i1
Species A Species D Species B Species C
Fig. 9.2 Anopheles culicifacies sibling species complex (Four only; A, B, C, and D) in a schematic
representation of polytene chromosomes (Source: WHOSEARO 2007; allowed with
acknowledgement)
Fig. 9.3 Anopheles culicifacies: Mitotic karyotypes; (a–c) chromosomes prepared from larval
brain tissue; (a) Species B female, (b) Species E male with submetacentric Y-chromosome, and (c)
Species B male with acrocentric Y-chromosome (Source: WHOSEARO 2007; allowed with
acknowledgement)
Fig. 9.4 Distribution of Anopheles culicifacies sibling species complex in Asia, and parts of
Middle East and Africa (Source: Dev 2020, 2022)
Polytene chromosome banding patterns are the most dependable attributes,

which, suitably supported by stage-specific morphometric traits, characterize all
the four sibling species (A–D) within the An. subpictus complex (Fig. 9.7). Like
India where the species and the complex have both been extensively studied
(Reuben et al. 1984), all four sibling species of the Subpictus Species Complex
have been described in the neighbouring island nation of Sri Lanka (Pavillupillai
et al. 2014). Bio-ecologically and behaviourally all the sibling species differ strik-
ingly among themselves, especially in context with breeding habit, fresh or saline/
Fig. 9.5 Western part of

Rajasthan State (India) with
the Thar Desert (indicated Thar Desert
with an arrow) is marked by
the presence of species A and
B in the Anopheles
culicifacies Complex
Fig. 9.6 Distribution of An. fluviatilis sibling species complex (Source: Dev 2020, 2022)
estuarine habitat, and resting habits indoors or outdoors, but also inclination for
blood-feeding (hematophagy) on man (anthropophily) or animals (zoophily). Spe-
cies A is present in the interior of the mainland India, while Species B, a compara-
tively stronger vector, exists in coastal areas (Suguna et al. 1994). In Sri Lanka it is
Species C which occurs inland. In the Indian Ocean’s pearl-island country,
9.3 The Enigmatic Status of Anopheles stephensi 165
Fig. 9.7 Polytene chromosome complement of An. subpictus species A. Break-points of

inversions, a and b, reported by Suguna et al. (1994) are shown on the X-chromosome (Source:
WHOSEARO 2007; allowed with acknowledgement)
Species B, C, and D are both anthropophilic and zoophilic, albeit Species C and D
are endophilic and endophagic, respectively, while species B is outdoor-resting with
no significant preference for indoor- or outdoor-resting (Pavillupillai et al. 2014).
9.3 The Enigmatic Status of Anopheles stephensi
Anopheles stephensi is currently the most intensely investigated species in the world,
due singularly to its following traits:
1. engendering ‘Desert Malaria’ in the Thar Desert,

2. adapting de novo to open ground surface water,
3. most importantly, transcending ecological borders from the Indian subcontinent,

the cradle of An. stephensi, to the Arabian Peninsula, through Iran and Iraq, in the
west of the Thar Desert (India), as well as Bangladesh, southern China, Myanmar,
and Thailand in the east, as the most important urban vector (Krishnan 1954), and
4. recent invasion over new geographic areas so far terra incognito for the species,
such as Djibouti (in the Horn of Africa) and Sri Lanka.
Anopheles stephensi is a notorious vector of urban environments (Rao 1984), but

after its discovery with epidemiological significance for malaria transmission in the
Thar Desert (Tyagi 1995a, b, 2020) the species has assumed an unparalleled
universal significance in the realms of malaria research. Under the changed dynam-
ics of phenotypic and genotypic plasticity, the dubious status of its species complex,
the enigmatic broad behavioural spectrum, e.g., endophily/exophily and endophagy/
exophagy, and rare activity to overwinter in both larval and adult stages during cold
months when temperature crosses approx. 50 °C, render An. stephensi an altogether
different identity and definition (Tyagi 2002). The urban ‘Type’ species (An.
stephensi s.s.) is highly anthropophlic/anthrophagic particularly when people, such
as those practicing water storage in a variety of containers in high-rise multistorey
buildings, a rising urban trait, are more active outdoors during warm months (Rao
1984), and therefore an increased risk of malaria transmission (Subbarao et al. 2019;
Rajagopalan et al. 1987; Tyagi pers. comm.). In general, malaria is considered to be a
disease confined to rural environments, as a simple consequence of the tendency of
anophelines to search for clean and unpolluted larval habitats, and thus the existence
of An. stephensi in such areas is a defining new characteristic of the species. In India,
Sharma et al. (1969) were among the first to have given a clear picture of the
polytene chromosomes of An. stephensi stephensi.
Anopheles stephensi Liston s.l. is regarded to have three subspecies or strains,
viz., the type subspecies, variety mysorensis, and an intermediate. These are classi-
cally distinguishable through cytogenetic techniques (WHOSEARO 2007)
(Fig. 9.8), although recently even more powerful molecular tools have reconfirmed
their presence. The type form is a strong vector and occurs in urban agglomerations;
mysorensis is a poor rural vector in certain pockets, while intermediate is not
showing any trait to assert it is a vector of concern.
In the Thar Desert region, Anopheles stephensi is the major vector of malaria. In
certain parts of Iran An. stephensi var. mysorensis was found as the only vector
transmitting malaria. In these areas, animal hosts were very low in number or were
totally absent. It is most interesting to note here that very recently this species is
speculated to be a complex based on examination of odorant binding protein 1 intron
I sequence in An. stephensi specimens collected from Iran and Afghanistan
(Firooziyan et al. 2018). The three biological species recognized as species A, B,
and C correspond to type form, intermediate form, and var. mysorensis, respectively.
Singh et al. (2021a, b) have refuted existence of the biological species. According to
them, AsteObp1 cannot serve as a marker for the identification of biological forms of
An. stephensi. The probable existence of sibling species in An. stephensi based on
the AsteObp1 intron-1 is thus refuted.
9.3 The Enigmatic Status of Anopheles stephensi 167
X 2 3 4 5
c
a
f1 i1 p1
c
p1
c g1.d
d a
i1 o1 q
f1
c1
f1
a.b e1.g1
d
d e1.f1 r1
n1
c c.c1 q
a b q1
d1
m1.n1.r1
o1
c.b1
d1.h1
b q1
m1
b1
g1
h1
h1
b
g1
h1
Fig. 9.8 Photomap of An. stephensi polytene chromosomes showing the break-points of the
inversions (Source: WHOSEARO 2007; allowed with acknowledgement)
Since An. stephensi is principally an urban vector, its control is naturally beset
with certain comprehensible operational constraints such as refusal of inhabitants to
allow spraying on the walls due to fear of stains left behind, repulsive smell of the
insecticides deployed in spraying, and, above all, contamination of living environ-
ment. Therefore, the main strategy to interrupt malaria transmitted by An. stephensi
in urban areas is generally based on larval control under the urban malaria scheme,
also followed by National Centre for Vector Borne Diseases Control (the erstwhile
Vector Borne Disease Control Programme, NVBDCP). However, in rural areas of
Rajasthan where this species is reported resting and biting indoors, the indoor
residual spraying is additionally practiced. Reacting to the excitorepellent properties
of insecticides like the DDT in Rajasthan, An. stephensi shifted much of its resting
behaviour from resting on walls during the pre-DDT era to that of the household
objects (e.g., hanging clothes, furniture, stacked clothes), to prevent contact with the
insecticide-sprayed surface on the wall.
Anopheles stephensi Liston 1901: Origin
and Chorogeography—A New Hypothesis 10
10.1 Introduction
Anopheles stephensi is an important malaria vector in several Middle East and South
Asian countries, most eminently in the urban India as well as its vast expansion in the
Thar Desert region (Zahar 1985, 1990a, b; Tyagi 2002; Ishtiaq et al. 2021). About
12% of malaria cases in India are due to An. stephensi (Sharma 1999). Apart from
malaria, in which case it is a serious vector for Plasmodium falciparum, the mosquito
An. stephensi is a vector of bovine leukaemia virus (Anon. 2019) and Plasmodium
berghei (Mack et al. 1979).
Anopheles stephensi is included under the same Subgenus—Anopheles—as is
Africa’s deadliest malaria vector, An. gambiae (Valenzuela et al. 2003). However,
though An. gambiae consists of a complex of morphologically identical species of
mosquitoes, along with all other major malaria vectors (An. arabiensis, An. funestus,
and An. sergentii), An. stephensi has not yet been identified to comprise any sibling
species complex (cf. Firooziyan et al. 2018), albeit two races in existence based on
differences in egg dimensions and the number of ridges on the eggs (Malhotra et al.
2000), exhibiting differential potential for malaria transmission:
1. Anopheles s. stephensi s.s., or the ‘type form’ (14–22 ridges on the egg-floats;
Subbarao et al. 1987), is the most dangerous malaria vector among all three forms
in the urban areas of India (Sharma 1986a, b) (Fig. 10.1). The ‘type form’ is never
encountered in rural areas (Subbarao et al. 1987). It is noteworthy here that the
species status of the desert specialist and the originally most dominant vector, An.
stephensi, which has been prominently incriminated in the Thar Desert, is still
evading a proper resolution (Tyagi et al. 1991). Indeed the Thar Desert’s An.
stephensi is neither ‘mysorensis’ nor ‘intermediate’ form which only occur in
rural environments, and certainly absolutely inevitably different from the ‘type’
form, which has no distribution outside the urban habitations.
Recently Chakraborty (2021) decoded the genome of An. stephensi and shed a
new light on genome evolution and phenotypic variations in the species via novel
species-specific transposable element (TE) families and insertions in functional
Ltd. 2023
170 10 Anopheles stephensi Liston 1901: Origin and Chorogeography—A New Hypothesis
Fig. 10.1 Anopheles stephensi Liston 1901 (Source: Free Wikipedia)
genetic elements. They revealed new candidate genetic elements and such
29 hidden members of insecticide resistance genes which were previously
unknown. They also identified seven new male-linked gene candidates, by far
the highest for any mosquito, and 2.4 Mb of the Y chromosome. The Y-linked
heterochromatin landscape revealed extensive accumulation of long-terminal
repeat retrotransposons throughout the evolution and degeneration of this chro-
mosome. More recently, Thakare (2022), working genomics on a 2016-collected
Chennai (IndCh) strain of An. stephensi, reported the genome assembly of the
type-form. The genome reported with an L50 of 4, completes the trilogy of high-
resolution genomes of strains with respect to a 16.5 Mbp 2Rb genotype in An.
stephensi known to be associated with adaptation to environmental heterogeneity.
2. Anopheles s. mysorensis, the ‘variety form’ (9–15 ridges on the egg-floats;
Subbarao et al. 1987), exists in rural and semiurban areas and exhibits consider-
able zoophilic behaviour, making it a poor malaria vector in western and penin-
sular India (Rao 1984; Malhotra et al. 2000), but a highly detrimental vector
species in certain areas of Iran (Sinka et al. 2011), and,
3. Anopheles stephensi ‘intermediate form’ (12–17 ridges on the egg-floats;
Subbarao et al. 1987) also exists in rural communities and peri-urban areas,
though its vector status is unknown (Basseri et al. 2008; Sinka et al. 2011).
Chavshin et al. (2014) have recently molecularly characterized all the three
biological forms and highlighted the malaria transmission potential of Anopheles
stephensi in southern Iran by counting sporozoite rate.
In the backdrop of information of three forms of An. stephensi, Tyagi et al. (1991)
had demonstrated that the Thar Desert populations of An. stephensi are of relatively
larger size (likely ‘type’ species) than those found in other parts of India and
10.2 Classification 171
elsewhere and propounded his hypothesis of the possibility of a sibling species

complex for An. stephensi. Recently, Firooziyan et al. (2018), based on odorant
binding protein Ansteobp1 (OBP1) intron I sequences, introduced a new robust
molecular marker for identification of its biological forms, viz., mysorensis, inter-
mediate, and type, using insectary colony specimens in Afghanistan. They suggested
as new Anopheles complex species including An. stephensi sibling A (type form),
An. stephensi sibling B (intermediate form), and An. stephensi sibling C (mysorensis
form). This is the first molecular markers’ evidence-based scientific report on the
existence of An. stephensi sibling species complex. Khan et al. (2020) have further
provided information on morphological and molecular characterization of
mysorensis biological form, and, based on gene sequence analysis for COI, COII,
ITS2 and OBP1 intron I, confirmed the presence of An. stephensi sibling C
(mysorensis biological form), while working in China.
10.2 Classification
Anopheles stephensi is an extraordinarily elegant mosquito adorned with heavily

spotted upper legs, mouthparts, and wings (Fig. 10.1). My experience for sampling
the adults in resting condition, particularly when they are resting on hanging objects
by roof, will guide me to spot the females in the torch-lit flash-lights as ‘the glittering
stars’ that this species will appear to make in the pitched-dark night. Three egg
phenotypes, based on varied dimensions of size and number of ridges on the floats,
have for the past several decades been regarded to exist in the species, viz., type
(Liston 1901), mysorensis (Sweet and Rao 1937), and intermediate (Subbarao et al.
1987). In contrast, WRBU (2022) informed on the genetic analysis of An. stephensi
(wherein four synonyms are on record: metaboles Theobald, intermedia Rothwell,
folquei de Mello, and mysorensis Sweet & Rao) using mtDNA COI barcoding that
clearly indicates two separate taxa: (1) one in India, Pakistan, Djibouti, Ethiopia, and
derived colony strains, and (2) another distinct species-level group originating in
Saudi Arabia.
In view of the continuous zoogeographic expansion, often transboundary (i.e.,
from across India to others), in parallel to anthropically induced climate change,
today An. stephensi emerges the only other mosquito, and the only anopheline, after
Wyeomyia smithii, which is known as the first animal model to demonstrate global
warming impact of climate change on life (Bradshaw and Holzapfel 2001), that is
again proving the phenomenon albeit a different factor in consideration this time,
i.e., rise in urbanization, prompting movement of An. stephensi over to new and
unexplored areas (countries or regions), hitherto terra incognito for the intruding or
invasive species! The species appears to be on the move with climate change,
demographic vicissitudes between rural and urban settings, and social behaviour
with respect to increased water storing habit (Surendran et al. 2019). Discovery of
An. stephensi (type form) in 2014 from Djibouti, followed by its reporting from
several localities in Ethiopia and the Republic of Sudan, marked its first incursion
onto the African continent, and introduction as the first urban malaria vector on the
African continent. Around the same time, An. stephensi (type-form) intruded
Mannar Island, Sri Lanka, a largely sylvatic environment.
Anopheles stephensi is perhaps the world’s most enigmatic species, which has
raised a very interesting debate on whether it is a species complex or not. There is no
species with which An. stephensi can well be confused; it is the only Indian as well as
global species, with broad thoracic scaling and a double broad pale band on the
palpi, in which the hind legs are not conspicuously with white. The species has such
marked features which make it distinguishable most comfortably from any other
anopheline species without an iota of scepticism. The species is classified as follows:
Phylum Arthropoda
Class Insecta
Order Diptera
Family Culicidae
Subfamily Anophelinae
Genus Anopheles
Subgenus Cellia
Series Neocelli
species stephensi
10.3 Etymology of Anopheles stephensi
The species Anopheles stephensi, discovered by Lt. Col. William Glen Liston in
1901, is derives its name after the famous malariologist and medical entomologist
Professor J.W.W. Stephens. The type locality of Anopheles stephensi is Ellichpur in
Vidharbha area of Maharashtra State, India. The type specimen of a female Anophe-
les stephensi is deposited in the Natural History Museum, London.
10.4 Distribution
Originally an Indian species (originated likely in the Thar Desert) it has now a wide
distribution in Asia, Middle East, Arabian Peninsula and north-eastern Africa
including Afghanistan, Bahrain, Bangladesh, Djibouti, Egypt, Ethiopia, India,
Iran, Iraq, Kuwait, Myanmar, Nepal, Oman, Pakistan, People’s Republic of China,
Philippines, Qatar, Saudi Arabia, Somalia, Sri Lanka, Sudan, Thailand, United Arab
Emirates and Vietnam (Fig. 10.2) (Christophers 1933; Rao 1984; Surendran et al.
2019).
10.5 The New ‘Out of Range’ Occurrence of An. stephensi Since. . . 173
Decade
1980 – 1989
1990 – 1999
2000 – 2009
2010 – 2019
year unknown
An. stephensi EO
Fig. 10.2 The latest ‘out of range’ occurrence of An. stephensi in the Arabian Peninsula and Horn
of Africa. Note: The 358 site locations for species distribution models (SDMs) were used as:
Yellow-shaded area shows the 2011 expert opinion range based on data published up to 31 October
2009; Data showing the presence of An. stephensi more westerly across the Arabian peninsula
(sampled in 2005–2006) were published after 2010. Thus, An. stephensi may have been present but
unreported or been expanding its range into the western areas of the Arabian peninsula over the last
30 years (Source: Sinka et al. 2020)
10.5 The New ‘Out of Range’ Occurrence of An. stephensi Since

Early Twenty-First Century
The acknowledged zoogeography of An. stephensi encompasses southern Asia and

the Arab Peninsula, including India, Pakistan, Afghanistan, Iraq, Iran, Baharin,
Oman, Saudi Arabia, Bangladesh, South China, Myanmar, and Thailand. Although
Rao (1984), citing Gad (1967), informed that An. stephensi, being the first record on
the African continent, showed its existence in Sinai, Egypt, about 1.5 km from the
Suez Canal, but later this claim was confounded (cf. Manouchehri et al. 1976).
According to Zahar the identification of this new find from Egypt was checked by Dr
P. F. Mattingly (British Museum, Natural History) who found it resembling
A. dancalicus Corradetti, thereby stripped off its identification as An. stephensi for
future reference. Five decades later, however, An. stephensi firmly established itself
in the African continent, without an iota of scepticism this time, alarming nations for
its impact on their disease elimination campaigns.
Anopheles stephensi seems to be spreading in geographic expansion within South
Asia (Sri Lanka 2016; Dharmasiri et al. 2017; Surendran et al. 2018, 2019; Abubakr
et al. 2022), the Middle East, and Africa (Djibouti in 2012, Ethiopia in 2016, Sudan
in 2018/2019, and Somalia; Balkew et al. 2020; Seyfarth et al. 2019; Carter et al.
2018; Faulde et al. 2014; WHO 2021a, b; Mnzava et al. 2022; Ahmed et al. 2022),
and there is growing evidence that this species might soon be expanding, if remains
unchecked, its geographical range would affect approximately 126 million people in
cities across Africa alone (Sinka et al. 2020). Due to its high degree of anthropophilic
behaviour, invasion of new geographic ranges, hitherto regarded terra incognito for
An. stephensi, has certainly raised many new challenges and threats to the policy
designers to thwart any attempt of either re-emergence of malaria (from a country
such as Sri Lanka which was declared malaria-free in 2016 by World Health
Organization) or establishment in, Egypt, Ethiopia, and Sudan in north-eastern
Africa about which World Health Organization has called upon to remain vigilant
(Sinka et al. 2020).
10.5.1 Gulf Countries
The oriental malaria vector An. stephensi is present over a fairly large area in the
northern and eastern parts of the Gulf region. Anopheles stephensi mysorensis has
been identified in the Eastern Province of Saudi Arabia and in southern Iran.
10.5.2 Africa
In contrast to the endemic African mosquitoes (e.g., An. gambiae, An. arabiensis,
An. funestus), the Asian malaria vector Anopheles stephensi is possibly the only
malaria mosquito yet known on the soil of Africa which is urban savvy, alluding to
its ability to quest for potable water in any kind of container to lay its eggs. Lack of
its propensity to breed in transient water bodies such as puddles or ditches, often
found to be turbid or polluted (e.g., with oil or sewage) in urban settings which repel
pollution-sensitive anophelines such as An. stephensi, the latter is so far confined to
freshwater containers only. However, there is increasing evidence that some African
species are increasing their tolerance against polluted and/or turbid water, and the
void is amply compensated by An. arabiensis—a member of the An. gambiae
complex and a desert specialist, which breeds in polluted, turbid water, just as in
clear, clean habitats, although unlike An. stephensi, it remains solely a rural environ-
ment breeder.
10.5.3 Middle East and West Asia
Anopheles stephensi, in all of its three forms, i.e., ‘type’, ‘intermediate’, and
‘mysorensis’ forms, is quite common in Pakistan, Afghanistan, and southern Iran
(e.g., Abadan, Bandar Abbas, Kazeroun and Dezfu, Jiroftl) (Mehravaran et al. 2012).
There it is highly anthropophilic, too (15.7%) (Manouchehri et al. 1976). While An.
stephensi stephensi (type form) and ‘intermediate’ occur in urban and urbanized
coastal areas with the type form predominant, An. stephensi mysorensis is found only
in rural mountainous areas (Vatandoost et al. 2006). Both the type form in urban
areas and mysorensis in rural areas are competent malaria transmitters, albeit the
latter being a weaker vector carrying a lower vectorial capacity. Against various
types of adulticides, such as bendiocarb, propoxur, malathion, fenitrothion,
deltamethrin, permethrin, cyfluthrin, and lambdacyhalothrin, all these forms of the
species exhibit susceptibility, save for one case of resistance against DDT, together
with low level of tolerance to dieldrin. In contrast to imagicides all the stephensi
forms are susceptible to malathion, fenitrothion, temephos, and chlorpyrifos at
diagnostic doses, except the larvicide fenitrothion. Pyrethroid insecticides like
permethrin and lambdacyhalothrin highly irritate the vector species, but have low
irritability to cyfluthrin and deltamethrin. Abai et al. (2008) compared the perfor-
mance of imagicides on Anopheles stephensi in southern Iran.
10.5.4 The Thar Desert
In terms of medical importance Anopheles stephensi is but next only to An.

culicifacies and A. fluviatilis in India (Christophers 1933; Zahar 1988, 1990a, b;
Rao 1984), although Tyagi (1991a–c, 1995a, b) has demonstrated for the first time
its predominance and epidemiological significance in the arid environments of the
Thar Desert—a unique ecosystem with which one usually does not associate
malaria. Common sense dictates that mosquitoes that breed only in stagnant water
would give arid, water-scarce spaces such as a desert a wide go-by. But that is not the
case in the Thar Desert in north-western Rajasthan, India, which is also the land of
persistent desert malaria (Anon. 2003). Amerasinghe (2004) has dedicated this
pathbreaking research finding to ‘long years of research into mosquitoes, malaria
and irrigated agriculture in the Thar Desert’ by Tyagi between 1988 and 2001, and
again 2015 onward (cf. Veer et al. 2021).
In cognizance of the fact that An. stephensi is the original species from the Thar
Desert’s arid environments, adapted to breed in fresh water, and there too mostly in
potable water, a highly carefully planned vector control without facing protest by the
village communities needs to be enacted to interrupt the malaria transmission cycle
(Tyagi 2020; Singh et al. 2021a, b). The matter of controlling malaria in the mobile
and difficult-to-approach people of the Thar Desert appear simple but it is in fact
highly complicated considering the transient human behaviour involved in the
mobile and hard-to-approach populations (Tyagi 2022).
The Thar Desert in the north-western Indian province of Rajasthan (23°–30° N
and 69°–78° E), lying between the irrigated lands of the rivers Indus and Sutlej in the
east and the western edge of the Aravalli Hills, is the only desertic ecosystem in the
country which supports a unique malariologic paradigm, ‘The Desert Malaria’.
Organized into 12 desert districts spread over 75,000 km2, it harbours a population
of 128 million. Until the 1980s it was regarded as a hypoendemic region of unstable
malaria with potential for occasional outbreaks. However, due to a mélange of
factors such as anthropization including extensive irrigation canal-network and
climate change, the Thar Desert has at present transformed into a towering inferno of
cyclic malaria epidemics dominated by Plasmodium falciparum.
The Thar Desert’s inhospitable conditions make human living extremely chal-
lenging. Populations living deep inside desert are hardly accessible by health care
provisions which render them vulnerable to malaria-related morbidity and mortality,
particularly infants and pregnant mothers. Humans live in sparsely and distantly
located habitations called ‘Dhani’—which can be one-to-few dwellings, in addition
to villages in the far flung remote areas, hardly interconnected with motorable
passages ever. Such ‘Dhanis’ as well as villages essentially associate with the
’Tanka’ or ‘Beri’—their indigenous innovations to conserve water as underground
reservoirs to meet their and animals’ vital needs round the year, perhaps more
(Fig. 10.3)! The desert malaria vector, An. stephensi, profusely breeds in these
marvellous engineering feats, spreading malaria through transmission of
P. falciparum and P. vivax. Human populations in ’Dhanis’ and villages are gener-
ally at the Nature’s mercy when sickened due to malaria, despite a well-placed health
care delivery system. Its noteworthy that Primary Health Centres (PHCs)/Drug
Distribution Centres (DDCs) with their multi-tasked staff called Multipurpose
Health Worker (MPWs), Lady Health Worker (LHW), and/or Auxiliary Nurse
Midwife (ANM), located at places far from ‘Dhanis’, find it extremely cumbersome
to make regular active surveillance.
Tyagi (2002, 2020, 2022) carried out long-term investigations into the eco-bio-
social aspects of malaria on these mobile and hard-to-reach populations during
1988–2001 and 2015–2022, and it was revealed that the ‘Dhani’-inhabitants were
at high risk of malaria infection. They were not only heavily malariated en masse but
almost inevitably lost precious time to either set out to access or to be accessed for
antimalarial treatment on time. Due to this ‘disconnect’, their knowledge about
malaria was also found to be clouded with uncertainties. They hardly knew the
role of mosquitoes in malaria transmission, particularly An. stephensi, breeding in
their only water reservoirs, ‘Tanka’ and ‘Beri’, a stone’s throw from the dwellings.
During malaria outbreaks the ‘Dhani’ inhabitants are hard to approach and timely
delivered treatment as an active surveillance measure.
Since draughts in the Thar Desert have been a recurring phenomenon every few
years, the life of the desert population, along with their cattle (camel, goat etc.), is
doubly challenged for survival. Thus, they are forced to set out in quest for green
pastures more than 1000 km away across the interstate borders over to other
neighbouring (malaria) hyperendemic States, e.g., Gujarat and Haryana. On return,
however, they bring malaria infection to their habitats in the Thar Desert where again
they are hard to reach. After the massive desert malaria epidemic in 1994 (deaths
>300), the scenario has changed (0 death in 2020), thanks to communication
technologies, advanced training, and regular exercise with Knowledge, Education
and Practice (KAP), the health department is optimally providing medical aid to such
mobile and hard-to-reach populations to prevent morbidity and mortality, but still
much is possibly desired to achieve the goal of malaria elimination.
Fig. 10.3 (a, b) ‘Beri’—the man-made underground well-like structure in the cavity of a pond
naturally recharged by occasional rains with a gap of several years; (c) Each mound of stones in the
middle of the near-dry belly of the pond marks the entry to a ‘Beri’ from where the local folks draw
a pail of water (Source: Tyagi and Yadav 1996a)
10.6 The Original Desert Mosquito: Anopheles stephensi
Anopheles stephensi is malariologically both important and enigmatic. Discovered at

Ellichpur, Vidharbha area of Maharashtra State, India, Dr William Glen Liston
scientifically described it from a single female specimen in 1901. It is interesting
to note here that Ross (1897) had claimed the mosquito, on which he had founded his
epochal theory about the discovery of malaria–mosquito relationship, to be possibly
An. stephensi—his ‘dappled winged mosquito’ or ‘Mosquito C’! Ever since the
species was described it has been subjected to continuous scrutiny for its gargantuan
potential to transmit human malaria, in general, and P. falciparum, in particular.
Also its status as a species or complex of species has always been intriguing the
scientists. At least three synonyms were put forward in the course: (1) metaboles
Theobald, 1902, (2) intermedia Rothwell, 1907, and (3) folquei de Mello, 1918. In
addition to the nominal subspecies stephensi Liston 1901, two more subspecies
(or varieties) have also been brought on record, namely, mysorensis Sweet and Rao
(1937) and intermediate Subba Rao et al. (1987). Anopheles stephensi is amongst the
most investigated mosquito species, yet there are many traits which are either
incompletely understood or not known at all. The following attributions make An.
stephensi the most sought-after malaria vector and still so enigmatic and quaint to
science:
1. An. stephensi (type species) is pronouncedly urban in nature as a vector;
however, it is 100% vectorial in the Thar Desert’s arid environments.
2. An. stephensi is preferably zoophilic (Rao 1984), but human blood index (HBI)
is reported as high as 37.5% (Nair and Samnotra 1967) in India.
3. An. stephensi, with a spectrum of three subspecies, stephensi, mysorensis, and
intermediate, is a vector in both urban and rural agglomerations.
4. An. stephensi is a pollution-sensitive species, inherently inclined to breed in
clean potted water of most kinds which are generally man made.
5. An. stephensi can breed prodigiously in both wells as deep as 30–40 ft and
overhead tanks in high rise buildings (>50 ft).
6. An. stephensi is able to overwinter in the Thar Desert, but not reported
elsewhere.
7. An. stephensi is able to manifest the phenomenon of reflex immobilization or
thanatosis (death-feigning) as a defence mechanism.
8. An. stephensi can transmit both P. falciparum and P. vivax parasites, but its
potential to transmit the former is threatening especially in newly invaded
nations of Africa and Sri Lanka.
9. An. stephensi has evolved as a strong synanthropic mosquito; it tends to move
with humans in their trade, travel, and settlements, since in all these events the
mosquito can find in plenty its breeding ground, the fresh potted water.
10. An. stephensi is recently attempted to be proven a species complex with a greater
degree of scientific experimentations (Firooziyan et al. 2018), even though Tyagi
et al. (1991) had pointed out about the same on the basis of morphometric studies.
Still there are studies which try to prove otherwise; Alam et al. (2008) and Islam
10.7 A New Hypothesis on the Origin and Evolution of Anopheles stephensi 179
et al. (2017) have demonstrated that the type and mysorensis forms of An.
stephensi in India exhibit identical ribosomal DNA ITS2 and domain-3 sequences.
10.7 A New Hypothesis on the Origin and Evolution

of Anopheles stephensi
10.7.1 The Hypothesis Based on the Rule of Reinig (1938, 1939)
Since the Darwin (1859) theory of origin of species by means of natural selection,
many zoologists have propounded several chorogeographic hypotheses most tenable
among which has in recent times been that by Reinig (1938, 1939), although Kiauta
(1968), who studied morphological and kinetical features of the so-called m-
chromosomes in dragonflies worldwide, refuted its validity entirely on the basis of
m-chromosome variability among various populations. Nonetheless he emphasized
that the relative size of the m-chromosomes varies in some species, but not in all, and
that the size is peculiar, in some dragonflies, for populations originating from
different portions of the species range, and therefore it could be used to advantage
in the taxonomy of infraspecific forms.
Reinig’s (1938, 1939) chorogeographic hypothesis explains that populations of a
given species evolved near the point of origin have larger size in comparison to those
borne far away from it! This implies that, as far as An. stephensi is concerned, the
size of specimens of the populations from the leveed Thar Desert environment,
which here is believed to be the cradle of this species, must be larger than all those
occurring elsewhere, in south India, Sri Lanka, Middle East, Arabian Peninsula, or
‘the Horn of Africa.’ A fair test of this hypothesis will explain it all.
10.7.2 The Basis
To test the Rule of Reinig (1938, 1939), it is desired foremost to put morphometric
attributes of the species existing in the Thar Desert as well as those (species or
subspecies) found in other parts of the world (Table 10.1).
From the tabulated data it is comprehensible that the type An. stephensi extant in
the arid environments of the Thar Desert seems to have an edge in morphometric
measurements over others of the same clan, which in a way justifies the application
of the chorogeographic hypothesis of Reinig (1938, 1939) in the case of An.
stephensi (Fig. 10.4), and supports the hypothesis alluding to its origin in the
Great Indian Thar Desert region.
An appreciable degree of intra-specific variation in An. stephensi is a testimony to
the species’ plasticity and adaptability potential to survive in ecologically different
biotopes (Krishnan 1954; Tyagi 1995b). In the Thar Desert, there is only one
published scientific study on the intra-specific variation in An. stephensi (Tyagi
et al. 1991). Females of An. stephensi examined in this study originated from a
group of ten highly irrigated villages of Sangaria Tehsil and another group of six
Table 10.1 Frequency (f) of selected characters of feral females of two geographically isolated
populations of An. stephensi
Villages of
Suratgarh- Villages of
Anupgarh tehsil Sangaria
(25)a tehsil (10)a Range
Part of f (No. of f (No. of between
the specimens specimens populations
body Standard characters examined) examined) (%)
Head (1) Vertex with nine flattened 0.08 (2) 0.90 (9) 8.0–90
chaetae forming frontal tuft
Palpi (1) Base swollen 1.0 (25) 1.0 (10) Nil
(2) Segment half or more 0.8 (20) 0.9 (9) 80–90
than the preceding segment
(index 0.58)
(3) Patches (2–3) of white 0.8 (20) 1.0 (10) 80–90
scales on dorsum of palpi
Thorax (1) Mesonotum covered by 0.92 (23) 0.5 (5) 50–92
scales
Wing (1) Prehumeral accessory 0.90 (24) 0.9 (8) 90–96
dark spot undivided
(2) Anal vein with three dark 0.56 (14) 1.0 (10) 56–100
spots
Legs (1) Front femur swollen at 1.0 (25) 1.0 (10) Nil
base
(2) Speckles distinctly 0.04 (1) 1.0 (10) 4.10
(3) First tarsus with 2–3 0.8 (20) 0.9 (9) 80–90
patches
a
Figures in parentheses show the number of females examined
unirrigated villages in totally desertic environment of Suratgarh-Anupgarh Tehsils in

Sri Ganganagar district (Fig. 10.5). Frequency of selected characters in the feral
females examined from physiographically isolated areas is given in Table 10.1,
whereas degree of variance in the measurement of different body parts in the females
examined from both the areas is given in Table 10.2.
Differences in various different kinds of body parts can be summarized as
follows:
(1) Palpi and Head: The palpi differed remarkably in size, speckling and extent of
white bands. In the desert specimens, the smallest palpi (1.4 mm) are equal to the
largest in the Sangaria specimens (1.5 mm). The apical and subapical white
bands are contiguous laterally, with the former often longer in size. Nearly all
Sangaria specimens (90%) had nine flattened chaetae in the frontal tuft, but very
few specimens in the desert villages (85%) had such a situation,
(2) Mesonotum: Desert specimens usually had more conspicuous mat of pale scales
on the mesonotum extending somewhat posteriorly to scutellum and to the
lateral aspects of dorsum,
Fig. 10.4 Average difference

in palpi size between (a)
desert and (b) non-desert
populations of Anopheles
stephensi Liston 1901
(Source: Tyagi et al. 1991)
(3) Wings: In several specimens from both the Sangaria villages and the desert
villages in Suratgarh/Anupgarh tehsils the prehumeral dark accessory spot was
found split into an inner and outer dark accessory spot. The largest specimen
(5.3 mm) collected from the above desert villages measured 7.8 mm across the
wings. The largest specimen (4.0 mm) collected from Masani village in the
Sangaria Tehsil measured 5.0 mm across the wings, and,
(4) Legs: Femur of the foreleg was swollen in all specimens but there was variation
in the pattern of speckling of femur, tibia, and the first tarsal segment in the
females of both ecotypes. While speckles in Sangaria specimens were far more
distinctly pronounced, in the desert specimens these are irregular in shape and
often contiguous. The first tarsus has a few white scales at 2–3 places, although
these white scales were sometimes obscured in the desert specimens.
10.7.3 The Evolution and Migration Pathways of New Species

or Subspecies to Other Regions
Anopheles stephensi originated, in every likelihood, in the Thar Desert region of

north-western Rajasthan state of India, from where several decades or even centuries
ago it must have migrated to Southeast Asia and the Arabian Peninsula. It has
recently emerged as an efficient and invasive urban malaria vector in Africa,
intruding four countries (Djibouti, Ethiopia, Somalia, and Sudan) within a short
Fig. 10.5 Variations in proboscis (A,B), legs (1,2,3), and wing parts of An. stephensi collected
from desert and non-desert areas in the Thar (Ph/h prehumeral/humeral dark spot) (Source: Tyagi
et al. 1991)
span of only 7 years (2012–2019); Djibouti being the foremost ‘invaded’ destination
in Africa in 2012 and Sudan the latest in its intrusions in Africa (2019).
Compared to all major malaria-endemic deserts of the world, the Thar Desert in
the north-western India seems to have undergone a more severe catastrophic
10.7
Table 10.2 Degree of variance in the measurement of various body parts in females of An. stephensi collected from physiographically different areas of highly
irrigated villages of Sangaria tehsil and unirrigated villages of Suratgarh/Anupgarh tehsil in Sri Ganganagar
Suratgarh/Anupgarh tehsil (10a) Sangaria tehsil (10a)
Part of the body measured Range (mm) Mean Standard deviation Variance Range (mm) Mean Standard deviation Variance
Palpi 1.4–1.9 1.05** 0.19 0.036 0.9–1.5 1.11 0.172 0.029
Proboscis 1.4–1.9 1.6** 0.19 0.036 0.9–1.5 1.13 0.182 0.0334
Full body length (including palpi) 5.1–5.3 5.23** 0.08 0.006 4.0–4.4 4.15 0.135 0.0183
Wing length 3.0–3.8 3.7** 0.29 0.084 2.4–2.6 2.47 0.082 0.0062
Foreleg 5.1–5.5 5.35** 0.15 0.022 4.4–4.7 4.57 0.125 0.0158
Midleg 5.8–6.3 6.08** 0.154 0.024 5.2–5.3 5.24 0.051 0.0026
Hindleg 6.2–7.2 6.8** 0.355 0.126 5.9–6.0 5.92 0.042 0.0014
a
Figures in parentheses show the number of females examined
**P < 0.001
A New Hypothesis on the Origin and Evolution of Anopheles stephensi
183
Fig. 10.6 Schematic representation of a possible ‘uniparous helicoids cyme’ type (blue arrows) of
chorogeographic evolutionary pathway of Anopheles stephensi, or its races/subspecies/sibling
complex species first to West Asia/Middle East/Arabian Peninsula and finally to the ‘Horn of
Africa’ (Source: B.K. Tyagi, original this work)
physiographic change. It is on record that the Thar Deserts various parameters have
so changed as to favour mosquito (An. stephensi) density, proliferation, and expan-
sion. While the ambient temperature in the IGNP region has decreased, (on the one
hand), the rainfall has significantly increased, on the other. The other factor, human
density, too, has increased several times, and so has diversified the mode of
transportation. All these factors seem to have in modern times favoured a significant
change in behaviour and ecology of An. stephensi which began moving out of its
cradle (the Thar Desert) in quest of more space for its successful survival (Fig. 10.6).
A careful scrutiny of environmental vicissitudes, physiographic metamorphosis
and phylodynamics of the desert specialist vector, An. stephensi—an Indian mos-
quito by origin, will reveal that there has been a direct correlation between extrater-
ritorial movement of the species and the climate change, and the most characteristic
factor involved in the process has been the urbanization—the newly mushrooming
urban centres!
10.7.4 Test of Bergmann’s Rule on the Origin of Anopheles stephensi
Notwithstanding the fact that the Bergmann cline, most often applied to mammals
and birds, is difficult to predict in poikilothermic insects, such as mosquitoes,
nevertheless, it seems adventurous enough to see that by putting credentials of
morphology of An. stephensi to the Bergmann’s Rule, whether it can be further
elucidated to pinpoint on the cradle point of the mosquito, i.e., the Thar Desert? The
Bergmann Rule (1847) explains that those species, populations, or individuals born
at high altitudes, with slow development process due to lower temperature, seem to
develop larger body size than those in relatively lowlands, with high temperature and
quick developmental process. Bergmann’s Rule is applicable to whole body size and
not the body parts.
Now, let us consider different locations of An. stephensi, in The Thar Desert, in
other parts of India, in Middle East and in the Horn of Africa. It is notable that most
of central and southern Indian plateaux (e.g. Delhi), coastal metropolises (e.g.,
Mumbai, Chennai, Kolkata) are at a lower altitude, with the latter group of cities
with warmer climate more or less throughout the year. While An. stephensi ‘type
form’ is common in all the metropolitan towns, it is mostly An. stephensi mysorensis
that is widely distributed in the peninsular rural plains (Rao 1984). Close to the
peninsular tip of India, in Sri Lanka it is An. stephensi ‘type-form’ detected for the
first time in Mannar Island—sylvatic environment with nearly uniformly warm
temperature. In Middle East, in northern Iran, mostly it is the ‘mysorensis’ form.
In contrast, the Thar Desert ecosystem, with both large-sized populations in the
penetralium of the desert and the relatively small-sized populations in the IGNP
Command Areas under irrigation, enjoys a relatively higher altitude, with far lower
precipitation and extreme temperature ranges in summer and winter months, more or
less in accordance with similar factors in both the Peninsular and Saharan deserts.
The Thar Desert is the only ecotype rife with the An. stephensi populations through-
out its expanse, while both the Arab Peninsula and the African Sahara deserts are but
recently inhabited or invaded by the vector, pointing out towards a possible pathway
commencing out of the Thar Desert into the African Continent via Arab Peninsular
deserts (Fig. 10.6). Thus, it appears that though Bergmann’s Rule is not fully
applicable in the case of An. stephensi, it nevertheless tries to explain the evolution-
ary significance of two populations of the vector in the Thar Desert, hook, line, and
sinker (Tyagi et al. 1991)!
Invasive Vector Species of Malaria in Desert
Environments 11
11.1 Introduction
Species that reproduce quickly and grow stupendously in population structure, and
disperse aggressively, with potential to cause harm, are labelled as ‘invasive’.
Mosquitos and the infections they carry are travelling along trade routes and settling
in ever-expanding cities. In as far as Culicidae is concerned, an invasive mosquito is a
species that, by its introduction, causes ecological, economic or health-related harm in a
new environment where it is not native. Human health and economies are at recurring
risk from invasive mosquito species’ potential to affect a large number of vector-borne
diseases. Such invasive species have an indelible, irreversible and multidimensional
influence on our natural ecosystems, particularly in context with human health and
economy, which may invite billions of dollars’ expenditure each year to counter its ill
effects by way of recurring investments in vector and vector-borne disease
interventions of different nature. Since healthy native ecosystems are essential to
sustain many of our commercial, agricultural and recreational activities, therefore, it
is desirable to keep a check on the invasion of such species of inimical attribute.
Many countries across the world have faced a quaint yet tragic phenomenon of
invasion by exotic mosquitoes, both in tropical and temperate regions. In as far as
malaria is concerned, the Asian An. stephensi and the African An. arabiensis are the
only two species which have very recently invaded either different lands within the
same country (e.g. An. stephensi in Lakshadweep in 2001 and Rameswaram ils. in
India), isolated island countries (e.g. An. stephensi in Sri Lanka in 2017) or inter-
continental regions (e.g. An. arabiensis in Natal, Brazil, in 1930) hundreds and even
thousands of kilometres away from their respective original habitat. However, in the
past several invasive malaria vector species had been brought on record:
(1) An. dirus seems to have intruded India from across Myanmar borders during
the 1970–1980s, and (2) An. stephensi was sampled for the first time in Kerala State
from Kochi in 1992. Apart from Anopheles, other mosquitoes too have their own
quota of invasive species, e.g. Aedes koreicus, an invasive species to India (Collec-
tor: Dr S.K. Ghosh; specimen identified at the ICMR-Centre for Research in Medical
Ltd. 2023
188 11 Invasive Vector Species of Malaria in Desert Environments
Entomology), near the Bengaluru Airport in 2013, and Aedes aegypti got introduced
to the Lakshadweep il. in 2001. In Europe, five Aedes mosquito species are regarded
invasive, namely, Aedes albopictus, Ae. aegypti, Ae. japonicus, Ae. koreicus and
Ae. atropalpus (Cebrián-Camisón et al. 2020). Two of these invaders, viz. Aedes
albopictus and Aedes aegypti, were also incriminated as vectors during the recent
outbreaks of chikungunya and dengue fever in Europe. In the USA, other than
Ae. aegypti and Ae. albopictus in the past, very recently even the presence of
Ae. scapularis, a vector for many kinds of encephalitides, has been documented
(Reeves et al. 2021).
After Aedes albopictus, the only other invasive mosquito that has captured the
mind of vector-borne disease specialists globally is Anopheles stephensi. However,
unlike Ae. albopictus which has unleashed a worldwide threat for chikungunya
epidemics in a very short time, An. stephensi, though slow, has already entered in
Africa and, considering its ecology and behaviour, might as well cross over to the
Americas in few decades from now! Currently, An. stephensi is rated as the most
intrusive, invasive and ‘silent’ vector species in the world!
11.2 What Makes a Vector Species ‘Invasive’
Every species, including a vector, needs its specific food (blood for haemophagic
vectors), shelter, interbreeding populations and, of course, breeding habitats. When
it has reached a point of optimum in terms of utilization of space and time, popula-
tion explosion, sex ratio imbalance and inter- and/or intraspecific competition, it
tends to move out, sometimes in long-distance migrations, in the quest of easy and
abundant resources or alternatives. In case of an invasive blood-feeding disease
vector, the species intrudes a land (ecosystem, country or region) on grounds of
heavy risks and uncertainties, the biggest of all being the pathogen’s response to the
vector in a changed ecology and physiography. If the intruding vector
(e.g. An. stephensi or An. arabiensis) receives well the biology of the pathogen
(in this case a human malaria causing Plasmodium species) and is potent enough to
effect successful transmission, then the vector turns out to be crowned ‘invasive’,
and the taxon involved is labelled as an invasive species. It is a logical move forward
(Perkins and Nowak 2013), implying that the phenomenon of conversion from
‘vector’ status to that of the ‘invasive vector’ is irreversible, in the outset at least
(Tyagi, this work). The Species Survival Commission (SSC) of the International
Union for Conservation of Nature (IUCN), looks into matters pertaining to the
unharmed sustenance of all the biological entities and their habitats, including the
invasive alien species (IAS) because these are regarded the main agent of biodiver-
sity loss in protected natural areas. In Fig. 11.1, a hypothesis on the possible mode of
reincarnation of a vector like An. stephensi into an ‘invasive alien vector species’
(IAVS) is graphically presented.
The role of invasive vector species, such as Anopheles stephensi and
An. arabiensis (the malaria vectors) and, for that matter, Aedes albopictus (the vector
for dengue and chikungunya) as well as scores of other arboviruses, is not yet
11.3 Interplay Between Vector-Pathogen Interaction Dynamics and the Climate Change 189
Fig. 11.1 A graphical presentation of a hypothesis on the possible mode of reincarnation of an

invasive vector species (IAS), e.g. Anopheles stephensi, into an ‘invasive alien vector species’
(IAVS)
established in context with the biodiversity dynamics, owing to the absence of any
integrated multinational bioinvasive risk assessments (Ruiz and Carlton 2003;
Brancatelli and Zalba 2018).
11.3 Interplay Between Vector-Pathogen Interaction Dynamics

and the Climate Change
Long-distance crossovers of both disease pathogens and vectors between continents

and/or regions have been greatly facilitated by the ever-increasing international trade
by land, sea and air routes. Invasive vectors encounter a spree of challenges in the
new lands where the environmental and climatic changes of foreign lands are likely
to raise the risk of pathogen transmission by these invasive mosquitoes. Realizing
the seriousness of the issues associated with invasive vector mosquitoes, the World
Health Organization has taken a lead in developing a framework to enact actions if
any invasive mosquito, particularly the vector, of public and/or veterinary health
importance is documented in any country and all neighbouring nations’ health policy
and intervention implementation managers of the receptive countries must be alerted
forthwith (van den Berg et al. 2013). The invasive vector-resident pathogen rela-
tionship depends much on the dynamics of climate change that shapes the future of
mosquito-borne disease epidemiology in the host country. For example, a striking
escalation in temperature in Europe during 1980–1990 witnessed an unprecedented
influx of the Asian tiger mosquito, Aedes albopictus, since the late 1990s whereafter
it continuously expanded its distribution to new countries every year (Medlock et al.
2012). Along with the yellow fever mosquito Aedes aegypti, the Asian Tiger
mosquito, Aedes albopictus, is a primary vector for chikungunya, and disease
Fig. 11.2 Distributional range of Anopheles stephensi (Source: Ishtiaq et al. 2021)
outbreaks that Europe experienced during the mid-2005 were largely transmitted
by it.
It must be cautiously remembered, however, that an invasive species does not
have to come from another country. While Tyagi and Yadav (1996a–c) and Tyagi
and Hiriyan (2004) have elicited the invasion of the Thar Desert by the yellow fever
mosquito, Ae. aegypti, more recently Tyagi et al. (2006) have demonstrated de novo
invasion of the Western Ghats region in Kerala by the yellow fever mosquito,
Ae. aegypti. In both these new ecosystems of invasion, the vector mosquito had
either originated transmission of dengue and chikungunya such as that in the xeric
environments of the Thar Desert or played a significant role in exacerbating both
these infections.
Deserts around the world, some of which are nefariously known for their hyper-
endemic nature for malaria, for example, Sahara Desert in Africa, are no exception
and are rather deeply vulnerable to invasive mosquito species due significantly to
human actions like the riverine and/or canalized irrigation, rare metal or ore mining
where they colonize stupendously. Their occurrence is often associated with changes
in ecosystems, human behaviour and climate (Randolph and Rogers 2010). The
most glaring example of an invasive mosquito to the African continent where it is
being widely feared to soon put more than 125 million city dwellers across Africa to
face a higher malaria risk, is the Asian mosquito, An. stephensi, that is quickly
moving across the continent and the eastern parts of Sahara Desert. Anopheles
stephensi has rapidly extended its geographical range, with the type form being
reported in the Lakshadweep islands (2001), in countries in the Horn of Africa
(2012), Sri Lanka (2017) and most recently in the Republic of Sudan (2019). The
introduced An. stephensi exhibits resistance to several classes of insecticides, posing
challenges in controlling the spread to new areas (Fig. 11.2).
11.4 Invasion of Anopheles stephensi Within India 191
11.4 Invasion of Anopheles stephensi Within India
As discussed in the previous chapter, it seems very likely that An. stephensi has its
cradle point in the Great Indian Thar Desert from where, during the course of several
decades’ long dispersal, the species spread far and deep in the mainland, particularly
Peninsular India, on the one hand, and to the various neighbouring countries in the
West Asia, on the other, all due largely and primarily to its strong affiliation for
breeding in the fresh and potable water, an attribution of the water-deficient growing
urban agglomerations and secondarily, and much to its advantage, a highly escalated
population movement, massive new constructions and trade both within and across
trans-international borders. Among all the known malaria vectors across the world,
Anopheles stephensi Liston 1901 is possibly the most important invasive species at
present, which has recently ventured to explore new habitats in Africa and South
Asia, from its historically established abode in Asia and the Middle East. It is
noteworthy to mention here that An. stephensi was discovered and reported for the
first time in Ellichpur in Vidarbha area of Maharashtra State, India. In India it occurs
in all the main zones, including the inhospitable arid environments of the Thar
Desert (Tyagi 2002, 2003a, b, 2004a, b, 2020; Tyagi and Baqri 2005), becoming
scarcer at high altitudes in the Himalaya and in the northeastern states. The species is
wanting in the Andaman and Nicobar islands where malaria has been endemic in for
nearly a century and An. sundaicus is the incriminated vector (Covell 1927a; Rao
1984), though the Lakshadweep archipelago has recently reported breeding of
An. stephensi (Sharma and Hamzakoya 2001).
Within the boundaries of the mainland of India, An. stephensi has first invaded the
nonmalarious Kerala State through its northern most district, Kasaragod, and
introduced malaria in the virgin ‘God’s own lands’, a sobriquet for Kerala, in 1969
onwards (Devi and Dass 1999). A similar scenario occurred in a rather more serious
manner when An. stephensi was for the first time observed in the Rameswaram
island in 2002 (Tyagi pers. comm.). Anopheles stephensi is a mysterious mosquito
due to the following unfamiliar characteristics: (1) its genomic traits are widely
differentiated from other closely allied taxa including An. arabiensis, (2) it is the only
Anopheles vector which can overwinter both in larval and adult stages and (3) it is
the only major vector of malaria Anopheles stephensi which manifests the phenom-
enon of ‘reflex immobilization’ or thanatosis (death-feigning) as a tool of self-
defence. In recent past, An. stephensi has caused several malaria outbreaks in Kerala
State, India, where such epidemics were not reported until 1996, and it is now even
reported breeding in water storage tanks in Lakshadweep islands almost a thousand
kilometres off the coast of Kerala, indicating possibilities of invasion of other nearby
islands (Sharma and Hamzakoya 2001). Establishment of this invasive species in the
Rameswaram island in the vicinity of Sri Lanka is a continuous reminder of a tip of
an iceberg of a major threat of resurgence of transmission of malaria in a recently
declared ‘malaria-free’ nation (Dharmasiri et al. 2017). Sri Lanka’s malaria-free
status is highly threatened by the ongoing socio-political turmoil in the country, and
the following factors will only aggravate the situation of re-introduction of malaria
into the country: hundreds of refugees ferrying out and in daily in Sri Lanka;
Rameswaram island in India is a site of important pilgrimage and thousands of

pilgrims gather there every day to visit the historic temples, and mixing of refugees
with them is likely to escalate fresh malaria-parasite picking by the two major
vectors, An. culicifacies and An. stephensi, and results in likely importation of
malaria cases from an endemic country; and different trades by workforces through
sea or air routes. The new entry of An. stephensi in the formerly already heavily
malariated island nation has further rendered the Sri Lankan people more vulnerable
and receptive to a possibility of re-introduction of malaria.
11.5 Invasion of Anopheles stephensi in Sri Lanka
The island nation of Sri Lanka situated in the Indian Ocean is situated only a few
kilometres south of Rameswaram island (India) but has been struggling to cope up
with a constantly dwindling economy due mostly to perennial malaria endemicity
across 22 districts in its intermediate and dry zones (Konradsen et al. 2000). In Sri
Lanka, An. culicifacies is the main vector of malaria, with support from
An. subpictus, An. annularis and An. varuna as the secondary vectors (Amerasinghe
et al. 1999). The World Health Organization certified Sri Lanka in November 2012
to harbour nil indigenous transmission of malaria and, in 2016, awarded it with the
certification of elimination of malaria. Thus, Sri Lanka became the first nation in the
Indian subcontinent who achieved this distinction of a malaria-free country.
Surendran et al. (2019) postulated the progression of movement of An. stephensi,
a major vector for malaria transmission in urban India (1970s, Goa; 1980s,
Kanyakumari; and 2001, Lakshadweep islands in the Arabian sea) from north- to
southwards into Sri Lanka in 2017 but also westwards into the Arabian Peninsula
and the northeastern Africa between 2012 and 2019, from the Indian mainland, more
or less in agreement to the brooding urbanization and associated water storage
practices. These developments have threatened the northern islands of Maldives
(90 km south of Lakshadweep), where water storage practices are identical, with an
invasion by An. stephensi in the future. In Sri Lanka An. stephensi has been sampled
both in larval and adult stages from multiple sites in Mannar and Jaffna, and a fear of
further expansion of the vector looms large over the country (Surendran et al. 2019)
(Fig. 11.3).
Earlier Dharmasiri et al. (2017), who credited the discovery of An. stephensi in
the island of Mannar, had made interesting observations on its breeding. Considering
the fact that An. stephensi has a great penchant for colonizing urban environments
and a strong affinity to P. falciparum and P. vivax in all of its resident countries, its
recent discovery in the Mannar Island can certainly pose a serious warning to thwart
the recurrence of malaria on the mainland in Sri Lanka, particularly when other
highly potential vector species such as An. culicifacies, An. subpictus, An. annularis
and An. varuna are already prevailing despite country-wide entomological
surveillances and intensified vector control programmes. In the Mannar Island
An. stephensi has been sampled breeding profusely in the wells. The occurrence of
larvae of An. stephensi was mainly reported from the wells, while adults were
11.6 Invasion of An. stephensi in West Asia/Middle East 193
Fig. 11.3 (a) Sri Lankan map in the Indian Ocean, located south of India, and (b) collection sites of
An. stephensi s.s. in Mannar and Jaffna (Source: Surendran et al. 2019)
sampled both from human dwellings and cattle-sheds. The presence of An. stephensi,
in both larval and adult stages, was confirmed microscopically and molecularly, the
latter by sequencing the barcode region of the cytochrome c oxidase I (COI) gene.
11.6 Invasion of An. stephensi in West Asia/Middle East
Mosquitos and the infections they carry are travelling along trade routes and settling
in ever-expanding cities. Anopheles stephensi is a major vector in the Middle East,
including areas of Iran, Afghanistan and Pakistan.
Recently in eastern Iran, Chavshin et al. (2014) have characterized biological
forms of An. stephensi and estimated its sporozoite rate in the transmission of
malaria using molecular techniques. Abai et al. (2008) studied comparative perfor-
mance of imagicides on An. stephensi in the southern Iran. On the other hand, Safi
et al. (2017) put on record evidence of metabolic mechanisms playing a role in
multiple insecticide resistance in Anopheles stephensi populations in Afghanistan. In
Pakistan An. stephensi is a major vector of malaria in all urban settings. In summary
in Iran and neighbouring West Asia countries An. stephensi, with its various
subspecies/species, is a serious vector for decades.
11.7 Invasion of An. stephensi in Arabian Peninsula
The Kingdom of Saudi Arabia (KSA) is the largest among all nations within the
Arabian Peninsula. Malaria transmission in the Arabian Peninsula is largely factored
by the dominant vector species and aridity with oases. At present malaria cases are
reported only in Saudi Arabia and Yemen, with the latter contributing to over 98% of
the clinical burden. The KSA is generally having a high quality of health machinery,
and malaria is largely under control. Anopheles stephensi ‘type form’, the main
malaria vector in the eastern region, is 1 of the 18 anopheline species found in the
KSA (Mattingly and Knight 1956; Zahar 1985; Daggy 1959); the other ecotypes are
not known to occur in the KSA. The Kingdom of Saudi Arabia is nearing elimination
of malaria due to its practical approach in tackling the disease, especially imported
cases.
11.8 Invasion of An. stephensi in Africa
The Asian vector An. stephensi was for the first time discovered by Djibouti in 2012
(soon followed by Ethiopia in Kebri Dehar, Somali Region, in 2017), and since then
the event raised concerns about the impact of vector control campaigns in the
country and the rest of the Horn of Africa. Developing effective malaria control
strategies needs updated knowledge of biology, ecology and behaviour of the local
mosquito vector species. With the uninvited addition of An. stephensi to local fauna,
the sense of disease control through vector management has become very compli-
cated and confusing since there is not much information yet mined on the intrusive
species on either the genotypic or phenotypic characteristics. Continuous expansion
of vectors into new areas has posed a serious threat to progress against malaria in
Africa already pathetically represented (>90%) of the disease burden, mostly in the
sub-Saharan Africa (SSA) region. Almost the entire malaria transmission in the
sub-Saharan Africa is carried out by the deadly An. gambiae complex species.
The capital port city in the Horn of Africa, Djibouti, is widely known as Pearl of the
Gulf of Tadjoura due to its location in the Republic of Djibouti (23,200 km2)—a
country strategically bordered in south by Somalia, in southwest by Ethiopia, in north
by Eritrea and in the east by the Red Sea and the Gulf of Aden, where an unusual
An. stephensi-driven urban outbreak of P. falciparum epidemic with 1228 cases struck
in 2013 (February–May), soon followed by yet another severe epidemic the same year
(November) and in 2014 (January–February). Since An. arabiensis is also present in
Africa, a careful scrutiny of the identity of Anopheles stephensi, based on both the
microscopic and molecular diagnoses (i.e. sequencing of the Barcode cytochrome c
oxidase I (COI) gene and the rDNA second internal transcribed spacer (ITS2) gene).
The indigenous nature of malaria infection was confirmed in March 2013 through
positive tests for P. falciparum circumsporozoite antigen in two of six female
An. stephensi sampled from the dwelling of malaria patients. This evidence of autoch-
thonous urban malaria transmission by An. stephensi in Djibouti complimented by
cognizance of the species’ genetical susceptibility to P. falciparum and tolerance to
11.8 Invasion of An. stephensi in Africa 195
3000
2500
2000
1500
1000
Km
500
Distance (km) covered/to be covered by the invasive An. stephensi
Fig. 11.4 Possible distances (in km) of An. stephensi covered/to be covered up to countries at risk
from the first Africa-based discovery in Djibouti in 2012
urban environment led water pollution and adaptive potential to the new arid
environments alarmed not only the African nations but also the World Health
Organization (WHO 2019a; Mnzava et al. 2022). The WHO (2019a, b) has particularly
urged all countries at risk to be vigilant and to improve and upscale their surveillance
systems for the early detection and control of this invasive mosquito species.
Next to the An. stephensi-mediated P. falciparum malaria in Djibouti in 2012, a
similarly unusual but of higher-intensity P. falciparum-dominated malaria epidemic
broke out in Ethiopian Somali region in the sub-Saharan Africa in 2016 and
An. stephensi, of which a total of 2231 morphologically and molecularly identified
samples were sampled, was incriminated there, too (Carter et al. 2018). Interestingly,
additionally, Aedes aegypti were noticed coexisting in many of the An. stephensi
larval habitats, an observation akin to that in the Thar Desert (Tyagi and Yadav
1996a–c; Tyagi and Hiriyan 2004). After Djibouti and Ethiopia, the presence of the
invasive emergence of Anopheles stephensi was first documented from the coastal
and sub-coastal regions of the Red Sea in Sudan (WHO 2019a), and subsequently its
geographical expansion was confirmed up to the capital city Khartoum, in Sudan
(Ahmed et al. 2021). Anopheles stephensi captured in Ethiopia and Sudan was
confirmed to be the same (Folmer et al. 1994; Kumar et al. 2007). The expansion
of the invasive An. stephensi continued far and wide, and the next country intruded
by the vector was Eritrea in the Horn of Africa, in addition to Chad, Egypt, Libya and
Republic of Central Africa (Abubakr et al. 2022).
Sinka et al. (2020) have developed, with the help of global data on zoogeography
of Anopheles stephensi in Africa during past one decade, a model reflecting a
possible future expansion of the invasive species in Africa: Kenya, Uganda,
Tanzania, Rwanda, DRC Egypt, CAR and Malawi. Figure 11.4 presents possible
distances to be (or already) covered in reaching new sites or countries.
With more data to generate on the expansion of An. stephensi in the next couple of
decades, it seems to make us grow au fait to presume with some degree of certitude
about a more far and wide distribution in Africa, and who knows much beyond, into
a new continent altogether, taking cues from the life of An. arabiensis.
Epidemiology of Desert Malaria
12
12.1 Introduction
Epidemiological patterns of malaria are influenced by different kinds of climate.

Epidemiology of malaria may change from one region to another or even within a
country from one specific population to another within the same region depending
on their ecological, biological and social conditions. Since the world’s deserts are
irreversibly impacted by the climate change, the epidemiology of malaria is also
shifted remarkably. Knowledge of the changing epidemiological trends of desert
malaria in the eliminating countries will ensure improved targeting of interventions
to continue to shrink the malaria map. Epidemiologists have recently paid greater
attention than in the past to the epidemiology of desert malaria owing to the fact that
it may help spread infection to the neighbouring plain areas where elimination has
been successfully carried out. This change of emphasis has been stimulated in part
by the need for better epidemiological definitions of malaria in the evaluation of
control measures such as insecticide-treated materials and malaria vaccines.
Methods of determining mortality from malaria and of defining severe and uncom-
plicated malaria have been devised through extensive epidemiological investigations
including clinical. For instance, the limited data available indicate that malaria-
attributable mortality and the incidence of severe malaria do not increase with an
increase in the entomological inoculation rate above a threshold value, an observa-
tion that has important implications for the likely long-term effects of attempts to
contain malaria through vector control in a typical desert ecosystem which is full of
challenges in establishing surveillance. Epidemiologic studies and clinical descrip-
tion of severe Plasmodium vivax malaria in adults living in malaria-endemic areas
are rare, and more attention is needed to understand the dynamics and its interaction
with the immune system.
Historically, the prevalence of malaria was significantly higher than today, even
in temperate regions of Europe and North America, before large control measures
were undertaken following World War II. Malaria elimination was achieved post
1970s for European countries and during the 1950s in the USA. Over the African
Ltd. 2023
198 12 Epidemiology of Desert Malaria
and Asian continents, the situation started improving during the past two decades
with increased financial support and malaria control efforts (insecticide spraying,
distribution of long-lasting impregnated bed nets, development of rapid diagnostic
tests, door-to-door availability of drugs and better infrastructure).
12.2 Ecological, Biological and Social Aspects of Malaria

Disease in Major Deserts
Studies of epidemiology of severe malaria in the African Sahara and the Great Indian
Thar deserts have shown different epidemiological patterns for the two most fre-
quent forms of this condition: cerebral malaria and relapsing malaria (Tyagi 2002;
Kochar et al. 2005, 2007). Severe malarial anaemia is seen most frequently in areas
of very high malaria transmission and most frequently in young children. In contrast,
cerebral malaria predominates in areas of moderate transmission, especially where
this is seasonal, and it is seen most frequently in older children. The study of patients
with uncomplicated malaria has established the relationship between fever and
parasite density and has demonstrated ways of defining fever thresholds.
Malaria-eliminating countries achieved remarkable success in reducing their
malaria burdens between 2000 and 2010. As a result, the epidemiology of malaria
in these settings has become more complex. Malaria is increasingly imported, caused
by Plasmodium vivax in settings outside sub-Saharan Africa, and clustered in small
geographical areas or clustered demographically into subpopulations, which are
often predominantly adult men, with shared social, behavioural and geographical
risk characteristics. The shift in the populations most at risk of malaria raises
important questions for malaria-eliminating countries, since traditional control
interventions are likely to be less effective. Approaches to elimination need to be
aligned with these changes through the development and adoption of novel strategies
and methods. Knowledge of the changing epidemiological trends of malaria in the
eliminating countries will ensure improved targeting of interventions to continue to
shrink the malaria map.
12.3 Dynamics of Malaria Prevalence in Major Deserts
Human malaria is a parasitic disease caused by five species of Plasmodium and is

transmitted by the bite of an infected Anopheles female mosquito to a human host.
The tropical form of the parasite, Plasmodium falciparum, causes the most severe
clinical form of malaria and is widespread in African Sahara Desert (Chemison et al.
2021). Malaria is responsible for many deaths worldwide: 405,000 reported in 2018
of which 67% occurred among children between 0 and 5 years of age (Griffin et al.
2014). Ninety-three percent of total cases and 94% of global deaths occurred in
Africa, mostly south of Sahara Desert, in 2018 (WHO 2019a). Hence desert malaria
has serious socio-economic impacts and can hamper development of overall malaria
elimination campaign in the world.
12.3 Dynamics of Malaria Prevalence in Major Deserts 199
Malaria is a climate-sensitive disease, with transmission often seasonal, as spe-

cific temperature and rainfall conditions are necessary for the development of
Anopheles mosquitoes and Plasmodium parasites. Various different deserts in the
world have their own specific vectors of malaria; for example, in Africa these include
An. gambiae, An. arabiensis and An. funestus are the primary malaria vectors in the
worst-affected desert and semiarid regions of Africa, while in the Thar Desert,
An. stephensi and An. culicifacies are the main transmitters (Tyagi 2002). They are
present when humidity exceeds at least 40%, but adult mosquitoes die rapidly above
38 °C; the only exception is being An. stephensi in the Thar Desert which evidently
has developed a mechanism to tide over extremities on both sides of temperature,
i.e. 40 °C in summer and 4 °C during winter. Their presence is strongly regulated by
the (rare seasonal) rains, which provide breeding sites after long gaps. After the
sporogonic cycle, which is the incubation period for the mosquito to become
infectious, the mosquito can infect additional humans. This incubation period
shortens when temperature increases. A minimum temperature for sporogonic
development was observed at 17 °C for An. gambiae and P. falciparum (Waite
et al. 2019). Therefore, temperatures must be high enough for the parasite to
complete its sporogonic cycle, but if the temperature is too high, then the mortality
of the vector increases, leading to a decrease in malaria transmission risk.
Malaria in Africa is phenomenally rampant in the region south of Sahara where species
of Anopheles gambiae Complex, viz., Anopheles arabiensis, An. bwambae, An. melas,
An. merus, An. quadriannulatus, An. gambiae sensu stricto (s.s.), An. coluzzii and
An. amharicus, especially An. gambiae and An. arabiensis, threateningly transmit
P. falciparum parasite. The Sahara Desert stretches from the Red Sea in the West
and the Mediterranean in the North to the Atlantic Ocean in the West, including ten
countries: Algeria, Chad, Egypt, Libya, Mali, Mauritania, Morocco, Niger, Sudan and
Tunisia. All these countries have been reporting malaria with varying degree of
prevalence. Smith et al. (2005) have worked on entomological inoculation rate in
malaria vectors and estimated Plasmodium falciparum infection in African children.
1. Algeria
Malaria in Algeria was first identified in 1880, and by the 1960s around 80,000
cases a year were reported. Through an integrated approach including free provision
of diagnosis and treatment, as well as indoor residual spraying and bed net use, this
figure declined over the next 40 years to just 28,000 cases/year. Thanks to the
malaria eradication campaign launched in Algeria in 1968, the number of malaria
cases fell down significantly from 95,424 cases in 1960 to 30 cases in 1978. At that
time the northern part of the country was declared free of Plasmodium falciparum.
Only few cases belonging to P. vivax persisted in residual foci in the middle part of
the country. In the beginning of the 1980s, the south of the country was marked by
an increase of imported malaria cases. The resurgence of the disease, and introduc-
tion of the exotic vectors, in the oases coincided with the opening of the Trans-
Saharan road and the booming trade with the neighbouring southern countries. Now,
the totality of malaria autochthonous cases in Algeria is located in the south of the
country where 300 cases were declared during the period (1980–2007). The recent
outbreak recorded in 2007 at the borders with Mali and the introduction of Anophe-
les gambiae, An. arabiensis and An. sergentii s.l. into the Algerian territory show the
vulnerability of this area to malaria which is probably emphasized by the local
environmental changes (Ramsdale and de Zulueta 1983; Hammadi et al. 2009).
Despite Algeria’s turbulent history of civil wars, the country joins the malaria-free
list as the third country from Africa, after Mauritius in 1973 and Morocco in 2010.
The present WHO Director-General, Dr Tedros Adhanom Ghebreyesus, credits this
success of Algeria to the unwavering commitment and perseverance of the people
and leaders of the country.
2. Chad
Some 80% of Chad’s population live in high malaria transmission areas, with 2.5
million cases and 8700 deaths reported in 2018. With high levels of malaria
transmission during a short rainy season, central areas of Chad can benefit from
implementation of seasonal malaria chemoprevention (SMC)—a particularly effec-
tive treatment for preventing malaria in children between 3 and 59 months during
peak transmission periods.
Malaria Consortium established an office in N’Djamena, the capital of Chad, in
May 2016 as part of its ACCESS-SMC project through which it continues to work
with government and partners to protect 900,000 children in 20 health districts from
malaria and cascade knowledge of SMC delivery through training of health workers.
3. Egypt
Like Algeria, Egypt, had eliminated malaria, and until now, the last locally
transmitted case was in 1998. It was argued that the P. vivax malaria came from
Sudanese migrants. However, with the recent invasion of the Asian malaria vector,
An. stephensi, possibilities of recurrence of malaria in the Egyptian town has become
stronger.
4. Libya
Libya, too, is now free from local malaria transmission and has no indigenously
reported cases of the malaria. The last local case was in 1973.
5. Mali
Mali is a landlocked country with a mostly flat terrain and some rocky hills in the
north. The Niger River crosses the southern part of the country and forms an interior
delta. Mali also has a subtropical to arid climate. Those parts of the country which
receive significant rainfall experience a rainy season for part of the year and
extremely dry weather for the remainder of the year. During the rainy season, Mali
often faces problems with flooding when the Niger River overflows. When com-
bined with environmental problems of deforestation, soil erosion and desertification,
this creates conditions ideal for the transmission of malaria.
Malaria is one of the principal causes of mortality and morbidity in Mali (Koné
et al. 2015). With a population of approximately 11 million, Mali has over 800,000
reported cases of malaria annually, according to the World Health Organization
(WHO). Malaria accounts for 13% of all mortality in Mali for children under the age
of 5. Malaria is endemic throughout the more populated southern half of the country,
with over 90% of the total population at risk of endemic malaria, with young
children and pregnant women being the most vulnerable. Anopheles gambiae and
An. arabiensis are the most dangerous vectors of malaria in Mali. The following
anophelines, including the two above, have been reported from Mali so far.
An. coustani coustani Laveran, 1900

An. coustani tenebrosus Donitz, 1900
An. coustani ziemanni Grünberg, 1902
An. funestus Giles, 1902
An. gambiae Giles, 1902
An. hancocki Edwards, 1929
An. leesoni Evans, 1931
An. longipalpis Theobald, 1903
An. maculipalpis Giles, 1902
An. nili Theobald, 1904
An. obscurus Grunberg, 1905
An. paludis Theobald, 1900
An. pharoensis Theobald, 1901
An. pretoriensis Theobald, 1903
An. rhodesiensis Theobald, 1901
An. rivulorum Leeson, 1935
An. rufipes Gough, 1910
An. squamosus Theobald, 1901
An. wellcomei Theobald, 1904
An. ziemanni Grunberg, 1902
Mali’s economy has been struggling. Therefore, keeping this fact in mind, a
low-cost control technology is a priority. Thus, public-private partnership (PPP)
funded by international health organizations and philanthropy and distribution of
long-lasting insecticide-treated nets (LLIN) brought a radical change malaria
prevalence.
6. Mauritania
The Islamic Republic of Mauritania (population 3,378,250) is situated in north-

west Africa between 15 and 27° N latitude and 5 and 17° W longitude. It is spread
over 1,030,700 sq. km. Population pyramid shows that nearly 43.7% are under
15 years old. Sedentarization and rural exodus, partly related to the periods of
drought in the 1970s and 1980s, are the most significant demographic phenomena
that have occurred in Mauritania since the country’s independence in 1960. Whereas
the proportion of urban population was 9% in 1965, it increased to 22.7%, 46.7%
and 60% in 1977, 2005 and 2010, respectively. Divided into three ecological zones,
two-thirds of the surface area of Mauritania is covered by the Sahara Desert, and
one-third is sub-Saharan semi-desert. It has a low annual rainfall that increases from
north to south, one rainy season from June/July to September/October, depending on
the year and/or region, and a dry season (‘cold dry season’ from November to March
and ‘hot dry season’ from March to June).
Malaria epidemiology in Mauritania has been characterized on the basis of
epidemiological strata, defined by climatic and geographic features, which divide
the country into three zones: (1) the Sahelian zone, (2) the Sahelo-Saharan transition
zone and (3) the Saharan zone. In a study of malaria incidence in Nouakchott,
Mauritania Lekweiry et al. (2009) had observed that malaria prevalence rate was
25.7% (61/237), the majority of positive blood slides as well as nested-PCR products
were due to P. vivax 70.5% (43/61) and P. ovale 24.6% (15/61). Two malaria
patients, both with P. vivax, have never travelled out of Nouakchott and seem likely
to have been autochthonous (3.3%). Of the 237 individuals included in the survey,
231 (97.5%) were clinically diagnosed and treated as malaria cases. 26.4% of
clinically diagnosed cases were positive for Plasmodium using microscopic exami-
nation and PCR. Thus, false-positive cases constituted 73.6% (170/231) of the
clinically diagnosed malaria cases. The search for mosquito vectors in Dar Naïm
district allowed morphological and molecular identification of An. arabiensis and
An. pharoensis. In another study Moukah et al. (2016) had found that out of 3445
children examined, 143 (4.15%) were infected with malaria parasites including
P. falciparum (n = 71, 2.06%), P. vivax (57, 1.65%), P. falciparum-P. vivax
(2, 0.06%), P. ovale (12, 0.35%) and P. malariae (1, 0.03%). A large majority of
P. falciparum infections were observed in the Sahelo-Saharan zone. Malaria preva-
lence (P < 0.01) and parasite density (P < 0.001) were higher during the rainy
season (2013), compared to cool dry season (2011). Plasmodium vivax was mainly
observed in the Saharan region [43 of 59 (73%) P. vivax infections], mostly in
Nouakchott districts, with no significant seasonal variation. Of 3577 mosquitoes
captured, 1014 (28.3%) belonged to genus Anopheles. The vector Anopheles
gambiae was the predominant species in all three epidemiological strata during the
‘cool’ dry season in 2011 but was absent in all study sites, except for Teyarett district
in Nouakchott, during the ‘hot’ dry season in 2012. During the rainy season in 2013,
An. gambiae, An. arabiensis, An. pharoensis and An. rufipes were abundant in
different zones.
Fig. 12.1 The number of reported malaria cases from 1990 to 2012 in Mauritania (Source:
Lekweiry et al. 2015)
Malaria has become a major public health problem in Mauritania since the 1990s,
with an average of 181,000 cases per year and 2,233,066 persons at risk during
1995–2012 (Lekweiry et al. 2015) (Fig. 12.1).
Totally the following 12 Anopheles species and subspecies occur in Mauritania:
An. funestus, An. gambiae s.l., An. pharoensis, An. rufipes, An. melas, An. dhtali,
An. rhodesiensis, An. coustani, An. ziemmani, An. pretoriensis, An. squamosus and
An. demilloni. Among these anopheline species, only An. gambiae, An. arabiensis
and An. funestus are known to be major malaria vectors in Africa. In Mauritania,
An. gambiae s.l. appears to be the dominant malaria vector (Sautet et al. 1948; Dia
et al. 2009). Anopheles arabiensis collected in Mauritania has been incriminated
with P. falciparum and P. vivax sporozoites in the salivary glands (Dia et al. 2009;
Lekweiry et al. 2011, 2015). Lemrabott et al. (2020) have brought on record the first
time occurrence of An. (Cellia) multicolor in Mauritania.
Mauritania faces several challenges in the management of malaria, including
limited financial resources, crisis in human resources, shortage of health workers
and health structures with reliable diagnostic facilities, insufficient epidemiological
data on parasite distribution and malaria vectors, and regular epidemics.
7. Morocco
Morocco is currently free from malaria. Malaria resurgence risk in Morocco

depends, among other factors, on environmental changes as well as the introduction
of parasite carriers since the local principal malaria vector, An. labranchiae, has low
infectivity for Afrotropical P. falciparum strains. It is noteworthy here that
An. stephensi has already made its entry in many African countries.
400k 5k
300k 4k
Admissions
Deaths
200k 3k
100k 2k
0k 1k
05
06
07
08
09
10
11
12
13
14
15
16
17
20
20
20
20
20
20
20
20
20
20
20
20
20
Admissions (all species) Admissions (P. vivax)) Deaths (all species)
Deaths (P. vivax))
Fig. 12.2 Malaria admissions and deaths (Source: Free Wikipedia)
8. Niger
Malaria is endemic throughout Niger and is the primary cause of illness (Anon.
2020). It accounts for 28% of all illness in the country and 50% of all recorded
deaths. However, the estimated number of cases decreased by 7.9%, between 2015
and 2019 (from 370 per 1000 population to 343 per 1000 of the population at risk),
and the number of deaths decreased by 25.9% in the same period (from 0.919 per
1000 population to 0.730 per 1000 of the population at risk) (WHO 2020)
(Fig. 12.2).
According to the National Malaria Strategic Plan (NMSP), between 2014 and
2015, children under 5 years of age accounted for about three-fifths of the burden of
disease (62%) and about three-quarters of malaria-related mortality in the country
(74%) (Anon. 2020).
9. Sudan
Sudan is one of the most dangerously malaria-affected countries in the Sahara

Desert region. In 2019 malaria breached the epidemic threshold in Sudan so far.
Over 1.8 million cases of malaria were reported from across Sudan so far in 2019.
Several states in Darfur region, White Nile, Khartoum, and several other states are
affected most. In November alone, about 250,000 cases of malaria were reported
from Darfur. The rise in malaria cases is closely related to the floods in Sudan this
year. The widespread presence of stagnant floodwaters offers breeding grounds for
mosquitoes—which transmit the malaria parasite. The main vector of malaria in
Sudan is An. arabiensis, a member of An. gambiae complex.
10. Tunisia
Tunisia has eradicated malaria in 1979. However, the threat of malaria continues
to hover in the country due to the persistence of mosquitoes and coexistence with a
potential parasite reservoir in the form of imported cases.
12.3.2 The Arabian Peninsula
The Arabian Peninsula’s constituent countries, all of which are mostly desert, are
Kuwait, Bahrain, Qatar, the United Arab Emirates, Oman, Yemen and Saudi Arabia.
While malaria has been eliminated from Kuwait, Bahrain, Qatar, the United Arab
Emirates and Oman, the last two countries in the Arabian Peninsula remaining to
achieve elimination yet are Saudi Arabia and Yemen (Snow et al. 2013).
1. Saudi Arabia
The Kingdom of Saudi Arabia covers the greater part of the Peninsula. The
majority of the population of the Peninsula lives in Saudi Arabia and Yemen. In
distant past the peninsular countries suffered from malaria episodes perennially.
Malaria control in Saudi Arabia was initiated in 1948 by the Arabian American Oil
Company (ARAMCO) in the Eastern province, primarily to protect employees
living around the oases, but soon, in 1954, the Saudi Arabian government adopted
the template of this programme for a national malaria programme. The country faced
a series of outbreaks in course, and the worst was in 1998. A rapid scaling up of
vector control measures, adoption of artesunate plus sulfadoxine-pyrimethamine as
first-line treatment, and the establishment of a regional partnership for a malaria-free
Arabian Peninsula (the latter two occurred in 2007) have resulted in the number of
autochthonous/indigenous (locally transmitted) malaria cases in Saudi Arabia
decreased dramatically between 2000 and 2014, from 511 in 2000 to just 30 in
2014, and the country has been included in the E-2020 WHO initiative, which is
focused on achieving a target of zero autochthonous cases by 2020 (Daggy 1959;
Coleman et al. 2014). Today Saudi Arabia is almost there to eliminate malaria, and
malaria persists in the provinces of Aseer and Jazan, both bordering the Republic of
Yemen (Memish et al. 2014).
Major vectors for malaria transmission in Saudi Arabia are An. arabiensis and
An. sergenti. Oases malaria is common in Saudi Arabia.
2. Yemen
Malaria remains a major public health problem causing heavy mortality and
morbidity in Yemen with great variations in different ecosystems; deserts are consid-
ered free of malaria, whereas other areas are plagued with the disease (Anon. 2002a,
2006), with an annual incidence of about 900,000 cases and approximately 60% of the
total population considered to be at risk of the disease (WHO 2009). Malaria parasites
Plasmodium falciparum, P. vivax and P. malariae exist in Yemen. In a cross-sectional

study, P. falciparum was detected with the predominance (83.33%) (Abdulsalam et al.
2010). Three vector mosquitoes are of concern in different ecosystems: Anopheles
arabiensis is the predominant, An. culicifacies plays an important role in malarial
transmission in the coastal areas of Yemen, and another known vector species,
An. sergenti, has been reported in the mountainous hinterland and highland areas of
the country (Alkadi et al. 2006; Bin Mohanna et al. 2007).
12.3.3 Middle East/West Asia/Central Asia Deserts
Approximately all the countries in the MENA region are at risk of malaria, except for
Egypt, the UAE and Jordan. The disease often affiliates travellers to most of the
countries of the Middle East. Malaria has been known to be endemic in the lowlands
of Saudi Arabia, and three species of Anopheles mosquitoes have been identified in
this region. However, the risk of malaria is very low in parts of North Africa and the
Middle East that are most visited by tourists. Malaria occurs in several endemic
regions of Iran, including provinces of Kerman, Hormozgan and Sistan and
Baluchestan (Ghasemian et al. 2016; Naddaf et al. 2003; Hanafi-Bojd et al. 2010;
Vatandoost et al. 2006). In south of Iran, Anopheles culicifacies was the most
frequent vector of malaria with a frequency of 37.5%, followed by An. d’thali
(18.3%). There have been no reports of malaria in Iraq since 2009. There has been
continued presence of imported malaria in Jordan, mainly from East Africa (Sudan
and Eritrea) and Southeast Asia.
12.3.4 The Thar Desert
The World Health Organization (WHO) estimated that between 2000 and 2010,
global malaria incidence decreased by 17% and malaria-specific mortality rates by
26% (WHO 2011). Subsequently, a greater degree of progress was brought on
record by many malaria-endemic countries such as India which, within the WHO
Southeast Asia Region, has recorded a continuous decrease in malaria—the largest
absolute reductions in the region—from about 20 million cases in 2000 to about 5.6
million in 2019 (Ranjha and Sharma 2021). An analytical understanding of the
epidemiological scenario of malaria in the desert environment will help control the
disease before it conflagrates to impact even in the hyperendemic neighbouring areas
where disease elimination campaigns would be underway (Tyagi et al. 2001a, b).
In India, after the northeastern states, the Thar Desert seems to be the most
vulnerable area to the new dimensions of malaria disease at present. The correlation
of environmental changes brought about in the Thar Desert by extensive canalization
and irrigational activities with malaria prevalence of varying intensities in different
physiographic situations is so clearly discernible and demonstrable that the Thar
Desert practically offers an infallible model to understand the causes underlying
resurgence of malaria in a desert ecosystem and control of vector mosquitoes with
12
10
8
A
6
P
4
I
2
0
1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994
Desert districts Non-desert districts
YEAR
Fig. 12.3 Comparison of annual parasite incidence (API) in the desert (the Thar) and non-desert
districts of Rajasthan between 1979 and 1994. Note the appreciable rise in API in desert districts
from the mid-1980s onwards
proper water management. Since the Thar Desert has vigorously undergone a drastic
change in its ecology during the last few years, in particular, it is worthwhile to
review the malaria situation in the following two time periods:
1. Pre-1994 Period: Malaria in Exacerbation
Before malaria epidemics began to appear regularly in the desert region from the
mid-1980s onwards, most of the positive cases were reported from the hilly and
forested terrain of Udaipur in the southern part of Rajasthan (Sharma 1986a, b).
Thus, while in 1986 the Udaipur zone had contributed 44.1% positive cases and
67.7% P. falciparum cases as against 24.4% positives and 11.6% P. falciparum
cases in the desert region (Anon. 1987a, b), in 1994 only 14.1% positives
(P. falciparum 26.6%) hailed from Udaipur zone compared to 53.3% positives
from the desert districts with a whopping 62.5% P. falciparum cases (Sharma
et al. 1995). Among the then 11 desert districts, Barmer was the most malarious in
1994 contributing 31.3% positive cases and 35.8% P. falciparum cases (Tyagi et al.
1995). In Fig. 12.3 a comparison of annual parasite incidence in desert and
non-desert districts in the state is presented for period 1979–1994 which indicates
a definite increase in the desert districts.
For the application of malaria control, all the districts in the Thar Desert have
been organized in three zones: Jodhpur zone (Jodhpur, Pali, Jaisalmer, Barmer and
Jalore districts), Bikaner zone (Sri Ganganagar, Hanumangarh, Bikaner, Churu and
Nagor districts) and Jaipur zone (Sikar and Jhunjhunu districts). Mostly malaria
epidemics affected Jodhpur and Bikaner zonal districts, particularly the former. In
this zone % P. falciparum showed a marked escalation in at least three of the five
districts during 1981, 1986 and 1991 (Table 12.1). When the data of Jodhpur zonal
districts at these three points of time are pooled and compared with those of Sri
Ganganagar district and the state, it became clear that the SPR had steadily increased
in the Jodhpur zonal districts, while in Sri Ganganagar and Rajasthan, it was down or
unchanged in 1991 against the base year 1981. On the other hand, the %
P. falciparum in the Jodhpur zonal districts, after being slightly down in 1986,
showed a significant rise in 1991, but in both Sri Ganganagar and Rajasthan, it was
down in 1991 after significantly increasing in 1986 against that in 1981 (Table 12.2).
However, in all the three categories, the % P. falciparum was much higher in
1991 than in 1981. It was suggested that changes in % P. falciparum over the years
had come about regardless of SPR. Therefore, in a region such as the Thar Desert, %
P. falciparum is a rather significant factor in determining the severity of the
magnitude of fatal infection or even future epidemics.
2. 1994–2000 Period: New Challenges
This period had posed several challenges to both disease controllers and manage-
ment implementers as well as the academicians and theoreticians. The slide positiv-
ity rates (SPR) and annual parasite incidence (API), along with the P. falciparum
proportion, had been alarmingly high in some of the districts in the Thar Desert.
After malaria-related deaths having been reported in 1994 and 1996, once again
deaths due to malaria were reported in 2000, which is only indicative of the grim
malaria situation in the Thar. Most of these alarmingly malariated districts are
covered under the Indira Gandhi Nahar Pariyojana (IGNP), and a possible correla-
tion between water management in the irrigated areas and the malaria resurgence has
been established (Tyagi and Chaudhary 1997). One of the most significant features
that has attracted attention in recent years is the recognition of Jaisalmer as the most
malarious district, followed by Barmer and Jodhpur districts. However, as far as the
prevalence of P. falciparum cases is concerned, the Jaisalmer district is unparalleled.
The district also boasts of the maximum focal outbreaks of malaria in recent years.
While during 1994 and 1995, Jaisalmer manifested P. falciparum proportion of
68.66% and 31.32%, respectively, after nearly 5 years of rigorous control measures,
it still exhibited relatively high (17.48%) % P. falciparum in 2000.
Most parts of Jaisalmer and Jodhpur districts, which have only recently been
brought under the IGNP, harbour A. culicifacies in addition to An. stephensi which
together transmit malaria in the area (Tyagi and Yadav 2001a; Tyagi et al. 1994).
The physiography of this part of the Thar Desert is currently under transformation,
and the population living there is largely non-immune to malaria infection. Under
such circumstances, and with P. falciparum having already ushered into interior
Thar Desert, the area is seemingly highly vulnerable to recurrent focal malaria
epidemics (Tyagi et al. 2001a, b). It is noteworthy that the 1999 epidemic had
engulfed only those villages which were in close vicinity (2–5 km) to the main
Indira Gandhi Canal. It is likely, rather sure, that more malaria outbreaks will strike
this area, with or without any rainfall. In addition to this, the urban malaria
12.3
Table 12.1 Malariometric data at 5-yearly intervals in the desert districts of the Jodhpur zone (Source: Tyagi 2002)
1981 1986 1991
Census Pf Census Pf Census Pf
District (×1000) ABER SPR API (%) (×1000) ABER SPR API (%) (×1000) ABER SPR API (%)
Jodhpur 1655 9.6 0.6 0.5 9.7 1965 6.0 1.7 1.0 6.3 2127 5.1 5.7 3.0 16.1
Barmer 909 12.4 0.3 0.4 9.9 1118 6.9 0.7 0.5 10.0 1433 7.1 10.7 7.7 11.0
Jaisalmer 167 11.1 0.5 0.6 16.3 231 6.1 1.0 0.6 1.9 343 6.2 1.3 0.8 29.5
Dynamics of Malaria Prevalence in Major Deserts
Pali 1346 13.4 1.3 1.7 7.2 1390 8.8 1.6 1.4 13.4 1484 9.0 7.2 6.5 12.5
Jalore 851 9.3 0.3 0.3 5.0 9.05 4.2 0.8 0.3 11.5 1141 6.5 2.2 2.1 13.1
209
210
Table 12.2 Comparison of averaged malariometric data of Jodhpur zonal desert districts with those of the most irrigated Sri Ganganagar district and Rajasthan
State (Source: Tyagi 2002)
1981 1986 1991
Census Pf Census Pf Census Pf
District (×1000) ABER SPR API (%) (×1000) ABER SPR API (%) (×1000) ABER SPR API (%)
Jodhpur zone 985.6 11.1 0.6 0.7 9.2 1067.8 6.4 1.1 0.7 8.6 1305.6 6.7 5.6 4.0 16.4
districts
Sri 1828 13.5 0.8 1.1 2.6 1984 9.6 2.2 2.1 6.8 26.18 6.0 0.1 0.1 5.5
Ganganagar
12
Rajasthan 32,491 11.0 2.5 3.1 14.6 34,670 8.5 1.8 1.5 25.6 45,880 7.0 2.5 0.2 21.2
particularly in Jodhpur township may pose serious challenges in the near future, due
mostly to the influx of malaria cases from the nearby quarry mines. The Soorsagar
area which abounds with quarry mines, on the one hand, and braces the north-
western flank of the city, on the other, is the major focus of P. falciparum cases.
3. Post-2000 Period
Although malaria incidence in the Thar Desert region is on the consistent decline,
now and then cases escalate with outbreaks in major desert districts like Jodhpur
which has been a pivotal point of various investigations. District Jodhpur
(22,850 sq. km.; 26°0′–27°37′ N Latitude and 72°55′–73°52′ E Longitude) has a
population of 6.86 Crores as per year 2011 census. The health setup in district
comprises nine block primary health centres (BPHCs). The temperature varies from
49 °C in summer to 1 °C in winter. The district enjoys an average annual rainfall of
302 mm. Although here is no perennial river in the district, two major seasonal
rivers, namely, Luni and Jojari, flow through it; the former enters Jodhpur district
near Bilara and flows for a distance of over 75 km within the district.
Tyagi et al. (2000) have emphasized on the breeding prowess of An. stephensi in
Jodhpur, in construction sites’ open-ground as well as underground tanks and the
multi-storey buildings’ overhead tanks. Batra et al. (1999) reported the problem of
malaria in district Jodhpur where they recorded slide positivity rate and slide
falciparum rates as 67.54% and 7.10%, respectively. Tyagi et al. (2001a, b)
investigated a differential potential of malaria transmission in vectors in both desert
and non-desert irrigated villages in the vicinity of Indira Gandhi Nahar Pariyojana
(IGNP). Anand (2009) conducted a primary health centre-based prospective case
control study wherein he recruited 42 cases of malaria along with 84 age- and
gender-matched controls. Information on selected exposures was collected on
pretested questionnaire by trained field staff after getting informed and written
consent of participant. Matched odds ratio and multivariable analysis were
performed in Epi Info software to estimate the independent association of exposures
with malaria without confounding effects of other variables. Malaria cases occurred
from the month of May till October, but only 2 months, i.e. August and September
being the months of rainy season, entirely yielded 27 cases from Fidusar PHC,
whereas Banar and Bisalpur PHCs recorded only 5 and 10 sets, respectively. No
cases could be found in Keru, Narwa and Salwakala PHCs. Maximum cases
occurred in the 15–44-year age group. Occupation-wise 50% of the cases were
manual labourers.
Anand et al. (2011) analytically summarized the secondary data obtained for the
Jodhpur district, city and the nine CHCs (Table 12.3). He plotted a secular trend of
malaria incidence, transmission dynamics, mapping of disease burden areas and
surveillance of malaria and deduced that the range of annual parasite incidence (API)
was from 0.52 to 2.85 in district Jodhpur, with API <2 in the last consecutive 3 years
(2004–2006). They further found that the slide positivity rate (SPR) ranged from
0.59 to 2.29 in district Jodhpur with continuous decline from 1.51 in 2004 to 0.56 in
2006.
Table 12.3 Annual parasite incidence (API) and slide positivity rate (SPR) in Jodhpur district,
Jodhpur City, and its nine community health centres (CHCs) during 2002–2006 (Source: Tyagi
2002)
2002 2003 2004 2005 2006
Place API SPR API SPR API SPR API SPR API SPR
Balesar 0.83 1.03 0.06 0.87 1.74 1.67 0.83 1.06 1.07 0.99
Banar 2.58 1.73 4.52 2.55 3.4 2.52 1.37 1.29 1.24 1.02
Baap 3.43 2.72 0.22 1.00 5.57 2.43 1.93 1.44 2.18 1.16
Bhopalgarh 0.61 0.59 0.94 0.71 0.61 0.56 0.2 0.23 0.27 0.24
Jodhpur City 0.59 1.64 0.89 1.63 0.82 1.93 0.36 0.93 0.21 0.29
Mathania 1.9 2.15 2.72 2.4 1.61 1.75 0.46 0.52 0.71 0.68
Pilwa 0.5 0.57 4.37 3.53 2.54 2.64 0.75 1.21 0.49 0.46
Pipar City 3.33 1.78 0.56 0.33 0.57 0.43 0.36 0.29 0.58 0.32
Salawas 0.16 0.13 0.76 0.6 0.24 0.27 0.11 0.14 0.22 0.23
Somesar 1.09 1.00 8.51 3.26 0.66 0.58 0.16 0.28 1.47 1.11
Jodhpur District 1.28 1.40 2.85 2.29 1.40 1.51 0.52 0.69 0.61 0.56
Based on these data, he surmised that the transmission dynamics of total malaria
varies from one year to another as the total malaria cases during each year reached at
peak in the different months during 2002–2006. Malaria is a persistent health problem
in district Jodhpur with variation in its transmission dynamics within and between the
years. District Jodhpur with its rural and urban areas is a low-risk area for malaria.
Malaria prophylaxis and management strategies as applicable in low-risk area would
be appropriate for district Jodhpur. In fine, it appears that malaria will continue to
persist in the Thar Desert for more years, possibly with epidemics now and then.
12.4 Review of Malaria Situation for Individual District Under

the Thar Desert
A review of the variation in malaria incidence over the years in each of the districts in
the Thar Desert will help understand the above hypothesis and the magnitude of
malaria problem in the near future. For reasons of convenience in understanding the
turning point of the escalation in malaria incidence in the Thar Desert, it is considered
appropriate to focus on the period before 2000 especially the eventful mid-1990s.
1. Sri Ganganagar
As in most districts of various states in the country during mid-1970s, Sri

Ganganagar also boasted of a relatively very high slide positivity rate (SPR)
(13.48%) and the annual parasite incidence (API) (18.28) but with an all-time low
% P. falciparum (1.24%). Thereafter, both these parameters declined steadily till
1982. In 1983–1984, Sri Ganganagar experienced an epidemic when SPR and API
both shot up to 4.92% and 5.46 which incidentally continued to be the highest values
12.4 Review of Malaria Situation for Individual District Under the Thar Desert 213
till date. The P. falciparum proportion particularly escalated during the mid-1980s
and mid-1990s. During 1980–1986, a clear escalation was visible in % P. falciparum
with an all-time high in 1983 (43.18%). Although thereafter it dipped initially, a high
profile however was discernible for most of the ensuing years but particularly
1994–1996 which had been acknowledged as a period of annual epidemics (range
6.26–35.47%). The rise in SPR and API during the mid-1980s was characteristically
attributable to an epidemic in Sangaria PHC (range 0.83–27% in 1983–1986) which
contributed more than two-thirds of the total positive cases in the district. The above
observations also seem to indicate towards the fact that under the changed
malariological scenario, the SPR or API is not as good an indicator, at least in
isolation, of the true magnitude of the disease’s impact as perhaps the P. falciparum
proportion in areas such as the Thar Desert (Table 12.4).
2. Hanumangarh
The malaria situation in Hanumangarh, a new district whose independent

malariometric data are available since 1994 only, seems to be under control. Yet,
there is no room for complacency due to the recent rising trend in P. falciparum
proportion in the district (Table 12.5).
3. Churu
Save for the mid-1970s and mid-1990s, when most of the districts in western
Rajasthan were badly hit by epidemics, the overall situation in the district seems to
be satisfactory. This district is largely dry but is planned to receive some canal water
under the IGNP for irrigation purposes. In view of this and a rather recent indication
of rise in % P. falciparum, it leaves no room for any complacency. Recently, malaria
caused death in the district for the first time in 2000 (Table 12.6).
4. Jhunjhunun
Like Churu, this district also has been completely non-problematic from malaria
point of view. However, like Churu again, this district too is expected to receive
partly some canal water for irrigation, etc. In view of this information and the
apparently rising trend of % P. falciparum, it is a matter of concern that appropriate
control methodologies and planning are exercised beforehand. More alarming,
however, is the fact that in the entire history of the district, death due to malaria is
reported for the first time, worse than that in Churu, during the recent spate of
epidemics in 1994 and 2000 (Table 12.7).
5. Bikaner
This is one of the important districts in view of incessant widespread malaria

epidemics in recent few years. After Sri Ganganagar district, this is the most canal-
irrigated district in the Thar Desert. Besides the mid-1970s and mid-1980s, when
Table 12.4 Epidemiological data, parameters and mortality in Sri Ganganagar (1975–2000) (Source: Tyagi 2002)
214
Year Population (×000) BSE Positives Pv Pf %Pf ABER API SPR SFR Death
1975 1594 194,086 22,039 21,765 274 1.24 12.18 13.83 11.36 0.14 0
1976 1621 219,942 29,639 28,912 727 2.45 13.57 18.28 13.48 0.33 0
1977 1683 206,380 21,040 20,742 298 1.41 12.26 12.50 10.19 0.14 0
1978 1716 213,488 17,463 17,242 221 1.26 12.44 10.18 8.18 0.10 0
1979 1798 210,390 7693 7625 68 0.88 11.70 4.28 3.66 0.03 0
1980 1828 259,735 2451 2389 62 2.52 14.21 1.34 0.94 0.02 0
1981 1828 247,920 2088 2033 55 2.63 13.56 1.14 0.84 0.02 0
1982 1829 196,942 2457 2276 181 7.36 10.77 1.34 1.25 0.09 0
1983 1984 183,277 4925 2798 2127 43.18 10.02 2.69 2.69 1.16 0
1984 1984 220,312 10,838 8041 2797 25.80 11.10 5.46 4.92 1.41 0
1985 1984 280,408 9000 7537 1463 16.25 14.13 4.54 3.21 0.74 0
1986 1985 191,014 4240 3954 286 6.75 9.62 2.14 2.21 0.15 0
1987 1985 191,194 1270 1238 32 2.50 9.63 0.64 0.67 0.02 0
1988 1985 170,250 238 223 15 6.3 8.58 0.12 0.14 0.01 0
1989 1985 143,115 376 361 15 3.99 7.21 0.19 0.26 0.01 0
12
1990 1985 150,175 223 211 12 5.38 7.57 0.11 0.15 0.01 0
1991 2619 158,710 218 206 12 5.50 6.06 0.08 0.14 0.01 0
1992 2619 162,823 984 693 291 29.57 6.22 0.38 0.60 0.11 0
1993 2619 151,977 559 524 35 6.26 5.80 0.21 0.37 0.01 0
1994 1238 100,442 640 413 227 35.47 8.11 0.52 0.64 0.23 0
1995 1238 93,235 664 579 87 13.10 7.53 0.53 0.71 0.07 0
1996 1238 107,426 443 351 92 20.76 8.67 0.35 0.41 0.08 0
1997 1238 82,204 201 191 10 4.97 6.64 0.16 0.24 0.01 0
1998 1238 77,370 122 107 15 12.29 6.24 0.98 0.15 0.01 0
1999 1238 93,336 89 82 7 7.87 7.54 0.07 0.09 0.01 0
2000 1402 104,121 85 76 9 10.59 7.43 0.06 0.08 0.01 0

12.4
Table 12.5 Epidemiological data, parameters and mortality in Hanumangarh district (1975–2000) (Source: Tyagi 2002)
1994 1385 89,067 5035 4745 290 5.75 6.43 3.63 5.65 0.32 0
1995 1242 94,482 2744 2545 199 5.75 7.60 2.20 2.90 0.21 0
1996 1237 127,211 2706 2611 95 3.51 10.28 2.18 2.12 0.07 0
1997 1384 104,532 1067 1028 39 3.65 7.55 0.77 1.02 3.65 0
1998 1384 81,183 439 438 1 0.22 5.85 0.31 0.54 0.01 0
1999 1385 99,249 221 218 3 1.36 7.17 0.16 0.22 1.35 0
2000 1226 105,075 114 107 7 4.39 8.57 0.09 0.11 6.14 0
Review of Malaria Situation for Individual District Under the Thar Desert
215
Table 12.6 Epidemiological data, parameters and mortality in Churu district (1975–2000) (Source: Tyagi 2002)
216
Year Population (×000) BSE Positives Pv Pf %pf ABER API SPR SFR Death
1975 996 109,324 15,591 15,441 150 0.97 10.98 15.65 14.26 0.14 0
1976 1013 123,838 19,886 19,643 243 1.22 12.22 19.63 16.06 0.20 0
1977 1052 142,973 10,720 10,656 64 0.59 12.59 10.19 7.50 0.04 0
1978 1073 214,606 16,889 16,854 35 0.20 20.00 15.75 7.87 0.02 0
1979 1124 97,721 3216 3212 4 0.12 8.69 2.86 3.29 0.00 0
1980 1142 103,113 1261 1248 13 1.03 9.03 1.10 1.22 0.01 0
1981 1161 94,189 999 985 14 1.40 8.11 0.86 1.06 0.01 0
1982 1161 61,411 709 689 20 2.82 5.29 0.61 1.15 0.03 0
1983 1176 77,483 1563 1441 122 7.80 6.59 1.33 2.02 0.16 0
1984 1176 86,323 2861 2757 104 3.63 7.34 2.43 3.31 0.12 0
1985 1177 90,715 3815 3714 101 0.26 7.70 3.24 4.21 0.11 0
1986 1177 80,400 1710 1673 37 2.16 6.83 1.45 2.13 0.05 0
1987 1177 73,934 577 570 7 1.21 6.28 0.49 0.78 0.01 0
1988 1177 77,662 644 611 33 5.12 6.60 0.55 0.83 0.04 0
1989 1177 68,766 1097 1042 55 5.01 5.83 0.93 1.60 0.08 0
12
1990 1177 67,632 1556 1419 137 8.80 5.75 1.32 2.30 0.20 0
1991 1539 59,922 1211 1179 32 2.64 3.89 0.79 2.02 0.05 0
1992 1539 67,675 1483 1197 286 19.29 4.40 0.96 2.19 0.42 0
1993 1543 69,980 1707 1649 58 3.39 4.53 1.10 2.43 0.08 0
1994 1543 97,483 5900 4378 1522 25.79 6.32 3.82 6.05 1.56 4
1995 1543 106,528 9001 8601 400 4.43 6.90 5.83 8.44 0.33 0
1996 1543 130,705 7905 7710 194 2.52 8.46 5.12 6.05 0.14 0
1997 1543 112,540 4062 3995 67 1.64 7.29 2.63 3.60 0.05 0
1998 1543 55,128 1233 1207 26 2.10 3.57 0.79 2.23 0.47 0
1999 1582 116,645 631 595 36 5.55 7.56 0.41 0.54 0.03 0
2000 1226 125,403 419 41 0 8.91 8.13 0.30 0.37 0.03 1

Table 12.7 Epidemiological data, parameters and mortality in Jhunjhunu district (1975–2000) (Source: Tyagi 2002)
12.4
1975 1078 99,606 8678 8588 90 1.03 9.24 8.05 8.71 0.09 0
1976 1096 113,690 17,675 17,384 291 1.62 10.37 16.13 0.27 0.26 0
1977 1138 137,241 19,279 18,954 325 1.71 14.05 16.94 14.05 0.24 0
1978 1161 137,690 13,320 23,254 66 0.49 11.86 11.47 9.67 0.05 0
1979 1217 127,728 5235 5212 23 0.43 10.49 4.30 0.44 0.02 0
1980 1237 123,281 1623 1597 26 1.60 9.97 1.31 1.32 0. 02 0
1981 1257 106,081 1371 1269 102 7.43 8.44 1.09 1.29 0.10 0
1982 1258 96,115 1689 1452 237 14.03 7.64 1.34 1.76 0.25 0
1983 1278 97,385 2667 1809 858 32.17 7.62 2.09 2.74 0.88 0
1984 1264 81,848 4084 3584 500 12.24 6.48 3.23 4.99 0.61 0
1985 1264 86,453 3611 3301 310 8.58 6.84 2.86 4.18 0.36 0
1986 1264 67,986 1516 1473 43 2.84 5.38 1.20 2.23 0.06 0
1987 1264 50,658 1032 1019 13 1.26 4.01 0.82 2.04 0.03 0
1988 1264 65,862 666 648 18 2.70 5.21 0.53 1.01 0. 03 0
1989 1264 57,040 827 799 28 3.39 4.51 0.65 1.45 0.05 0
1990 1264 80,775 800 725 75 9.38 6.39 0.63 0.99 0. 09 0
1991 1565 73,572 674 634 40 5.93 4.70 0.43 0.92 0.05 0
1992 1565 84,406 662 534 128 19.34 5.39 0.42 0.78 0.15 0
1993 1582 87,278 761 705 56 7.36 5.52 0.48 0.87 0.06 0
1994 1582 130,800 3211 2315 896 27.90 8.27 2.03 2.45 0.69 5
1995 1582 149,133 6906 6516 390 5.65 9.43 4.37 4,63 0.26 0
1996 1582 252,798 12,369 10,805 1564 14.47 15.97 7.81 4.89 0.61 0
1997 1582 225,510 13,961 13,680 281 2.01 14.25 8.82 6.19 0.12 0
1998 1582 158,928 2568 2466 102 3.97 10.04 1.62 1.61 0.06 0
1999 1582 189,401 767 50 0 6.52 11.97 0.48 0.40 0.03 0
217
2000 1582 167,804 258 224 24 13.18 10.61 0.16 0.15 0.02 1
Bikaner experienced severe malaria epidemics, the district also endured the
onslaught of malaria in 1994 and 1995, with several deaths, and in 2000, too,
death in the district has been reported with a characteristic rise in % P. falciparum
(Table 12.8).
6. Nagaur
The only time Nagaur showed signs of malaria-oriented scourges was the
mid-1990s, albeit characteristic rise in positive cases in both mid-1970s and
mid-1990s. This district is one of those which easily get flooded during monsoon
rains and develop a large number of new breeding grounds, suitable for breeding of
An. culicifacies and An. subpictus (Table 12.9).
7. Jodhpur
Along with Jaisalmer and Barmer, this is one of the most problematic districts in
view of severity of malaria. The district has recently been brought under the IGNP,
and due to quarry mine malaria, the district is often reporting one of the highest
annual incidence of malaria. Jodhpur too had its share of malaria scourges in the
mid-1970s and mid-1980s, but the most significant period has been the whole of the
1990s when malaria in the district touched new heights and left indelible imprint in
the annals of malaria history with % P. falciparum reaching as high as 64.21 in 1996
(Table 12.10).
8. Jaisalmer
Perhaps this is the most problematic district in recent times, in the sense that it had
been recording the highest ever P. falciparum cases for some years now in the Thar
Desert region, with a maximum % P. falciparum (68.66%) in 1994. The district has
been extensively irrigated under the IGNP, although a large part of the district is yet
to be brought under the scheme. This district had endured most of the epidemics in
the Thar Desert during the past nearly 12 years, more or less in a row. The steady
high plateau of P. falciparum proportion for several years is a serious concern
(Table 12.11).
9. Barmer
This district is most flood-prone and is often struck by malaria epidemics

following monsoon rains. Once infamous for the most malarious district in the
Thar Desert (like in 1990 and 1994), this now ranks second after Jaisalmer district.
Its malaria epidemiology is largely dependent possibly on El Niño-triggered heavy
rains, when P. vivax-dominated malaria invariably occurs in the area, along with the
prodigiously breeding An. culicifacies (Table 12.12).
Table 12.8 Epidemiological data, parameters and mortality in Bikaner (1975–2000) (Source: Tyagi 2002)
12.4
1975 581 97,768 12,214 11,879 335 2.74 16.83 21.02 12.49 0.34 0
1976 591 111,457 20,810 20,379 431 2.07 18.86 35.21 18.67 0.39 0
1977 614 102,585 11,393 11,197 196 1.72 16.71 18.56 11.11 0.19 0
1978 623 99,268 5435 5354 81 1.49 15.93 8.72 5.48 0.08 0
1979 653 81,601 1489 1478 11 0.73 12.50 2.28 1.82 0.01 0
1980 664 91,145 495 486 9 1.80 13.73 0.75 0.54 0.01 0
1981 840 10,098 632 612 20 3.16 15.09 0.95 0.63 0.02 0
1982 840 81,086 533 507 26 4.87 9.65 0.63 6.66 0.03 0
1983 840 86,497 1119 1028 91 8.13 10.30 1.33 1.29 0.11 0
1984 840 80,551 1007 896 111 11.02 9.59 1.20 1.25 0.14 0
1985 840 75,850 1344 1274 70 5.20 9.03 1.60 1.77 0.09 0
1986 840 67,837 1277 1203 74 5.79 8.08 1.52 1.88 0.11 0
1987 840 70,210 799 783 16 2.00 8.36 0.95 1.14 0.02 0
1988 840 67,488 565 537 28 4.96 8.03 0.67 0.84 0.04 0
1989 840 74,206 1114 982 132 11.85 8.83 1.33 1.50 0.18 0
1990 840 76,015 2043 1523 520 25.45 9.05 2.43 2.69 0.68 0
1991 1209 64,729 1120 991 129 11.52 5.35 0.93 1.73 0.20 0
1992 1209 95,455 7237 3534 3703 51.17 7.90 5.99 7.58 3.88 0
1993 1211 83,980 3675 3221 454 12.35 6.93 3.03 4.38 0.54 0
1994 1211 156,034 13,329 9689 3640 27.31 12.88 11.01 8.54 2.33 94
1995 1211 180,158 13,513 12,689 924 6.79 14.88 11.24 7.56 0.51 18
1996 1211 152,089 5053 4828 225 4.45 12.55 4.17 3.32 0.14 0
1997 1211 128,281 2769 2620 149 5.38 10.59 2.28 2.15 0.11 0
1998 1211 104,255 1213 1150 63 5.19 8.60 0.99 1.16 0.06 0
1999 1211 98,267 1431 1376 55 3.84 8.11 1.18 1.46 0.06 0
219
2000 1211 108,812 836 60 0 7.18 8.99 0.69 0.77 0.06 1

Table 12.9 Epidemiological data, parameters and mortality in Nagaur (1975–2000) (Source: Tyagi 2002)
220
1975 1342 176,452 29,025 25,880 445 1.53 13.15 21.63 16.45 0.25 0
1976 1365 196,697 23,598 23,249 349 1.47 14.41 17.29 12.00 0.18 0
1977 1417 152,327 11,588 11,458 130 1.12 10.75 8.18 7.61 0.09 0
1978 1445 172,145 8688 8610 78 0.89 11.91 6.01 5.05 0.05 0
1979 1514 193,075 3107 3094 13 0.41 12.75 2.05 1.61 0.01 0
1980 1538 226,625 2106 2088 18 0.85 14.74 1.37 0.93 0.01 0
1981 1538 222,938 1246 1202 44 3.53 14.50 0.81 0.56 0.02 0
1982 1686 190,131 1246 1215 31 2.48 11.81 0.74 0.03 0.02 0
1983 1686 185,348 1717 1661 56 3.26 10.99 1.02 0.93 0.03 0
1984 1686 179,846 1365 1331 34 2.49 10.67 0.81 0.76 0.02 0
1985 1696 204,277 699 677 22 3.14 12.04 0.41 0.34 0.01 0
1986 1710 201,131 269 265 4 1.49 11.76 0.16 0.13 0.01 0
1987 1710 188,456 158 154 4 2.53 11.02 0.09 0.08 0.01 0
1988 1710 202,988 308 284 24 7.79 11.87 0.18 0.15 0.01 0
1989 1710 192,047 426 390 36 8.45 11.23 0.25 0.22 0.02 0
12
1990 1710 174,332 500 429 71 14.20 10.19 0.29 0.29 0.04 0
1991 2137 197,898 360 295 65 18.06 9.26 0.17 0.18 0.03 0
1992 2137 202,586 1330 1006 324 24.36 9.48 0.62 0.66 0.16 0
1993 2145 190,717 1465 1385 80 5.46 8.89 0.68 0.77 0.04 0
1994 2145 306,914 5638 4118 1520 26.96 14.31 2.63 1.84 0.50 2
1995 1593 218,448 7190 6558 632 8.79 13.71 4.51 3.29 0.29 0
1996 1593 265,557 7746 6938 808 10.43 16.66 4.86 2.91 0.30 0
1997 1593 234,595 5048 4929 119 2.35 14.75 3.16 2.15 0.05 0
1998 1593 214,362 1526 1491 35 2.29 13.45 0.95 0.71 0.02 0
1999 2145 233,570 863 837 26 3.01 10.89 0.40 0.37 0.01 0
2000 2145 239,796 781 22 0 2.82 11.18 0.36 0.33 0.01 0

Table 12.10 Epidemiological data, parameters and mortality in Jodhpur (1975–2000) (Source: Tyagi 2002)
12.4
1975 1264 217,758 47,828 36,236 11,592 24.24 17.23 37.84 21.96 5.32 0
1976 1286 305,037 49,536 46,614 2922 5.89 23.72 38.52 16.24 0.96 0
1977 1335 147,761 21,698 20,828 870 4.00 11.07 16.25 14.68 0.59 0
1978 1361 125,757 10,044 9688 356 3.54 9.24 7.38 7.99 0.28 0
1979 1426 137,263 4770 4631 139 2.91 9.63 3.35 3.48 0.10 0
1980 1449 156,689 2119 2070 49 2.31 10.81 1.46 1.35 0.03 0
1981 1665 160,280 971 876 95 9.78 9.68 0.59 0.61 0.06 0
1982 1654 166,532 1509 1279 230 15.24 10.07 0.91 0.91 0.14 0
1983 1654 135,096 5934 4457 1477 24.89 8.17 3.59 4.39 1.09 0
1984 1696 118,279 4803 4354 49 9.34 6.97 2.83 4.06 0.38 0
1985 1696 128,199 1301 984 317 24.36 7.57 0.77 1.01 0.25 0
1986 1696 102,314 1034 922 112 10.83 6.03 0.61 1.01 0.11 0
1987 1696 100,019 399 372 27 6.77 5.90 0.24 0.40 0. 03 0
1988 1696 103,346 2877 2604 273 9.49 6.09 1.70 2.78 0.26 0
1989 1696 97,645 6011 4629 1382 22.99 5.76 3.54 6.16 1.42 0
1990 1696 125,399 10,462 7462 3000 28.68 7.39 6.17 8.34 2.39 2
1991 2128 110,099 6374 5332 1042 16.35 5.17 3.00 5.79 0.95 0
1992 2128 140,083 9685 5005 4680 48.32 6.58 4.55 6.19 3.34 0
1993 2153 133,403 3096 2288 808 26.10 6.20 1.44 2.32 0.61 0
1994 2153 233,772 14,919 5339 9580 64.21 10.86 6.93 6.38 4.10 69
1995 2153 194,200 8922 6596 2326 26.07 9.02 4.14 4.95 1.20 1
1996 2153 207,188 4389 3681 708 16.13 9.62 2.03 2.11 0.34 0
1997 2153 223,547 2114 1818 296 14.00 10.38 0.98 0.94 0.13 0
1998 2153 217,113 1140 1075 65 5.70 10.08 0.53 0.52 0.03 0
1999 2153 220,572 678 612 66 9.59 10.24 0.31 0.31 0.03 0
221
2000 2153 245,296 728 668 60 8.24 11.39 0.34 0.30 0.02 0
Table 12.11 Epidemiological data, parameters and mortality in Jaisalmer (1975–2000) (Source: Tyagi 2002)
222
1975 144 23,880 5607 5103 504 8.98 16.58 38.94 23.48 2.11 0
1976 147 27,923 5429 4776 653 12.02 19.00 36.93 19.14 2.34 0
1977 153 15,560 950 817 133 14.00 10.17 6.21 6.11 0.85 0
1978 156 16,862 320 300 20 6.25 10.81 2.05 1.90 0.12 0
1979 164 21,223 208 201 7 3.36 12.94 1.27 0.98 0.03 0
1980 167 25,759 87 83 4 4.95 15.42 0.52 0.34 0.02 0
1981 167 18,445 101 94 7 6.93 11.10 0.60 0.54 0.04 0
1982 167 14,374 98 82 16 16.32 8.61 0.59 0.68 0.11 0
1983 167 19,364 881 858 21 2.61 11.60 5.28 4.55 0.12 0
1984 169 15,325 618 595 28 4.53 9.07 3.66 4.03 0.18 0
1985 231 13,666 370 349 21 5.67 5.89 1.60 2.71 0.15 0
1986 231 14,300 152 151 1 0.66 6.19 0.66 1.06 0.01 0
1987 231 18,321 100 84 16 16.00 7.93 0.43 0.55 0.09 0
1988 241 17,907 335 320 15 4.48 7.43 1.39 1.87 0.08 0
1989 241 19,608 554 429 128 22.98 8.14 2.31 2.84 0.05 0
12
1990 241 29,647 2007 1588 419 20.88 12.30 8.33 6.77 1.41 0
1991 344 21,579 301 222 79 26.25 6.27 0.88 1.39 0.37 0
1992 344 35,516 3695 2128 1567 42.41 10.32 10.74 10.40 4.41 0
1993 344 36,233 3131 1529 1602 51.17 10.53 9.10 8.64 4.42 0
1994 344 87,379 19,115 5990 13,125 68.66 25.40 55.57 21.88 15.02 56
1995 344 90,020 15,540 10,672 4868 31.32 26.12 45.10 17.26 5.40 15
1996 344 74,835 5350 4429 921 17.21 21.72 15.50 7.14 1.23 0
1997 344 67,287 3341 2621 720 21.55 19.53 9.69 4.96 1.07 0
1998 344 66,963 1891 1491 400 21.15 19.43 5.49 2.82 0.59 0
1999 345 73,917 2557 1870 687 26.87 21.43 7.41 3.46 0.93 0
2000 344 68,022 1505 1233 272 17.48 19.77 4.38 2.21 0.39 1
Table 12.12 Epidemiological data, parameters and mortality in Barmer (1975–2000) (Source: Tyagi 2002)
12.4
1975 792 126,953 12,233 10,997 1236 10.10 16.03 15.45 9.64 0.97 0
1976 806 124,698 13,574 12,041 1533 11.29 15.47 16.84 10.89 1.23 0
1977 837 117,785 4852 4367 485 9.99 14.10 5.80 4.11 0.41 0
1978 853 99,013 1667 1531 136 8.15 11.61 1.95 1.68 0.14 0
1979 894 119,785 464 423 41 8.83 13.40 0.52 0.39 0.03 0
1980 909 120,949 250 226 24 9.60 13.31 0.28 0.21 0.02 0
1981 909 112,881 362 326 36 9.94 12.42 0.40 0.32 0.03 0
1982 909 107,453 526 462 64 12.16 11.82 0.58 0.49 0.06 0
1983 1119 97,525 1779 1632 147 8.26 8.72 1.59 1.82 0.15 0
1984 1119 76,043 1040 939 101 9.71 6.80 0.93 1.37 0.13 0
1985 1119 88,875 1752 1444 308 17.57 7.94 1.57 1.97 0.35 0
1986 1119 77,317 566 509 57 10.07 6.91 0.51 0.73 0.07 0
1987 1119 81,608 207 173 34 16.43 7.29 0.18 0.25 0.04 0
1988 1119 90,345 1710 1518 192 11.23 8.07 1.53 1.89 0.21 0
1989 1119 110,781 8133 5830 2303 28.32 9.90 7.27 7.34 2.08 12
1990 1119 159,242 19,322 12,797 6525 33.77 14.23 17.27 12.13 4.10 47
1991 1433 103,042 11,033 9812 1221 11.07 7.19 7.70 10.71 1.18 4
1992 1433 162,375 12,210 4182 8028 34.25 11.33 8.52 7.52 2.58 0
1993 1435 133,791 5508 4672 836 15.18 9.32 3.84 4.12 0.62 0
1994 1435 382,423 39,656 18,863 20,793 52.43 26.65 27.63 10.37 5.44 108
1995 1435 359,700 36,542 33,050 3492 9.56 25.07 25.46 10.16 0.97 7
1996 1435 190,318 5615 5383 232 4.13 13.26 3.91 2.95 0.12 0
1997 1435 262,005 9530 8318 1212 12.71 18.25 6.64 3.63 0.46 0
1998 1435 200,374 3141 3004 137 4.36 13.96 2.18 1.56 0.06 0
1999 1435 175,093 1037 941 96 9.26 12.20 0.72 0.59 0.05 0
223
2000 1435 187,312 1497 1408 89 5.95 13.05 1.04 0.80 0.05 0
10. Pali
This is another district which always suffers badly with malaria outbreaks after
heavy rains during monsoon. The district had endured epidemics in the mid-1970s
and mid-1990s, with some deaths in 1994 (Table 12.13).
11. Jalore
The rising trend of % P. falciparum in recent years is a serious concern. This

district occupies a strategic position between the Thar Desert and the sylvan Aravalli
mountains and hence is always rich in water sources that breed vector mosquitoes.
Deaths due to malaria had occurred in the district only in 1994 (Table 12.14).
12. Sikar
It is a rather non-problematic district from malaria standpoint, although its

malaria epidemiology is easily affected when the breeding of A. culicifacies, in
particular, is augmented following heavy rains in the plains of Jaipur region. This
district has never recorded any death due to malaria except for the year 1994
(Table 12.15).
12.5 Possible Factors Responsible for Conflagration of Malaria,

Particularly P. Falciparum-Dominated Malaria
It is an enigma so far as to how P. falciparum ushered in the interior of the Thar Desert
and manifested so often in the form of epidemics with high morbidity and mortality.
Although some explanations to this phenomenon have already been put forward
(Sharma 1995; Sharma et al. 1995, 1996a, b; Tyagi 1996a; Tyagi and Chaudhary
1997), there remain several queries unanswered and which need to be addressed in
detail. A summary of possible reasons thought to be responsible for intensification of
malaria incidence, particularly P. falciparum-dominated malaria, is presented below:
1. With the establishment of extensive canal-based irrigation in the interior parts of the
Thar Desert, a far more serious vector of malaria, An. culicifacies, ushered in the xeric
environments. This species being highly adaptive to new physiographic situations
built up its density very fast under given circumstances of a large variety of breeding
places in the IGNP area, particularly the inevitable and numerous seepage water
collections from the canals. What Anopheles culicifacies lacks in its susceptibility to
infection by P. falciparum, it compensates by its relatively much higher density and
hence also induces vigorous and prodigious biting on human host.
2. Anopheles stephensi, chronologically the oldest and most dominant vector of
malaria in the typical sand-duned xeric environments of the Thar Desert, and
which traditionally bred only in the ‘tanka’, the only major source of reserved
potable water invariably present in every desert village, transmitted ‘desert
Table 12.13 Epidemiological data, parameters and mortality in Pali (1975–2000) (Source: Tyagi 2002)
12.5
1975 1132 135,896 16,403 15,153 1250 7.62 12.00 14.49 12.07 0.92 0
1976 1151 140,063 18,646 17,604 1042 5.58 12.17 16.20 13.31 0.74 0
1977 1195 125,349 6812 6256 556 8.16 10.49 5.70 5.43 -0.44 0
1978 1218 136,644 3083 2877 206 6.68 11.22 2.53 2.26 0.15 0
1979 1277 170,805 2592 2410 182 7.02 13.38 2.03 1.52 0.11 0
1980 1298 191,114 3087 1918 169 5.47 14.72 2.38 1.62 0.09 0
1981 1346 180,805 2376 2203 173 7.28 13.43 1.77 1.31 0.10 0
1982 1370 172,877 2494 2313 181 7.25 12.62 1.82 1.44 0.10 0
1983 1379 136,415 6575 5792 783 11.90 9.89 4.77 4.82 0.52 0
1984 1379 124,020 5163 4883 280 5.42 8.99 3.74 4.16 0.23 0
1985 1390 115,856 2869 2610 259 9.01 8.33 2.06 2.48 0.22 0
1986 1391 122,940 1989 1724 265 13.32 8.84 1.43 1.62 0.22 0
1987 1391 146,337 3217 2751 466 14.48 10.52 2.31 2.20 0.31 0
1988 1391 194,930 10,706 8132 2574 24.04 14.01 7.70 5.49 1.32 0
1989 1373 160,239 12,097 10,133 1964 16.24 11.67 8.81 7.55 1.23 0
1990 1391 189,542 14,678 10,642 4036 27.50 13.63 10.55 7.74 2.13 0
1991 1485 134,850 9746 8430 1316 13.50 9.08 6.56 7.23 0.98 0
1992 1485 156,494 7957 6122 1835 23.06 10. 54 5.36 5.08 1.17 0
1993 1486 146,679 7339 6239 1100 14.99 9.87 4.94 5.00 0.75 0
1994 1486 199,921 12,631 8903 3728 29.51 13.45 8.50 6.32 1.86 3
1995 1486 184,882 9499 8301 1198 12.61 12.44 6.39 5.14 0.65 0
Possible Factors Responsible for Conflagration of Malaria, Particularly . . .
1996 1486 188,583 3048 2905 143 4.69 12.68 2.05 1.61 0.07 0
1997 1486 164,529 2263 2213 50 2.20 11.06 1.52 1.37 0.03 0
1998 1486 164,394 1366 1341 25 1.83 11.05 0.91 0.83 0.01 0
1999 1688 182,835 1818 991 27 2.55 10.83 0.63 0.56 0.01 0
225
2000 1486 197,413 1315 1233 82 5.63 13.28 0.88 0.67 0.04 0
Table 12.14 Epidemiological data, parameters and mortality in Jalore (1975–2000) (Source: Tyagi 2002)
226
1975 745 68,582 3742 3118 624 16.67 9.21 5.02 5.46 0.91 0
1976 758 90,647 5446 4436 1010 18.54 11.96 7.18 6.01 1.11 0
1977 784 78,009 3257 2774 483 14.82 9.95 4.15 4.18 0.62 0
1978 799 74,177 586 550 36 6.14 9.28 0.73 0.79 0.05 0
1979 837 76,549 335 319 16 4.77 9.15 0.40 0.44 0.02 0
1980 851 93,914 278 160 18 6.47 11.04 0.33 0.30 0.02 0
1981 851 79,567 255 242 13 5.09 7.37 0.36 0.49 0.02 0
1982 906 66,730 325 312 13 4.00 7.37 0.36 0.49 0.02 0
1983 906 59,213 293 265 28 9.55 6.54 0.32 0.49 0.05 0
1984 906 33,887 244 227 17 6.96 3.74 0.27 0.72 0.05 0
1985 906 39,960 412 374 38 9.22 4.41 0.45 1.03 0.10 0
1986 906 38,043 319 282 37 11.60 4.20 0.35 0.84 0.10 0
1987 906 55,080 570 529 41 7.19 6.08 0.63 1.03 0.07 0
1988 906 87,889 7131 4833 2298 32.23 9.70 7.87 8.11 2.61 0
1989 906 82,117 4979 4269 710 14.26 9.06 5.50 6.06 0.86
12
1990 906 123,629 7058 4936 2122 30.07 13.65 7.79 5.71 1.72 0
1991 1142 74,632 2409 2093 316 13.12 6.54 2.11 3.23 0.42 0
1992 1142 106,672 2103 1094 1009 47.98 9.34 1.84 1.97 0.95 0
1993 1142 36,201 1536 1071 465 32.27 3.17 1.34 4.24 1.28 0
1994 1142 160,375 5541 2771 2770 49.99 14.04 4.85 3.46 1.73 20
1995 1142 129,332 3836 3137 666 17.36 11.32 3.36 2.97 0.51 0
1996 1142 111,783 1661 1509 152 9.15 9.78 1.45 1.48 0.13 0
1997 1142 123,828 1861 1655 206 11.06 10.86 1.62 1.50 0.16 0
1998 1142 115,057 1491 1323 168 11.26 10.07 1.30 1.29 0.14 0
1999 1143 119,854 354 313 41 11.59 10.49 0.31 0.30 0.03 0
2000 1142 123,633 344 280 64 18.31 10.83 0.30 0.28 0.05 0
Table 12.15 Epidemiological data, parameters and mortality in Sikar (1975–2000) (Source: Tyagi 2002)
12.5
1975 1172 111,976 11,056 10,896 160 1.44 9.55 9.43 9.87 0.14 0
1976 1192 122,455 15,247 14,932 315 2.06 10.27 12.79 12.45 0.26 0
1977 1237 127,151 11,905 11,768 137 1.15 10.28 6.62 9.36 0.11 0
1978 1261 101,890 4199 4171 28 0.66 8.08 3.33 4.12 0.03 0
1979 1321 109,062 1559 1548 11 0.70 8.26 1.18 1.43 0.01 0
1980 1342 97,986 461 453 8 1.73 7.30 0.34 0.47 0.01 0
1981 1387 114,163 317 302 15 4.73 8.23 0.23 0.28 0.01 0
1982 1415 94,073 368 328 40 10.86 6.65 0.26 0.39 0.04 0
1983 1445 82,027 693 512 181 26.11 5.68 0.48 0.84 0.22 0
1984 1445 83,532 1183 1088 95 8.03 5.78 0.82 1.42 0.11 0
1985 1445 77,577 702 655 47 6.69 5.37 0.49 0.90 0.06 0
1986 1446 95,410 300 283 17 5.67 6.60 0.21 0.31 0.02 0
1987 1541 119,032 87 87 0 0.00 7.72 0.05 0.07 0.00 0
1988 1541 120,482 138 123 15 10.87 7.82 0.09 0.11 0.01 0
1989 1541 101,345 127 112 15 11.81 6.58 0.08 0.13 0.01 0
1990 1541 113,436 141 129 12 9.30 7.36 0.09 0.12 0.01 0
1991 1837 106,479 89 78 11 12.36 5.80 0.05 0.08 0.01 0
1992 1837 116,110 82 67 15 18.29 6.32 0.04 0.07 0.01 0
1993 1843 127,652 78 70 8 10.25 6.93 0.04 0.06 0.00 0
1994 1843 189,046 675 201 474 70.22 10.26 0.37 0.36 0.25 10
1995 1843 198,977 638 480 158 24.76 10.80 0.35 0.32 0.08 0
Possible Factors Responsible for Conflagration of Malaria, Particularly . . .
1996 1843 295,454 10,324 7357 2967 28.7 16.03 5.60 3.49 1.00 0
1997 1843 295,037 15,352 14,594 758 4.93 16.00 8.33 5.20 0.25 0
1998 1843 175,925 1491 1362 129 8.65 9.54 0.80 0.84 0.07 0
1999 1843 165,476 811 786 25 3.08 8.98 0.44 0.49 0.02 0
227
2000 1843 184,911 414 369 45 10.87 10.03 0.22 0.22 0.02 0
malaria’ (Tyagi 1995b, 1998a, b) at a low ebb, and without epidemics, and
successfully through. After the establishment of the IGNP in the Thar Desert, it
shifted its breeding habits with the availability of extensive and varied breeding
sites due to canalization and competed with that of An. culicifacies.
3. The massive Indira Gandhi Nahar Pariyojana, along with the Gang canal system
and the Bhakra-Sirhind feeder canal system together, span over nearly 70 years of
initiation. During this period the project had attracted large labour forces from
distant and often hyperendemic states like Bihar, Uttar Pradesh, Punjab, Haryana,
Gujarat and Madhya Pradesh. Such labour forces presumably brought resistant
P. falciparum strain along with them, which in the non-immune population had
the potential to spread and manifest fast particularly in suitable climatic situations
of IGNP-induced environment in a part of the Thar Desert. Sharma (1995) had
pointed out that the 1994 outbreak of cerebral malaria in the Thar Desert proved
fatal because the affected population had been exported to the parasite for the
first time.
4. The resistant strain of P. falciparum inadvertently inveigled into the Thar
interiors in the manner mentioned above did not seem to respond to the normal
regimen of the prescribed specific antimalarial.
The above hypothesis can be further aptly understood if the modus of pathways of
malaria epidemics in the Thar Desert is studied carefully.
12.6 Malaria-Associated Complications or Malaria Syndromes
Prolonged and untreated malaria may often lead to several different kinds of
complications involving neurological, anatomical and physiological anomalies
(Gupta et al. 1987; Padhiary et al. 1996; Tyagi and Chaudhary 1996). Severe
malarial infection, particularly by P. falciparum, is dangerous and can also be fatal
in the absence of prompt recognition of the disease and its complications, although
active and appropriate patient management can help save several lives (WHO 2000;
Mathur 1990). Severe complicated falciparm malaria is defined by the presence of
one or more pernicious signs and symptoms in a patient showing asexual
parasitaemia of P. falciparum on the peripheral blood. Symptoms of these severe
manifestations can occur singly or more commonly in combination in the same
patient.
There are a few studies made on the subject in the Thar Desert region pioneered
by Gupta et al. (1987), Mathur (1990), Gupta and Kataria (1993) and, in recent years,
most importantly by Kochar et al. (1997a, b, 1998a–c). More often complications
encountered as a follow-up of severe and untreated malaria due to P. falciparum
included cerebral malaria, severe anaemia, renal failure, jaundice, hypoglycaemia,
etc. Kochar et al. (1997a, b) had enlisted 15 such syndromes resulted from
P. falciparum-triggered complicated malaria cases (total 532) admitted at the tertiary
level of healthcare system at S.P. Medical College and associated group of hospitals
at Bikaner, following the 1994 malaria epidemic (Table 12.16).
12.6 Malaria-Associated Complications or Malaria Syndromes 229
Table 12.16 Morbidity and mortality in various malaria syndromes in 532 cases of severe and
complicated malaria
No. of cases No. of deaths
Syndrome (%) (%)
Cerebral malaria 137 (25.75) 46 (33.57)
Severe anaemia 31 (5.83) 22 (70.97)
Renal failure 11 (2.07) 5 (45.45)
Pulmonary oedema (ARDS) 16 (3.00) 13(81.25)
Hypoglycaemia 11 (2.07) 3 (27.27)
Circulatory collapse, shock 28 (5.26) 13(46.43)
Spontaneous bleeding 51 (9.58) 4 (7.84)
Repeated generalized convulsion (other than cerebral 13 (2.44) 1 (7.69)
malaria cases)
Macroscopic haemoglobinuria 42 (7.89) 4 (9.52)
Impaired consciousness (but arousable) 34 (6.39) 1 (2.94)
Prostration, weakness 68 (12.78) 2 (2.94)
Jaundice (S. bilirubin >3 mg/dl) 61 (11.47) 22 (36.06)
Hyperpyrexia 132 (24.81) 20 (15.15)
Psychosis 11 (2.07) 2 (18.18)
Multiple factors 51 (9.59) 42 (82.35)
The overall mortality recorded due to complications was 11.09% (# 59) which
was quite high because of infection in the non-immune population in the Thar Desert
(Sharma 1995). Mortality was reported more (82.35%) in those patients who
presented with more than three syndromes together. It is interesting to note that, in
variation to general belief, though the largest group of cases admitted was of cerebral
malaria, deaths caused due to cerebral malaria stood only next to those having
pulmonary oedema (81.25%), severe anaemia (70.97%), algid malaria (46.43%),
renal failure (45.45%) and jaundice (36.06%).
Most pregnant women with malaria were found to be more prone to develop
severe anaemia, hypoglycaemia, cerebral malaria and pulmonary oedema compared
to non-pregnant women, and these factors obviously contributed to high mortality
and morbidity. The aetiology of foetal distress had been traced to the preferential
parasite sequestration and development in the placenta, wherein it interferes with the
transplacental delivery of nutrients to the foetus. Acute placental insufficiency is the
net result, and, in areas like the Thar Desert with unstable malaria transmission
where symptomatic disease in the mother is not uncommon, foetal distress is
generally undiagnosed, resulting in high mortality. Of the 30 pregnant malaria
patients, of which 10 (33%) had died, only 11 (37%) succeeded to continue with
pregnancy, while 5 (17%) had aborted and 4 (13%) delivered still birth. Mortality
reported in females was more than double (16.06%) than in males (7.64%) because
of specific neglect in getting rapid treatment for them and the deleterious effect of
pregnancy.
Clinical pattern arisen due to complicated malaria in the Thar Desert population
was stressed by some workers (Gupta et al. 1987). In an important investigation,
Kochar (2001) studied 441 adult patients suffering with cerebral malaria from
Bikaner. Apart from fever and unconsciousness in all patients, other complications
included convulsions (12.13%), neck rigidity (19%), psychosis (5.21%), conjugate
deviation of eyes (2.26), extrapyramidal rigidity (2.25%), trismus (1.13%), decorti-
cate rigidity (1.13%) and de-cerebral rigidity (0.90%). A total of 145 (32.87%)
patients expired, and mortality was highest in pregnant ladies (39.28%). The most
important neurological sequelae in survivors were psychosis (5.06%), cerebellar
ataxia (4.72%), hemiplegia (1.68%), peripheral neuropathy (1.01%) and isolated
sixth nerve palsy (0.33%). All the survivors, treated with quinine orally, recovered
but continued to manifest certain complications in the follow-up examinations. The
associated illness included microscopic haemoglobinuria (12.92%), ARF (9.07%),
jaundice (6.8%), anaemia (6.8%), bleeding (6.8%), pulmonary oedema (4.53%) and
hypoglycaemia (4.08%). Multiple organ dysfunction syndrome (MODS) was
observed in 14.51% patients.
In a pilot study to assess the impact of malaria epidemic on the health of affected
population in some villages of Jaisalmer in 1999, the following most common
illnesses were found to inflict the population (Tyagi et al. 2001a, b). Clinically
fever (47.9%) was identified as the most common cause of illness, followed by
headache (21.1%), abdominal pain (8.9%), body ache (6.5%), giddiness (5.6%), loss
of appetite (3.2%), cough and expectoration (1.6%) and nausea/vomiting (1.6%).
Most of the examined cases were febrile in all but one age group (0–11m), while
most febriles were found in the 15+-year age group. No serious illness could be
identified in the cases in <11-month age group.
Ophthalmoscopic abnormalities or eye changes are causable due to P. falciparum
malaria, and several studies are on record from outside the Thar Desert region in
India. Kochar et al. (2000) examined in detail for the first time the prognostic
significance of eye changes in cerebral malaria. In the 214 adults examined, they
detected retinal haemorrhage in 25 (11.68%) patients, papilloedema in 17 (7.94%),
blurring of disc margins in 25 (11.68%), retinal oedema in 6 (2.8%), disc pallor in
5 (2.33%), vitreous haemorrhage and hard exudates in 1 (0.46%) each and
subconjunctival haemorrhage in 6 (2.8%) patients. They concluded that the presence
of eye and/or retinal changes in patients of cerebral malaria reflects a slight predilec-
tion for increased activity of the disease but do not have the prognostic significance
per se.
Splenomegaly was found to be quite common, though was absent entirely in the
<11-month age group when a small sample from four desert villages in Mohangarh
area in Jaisalmer district was studied soon after they were struck by a focal malaria
outbreak in 1999 (Table 12.17). In the age group 11–23 months, only females had
splenomegaly, while in the age group 10–14 years, only males were suffering with
spleen enlargement. Males were found to suffer more with the enlargement of spleen
(n = 9; 64.2%) than females (n = 5; 35.8%). The child spleen rate (CSR) was
estimated as 3.6%, while the adult spleen rate was 4.3%. The average enlargement of
spleen (AES) stood at 2.3.
12.6 Malaria-Associated Complications or Malaria Syndromes 231
Table 12.17 Spleen Age group Male Female Total

enlargement survey during
0–11 months – – –
malaria epidemic during
May 1999 in the four study 12–23 months – 1 1
villages in Jaisalmer 2–4 years 2 1 3
5–9 years 3 1 4
10–14 years 2 – 2
15+ years 2 2 4
Total 9 5 14
Epidemics of Malaria in Major Deserts
13
13.1 Introduction
An epidemic is, in principle, defined as any sudden increase in disease incidence

beyond what is considered normal (cf. Najera et al. 1998). Epidemics differ not only
in their causality but also in their form of presentation, evolution, incidence by age
groups, severity and socio-economic impact (Najera et al. 1992). The epidemics, in
the outset, characteristically follow a 2–5 or 7 years’ cycles, recurring in associating
with a similar periodicity of abnormal meteorological conditions (heavy rains,
floods, draughts, etc.). These abiotic factors actually help in increasing proliferation
and survival of vectors such as Anopheles arabiensis, in the desert fringes of Sahara
Desert. The higher the favourable temperature and humidity in the desert fringes, the
higher is also the transmission rate of malaria and the resultant morbimortality. The
impact of epidemics could be minimized through prediction, improved prevention
through timely vector control and deployment of appropriate control measures. The
implementation of a Malaria Early Warning System may enable regional/national
health ministries and/or control managers to focus on epidemiological surveillance
and be better prepared to take necessary actions.
Desert fringes are among the most populated areas in the desert ecosystem where
malaria epidemics regularly recur due to change in marginal environmental
conditions, brought about by heavy seasonal rainfall, for the commensurate devel-
opment of the parasite and the population dynamics of the Anopheles mosquito
vectors. Despite phenomenal success achieved by many north Saharan countries in
eliminating malaria in cent years, the infection is re-emerging in most of the African
highlands exposing the non-immune populations to deadly epidemics (Protopopoff
et al. 2009). Over the years, malaria epidemic affected about 3 million people in
Nigeria (Tewari et al. 2009). In Ethiopia the incidence of malaria varies from place to
place and at different times: there are areas where the incidence of malaria is high
and other areas where the incidence is low, and some areas are malaria-free; in some
communities, malaria transmission lasts for several months or happens throughout
the year, and in other areas, it is very brief. Like elsewhere in the deserts of the world,
Ltd. 2023
234 13 Epidemics of Malaria in Major Deserts
in Ethiopia, too, climate affects the natural distribution of malaria, and the three main
climatic factors that directly affect malaria transmission are temperature, rainfall and
relative humidity (the amount of moisture in the air). Desert fringe areas are entirely
dependent on sudden climatic variabilities dominated by heavy downpours, increase
in humidity and lowering the temperature to suit the population growth of the vector
and the parasite’s development within the vector. Thus, as a rule, climate variability
in desert fringe areas has a key to fulmination of malaria cases and the disease
dynamics. Besides, climate variability is fundamental to early warning systems,
whereby precious human life can be saved if long-term data base are integrated to
develop an effective forecasting signal and execute timely implementation of effec-
tive control methodologies. A better understanding of the factors impacting trans-
mission in the highlands is crucial to improve well-targeted malaria control strategies
(Lindsay and Martens 1998).
Due to the instability of malaria transmission in the deserts, small variations in
environmental or human related factors can have dramatic consequences for malaria
transmission due to the low immune status of the human population. Different
factors can drive these changes by influencing the vector’s transmission capacity
and the malaria prevalence. These factors can be grouped as follows:
1. Environmental factors such as altitude and climate

2. Biological factors related to the Anopheles vector, the parasite and the human host
3. Human-related factors such as socio-economic status, health access, migration,
gender, control activities (IRS, insecticide-treated net and intermittent preventive
treatment) and land use (irrigation, deforestation, swamp drainage and living near
breeding sites)
The conceptual model of potential factors influencing either Anopheles (density,

longevity and/or contact with human) or the outcome of transmission (i.e. malaria
infection) in the highland based on this review is presented in Fig. 13.1.
13.2 Malaria Epidemic Modelling
Two models are popular: (1) the P. falciparum infection model and (2) the Liverpool
malaria model. The principles on which these two models are based are succinctly
described.
13.2.1 The P. falciparum Infection Model
In order to derive a demonstrable correlation between one of the most significant

entomo-epidemiological factors, the entomological inoculation rate (EIR) and
P. falciparum infection in children in Africa, Smith et al. (2005) and Hay et al.
(2005) proposed a very similar model (the S2005 model) after studying
119 published works on the subject. This model was erected on the assumption of
the presence of heterogeneous infection rates without imparting immunity to
13.2 Malaria Epidemic Modelling 235
Fig. 13.1 Conceptual model of important risk factors affecting malaria prevalence in the African
highlands. Factors are regrouped in three main classes (environmental factors, green label;
biological factors, grey label; and human-related factors, blue label). Dependent variables included
in the CART analysis are displayed in red, and predictor variables are highlighted in white (Source:
Protopopoff et al. 2009)
reinfection, albeit occurrence of superinfection (i.e. an infection that follows a

previous infection). This is expressed by the following equation:
-k
b × EIRa
PR < 15 = 1 - 1 þ
r×k
[where b represents the transmission efficiency (the probability that an infectious

mosquito bite causes infection) and 1/r is the expected time for parasite clearance.
The S2005 model assumes heterogeneous infection rates following a Γ (gamma)
distribution, with a mean of 1 and variance 1/k. The estimated parameters were b/
r = 0.45 and 1/k = 4.2. Note that the S2005 model reveals a large uncertainty
because of the large variability of the observations (Smith et al. 2005)].
13.2.2 The Liverpool Malaria Model (LMM)
Originally formulated by Hoshen and Morse (2004) and subsequently elaborated and
deployed by Jones and Morse (2010), this model considered weather-resulted
vicissitudes, i.e. daily mean temperature and 10-day accumulated precipitation, for
comprehending dynamics in malaria biology, but does not include, among many
attributes, the parasite-imparted immune status of affected humans. Therefore, an
improvised model was further put forward by Ermert et al. (2011a) for malaria in
West Africa which included even certain additional features of vector’s bioecology
such as flushing of breeding habitats by excessive rains.
13.3 Epidemics in Saharan Countries
1. Mali
The West African nation, Mali, is a large and arid country that is strategically located
partly in Sahara. The mighty Niger River traverses through it, divides into countless
channels and forms the largest wetland in Western Africa. Harbouring an array of
important malaria vectors, e.g. A. arabiensis and A. gambiae, and the dominant
malaria parasite, P. falciparum, Mali is among the ten most malariated African
countries (with a prevalence of 1% in Bamako to a maximum of 30% in Sikasso
region, besides children below 5 years old and pregnant women, in particular, being
at high risk), reporting nearly 3% of the global cases and deaths. Also, Malian
children under 5 years old suffering with anaemia are second in the world (WHO
2019a–c). The disease prevalence among children under 5 years of age was 19% in
2018. Malaria is endemic to the central and southern regions, where about 90% of
Mali’s population lives, and it is epidemic in the north due to the limited viability of
Anopheles species in the desert climate. The country therefore has three malaria
zones:
(a) Stable malaria zones: In this zone, the disease is transmitted throughout the year,
with some seasonal variations. This transmission type impacts the Guinean and
Sudanese zones as well as the dams and inner Niger Delta areas.
(b) Unstable malaria zones: These areas have intermittent transmission of malaria
(mainly the Sahelian-Saharan zone) and are impacted by epidemics; local
inhabitants are therefore not sufficiently immune to malaria.
(c) Sporadic malaria zones: This is typical of the Saharan zone, and the population
has no immunity against malaria with all age groups being exposed to severe
and complicated malaria infections.
Even though several policies in support of pregnant women and children have
been introduced (Anon. 2019), the poor people such as destitute and those difficult to
approach, e.g. internally displaced, refugees, immigrants and nomads, repatriated,
and populations which have limited geographical access to health centres are more
often than not deprived of the health opportunities like the insecticide-treated
mosquito net (ITN), despite the fact that Mali continues to have high access to
(90% in 2018) the ITNs.
13.3 Epidemics in Saharan Countries 237
2. Ethiopia
Ethiopian malaria epidemiology is significantly characterized by a short spell of

the transmission season in most areas over 5000 ft in altitude, which precludes the
development of immunity and favours the incidence of periodical regional epidemics
of great severity. The predominant malaria parasite in this region is Plasmodium
falciparum, and the principal mosquito vector is Anopheles gambiae. Among all
vector-borne diseases prevalent in Ethiopia, malaria ranks number one as far as
morbimortality is concerned. Approximately 65% of Ethiopian population live in
malaria endemic areas (2,174,707 malaria cases reported in the year 2014–2015 of
which 63.7% were positive for P. falciparum). In the same year, a total of 302,136
cases, diagnosed either microscopically or through rapid diagnostic test (RDT), were
reported from the Tigray region, among which 70.2% were positive for
P. falciparum (Gerensea and Teklay 2017).
Malaria in Ethiopia occurs cyclically every 5–8 years, and the transmission
pattern of large-scale epidemics is quite unusual (EPHI 2016). Two of these
epidemics are briefly narrated below. An epidemic occurred in the latter half of
1958 over an area of about 100,000 square miles, involving chiefly the provinces of
Shoa, Gojjam, Begemder and Wollo. The number of malaria cases occurring during
the epidemic was estimated at not less than 3 million, with 150,000 deaths. A
previous regional epidemic, also attended with a high mortality, had been recorded
in the area immediately north of Lake Tana in 1953. Climatic conditions in 1958
were unusually favourable for the propagation, longevity and dispersal of the insect
vector. The epidemiological scenario resembles closely to that found in north-west
India (Thar Desert), where regional malaria epidemics are also prone to occur,
provided communal immunity is at a low level. Most of the adults who received a
single dose of 600 mg of chloroquine (base) had recovered sufficiently to take part in
the harvest within 3 or 4 days after treatment.
More recently a severe outbreak erupted in Tanqua Abergele district, Tigray,
Ethiopia, in 2017 where a total of 876 (67.4%) positives were diagnosed (Tesfay
et al. 2019). A study conducted between September 8 and October 18, 2017,
concluded that the epidemic-associated factors included (1) mosquito breeding
sites, (2) sleeping outdoors by inhabitants and (3) absence of mosquito screens
over doors and windows. Overall median age of suspected malaria cases was
27 years with interquartile range (IQR) of 19.40. Surprisingly the study found
more females (694/1300, 53.4%) falling ill due to malaria. The hardest malaria-hit
was the younger age group (5–14 years of age) which exhibited the highest positivity
rate (76.8%), followed by working adult group (15–44 years of age) (67.3%). Zhou
et al. (2004) addressed to the association between climate variability and malaria
epidemics in the East African highlands. They propounded that climate variability
could be more relevant than mean temperature change and humidity, and its effects
on malaria epidemics are more far reaching. The net variance in the number of
monthly malaria outpatients caused by autoregression and seasonality varied among
sites and ranged from 18 to 63% (mean = 38.6%), whereas 12–63% (mean
= 36.1%) of variance is attributed to climate variability. They suggested that there
was a high spatial variation in the sensitivity of malaria outpatient number to climate
fluctuations in the highlands and that climate variability played an important role in
initiating malaria epidemics in the East African highlands.
3. Niger
Malaria is a major public health problem with economic consequences in Africa

and particularly in Niger where Plasmodium falciparum is encountered. In 2000,
malaria was the fourth leading cause of death in Niger, after acute lower respiratory
infections, perinatal diseases and diarrhoea among children less than 5 years of age
(WHO 2008). Niger was classified among the 31 high-burden countries for malaria
by the WHO. More than 2 million cases were notified to the national surveillance
system with 2691 deaths, all occurring in children less than 5 years old. This
represents a case fatality rate of 0.13% in the general population and 0.45%
among children (WHO 2009).
In Niger, the last malaria peak was in 2012. The country made a good progress in
containing cases, but after a significant decline in malaria cases over the last 3 years,
there has been a resurgence of the disease in certain areas, though no apparent
outbreak was documented (Anon. 2020).
13.4 Epidemics in the Thar Desert
Although documentable outbreaks of malaria epidemics are available in the annals

of Thar’s malaria after 1975, there is however every possibility that morbidity might
have also occurred in the desert during the nation-wide epidemic in 1908 and
perhaps thereafter as well on other such occasions (Tyagi and Yadav 2001b)! It is
noteworthy that the explosive and disastrous epidemic which effected large parts of
India in 1908 was officially estimated to have attacked 100 million people and
caused about 1 million deaths (Najera et al. 1998). As a consequence, at least
13 episode-years of malaria epidemics are identifiable since 1975. Save for the
massive outbreaks of malaria in 1975, 1976, 1990 and 1994; most other epidemics
were focal in nature covering often a part of a district or two. While the epidemics of
1975 and 1976 were predominantly characterized by a resurgence in P. vivax cases,
the outbreaks of 1983–1984 onwards saw a phenomenal rise in P. falciparum
(Table 13.1). That these epidemics had occurred so systematically and predictably,
along the course of Indira Gandhi Nahar Pariyojana (IGNP), it does not seem to be
entirely out of place to correlate these with the phenomenon of the evolution of the
pathways for the resurgence of P. falciparum-dominated malaria in the Thar Desert
(Tyagi 1996f, 1998a, 2001a, b; Tyagi and Chaudhary 1997; Tyagi et al. 1995,
2001a, b).
Due to mortality-related importance attached with P. falciparum-dominated
malaria, it is considered worthwhile to have a stock of the magnitude of the impact
of some of these impactful epidemics which forced an inevitable bearing on the
entire course of conventional disease epidemiology of the Thar Desert.
13.4 Epidemics in the Thar Desert 239
Table 13.1 Overview of malaria epidemics in the Thar Desert districts from 1975 to 2002 (Source:
Tyagi 2004a, b)
Dominant
malaria species at
Years of the epicentre of Possible reason associated with
District epidemics epidemic epidemic Deaths
Sri 1983, 1984, P. falciparum Increased vector activity with 0
Ganganagar 1985 increase in varied breeding sites
Bikaner 1975, 1976, P. falciparum Increased vector activity with 113
1990, 1992, increase in varied breeding sites
1993, 1994
Churu 1975, 1976 P. falciparum Inter-state population migration 5
Jhunjhunu 1975, 1976 P. falciparum Inter-state population migration 6
Nagaur 1975, 1976, P. vivax Inter-state population migration 2
1990
Jodhpur 1990, 1992, P. vivax, Increased vector activity with 72
1993, 1994, P. falciparum increase in varied breeding sites;
2001, 2002 excessive quarry-mining
brooding perennial vector
breeding
Jaisalmer 1975, 1990, P. vivax, Increased vector activity with 72
1992–1996, P. falciparum increase in varied breeding sites;
1999–2001, non-immune human population
2002
Pali 1975, 1976, P. vivax, Inundative vectorism 3
1990 P. falciparum
Barmer 1975, 1990, P. vivax, Inundative vectorism 178
1994 P. falciparum
Jalore 1975, 1976, P. falciparum Inundative vectorism 20
1990
Sikar 1975, 1976 P. falciparum Flooding 10
1. Malaria Epidemics of 1975–1977
Even though no incidence of death was brought on record, it was crystal clear
that, in view of the steep rise in malaria-positive cases compared to the 1966 base
level of malaria cases, outbreaks of malaria had also struck the entire Thar Desert,
just like they occurred in other parts of the country. These epidemics were mainly
characterized by P. vivax domination.
Sri Ganganagar experienced a focal P. falciparum-dominated malaria outbreak

for the first time in 1983, with 4925 positive cases of which 43.4% were
P. falciparum cases. In spite of the fact that in 1983 API was but second lowest
during the last few years, the malaria outbreak in the Nalibed area in the erstwhile
Hanumangarh tehsil of Sri Ganganagar caused high morbidity. Two primary health
centres (PHCs), Sangaria and Pilibanga, which were most severely affected, had
jointly contributed 72.2% of the total positive cases in the district during the
epidemic. It is noteworthy that P. falciparum, after keeping a plateau for some
years following 1987, had since constantly increased for at least few years, while
conversely the API had kept a low ebb for the same period.
3. Malaria Epidemic of 1990
In 1990, a widespread epidemic-hit western Rajasthan districts but particularly

the Barmer district claiming 47 lives (Mathur et al. 1992). A total of 19,322 positive
cases (P. falciparum 66%) were recorded in Barmer district which was 2.5 times
higher than what was reported in the preceding year. It was advocated that the
epidemic in Barmer district occurred as a sequel to widespread floods in the region. It
was demonstrated that the rise in the incidence of malaria was associated with the
increase in the rainfall. During 1977, when annual rainfall was 13% above the
normal, the annual parasite incidence (API) showed a conspicuous rise at 5.3 and
annual falciparum incidence (AFI) between 0.03 and 0.1. However, 1985 was a year
of exception when there was a noticeable increase in cases, particularly of
P. falciparum, despite low rainfall. This increase was, however, attributed to the
migratory cases, since the cases did not proliferate locally due to non-conducive
transmission conditions. This was substantiated by a significant decline in the
incidence in the next 2–3 years.
Both rural and urban areas were equally and simultaneously affected by the
epidemic. Though all the eight PHCs presented a rising trend, the Baitu PHC was
the worst affected with API touching a peak of 55.3 and AFI 19.6. The highest
increase in AFI were in Mandli (4.5 times), Gudamalani (4 times), Ramsar (2.8
times), Ganga (2.3 times), Sindhari (1.75 times) and Chohtan (1.6 times).
The Barmer town also recorded a fourfold rise in API and threefold rise in AFI.
The district’s overall API and AFI recorded 2.5- and 3-fold increases, respectively.
The mass blood survey carried out during the epidemic showed that all age groups
were affected. The slide positivity rate was 61% and more than 93% of these had
P. falciparum infection. A total of 122 infants were found positive of which less than
30% had P. falciparum infection. A total of 103 infant positives were from Baitu
PHC only. About 88% of the positive infants were detected during September–
November, 1990. Baitu, along with Ramsar, also recorded maximum deaths (13),
followed by Sindhari (6), Mandli (4), Samdhari (4), Ganga (3), Chohtan (2) and
Gudamalani (2). A maximum number of deaths (21) were recorded during October,
while mortality figures in September and November were 12 and 14, respectively. It
was only in 1992 and 1994 when P. falciparum cases had exceeded than reported
earlier for 1990, being the highest ever till then in the past. No doubt it was only in
1990 when a maximum number of deaths (48) due to cerebral malaria were recorded.
They, however, presumed a much higher total of deaths among infants and paediatric
groups, in view of the high infectivity by the malaria parasites.
During late 1992 and early 1993, epidemics of malaria broke out simultaneously
in several districts, i.e. Bikaner (Bajju and Kolayat PHCs), Jodhpur (Baap and
Phalodi PHCs) and Jaisalmer (Pokaran, Nachna and Sangad PHCs) (Table 13.2).
If the malariometric data from the three PHCs in Jaisalmer district alone are
reviewed, it becomes clear that the malaria scenario has drastically changed over
the years. A total of 2128 positive cases (P. falciparum 73.6%) were reported against
a combined total for of 1809 cases in the two preceding years, i.e. 1990 and 1991
(P. falciparum 27.6%), clearly indicating a shift towards an ascending order of the
P. falciparum-dominated malaria cases.
In a pilot survey carried out in two desert villages, namely, Madassar and Awai,
near the Indira Gandhi canal, both the SPR (85.0) and the P. falciparum proportion
(88%) were relatively much higher in the desert or non-canal-irrigated villages
outside the command area, Kanasar and Khetusar (Tyagi et al. 1994). Mass blood
surveys (MBS) in the four study villages revealed that the SPR was much higher in
the IG Canal villages (85.2%) than in the desert villages (26.3%), with an overall
average of 58.5% in these villages (Table 13.3). The P. falciparum rate ranged from
72.7 to 92.8%, with a distinct higher P. falciparum prevalence in the IG Canal
villages (88.8%). Interestingly, more than three-fourths pf the total positive cases
were found to be asymptomatic or afebrile type. While 87.3% asymptomatic cases
were detected in the desert villages, only 74.1% cases were identified in the canal-
irrigated villages. A total of six gametocyte carriers (9.5%) were reported in
Madassar against only one carrier (7.6%) in Kanasar village. The relatively high
gametocyte carriers in the IG Canal-irrigated villages point out towards a greater
degree of sustained transmission of malaria in these villages.
Subsequently, when regular fever surveys were conducted, it brought out the fact
that active transmission had been continuing in all the study villages, though the
prevalence in the IG Canal villages was 2.3–12 times more in January and February,
1993. Cumulatively the number of P. falciparum cases was much higher (76.6%) in
the IG Canal villages, besides the frequent presence of gametocytes. Nearly 50% of
the positive cases were the children of less than 12 years of age.
Eight Anopheles species prevailed in the outbreak-affected villages: An. stephensi,
A. culicifacies, A. subpictus, A. vagus, A. nigerrimus, A. annularis, A. splendidus and
A. d’thali. In the desert villages, it was An. stephensi (54.7%) which dominated
the fauna. The resting behaviour in human dwelling and cattle shed by both
An. stephensi (1.5:1) and A. culicifacies (2.3:1) pointed out towards a preference
for resting in the human dwelling.
In bioassay tests it was noticed that during the period of outbreak the insecticide
deployed in the villages had lost effectiveness by 40–60% against An. stephensi.
Additionally An. stephensi exhibited tolerance (50% kill) against DDT (4%
impregnated papers) but complete susceptibility against malathion (5% impregnated
papers).
242
Table 13.2 Malariometric indices in three primary health centres (PHCs) in Jaisalmer district for the period 1992
1988 1989 1990 1991 1992
PHC SPR SFR API SPR SFR API SPR SFR API SPR SFR API SPR SFR API
Pokaran 2.0 0.1 2.2 0.8 0.2 0.7 5.2 1.2 8.3 1.2 0.3 1.2 11.8 2.9 17.3
Nachna 1.6 1.0 1.4 5.7 1.5 5.7 5.1 1.5 6.4 2.1 0.8 1.9 9.8 7.3 10.8
13
Sangad 0.6 0.8 0.8 2.3 0.3 0.8 11.5 1.8 9.8 1.3 0.3 5.1 10.3 4.4 10.7
Table 13.3 Results of parasitological surveys in four study villages in Jaisalmer and Jodhpur
districts in the Thar Desert (Rajasthan, India) (Tyagi et al. 1994)
Month/ BSC/ Total
Village Population year BSE Pv Pf +ves Pf% SPR
Madassar 2496 Jan. 1993 83 8 63 71 88.73 85.54
Awai 1152 Jan. 1993 32 3 24 27 88.88 84.37
Kanasar 1467 Feb. 1993 58 1 13 14 92.85 24.13
Khetusar 1200 Feb. 1993 37 3 8 11 72.72 29.72
In mid-1994 a major epidemic of malaria broke out in whole of the Rajasthan

state taking a toll of 452 lives (Bose 2004). The worst affected three districts
included Barmer, Jaisalmer and Jodhpur, contributing nearly two-thirds of the total
mortality. Plasmodium falciparum accounted for over 60% of cases in the desert and
was considered as the main cause of death (Jain 1994; Sharma et al. 1995; Tyagi
et al. 1995).
In a year-long study during 1993–1994, some very important observations were
made (Table 13.4). Following a rapid mass blood survey immediately after the
epidemic in the late autumn of 1992 in the two IGNP command villages of Madassar
and Awai (P. vivax 11.1%, P. falciparum 88.7%) and two unirrigated villages of
Kanasar and Khetusar (P. vivax 17.1%, P. falciparum 82.7%), fever surveys were
conducted for one full year between April 1993 and March 1994 which had shown a
slightly higher slide positivity rate in the IGNP villages (32.3%) than in the unirri-
gated villages (25.5%). The most important feature was, however, the higher
proportion of P. falciparum in the IGNP villages (76.6%) compared to that in the
unirrigated villages (16.6%). Influenced by high percentage of P. falciparum in the
study villages, the slide positivity rate maintained a high profile throughout. Plas-
modium falciparum exhibited two distinct peaks; first, during the summer months of
April–May and second during July–August (Fig. 13.2). Mixed infections occurred in
all villages, although more occurred in the unirrigated villages (11.5%) than the other
two villages (3.2%). Interestingly, more gametocyte carriers were present in the
IGNP command villages (16#, 17.8%) compared to the unirrigated villages (2#,
8.3%). Cumulatively, 73.7% of all the positive cases were found in children of less
than 14 years of age. The male population (68.4%) suffered more than the females
(31.5%).
In another short-term epidemiological investigation involving villages in three
districts (Jodhpur, Barmer and Jaisalmer) with different canal-based development
status, a rather high-profile results were obtained (SPR 50.2%, SFR 28.5%). Plas-
modium falciparum infection contributed 56.0% of the total cases. The high spleen
rate (59.7%) was an indication of a serious situation of malaria in the study villages.
Several other researchers have evidenced the above observations. Shukla et al.
(1995) carried out investigations on malaria epidemic in three primary health
centres, viz. Pokaran PHC and Nachana under Jaisalmer district and Dhorimana in
244
Table 13.4 Malariometric information from the four villages in Jodhpur and Jaisalmer districts, during 1993–1994
Positive P. vivax P. falciparum Mixed parasites Gametocyte Males Females
Village BSC/BSE (%) (%) (%) (%) (%) (%) (%) API
Madassar 177 52 8 42 2 12 36 16 20.8
(29.3) (15.3) (80.0) (3.8) (23.0) (69.2) (30.7)
Awai 101 38 10 27 1 4 23 15 32.9
(37.6) (26.6) (71.0) (2.6) (10.5) (60.5) (39.4)
Kanasar 65 18 13 4 1 2 14 4 12.2
13
(27.6) (72.2) (22.2) (5.5) (11.6) (77.7) (22.2)

Khetusar 29 6 5 0 1 0 5 1 5.0
(20.6) (83.3) (0.0) (16.6) (0.0) (83.3) (16.6)
Total 372 114 36 73 5 18 8 36 18.0
(30.6) (31.5) (64.0) (4.3) (15.8) (68.4) (31.5)
Fig. 13.2 Comparison of P. falciparum cases during a study in irrigated and unirrigated villages in
Jaisalmer and Jodhpur districts, respectively (Source: Tyagi 2002)
Barmer district during 1994 when the Thar Desert had experienced an unprecedented
heavy rain. They in Pokaran PHC revealed the presence of small foci of stable
malaria. They considered rain, which formed large bodies of water (ponds/lakes), as
the main factor behind the epidemic foci in Pokaran spread over adjoining villages
within a radius of 5 sq. km. Slide positivity rate (SPR), slide falciparum rate (SFR)
and child spleen rate (SR) were 60.1%, 56.9% and 86.9%, respectively, with three
deaths reported. A. culicifacies and An. stephensi were found to be the major malaria
vectors. Nachana PHC which being in close proximity of Indira Gandhi Canal (IGC)
already suffered with malaria round the year. The SPR, SFR and SR accordingly
steeped to 52.35%, 50.58% and 80.8%, respectively. In addition to the main malaria
vectors, i.e. An. stephensi and A. culicifacies, the mosquito A. fluviatilis was also
considered a major player in relays. A. fluviatilis seems to have established breeding
in silted grassy margins of the IGC. Dhorimana PHC, a border district, exhibited
stable malaria foci with relatively low indices. These authors assumed that
A. culicifacies and An. stephensi, with expanded breeding potential, are the main
factors in maintaining malaria endemicity in the region.
There is some debate whether the year of 1995 to be regarded as a year of

epidemic or not. Najera et al. (1998), however, clearly described severe epidemics
during both 1995 and 1996, associating with them as possible reasons the excep-
tional meteorological conditions like abnormal extension of waterlogged areas in
lowland plains from massive irrigation systems. In view of the unprecedented high
morbidity and mortality in 1996, claiming 45 lives (60.7% of the total deaths in
Rajasthan) in the Thar Desert region alone, both these years can undoubtedly be
regarded as epidemic years. The malariometric data of 1995 are comparable with
some of the past epidemic years.
Fig. 13.3 Spot map of malaria outbreak-hit villages in Ramgarh Taluk, Jaisalmer district, in the
Thar Desert during April 1999: (1) Raghwa, (2) Seuva, (3) Hada, (4) Raimala, (5) Sadhna,
(6) Tejpala, (7) Badha, (8) Nagga Dhani, (9) Nagga village and (10) Hucha (Note: Villages in
dark circles were investigated for the malaria outbreak) (Source: Redrawn from Tyagi et al.
2001a, b)
A focal outbreak of malaria occurred in the villages situated close to the main
Indira Gandhi Canal near Ramgarh in Jaisalmer district, western Rajasthan
(Fig. 13.3). Stagnation of water over a month’s period in the main canal as well as
long-standing rain water in the form of large lake-like bodies near these villages
formed vast breeding grounds for the vectors like A. culicifacies along with
An. stephensi already breeding in the ‘tanka’ and ‘beri’ in the epidemic-hit villages.
A joint entomological and epidemiological investigation was undertaken in four
of the epidemic-hit villages, namely, Seuva, Raghwa, Raimala and Sadhna, all
within a distance of 2 km from the main Indira Gandhi Canal. During mass blood
survey in the four study villages, both thick and thin blood films from a total of
380 persons with a history of fever in last 1 month were prepared for examination. Of
these 49 (12%) were P. vivax, and 40 (10.5%) were P. falciparum, while 8 (2.1%)
had mixed parasitism with both parasites. Results of the mass blood survey pointed
out towards a high slide positivity rate (25.5%) and P. falciparum proportion
(49.5%) in the villages hit by the epidemic. While Raghwa village had presented
the highest SPR (30.4%), Raimala showed the lowest SPR (13.1%). Interestingly,
however, while on the one hand Raimala singled out with the highest %
P. falciparum (60%), Seuva offered the lowest P. falciparum proportion (41.0%),
on the other. Maximum P. falciparum cases nevertheless originated from Sadhna
village (Table 13.5).
With regard to anophelines, four species, viz. An. stephensi (47.4%), A. culicifacies
(41.0%), A. subpictus (11.2%) and A. Annularis (0.4%), were sampled over a period
of 6 months (Fig. 13.4). Anopheles stephensi was found breeding in the household
‘tanka’ and the community-based ‘beri’, whereas A. culicifacies preferred breeding
Table 13.5 Results of mass blood survey in the four study villages during May 1999 epidemic
Ramgarh area in Jaisalmer district
Village Population BSC/BSE Pv Pf Mix. SPR %Pf
Seuva 505 143 23 11 5 27.2 41.0
Raghwa 600 69 9 10 2 30.4 57.8
Raimala 69 38 2 3 0 13.1 60.0
Sadhna 1100 130 15 16 1 24.6 55.5
Fig. 13.4 Proportional distribution of vector species in epidemic-hit villages in Jaisalmer in the
Thar Desert
in the canal-logged water, irrigation channel and the rain-fed lakes in the close
vicinity of the affected villages. Although there was a sharp decrease initially in the
relative density of these species following the indoor residual spray (IRS) with DDT,
the species bounced back soon and built up density again in the epidemic-struck
villages.
Fever surveys conducted between June and September 1999 indicated emergence
of P. falciparum in the epidemic-hit villages, although readily put under control with
the antimalaria control programme (Fig. 13.5).
When susceptibility/resistance tests with insecticide DDT (4% impregnated
papers) and malathion (5% impregnated papers) were performed both vectors,
An. stephensi and A. culicifacies exhibited resistance against DDT but susceptibility
to malathion. The bioassay evaluation of the residual effectiveness of the indoor
spraying of the DDT indicated towards an early degradation of the residual property
56
30 30
29
22 21
20 20
17
12
0
JUNE JULY AUGUST SEPTEMBER
Raghwa Raimala Seuva Sadhna
Fig. 13.5 Malarial fever trend with the slide positivity rate (SPR) in the four epidemic-hit villages
in Jaisalmer in the Thar Desert (Source: Tyagi et al. 2001a, b)
of the insecticide as the vector species soon began to resist the toxicity of the sprayed
dose of 1 g (a.i.)/sq. m. of DDT and survived without mortality even after 1 month
following spray.
Additionally, there had been focal outbreaks of malaria in the Thar Desert during
2001 and 2002, too, as evident by various reports (Anon. 2002a, b), but since any of
these reports are yet to be published in a scientific journal, at present no reference to
the trend of disease prevalence is being attempted.
13.5 Possible Pathways of Evolution of Malaria Epidemics

in the Thar Desert
In the Thar Desert, malaria epidemics seem to occur periodically either following
(1) extensive rains and floods in arid areas, punctuated with periods of droughts, or
(2) canalized irrigation of desert areas, associated with large-scale waterlogging
and/or similar factors responsible for sudden build-up of high densities of vectors
like A. culicifacies and, even, An. stephensi. These situations, coupled with lack of
malaria-related immunity in local folks, development of resistance against
insecticides in vector species and against antimalarials (e.g. chloroquine) in parasites
as well as several other significant but less understood socio-economic factors,
sowed the seed of prospective epidemics and compounded the misery often brought
about by such meteorological calamities as severe floods and droughts (Tyagi
1994b; Tyagi and Yadav 1996c; Tyagi and Choudhary 1997). As a result in at
13.6 Early Warning Systems for Epidemic Malaria in the Thar Desert 249
least some areas under the IGNP, many of these epidemics were directly responsible
for slowing down the process of irrigating the dry lands of the Thar Desert. An
essential prerequisite for the occurrence of the epidemics is the existence of a large
enough number of susceptible persons who are likely to become clinically ill when
suddenly exposed to infection. There is, therefore, an inverse relationship between
endemicity (as was the case in the typical desertic conditions of the Thar of yore
characterized by the presence of An. stephensi and predominance of P. vivax) and the
epidemicity (as is now seen in the changed physiographic scenario of a part of the
Thar under the aegis of IGNP characterized by the high density of the new entrant
A. culicifacies and an overwhelming P. falciparum proportion). Since malaria
epidemics cannot affect the population of highly endemic areas who develop
sufficient immunity early in life, it appears under the circumstances explained
above that epidemics in at least the north-western Thar Desert have taken place
essentially by a combination of development of IGNP and the progressive establish-
ment of A. culicifacies, the malaria vector, and P. falciparum, the malaria parasite.
Malaria epidemics in the Thar Desert present their spread in two ways:
1. They may arise in an explosive way (as encountered in flood-prone Barmer

district), covering hundreds of thousands of square kilometres at practically the
same time and then subside after a year or two.
2. They may progress slowly from locality to locality (as experienced in the areas
under the IGNP) taking several years to spread and showing little tendency to
subside.
From Table 13.6 it becomes apparent that P. falciparum-dominated malaria

epidemics advanced systematically since 1983 from the northern most desert district,
Sri Ganganagar, down along the route of progression by the Indira Gandhi Nahar
Pariyojana (IGNP) towards western (Jaisalmer) and southern (Bikaner, Jodhpur,
Barmer, etc.) districts within the Thar Desert region. With this a new era of the P.
falciparum-dominated malaria seemed to have dawned in the Thar Desert (Tyagi and
Yadav 2001a, b; Tyagi 2002).
13.6 Early Warning Systems for Epidemic Malaria in the Thar

Desert
It is inevitably indispensable to develop early warning systems (EWS) for an

effective preparedness to tackle onslaught of all communicable diseases but more
especially the vector-borne diseases owing to involvement of a strong biotic factor—
the vector (Bouma et al. 1994a, b; Laneri et al. 2010; Sarkar et al. 2019; IvyPanda
2022). Quite a few early warning systems have, therefore, been developed for the
onslaught of epidemic malaria, and the recent addition of EWS based on climate
variability based on biotic information on a global basis is considered to be highly
useful (Gill 1921, 1923; Bouma et al. 1994a, b; Bouma and Kaay 1996). Early
Table 13.6 Possible evolutionary correlation between the anopheline fauna, malaria incidence and the extent of canal irrigation in the Thar Desert (Source:
250
Tyagi 2003a, 2004a, b)

Number of anopheline species Cases reported
Non-vectors (including
occasional or secondary % P.
Period Vectors vectors) P. vivax falciparum Irrigation (×106 ha)
Pre- 1 An. stephensi – – – – –
1930
1931– 1 An. stephensi – – – – –
1935
1936– 2 An. stephensi, 4 A. subpictus, A. annularis, A. vagus, – – 0.24
1940 A. culicifacies A. splendidus
1945 A. culicifacies A. splendidus
1950 A. culicifacies A. splendidus, A. barbirostris
13

1976– 2 An. stephensi, 5 A. subpictus, A. annularis, A. vagus, 639,754 21,649 (5%) 1.22
13.6
1991– 3 An. stephensi, 6 A. annularis, A. subpictus, A. vagus, 368,208 106,963 (29%) 2.17
1995 A. culicifacies, A. splendidus, A. nigerrimus,
A. fluviatilis A. barbirostris
1996– 3 An. stephensi, 9 A. annularis, A. subpictus, A. vagus, 245,960 30,077 (11%) 2.17
2000 A. culicifacies, A. splendidus, A. nigerrimus,
A. fluviatilis A. barbirostris, A. pulcherrimus, A. d’thali
a
Until the late 1980s, A. culicifacies was recorded only from desert fringe urban areas
b
A. fluviatilis is yet to be incriminated with malaria parasites in the Thar Desert, though it is a very efficient vector in southern Rajasthan
c
A. subpictus is only rarely incriminated in the Thar Desert
Early Warning Systems for Epidemic Malaria in the Thar Desert
251
Fig. 13.6 (a) Annual rainfall in the Indian subcontinent (Bartholomew and Herbertson 1899);
isohyets of 25, 50 and 100 cm in formerly British India (grey, 25–50 cm belt) and 200 cm in
formerly Ceylon (hatched area, 100–500 cm) (L, Lahore; C, Colombo). (b) The old Punjab province
with the Indus river and tributaries. The dotted area is that described by Gill (1921) as prone to
severe malaria epidemics in the period 1901–1917. (c) The old Punjab province with the border
between the East and West Punjab (broken line) and the present India-Pakistan border (double line).
Indian provinces shown are Himachal Pradesh (1), Indian Punjab (2), Haryana (3) and West
Rajasthan (4), and the cities shown are Lahore (L) and Delhi (D)
warning systems may include biotic, abiotic or a melange of both. For instance,
whereas typically stationary conditions (e.g. retrospective surveillance and/or mete-
orological data) form the fundamental ground for modelling approaches
(Mukhopadhyay et al. 2019), on the one hand, the epidemiological systems are
based on dynamics of variations in control methods over a period of time which is
spatially larger than inter-epidemic periods (Roy et al. 2015). Despite having an edge
over others, even an epidemiological approach fails to interpret the possible onset of
epidemics, implying that more intense and integrated research of consilience is
desired.
Bouma and Kaay (1996) propounded a new hypothesis based on linkage between
climate change, especially El Niño-Southern Oscillation (ENSO) and malaria in the
Thar Desert, western India (Fig. 13.6).
In this hypothesis Bouma and Kaay (1996), based on their earlier experience in
the Thar Desert (Bouma and Kaay 1995), explained a possible relationship between
13.6 Early Warning Systems for Epidemic Malaria in the Thar Desert 253
epidemic malaria and precarious monsoon rainfall, aided by a Pacific Ocean phe-
nomenon called El Niño-Southern Oscillation. It is noteworthy that Tyagi et al.
(1995) have refuted their hypothesis and explained causes behind the emergence of
P. falciparum-dominated malaria epidemics based on a highly deadly combination
of the original desert vector, An. stephensi, and the newly introduced with the
irrigation water from the IGNP, A. culicifacies, in the Thar Desert.
Urban Malaria in the Desert
14
14.1 Introduction
Historically malaria was associated for centuries with the rural environments of the
countryside villages, and the urban environments which began to be intensified
following the turn of the nineteenth century hardly experienced any malaria episode,
leave aside presence of any malaria vector like Anopheles stephensi. This observa-
tion further restrengthens the hypothesis that the mosquito An. stephensi was
originally a desert species which in course of evolution, along with human’s needs
to urbanize, became adapted synanthropically to the urban environments. It is
predicted that by 2050 about 64% of the developing world and 86% of the developed
world—equivalent to approximately 3 billion urbanites by 2050, much of which will
occur in Africa (where in 2003, 39% of Africa’s 850 million people lived in urban
settings and by 2030, 54% of Africans are expected to do so) and Asia—will be
urbanized. Notably, the United Nations has also recently projected that nearly all
global population growth from 2017 to 2030 will be by cities, with about 1.1 billion
new urbanites over the next 10 years (Cohen 2015). Currently, not only An.
stephensi has established as a predominantly strong malaria vector in the global
urban centres but being joined by many other serious vectors, malaria has critically
bonded with the fast evolving environment in the form of ‘urban malaria’.
14.2 Factors Responsible
Urbanization, especially unplanned urbanization, is inherently plagued with a large

number of factors which may enhance vector breeding and create a risk for high
malaria transmission in the thickly populated environment. Some of these factors are
inventorized below:
(i) Often shortage of conduit water supply to residences, people resort to storing
water in all kinds of pots, pitchers, urns, etc.
Ltd. 2023
256 14 Urban Malaria in the Desert
(ii) In order to have sufficient in-house water supply, people resort to making
underground tanks, which in almost all cases tend to breed An. stephensi. The
most glaring example is the Thar Desert region in western India.
(iii) Because the underwater storage needs a proper time-dependent supply to meet
domestic chores, often people instal overhead tanks at the house roof (which is
now a permanent fixture in multistorey buildings) which again invite An.
stephensi to breed. Megapolises like Delhi, Chennai, Bangalore, Mumbai
and Kolkata, and similar urban centres mostly across Africa and Asia, are
nefariously plagued with such breeding habitats. A city like
Thiruvananthapuram in Kerala, which neither experienced malaria nor the
presence of An. stephensi before the 1980s, is now reeling with cyclic annual
malaria episodes, besides innumerable breeding sites (overhead tanks) of the
vector.
(iv) Frequent mobile populations from hypo- to hyperendemic malarious areas, and
back, become the mode of transportation of malarial parasites.
(v) Poor house quality.
(vi) Poor sewage system and production of innumerable cesspits, cesspools, etc.
within living conditions.
(vii) Lack of awareness by the community.
14.3 Vectors
Even though a large number of vector mosquitoes occur in all urban centres, yet
singularly the most important of all these is An. stephensi (Covell 1928; Rao 1984;
Tyagi 2002).
14.4 Urban Malaria
14.4.1 Sahara Desert
Growing urban population is not only spectacular in sub-Saharan Africa (SSA),

which is one of the highest across the world, even the Sahara Desert is showing
emergence and growth of urban settlements mushrooming everywhere. The fact that
an estimated >75% of the population in the region SSA region will be urbanized by
living by 2050 (Doumbe-Belisse et al. 2021), this almost catastrophic ecological
imbalance is bound to impact the otherwise quiet expanses of the Sahara Desert.
When done this kind of unorganized and unplanned urbanization with hardly any
effective drainage system will certainly affect preponderance of vector populations
and disease transmission. It is worthy to be noted here that some of the species under
An. gambiae complex such as the native desert vector, An. arabiensis, are capable to
breed in the polluted waters, and larvae were reported to have adapted to different
aquatic habitats in most urban settings. In view of paucity of information on the
distribution of the vector population and the dynamics of malaria transmission in
14.4 Urban Malaria 257
urban settings, it is too early to foretell the future damage to health by these
circumstances. The discovery of An. stephensi, a vector mosquito well known for
its propensity to both P. falciparum and P. vivax, first in Djibouti and then in quick
succession in Ethiopia, Sudan and Somalia is but an alert for future malaria confla-
gration in Africa particularly upcoming urban agglomerations.
14.4.2 Middle East/Central and West Asia
Some countries like Iran, mostly in northern and southern parts, malaria has been
reported, often through outbreaks, in several provinces, for example, Kermanshah
province. Nazari et al. (2022) have analysed information on malaria for this province
for the period 1990–1997 and reported that during an epidemic more than 80% of
positive cases were registered with P. vivax malaria being the most common type
(99.32%), followed by P. falciparum, with a very egregious difference (0.68%). The
average age of the affected community was found to be 23.1 years, and men were
infected twice more than women. Also a positive correlation between malaria cases
and rainfall was detected in these cities.
14.4.3 Thar Desert
In the Thar Desert, too, urban malaria is becoming a major threat to the inhabitants,
particularly because of the rather unorganized development of the cities and
townships. There are but few studies on the urban malaria in the Thar Desert, and
one of the earliest studies was made by MacDonald (1931) who, during a 10-day
long survey, found out a spleen rate of 1.1% in school children (Table 14.1).
He noted that within last 10 years no serious epidemic of malaria had occurred,
although on an average 12.8% of all the patients attending hospital were confirmed
to be suffering with malaria. The highest percentage was seen in 1930, with 16.6%,
and the lowest in 1925 with just 8.8%. In the nearby Lallgarh and Vijay Bhawan
palaces, there is presence of the three common malarial parasites, viz. P. vivax
(42.85%), P. falciparum (8.16%) and P. malariae (1.02%). Single case (1.02%)
with mixed infection of P. vivax and P. falciparum was also reported. In Gajner,
some 36 km away from Bikaner in a rather rural environment, 19% of the children
examined were found to suffer with splenomegaly.
Table 14.1 Spleen rate in and around Bikaner city

Numbers Number found Spleen
Site of school in Bikaner examined positive rate
Schools within city walls 1080 12 1.1
Schools outside city walls schools in Binesar 146 1 0.7
and Jangesar 188 3 1.6
Table 14.2 Epidemiological data for Jodhpur city between 1988 and 1993
Year Population BSC/E +ves Pv Pf Mix-ed ABER API SPR
1988 506,345 17,854 536 484 52 0 3.5 1.2 3.0
1989 506,345 19,574 1368 983 365 20 3.8 2.7 6.9
1990 506,345 33,953 4445 3284 1150 11 6.7 8.7 13.0
1991 506,345 24,877 2476 2176 294 3 4.9 4.8 9.9
1992 645,940 23,990 1447 1021 420 6 3.7 2.2 6.0
1993 645,940 21,907 681 560 118 3 3.3 1.0 3.1
Table 14.3 Epidemiological data for Bikaner city during 1997

Year Population BSC/E +ves Pv Pf Mixed ABER API SPR
1997 1,339,097 29,984 597 563 34 0 6.28 1.25 1.99
Tyagi et al. (2000) recently cautioned about increased breeding sites of An.
stephensi in the multistoreyed complexes in Jodhpur city and suggested appropriate
control strategies. Yet, in the total absence of any major scientific study made in
cities or towns in the Thar Desert, it would be useful to consider the available
epidemiological data to develop appropriate vector control strategies for Jodhpur and
Bikaner cities (Tables 14.2 and 14.3).
It will be seen that various epidemiological parameters present a comfortable
situation of disease control in these cities, although increase in P. falciparum cases in
recent years is a matter of great concern. One of the major reasons attributable to
increase in malaria cases in the city of Jodhpur is the influx of infection from the
nearby vast quarry mine area.
14.4.4 Quarry Mine Malaria
Only one scientific study, contributed by the author himself in the quarry mines near
Jodhpur during 1996–1998, has been made in this important aspect of new malaria
paradigm. These quarry mines, spanning over an approximate area of 70,000 km2,
brace the city along its southwestern flank. The quarry mines are generally deluged
with rain water and abound with vector breeding (Fig. 14.1). Hundreds of labourers
hailing from far off areas both within Rajasthan and neighbouring states are settled in
shanties along the quarry mines and continue to suffer with prodigious vector biting
throughout the year. The suburban Soorsagar locality is conspicuous with abundance
of quarried areas perennially filled with water. A high slide positivity rate (SPR)
(21.83%), along with the predominance of % P. falciparum (59.8%), is good enough
to show importance of these quarry mine-dwelling populations in building up a
parasite reservoir. Mostly positive cases were contributed by 1–14-year age group,
with an infant parasite rate (IPR) of 8.0% which was quite alarming. More of the
male population was found positive for malaria infection than the female population
(4:1).
Fig. 14.1 Query mine in

Soorsagar, Jodhpur (Thar
Desert, India) with plentiful
breeding sites for a large
number of vectors including
An. stephensi
14.4.5 Construction Site-Water Storage Pits
All over the world urban malaria is not as serious a problem as in India. In India
urban malaria spread mainly by An. stephensi has been referred to as a major way of
exacerbation of malaria. Regarding Jodhpur whose urban population in 1981 was
0.5 mill., by 2021 it has grown to 2.33 mill., which is further expected to grow by
33.04% by the next decade end. Jodhpur town is now on its way to developing into
another metropolis.
In order to meet the demand of peoples’ housing the city of Jodhpur has been
continuously advancing infrastructurally, with a new trend of multistorey residential
flat-system mushrooming everywhere. Such construction sites, particularly, need
several groundwater tanks to be used in erecting construction. These water tanks
have seemingly clean water and are made to exist for several months, sometimes
years. These water tanks attract the mosquito, An. Stephensi, as well as An. subpictus
which breed their unhampered (Fig. 14.2). Malaria among residents due to copious
breeding by An. stephensi in water tanks at construction sites has been highlighted
by Tyagi (1999) in Jodhpur and Kumar et al. (1995) elsewhere in India where they
demonstrated use of Bacillus thuringiensis var. israelensis in controlling the vector
breeding.
In a similar manner Kiszewski et al. (2014) have found a relationship between
construction pits (82 number of borrow pits) and the ecological succession of
Fig. 14.2 Construction site-water storage pit site in Jodhpur breeding An. stephensi, besides An.
subpictus (Source: Dr. B.K. Tyagi, personal archive)
malaria vectors, viz. Anopheles gambiae s.l. and An. coustani, the primary local
malaria vectors in a maize-farming region of western Ethiopia, with particular
emphasis on relationships between stage of succession and the structure and com-
position of invertebrate and plant communities such as Cyperus elegantulus,
C. flavescens, C. erectus and C. assimilis, besides a plenty of the legume (Smithia
abyssinica), Nile grass (Acroceras macrum), cutgrass (Leersia hexandra), clover
(Trifolium spp.) and the edible herb, Centella asiatica. The presence of An. gambiae
s.l. immatures was negatively correlated with the presence of backswimmers
(Notonectidae) (Z = -2.34, P = 0.019). Anopheles gambiae exhibited succession
more pronouncedly in older pits, and as they aged, they became less likely to serve as
habitats for An. gambiae s.l. (Z = 0.26, P = 0.796) and more likely to support An.
coustani (Z = 0.728, P = 0.007). Both, the notonectid predators and plant species
did not show a positive indicator with the abundance of An. gambiae s.l. in
borrow pits.
14.4.6 Roadside Water Tanks for Cattle/Animal Drinking
The urban centres in the Thar Desert region such as Jodhpur, Bikaner, Jaisalmer and
Barmer are inherently water-deficient; therefore conservation is widely practiced in
cities and among communities. Particularly, to provide drinking water to their scarce
animals such as camels, goat and bullocks, a plenty of rectangular cement tanks are
built along the roadside throughout the city. These tanks breed An. stephensi and An.
subpictus when the water is mostly clean and successively replaced by Aedes aegypti
when the water turns slightly turbid biologically or organically (Fig. 14.3).
14.4.7 Overhead Water Tanks
The Thar Desert/Asian malaria mosquito, Anopheles stephensi, is one of the few
malaria mosquitoes that thrives in urban areas because of its ability to find clean
water to lay its eggs, and one of the preferred habitats for breeding in urban
agglomerations is the overhead tanks (Thomas et al. 2016, 2017; Tyagi et al.
2000, 2020).
In Africa where so far malaria was traditionally considered to be a rural disease,
the city centres are supposed to be completely free of malaria transmission. How-
ever, with the first ever discovery of invading An. stephensi in the Horn of Africa’s
Djibouti City, with Ethiopia and Sudan also reporting cases, there is expected to be a
very real possibility of mass outbreaks of malaria among 126 million people in
Africa’s cities, which can be catastrophic particularly if the invasive vector species
continues its incursion into the African continent unchecked. Targeted vector sur-
veillance is therefore urgently needed, though it is not as easy as said; the more
deeper surveys are made to map its distribution, the more far and away it is being
found. The magnitude of the threat can be assumed from the fact that almost a
century ago, in 1930, when the world had failed to react quickly to the invasion of
Fig. 14.3 Construction of rectangular water tanks for cattle drinking along the roadside in Jodhpur
which profusely breed An. stephensi, besides An. subpictus (Source: Dr. B.K. Tyagi, personal
archive)
the African mosquito Anopheles gambiae in Brazil, the fiasco resulted in a major
malaria epidemic in 1938. Therefore, in Africa’s, too, the Brazil crisis should be
noted as a burning alert.
Clinical Scenario of Desert Malaria
15
15.1 Introduction
Malaria is largely regarded a local and focal disease. Human being is the final host
where the disease shows symptoms of illness, sometimes leading to death if not
treated timely. The first malaria symptoms—fever, headache and chills—usually
appear 10–15 days after the infective mosquito (an Anopheles) bite and may be mild
and difficult to recognize as malaria without simultaneous microscopic and/or
molecular examination of the blood of the suspected patient of malaria. Most malaria
cases in the world come from Africa south of Sahara where Plasmodium falciparum
predominates. Plasmodium vivax is the dominant malaria parasite in most other
countries including those in the Southeast Asia and the Latin America. In as far as
the Thar Desert in western India is concerned, malaria scenario has largely shifted
from a predominantly P. vivax malaria till the 1970s to that of appreciably high
P. falciparum-dominated malaria in the 1980s onwards (Tyagi 1995a, b, 2020, 2002,
2004a, b; Tyagi and Chaudhary 1997; Tyagi et al. 1995). Kochar et al. (1997a, b)
have innovatively demonstrated in Bikaner, a desert district in Rajasthan state
(India), that P. vivax can also result into severe and complicated malaria. The clinical
symptomatology in such patients with P. vivax-driven severe and complicated
malaria may be also altered.
Malaria infection in humans may show an array of symptoms, but, generally
speaking, malaria-affected humans show initially the symptoms of high fever,
followed by sweating and finally shivering (Bruce-Chwatt 1985), although
exceptions occur to this rule, e.g. communities living in areas hyperendemic for
malaria-most infected, such as those in sub-Sahara region, do not exhibit these or any
symptom at all or do minimally so. In clinical epidemiology of malaria, therefore,
diagnosing symptoms of the disease in patients is of paramount importance, along
with those who are symptomless. Desert communities are generally vulnerable to
malarial infection due to low or no exposure to the parasite. Thus, when infected
their symptomology might be at a variance from those living in endemic areas such
as forests or agriculture ecosystems. Moreover, if not properly investigated for the
Ltd. 2023
264 15 Clinical Scenario of Desert Malaria
cadence in epidemiological trend of incidence, the desert ecosystem not only

exacerbates malaria prevalence in the arid environments, it emerges as a threat to
the neighbouring hyperendemic areas for reinforcing infection despite vector/disease
control campaigns in the past. In essence, among all ecosystems in the world deserts
are the most vulnerable region from malaria point of view, because of:
(i) low or no immunity to malaria in local inhabitants,

(ii) least potential or no Anopheles vector in the extreme and inhospitable arid
environments,
(iii) inability of malaria parasites to survive in extreme ambient temperatures, and
(iv) migration of human populations along with their cattle during drought to areas
far away in different ecosystems in search of fodder and verdure as well as their
own wages, and on return they could transport parasites in their blood but
accidentally also the vector mosquito breeding in sored potable water (Tyagi
2002). However, when pinned down by malaria fever, the desert community
may exhibit certain variations in symptoms of the disease as well as their
response to the ecological, biological and social impacts of the disease.
Malaria, through various different syndromes, affect a large number of organs,

e.g. brain and nervous system, liver, kidney pancreas, etc. People who contract
malaria may become anaemic, and their pancreas, kidney and liver may dysfunction
and when affected for long duration may also release black urine (Bruce-Chwatt
1985).
15.2 Malaria Clinical Spectrum
Despite the fact that malaria has been mushrooming in various hot deserts of West
Asia, Middle East Asia and Africa, it is however the Thar Desert where several
clinical investigations on desert patients of malaria had been conducted and
published (Kochar et al. 2007; Tyagi 2002). During the past five decades several
clinical studies have been made on various communities in the Thar Desert but more
especially in Jaisalmer, Jodhpur, Barmer and Bikaner.
15.2.1 Symptoms
In a prospective study on malaria in four villages, namely, Seuwa, Raghwa, Raimala

and Sadhna in the hyperendemic Jaisalmer district, the following symptoms were
reported among the affected communities: fever (47.9%) was identified as the most
common cause of illness, followed by headache (21.1%), abdominal pain (8.9%),
body ache (6.5%), giddiness (5.6), loss of appetite (3.2%), cough and expectoration
(1.6%) and nausea/vomiting (1.6%). Most of the examined cases were febrile in all
but one age group (0–11 months). Most febrile persons were found in the 15+ year
age group. No serious illness was noted in the cases in <11 months age group (Tyagi
15.2 Malaria Clinical Spectrum 265
Table 15.1 Results of clinical observations on the febrile cases examined in the four Ramgarh
(Jaisalmer district) villages during malaria epidemic in May 1999 (Source: Tyagi et al. 2001a, b)
Age group
0– 12– 2– 5– 10– 15+
Symptoms 11 months 23 months 4 year 9 year 14 year year
Fever – 3 5 8 6 37
Headache – – – – 2 24
Body ache – – – – – 8
Nausea/vomiting – – – – – 2
Abdominal pain – – – 1 1 9
Loss of appetite – – – – – 4
Giddiness – – – – – 7
Cough & – 1 – 1 2 2
expectoration
Total – 4 5 10 11 93
Table 15.2 Spleen Age group Male Female Total

enlargement survey during
0–11 months – – –
malaria epidemic in May
1999 in the Ramgarh 12–23 months – 1 1
(Jaisalmer) villages 2–4 year 2 1 3
5–9 year 3 1 4
10–14 year 2 – 2
15+ year 2 2 4
Total 9 5 14
et al. 2001a, b) (Table 15.1). These villages under Ramgarh are located about 90 km
NW of Jaisalmer. These villages are distantly located (2–12 km) from each other in
close approximation with the Indira Gandhi Canal. Before the malaria outbreak
erupted, the water supply in the canal was disrupted for about 30 days on account of
cleaning and maintenance. The stagnated shallow pools in the basin of the canal had
apparently formed favourable breeding grounds for the vector An. culicifacies, in
particular.
15.2.2 Splenomegaly
Tyagi et al. (2001a, b) also encountered splenomegaly in a sizable population in the

above outbreak-struck Ramgarh villages, albeit entirely absent in the <11 months
age group (Table 15.2). In the age group 11–23 months only females had spleno-
megaly, while in the age group 10–14 years only males manifested spleen enlarge-
ment. Males were found suffering more with the enlargement of spleen (n = 9;
64.2%) than females (n = 5; 35.8%). The child spleen rate (CSR) was estimated as
3.6%, while the adult spleen rate was 4.3%. The average enlargement of spleen
(AES) stood at 2–3, pointing out to spleen as high as 85.7%.
Bikaner (area 27,000 km2; population 6,44,406 by 2011 Census) is surrounded by

the Thar Desert and characterized by a hot summer with extremes of temperature
ranging from a minimum of 2 °C in winters to a maximum of 48 °C in summers.
Rains are minimal and erratic during single period between July and September.
Bikaner has been endemic with P. vivax malaria for long, transmitted by An.
stephensi in the xeric rural surroundings, and by An. culicifacies in the peri-urban
Lalgarh area of Bikaner with irrigation activities.
Kochar et al. (2007) have interpreted the dynamics of P. vivax vs P. falciparum
infections in Bikaner people, to help further in designing effective control strategies
(Table 15.3). They analysed epidemiological data of last 32 years from 1975 to 2006
with maximum P. vivax and P. falciparum cases occurring in the post-rainy season.
A difference in parasite frequency may be possibly due to vector’s genotypic
plasticity favouring transmission of P. vivax or the vice versa in comparison to
P. falciparum (Kochar et al. 2005; Rajesh et al. 2007). The malaria cases escalated
by at least four times between 1975 (5,73,149) and 2006 (23,29,138), with 12,056
cases of P. vivax and 441 cases of P. falciparum in 1975, suggesting an epidemic of
malaria with more than 90% (20,370) cases of P. vivax in 1976. Subsequently, even
though P. vivax cases rose and fell inter alia 1978 and 2003, there was a steady
increase in proportion of P. falciparum cases. In 2003, however, the P. vivax cases
once more increased abruptly and shared about 90% of the total cases.
Kochar et al. (2005) made the phenomenal observations on malaria patients who
suffered with cerebral malaria, in principal. They reported 11 cases of severe
Plasmodium vivax malaria in Bikaner (western India). Patients exhibited cerebral
malaria, renal failure, circulatory collapse, severe anaemia, haemoglobinurea, abnor-
mal bleeding, acute respiratory distress syndrome and jaundice. Peripheral blood
microscopy, parasite antigen-based assays and parasite 18 s rRNA gene-based
polymerase chain reaction showed the presence of P. vivax and absence of
P. falciparum. Kochar et al. (2009) further investigated patients who suffered with
P. vivax and manifested unusual severe malaria which included severe anaemia,
thrombocytopaenia, cerebral malaria, acute respiratory distress syndrome, hepatic
dysfunction, renal dysfunction and abnormal bleeding. This observational study
included 1091 adult patients admitted to medical wards of S. P. Medical College
and associated group of hospitals in Bikaner, India, from September 2003 through
December 2005. The diagnosis of P. vivax malaria was established by peripheral
blood film (PBF), rapid diagnostic test (RDT) and polymerase chain reaction (PCR),
and severe malaria was categorized as per World Health Organization guidelines. Of
1091 patients with malaria, 635 had P. falciparum malaria and 456 had P. vivax
malaria. Among patients with severe manifestations, 40 had evidence of
monoinfection of P. vivax malaria diagnosed by PBF, RDT and PCR. Complications
observed were hepatic dysfunction and jaundice in 23 (57.5%) patients, renal failure
in 18 (45%) patients, severe anaemia in 13 (32.5%) patients, cerebral malaria in five
patients (12.5%), acute respiratory distress syndrome in four patients (10%), shock
in three patients (7.5%) and hypoglycaemia in one (2.5%) patient.
Thrombocytopaenia was observed in five (12.5%) patients, and multi-organ dys-
function was detected in 19 (47.5%) patients.
Table 15.3 Malariometric data in Bikaner (1975–2006)
15.2
Blood slide Annual blood Annual parasite P. falciparum P. vivax

Year Population collection P. vivax P. falciparum examination rate incidence % %
1975 573,149 107,026 12,056 441 18.6 21.8 3.53 96.47
1976 573,149 111,457 20,370 440 19.4 36.3 2.11 97.89
1977 573,149 102,585 11,192 201 17.8 19.8 1.76 98.24
1978 573,149 99,268 5352 83 17.3 9.4 1.53 98.47
1979 573,149 81,601 1476 13 14.2 2.5 0.87 99.13
1980 573,149 91,145 486 9 15.9 0.8 1.82 98.18
Malaria Clinical Spectrum
1981 840,059 100,192 612 20 11.9 0.7 3.16 96.84

1982 840,059 81,026 507 26 9.6 0.6 4.88 95.12
1983 840,059 86,497 1026 93 10.2 1.3 8.31 91.69
1984 840,059 80,551 895 112 9.5 1.1 11.12 88.88
1985 840,059 75,050 1274 70 8.9 1.5 5.21 94.79
1986 840,059 67,837 1202 75 8.0 1.5 5.87 94.13
1987 840,059 70,210 782 17 8.3 0.9 2.13 97.87
1988 840,059 67,488 537 28 8.0 0.8 4.96 95.04
1989 840,059 74,206 980 134 8.8 1.3 12.03 87.97
1990 840,059 76,015 1518 525 9.0 2.4 25.70 74.30
1991 1,217,361 64,729 991 129 5.3 0.9 11.52 88.48
1992 1,217,361 95,455 3533 3704 7.8 5.9 51.18 48.82
1993 1,217,361 83,980 3271 458 6.8 3.0 12.28 87.72
1994 1,217,361 156,034 9672 3657 12.8 10.9 27.44 72.56
1995 1,217,361 180,158 12,689 924 14.7 11.1 6.79 93.21
1996 1,217,361 152,089 4828 225 12.4 4.1 4.45 95.55
1997 1,339,097 128,281 2620 149 9.5 2.0 5.38 94.62
1998 1,339,097 104,255 1150 63 7.7 0.9 5.19 94.81
1999 1,556,314 98,267 1376 55 6.3 0.9 3.84 96.16
267
(continued)
268
Blood slide Annual blood Annual parasite P. falciparum P. vivax

Year Population collection P. vivax P. falciparum examination rate incidence % %
2000 1,556,314 108,812 776 60 6.99 0.53 7.18 92.82
2001 1,867,500 208,559 4650 362 11.16 2.68 7.22 92.78
2002 1,977,755 173,494 1131 82 8.77 0.61 6.76 93.24
2003 20,926,676.5 378,230 12,684 926 18.07 6.5 6.80 93.20
2004 2,092,667 314,364 6363 78 15.02 3.07 1.21 98.79
2005 2,092,667 228,591 773 19 10.92 0.37 2.40 97.60
2006 2,329,138 348,709 3017 50 14.47 1.49 1.63 98.37
15
Clinical Scenario of Desert Malaria
15.2 Malaria Clinical Spectrum 269
Table 15.4 Severe manifestations in patients with P. vivax, P. falciparum and mixed infections
Risk Pv Pf Mixed
Hepatic dysfunction 43.89% (97/221) 50% (137/274) 54.55% (24/44)
Multi-organ dysfunction 33.48% (74/221) 37.59% (103/274) –
Severe malaria 4.52% (10/221) 7.30% (20/274) 9.09% (4/44)
Kochar et al. (2010a), while studying malaria in 303 children in Bikaner, con-
firmed the evidence of severe P. vivax malaria, albeit presence of P. falciparum
(61.01%), mixed (4.95% P. falciparum + P. vivax) infection, besides P. vivax
(33.99%). Again, Kochar et al. (2014) reconfirmed preponderance of all major
modes of malaria infection (221, 41% P. vivax; 274, 50.83% P. falciparum; and
44, 7.97% mixed infection of Pv + Pf) in Bikaner’s hospitalized malaria patients
(#539). Notwithstanding a distant correlation between high level of
thrombocytopaenia and high P. vivax ( p = 0.030) and mixed infection
( p = 0.004), it was apparent that the risk of developing severe malaria was higher
in patients of mixed infection [53.01% (44/83)] than those with either P. falciparum
malaria [49.37% (274/555), RR = 1.135; p = 0.616] or P. vivax malaria [45.38%
(221/487), RR = 1.299, p = 0.243] (Table 15.4).
Soon, Kochar et al. (2010b) discovered that thrombocytopaenia’s occurrence,
relation and magnitude in different species of malaria are not clearly defined. In
order to comprehend aetiology of thrombocytopaenia, they investigated 1064
patients (platelet count <150,000/mm3) in P. falciparum (Pf) and P. vivax
(Pv) monoinfection and mixed infection (Pf + Pv). They concluded that the risk
was greatest in the patients with mixed infections in comparison to monoinfection
individually, notwithstanding severe thrombocytopaenia being also higher in Pv
monoinfection in comparison to either Pf monoinfection or mixed infection. Taking
cues from this significant study, Tanwar et al. (2012), in a prospective study,
included 676 admitted children of malaria diagnosed with P. falciparum
monoinfection (262), P. vivax monoinfection (380) and mixed (Pf + Pv) infection
(34) and found thrombocytopaenia (platelet count <150 × 103/mm3 on admission) in
442 (65.38%) children [Pf monoinfection 55.3% (145/262), Pv monoinfection
73.16% (278/380) and mixed infection 55.88% (19/34)]. The association of
thrombocytopaenia was statistically significant with Pv monoinfection [73.16%
(278/380)] in comparison to either Pf monoinfection [55.34% (145/262)] or mixed
infection [55.88% (19/34) p = 0.032]. In Pv monoinfection, thrombocytopaenia was
highest in 0–5 years age group and subsequently decreased with advancing age,
whereas in Pf monoinfection it was reverse. Till today, thrombocytopaenia is not
included in severe malaria criterion described by WHO.
Kochar et al. (2012) provided yet another argument that P. falciparum is highly
unlikely to cause such profound thrombocytopaenia as diagnosed in 599 hospital
patients with P. vivax monoinfection (although the parasite density was done only in
546 patients fulfilling the eligibility criteria) from June to December 2011.
Thrombocytopaenia (<150,000/mm3) was present in 468/546 (85.71%) patients
with a mean platelet count of 72,715.8 ± 38,625.4. No statistical correlation seemed

to be present between platelet count and parasite load.
Agroeconomical and Eco-Bio-Social Aspects
of Malaria in Deserts 16
16.1 Introduction
Malaria is unique among communicable vector-borne diseases because its roots lie
so deep within human communities, particularly in the rural environments, and the
deserts are no exception (Spielman 2003; Tyagi 1992a, b, c, 1994a, b, c, d, e, f, g,
2002; Tyagi and Yadav 1994). The disease not only impoverishes communities and
emaciates their health but also saps off their intelligentsia (Sinton 1936). The most
dangerous vectors of malaria thrive mainly within the village environment
(Heggenhougen et al. 2003). Logically, since in the rural agglomerations both the
human dwellings and cattle sheds are very closely built, the adult vectors remain
close to their nocturnal source of human blood, besides that of animals, and the
developmental stages of these mosquitoes exploit the nearby accumulations of water
that form where people have disturbed the natural drainage. The borrow pits made in
the course of mud-brick construction, tyre tracks and hoof prints, for example,
promote vector abundance in much of sub-Saharan Africa. Malaria is most intracta-
ble for countries in the poorest continent, Africa. The only parts of Africa free of
malaria are the northern and southern extremes, which have the richest countries on
the continent. India’s Thar Desert, which is a rural ecosystem, dotted with rising
urban points and a massive canal-based irrigation network in a part, has a serious
malaria problem (Tyagi and Yadav 1996a, b, c).
16.2 Agroeconomical and Social Impacts of Malaria: Paradox

about Rice Cultivation in the Irrigated Desert Region
and Malaria
Malaria severely affects not only the economy of a nation but also the health of its
people. In a way malaria has affected every aspect of life in India whether agriculture
or industrial development. It constitutes one of the most important causes of eco-
nomic misfortune, engendering poverty, diminishing quantity and quality of food
Ltd. 2023
272 16 Agroeconomical and Eco-Bio-Social Aspects of Malaria in Deserts
supply, lowering physical and intellectual standards of the nation and hampering
increased prosperity and economic progress in every way. Quite many reports on
various of these aspects occur from other parts of the country (Sinton 1935; Russell
and Menon 1942; Ramaiah 1980; Sharma 1996a, b), but there are very few studies
made in the Thar Desert (Yadav et al. 1998, 2001).
In the past several authors have associated paddy cultivation with the onset of
high prevalence of malaria (Dossou-yovo et al. 1994; Russell and Rao 1940),
although some others disapproved of it (Sharma et al. 1994). As far as the Thar
Desert region is concerned only one major study has been made by Tyagi and Yadav
(2000). The positive correlation between paddy cultivation and preponderance of
malaria vector breeding, on one hand, and the increase in malaria incidence, on the
other, was used as a warning tool for future exacerbation of the disease intensity
(Tyagi and Yadav 1998). Ironically, a negative correlation appeared to persist
between paddy coverage and slide positivity rate (SPR) in Rajasthan state but not
so in the area of Sangaria tehsil (now in Sri Hanumangarh district) where paddy has
been extensively grown in Sri Ganganagar district. Considering the flare-up in
malaria incidence in Sri Ganganagar district during the mid-1980s and early 1990s
(the former characterized by a negligible P. falciparum proportion, while the latter
with a rather prominent impact of this parasite), it is possible to clearly exhibit a
positive correlation (r = 0.46, p < 0.05) combinedly with paddy cultivation, rise in
water table and extensive waterlogging, on one hand, and establishment of the new
incumbent vector An. culicifacies. However, it is also noteworthy that when, on one
hand, the percent P. falciparum was on the decline during 1986–1989, the paddy
production had escalated, on the other. This implies that the paddy coverage or
paddy production alone is not a good indicator for forecasting hyperendemic situa-
tion of malaria. It is further ascertained by the fact that while lower hectare utilization
of paddy during the mid-1970s has corresponded with a severe P. vivax malaria
outbreak in the Sangaria PHC villages, no correlation seemed to exist during the
1990s when malaria prevalence was on a low ebb. They have argued that in a region
such as the Thar Desert where extensive canal-based irrigation and other associated
developmental activities have changed the ecology to a great extent, the epidemiol-
ogy of malaria is quite intricate due particularly to the exacerbation of the P.
falciparum-dominated malaria and stressed on considering several malariometric
parameters to comprehend the true correlation. Conclusively, it appears that intro-
duction of paddy cultivation per se in the Thar does not directly cause conflagration
of malaria cases, but probably a series of associated factors like practices involved in
paddy cultivation encouraging extensive and long-time waterlogging and faulty flow
of water in the irrigation channels that contribute decisively in the direction of
making paddy cultivation in the IGNP command area a more conductive ecosystem
for vector propagation.
16.3 Health Impact of Malaria 273
16.3 Health Impact of Malaria
Only three critical reviews dealing with various health aspects of malaria in the Thar
Desert have been brought on record (Anonymous 1987a, b, 1991a, b; Sharma et al.
1995). According to a health survey made by the National Council of Applied
Economic Research (NCAER), Delhi malaria contributed 12.1% of all kinds of
illnesses, although general febrileness (23.9%) was considered as a separate illness.
Malaria patients received allopathic treatment (82.7%), Ayurvedic treatment
(12.3%), homeopathic treatment (3.6%) and ethnomedical treatment (2.4%). As
regards ethnomedicinal use of traditional wisdom, Dam et al. (1997, 2000a, b) had
pointed out on the practical utilization of the resources for mitigating different types
of fevers including malarial fever in the Thar Desert. Malaria patients in Jaisalmer
received more ethnomedicinal treatment than those in Sri Ganganagar district where
allopathic treatment was commonly accessed. In a detailed study on ethnomedicinal
usage in getting rid of common illnesses in the Thar Desert rural population, Dam
et al. (1999, 2000a, b) identified certain home-made remedies based on traditional
wisdom as well as knowledge about usage of local flora and fauna. Use of traditional
practices in alleviating 16 common illnesses was investigated intensively in
338 households of 11 villages in three districts (Jaisalmer, Nagaur and Jodhpur) in
the Thar Desert by Dam et al. (1997, 1999, 2000a, b) (Table 16.1; Fig. 16.1).
The sample size was determined with the assumption that (1) at least 50% of the
Thar Desert’s rural households (P) use ethnomedicine for the treatment of common
health problems and (2) the tolerable error in estimation of proportion of people
using ethnomedicine is 10%. Thus the household sample size (where Q = 1-P) was
estimated as:
Table 16.1 Distribution of respondents according to their percentage use of ethnomedicine against
16 common ailments and the availability of health facilities in 11 villages of the Thar Desert
Health facilities Traditional Ecological
District Villages available Households healers zones
Jaisalmer Randha None 16 4 Marusthali
Diddu None 35 Nil Marusthali
Dabla Yes 35 5 Marusthali
Dantal Yes 33 Nil Marusthali
Chandhana Yes 15 Nil Marusthali
Jodhpur Morna bara None 44 Nil Luni
Duggar Yes 35 5 Luni
Bhakri Yes 33 1 Luni
Nagaur Dhamaniya None 35 Nil Shekhawati
Gogelav Yes 35 1 Shekhawati
Panchota Yes 22 Nil Shekhawati
Fig. 16.1 (a, b) Survey of households in the Thar Desert villages with health facility (HF) or
without health facility (WHF) (Source: Dr. B.K. Tyagi, personal archive)

N = 4 × P × Q= L2
= 4 × 0:5 × 0:5=ð0:05Þ2
= 400 households
Now presuming that only 35 could be covered in each village, the total villages
needed to be covered were 400/35 = 11.42 or 11.
A total of 130 households from four villages without health facility (WHF) were
surveyed within a diametric distance of 10 km, while 208 households were covered
from such seven villages where some health facilities (HF) existed (Fig. 16.1). The
age of all respondents ranged between 35 and 63 years. Of the 338 respondents
examined, 63.5% were between 35 and 40 years, 14.1% between 40 and 45 years
and 22.3% were above 45 years of age (Table 16.2).
It is noteworthy that though more people (1776/3198; 55.5%) resorted to ethno-
medicine in the HF villages, nonetheless far more proportion of people (1254/1991;
63%) used ethnomedicine in WHF villages. Mostly people used ethnomedicine for
curing toothache, constipation, eye infection, diarrhoea, intestine worm infection,
typhoid and bleeding due to injury (Dam et al. 2000a, b). Table 16.3 shows a variety
of ingredients in different proportions for ethnomedicinal formulations to cure
different ailments or disorders, with a varying degree of achievement of success.
In view of the fact that health facilities greatly lacked in the arid environments of
the Thar Desert, most of the people showed an inclination towards local medication
available to them. Table 16.4 presents a list of health problems treated in past 90 days
by the households according to their frequency and type of treatment taken by them
(see also Fig. 16.2).
The cost of treatment (Indian Rupees per illness episode) of malaria was deter-
mined to be highest in Sri Ganganagar (Rs. 110.-), followed by Jaisalmer (Rs. 97.-)
and Bikaner (Rs. 46.-), averaging at Rs. 84.33 in the IGNP command area. A malaria
patient is found to generally travel over 10 km to reach a medical health facility.
Malaria patients in a developed IGNP command area like Sri Ganganagar district far
more exceeded in putting up expenditure on malaria treatment than those in less
irrigated or non-command areas. This is possibly due to the fact that perception of
the people about health care has changed with the increase in income levels as they
are capable to avail more expensive health-care facilities. Yadav et al. (2001) have
also recently drawn a fruitful correlation between economic development and impact
of severe malaria episodes and stressed that the disease reduced both economy and
health of the affected people.
Malaria directly or indirectly affected women most in the penetralium of the
desert, and Yadav and Tyagi (2000) made a retrospective study on the women with
malaria history in relation to family management and support in the Thar Desert,
under constant threat of contraction of malaria disease.
276
Table 16.2 Results of the survey for use of ethnomedicine in villages with or without health facility
Villages with health facility Villages without health facility
# respond- # opted ethnom- % # respond- # opted ethnome- % Significance
S. no. Health problem ents edicine usage ents dicine usage (P value)
1 Fracture 206 183 88.8 129 110 85.3 >0.05
2 Measles 198 164 82.8 128 104 81.3 >0.05
3 Pain in bone joint 205 163 79.5 128 107 83.6 >0.05
4 Cough and cold 207 163 78.7 130 105 80.8 >0.05
5 Toothache 207 157 75.8 129 110 85.3 >0.05
6 Bleeding 202 144 71.3 130 113 86.9 <0.001
7 Constipation 185 112 60.5 127 109 85.8 <0.001
8 Eye infection 206 120 58.3 129 94 72.9 <0.01
9 Diarrhoea 191 107 56.0 130 104 80.0 <0.001
10 Single boil 198 89 44.9 96 38 39.6 >0.05
11 Intestinal worms 186 83 44.6 127 81 63.8 >0.001
12 Typhoid 203 79 38.9 127 74 58.3 <0.001
13 Multiple boils 196 73 37.2 96 32 33 >0.05
14 Headache 201 72 35.8 129 39 30.2 >0.05
15 Fever—Short 205 54 26.3 126 23 18.3 >0.05
duration
16 Fever—Long 202 13 6.4 130 11 8.5 >0.05
duration
Pooled 3198 1776 55.5 1991 1254 63.0
16 Agroeconomical and Eco-Bio-Social Aspects of Malaria in Deserts
Table 16.3 Indigenous preparations used for remedying different common health disorders in
villages with Health Facilities (HF) and Without Health Facility (WHF)
S. Health Type of Respondents (%)

no. problem villages >33% 20–33% 10–20%
1 Fracture HF Traditional plaster Ghee from Black soot (10.9),
(70.5) cow’s milk indigenous sugar
(20.8) (12.0), common
tallow Laurel
(14.8)
WHF Milk (47.3), Indigenous Ghee from cow’s
common tallow sugar (25.5) milk (18.2), wheat
Laurel (40.0) flour (18.2), black
soot (11.8)
2 Measles HF Millet (69.5), Crocus (25.6), Oriental cashew
jaggery (72.1) thyme-leaved (15.9), singhmora
gratiola (22.6), (12.2), nutmeg
omum (21.3), (18.3)
black salt
(21.3)
WHF Millet floor (73.1), Thyme-leaved Nutmeg (10.0)
jaggery (72.1) gratiola (30.8),
holy basil
(30.8), omum
(30.8), water
(21.0)
3 Pain in bone HF – Ghee from Common tallow
joints cow’s milk Laurel (14.1),
(31.3), seed traditional plaster
(23.3), aloe (13.5), indigenous
((27.6) sugar (12.9), wheat
flour (12.3),
Commiphora
mukul (12.3)
WHF – Aloe (26.2), Dactyloctenium
ghee (25.2), grass (15.9),
sheep’s milk turmeric (13.1),
(20.6) fenugreek seed
(12.1), mustard oil
(11.2), wheat flour
(10.2)
4 Cough and HF Dried ginger Coriander Clove (15.3),
cold (41.1), black (25.8) common fig.
pepper (34.9), (14.7), holy basil
indigenous sugar (13.4), cinnamon
candy (34.9), (12.2), date palm
nutmeg (33.1) (10.4), millet flour
(12.2)
WHF Dried ginger Indigenous Hot milk (18.1),
(58.0), coriander sugar candy omum (18.1), date
(47.6), black (20.9) palm (17.1), holy
pepper (37.1)
(continued)

basil (16.1),
nutmeg (14.2)
5 Toothache HF Tobacco (43.3) – Clove oil (19.1),
alum (11.5), garlic
(11.5), mustard oil
(10.8), salt (10.8)
WHF Tobacco (40.9) Yellow-berried Traditional healer
night shade (15.5), clove (13.6)
(23.6)
6 Bleeding HF Rifle/machine oil Burnt cloth ash Infant urine (11.8)
due to injury (57.6) (24.3)
WHF Bristles of rachis Rifle oil (25.7) Burnt cloth ash
from elephant grass (15.0)
(48.7)
7 Constipation HF Cassia (42.9) Chebulic Rock salt (22.3)
myrobalan
(29.5),
WHF – Spogel seeds Castor seed oil
(30.0), Cassia (18.3), chebulic
(26.6), milk myrobalan (14.7),
(20.2) black salt (10.1)
8 Eye HF Alum (39.2) – Ghee from cow’s
infection milk (19.2), breast
milk (13.3)
WHF Sweet basil leaves – Alum (16.0), pink
(50.0) colour (13.8)
9 HF Opium(55.1), curd – Turmeric (19.6),
(52.3) ghee from cow’s
milk (12.1), millet
(11.2), breast milk
(10.3), Corchorus
trilocularis (11.2)
WHF Curd (75.0), spogel – Ghee from cow’s
seeds (35.6), opium milk (19.3), rice
(31.7) (18.3), turmeric
(18.4), sago (10.6)
10 Single boil HF – Ghee from Soot from kitchen
cow’s milk smoke (19.1)
(24.7)
WHF – Ghee from Wheat flour (10.5),
cow’s milk butter milk (10.5)
(28.9), soot
from kitchen
smoke (28.9),
margosa (28.9)
11 Intestinal HF Asafoetida (48.2) Black salt (16.9)
worms WHF Omum (20.5) Black salt (16.0)
(continued)

Omum
(Trachyspermum
ammi) (42.0),
fenugreek seed
(40.7), asafoetida
(39.5)
12 Typhoid HF Indigofera (50.0) – Gum arabic (18.9),
indigenous sugar
(19.0), indigenous
sugar candy (19.0),
nutmeg (13.9),
black pepper
(13.9), thyme-
leaved gratiola
(13.9), Lippia
(11.3), oriental
cashew (11.3),
coriander (11.3),
black salt (10.1)
WHF Dried ginger Clove (17.56), holy
(25.6), Indigofera basil (16.2), black
(27.0) pepper (16.2),
omum (14.8),
Indian long pepper
(13.5), coriander
(13.5), millet flour
(10.8)
13 Multiple HF – Margosa bark Fagonia (17.8)
boils (28.8)
WHF – Margosa leaves Rohida tree bark
(68.8) (18.8)
14 Headache HF – Black pepper Desi misri (16.7),
(25.0), balm (12.5), inula
coriander (11.1)
(23.6), dried
ginger (22.2)
WHF Dried ginger – Nutmeg (17.9),
(92.3), black desi ghee (black
pepper (87.1), salt 10.2), boiled
coriander (79.4) water (10.2)
15 Fever— HF Black pepper – Margosa leaves
Short (94.4), dried ginger (14.8), millet
duration (68.5), coriander (11.1), holy salt
(62.9), indigenous (11.1)
sugar candy (55.5),
nutmeg (38.8)
Coriander (43.5), – Calotropis (13.0)
black pepper
(continued)

(39.1), indigenous
sugar candy (39.1),
dried ginger (34.8)
16 Fever— HF Latex from leaf Sand (30.7), Coriander (15.3),
Long nodes of Calotropis black pepper dried ginger (15.3),
duration (38.4) (23.0) millet (15.3),
margosa leaves
(15.3)
WHF Black pepper Margosa leaves Margosa leaves
(36.4), dried ginger (27.3) (15.3)
(36.4)
Table 16.4 List of health problems according to their frequency and type of treatment taken by
respondents in the past 90 days
Type of treatment
Ethnomedicine Allopathy
Health problem No. of cases % No. of cases %
Cough and headache 50 96.2 2 3.8
Fever with shivering 23 12.9 155 87.1
Night blindness 11 73.3 4 26.7
Asthma 11 50.0 11 50.0
Abdominal pain 17 68.0 8 32.0
Anaemia 24 100.0 0 0.0
Pneumonia 19 100.0 0 0.0
Premature ejaculation 15 100.0 0 0.0
Bleeding from nose 10 100.0 0 0.0
Piles 8 100.0 0 0.0
Scorpion sting 7 100.0 0 0.0
Jaundice 6 100.0 0 0.0
Others 28 77.7 8 22.3
Total 229 54.9 188 45.1
16.4 Knowledge, Attitude and Practice of the Rural Population

about Malaria in the Thar Desert
Tyagi and Yadav (1996b) and Yadav et al. (1999) conducted a study in four villages,
two each from a recently canal-irrigated northern part of Jaisalmer district (Madasar
and Awai villages) and the more desertic part of Jodhpur district (Kanasar and
Khetusar villages), involving 345 persons (206 males and 139 females) with a
history of malaria infection during the past 1 year, with a comparable control
16.4 Knowledge, Attitude and Practice of the Rural Population about Malaria. . . 281
120
100
80
% 60
40
20
0
1 2 3 <6 >7
WHF Villages HF Villages
Days
Fig. 16.2 Cumulative percentage of respondents seeking treatment of ethnomedicine by days
group without any history of malaria, following a malaria outbreak in the area during
1992–1993 (Fig. 16.3).
These people represented different age groups and economic classes such as
agriculturists (43.5%), agriculture labourers (10.4%) animal keepers (30.9%), daily
wagers (5.5%) and miscellaneous including students, jobless and retired persons,
etc. (9.7%). Females generally looked after household chores, besides children,
animals and old family members, at times in addition to their full-time professional
jobs. A majority of the respondents (88.0%) were married. Literacy rate was
determined to be low among the respondents; those having acquired primary educa-
tion were 11.4%, middle education 8%, high school 4.8% and higher education 3%.
The remaining 18.8% respondents were literate but without any formal educational
background.
People were found to have very poor knowledge as to the real causation of the
disease (97%), although the affected people knew better about the signs and
symptoms of malaria. About 76% of malaria patients attributed fever with chill
and sweating as the most important sign and symptoms of malaria. In contrast, 39%
of healthy subjects associated malaria with fever, giddiness and rashes on the body
as major signs and symptoms of malaria. More of the affected people acknowledged
having used frequently prophylactic measures such as mosquito nets (98%),
repellents like Odomos cream and different types of oils (29%) and fumigants
(24%). The affected group (74%) showed better concern about management of
malaria fever by primarily taking full course of chloroquine tablets during illness,
although those who complained of some kind of uneasiness after consuming chloro-
quine were also not uncommon (67%). About 40% of affected women avoided the
use of chloroquine during pregnancy (Fig. 16.4).
According to Yadav and Tyagi (2000), in yet another study on women with
malaria history in relation to family management and support, while 66.61% women
Fig. 16.3 Sketch showing sites for villages investigated in the highly irrigated Indira Gandhi
Nahar Pariyojana command area (1 = Madassar village, 2 = Awai village), and in the truly desertic
non-command area (3 = Kanasar village, 4 = Khetusar village) in Jaisalmer and Jodhpur districts,
respectively, in the Thar Desert, north-western Rajasthan (India) (Source: Dr. B.K. Tyagi, personal
archive)
resented the parturition-related management in villages, nearly 95% of the pregnant

women had complained of not getting any major relief from the domestic works
during malarial pyrexia. The impact of malaria on the health of rural people was
clearly visible as 91% of the malaria patients reported their working capacity being
reduced during indisposition. This led the rural-folk to following certain taboos since
49.6% of the respondents avoided fried foods but preferred ‘rabadi’ (local prepara-
tion made from millet flour and yogurt), ‘Khichchadi’ (a semi-liquid preparation
from the mixture of rice and pulses) and ‘mateera’ (fruits of a cucurbitaceous plant
akin to watermelon). The overall costs of malaria treatment were prohibitive to many
of the affected people as 55% of malaria patients expressed their resentment for
16.4 Knowledge, Attitude and Practice of the Rural Population about Malaria. . . 283
Fig. 16.4 Awareness campaign in the Thar Desert village communities and schools (Source:
Yadav and Tyagi 2000)
bearing a major part of the expenditure by themselves, though they were also
appreciative of the anti-malaria campaigns by the government.
Knowledge about vector mosquitoes was found to be better among the malaria
patients (26%) as compared to the healthy subjects (14%). Nearly 28% of malaria
patients knew about the feeding and resting habits of malaria mosquitoes. In the
same way, 29% of malaria patients also appeared to have better knowledge about
their laying eggs and development of larvae. Since the ‘tanka’ was shown to be
associated with the vector breeding, 23% of malaria patients acknowledged the fact
that vector population could be reduced by properly covering the ‘tanka’.
Vector Identification and Malaria Diagnosis
in Major Deserts 17
17.1 Introduction
Generally malaria is diagnosed in a community of arid environments on the basis of

presence of parasite in the patient’s blood, clinical symptoms and vector incrimina-
tion with malaria parasite (Hay et al. 2010a, b). Of the three biological species in the
epidemiological triad, anopheline vector mosquitoes and Plasmodium parasites are
involved in the transmission of the disease to man. There are well over 400 Anophe-
les species throughout the world, but only less than 70 species participate in the
mechanism of parasite transmission to humans. Likewise there are five Plasmodium
species of human malaria, notwithstanding information on at least 11 Anopheles
species capable to transmit human parasites. To manage control of malaria both in
nature (i.e. mosquito control) and in infected human being, a proper, accurate and
timely identification/diagnosis of the species of vectors and parasites is of paramount
importance. Despite a large number of alternate technologies, insecticides continue
to be the main pillar of control of vectors both in adult and aquatic stages, even
though there are serious issues associated with human health and environment
(Tyagi 2021). However, most vector species have developed resistance of some
kind (mono-, multiple and cross-resistance) against the conventional insecticides
rendering them ineffective (Nauen 2007). At the same time, Plasmodium parasites
such as Plasmodium vivax have also widely developed resistance against the anti-
malarial drug of choice, chloroquine (Price et al. 2014).
17.2 Dichotomous Keys for Identification of Vectors of Malaria

in India
India harbours 61 anopheline species of which six are primary vectors which are the
Dominant Vector Species (DVS) in context with malaria in India and carry immense
epidemiological importance. These are, namely, An. culicifacies, An. fluviatilis,
An. stephensi, An. minimus, An. baimaii and An. sundaicus. Of these the most
Ltd. 2023
286 17 Vector Identification and Malaria Diagnosis in Major Deserts
important vectors, viz. An. stephensi, An. culicifacies and An. fluviatilis, particularly
the first two species, prevail in the Thar Desert. Besides, there are five secondary
vector species which carry lesser epidemiological significance. These transmit
malaria along with either one or two major vectors in different parts of the country.
These are An. subpictus, An. annularis, An. nivipes, An. philippinensis and An.
varuna.
In addition to the magnum opus on Indian Anopheles by Christophers (1933), a
large number of culicidologists have also offered annotated field guides for identifi-
cation of anophelines, both larvae and adults, of the country (Puri 1960; Wattal
1963; Wattal and Kalra 1961; Das et al. 1990; Tyagi et al. 2012, 2014). However,
there are no updated dichotomous keys available for the Thar Desert Anopheles
species, and, therefore, it is considered most opportune to offer here detailed keys for
their identification.
17.2.1 Fourth Instar Larvae of Malaria Vectors
1. Bases of inner clypeal hairs much closer to one another than to outer Subgenus
clypeal hairs; antennal hair branched or simple (Fig. 17.1) Anopheles
Bases of inner clypeal hairs wide apart and closer to the bases of outer Subgenus
clypeal hairs; antennal hair simple (Fig. 17.2) Cellia (2)
2 Anterior tergal plates on abdominal segments III–VII very wide and 3
(1) enclosed the rounded median chitinous spot posteriorly (Fig. 17.3)
Anterior tergal plates on abdominal segments III–VII not very wide and 5
never enclosing the rounded median chitinous spot (Fig. 17.4)
3 Inner and outer clypeal hairs simple (Fig. 17.5) 4
(2)
Inner and outer clypeal hairs with short scattered branches (Fig. 17.5) aconitus
4 A pair of minute hairs arising from the tergal plate on segments II–VIII varuna
(3) (Fig. 17.6)
The pair of minute hairs not arising from the tergal plate but lying minimus and
external and a little posterior to the plate on each side (Fig. 17.7) fluviatilis
5 Inner and outer clypeal hair simple or with short in inconspicuous 6
(2) lateral fraying
Inner and outer clypeal hair with conspicuous lateral branches 12
(Fig. 17.8)
6 Mesothoracic pleural hairs all simple, with two long hairs (Fig. 17.9) 7
(5)
One of the long mesothoracic pleural hair pectinate others simple 10
(Fig. 17.10)
Meso- and metathoracic pleural hairs all simple (Fig. 17.11) 11
17.2 Dichotomous Keys for Identification of Vectors of Malaria in India 287
Figs. 17.1–17.11 (1) Inner clypeal hairs, closure; (2) inner clypeal hairs, wider; (3) anterior tergal
plates; (4) anterior tergal plates; (5) inner and outer clypeal hairs; (6) minute hairs in tergal plate;
(7) minute hairs not in tergal plate; (8) inner and outer clypeal hairs with branches; (9) mesothoracic
hairs simple; (10) mesothoracic hair with pectinate; (11) meso- and metathoracic hairs simple
7 Both the long metathoracic pleural hairs pectinate (Fig. 17.12); palmate hair 8
(6) on thorax not differentiated
One of the long metathoracic pleural hair pectinate others simple 9
(Fig. 17.13); palmate hair on thorax well differentiated
8 Posterior clypeal hair short and placed very close to inner clypeal hair vagus
(7) (Fig. 17.14)
Posterior clypeal hair placed not very close to inner clypeal hair; sundaicus
mesothoracic hair four most often with three branches (2–4) from near the
base (Fig. 17.15a, b)
Posterior clypeal hair placed not very close to inner clypeal hair; subpictus
mesothoracic hair four most often with two branches (1–3) from near the
base (Figs. 17.15a and 17.16)
9 Filaments of abdominal palmate hairs about half as long as the blades of culicifacies
(7) leaflets; Seta 9-T with few branches, 10-T simple; only the end of outer
submedio-dorsal caudal hairs curved to form hooks, the branches of inner
hairs, fine and straight (Fig. 17.17a, b, c)
Filaments of abdominal palmate hairs about half as long as the blades of d’thali
leaflets; both the ends of inner and outer submedio- dorsal caudal hairs
curved to form hooks, the branches of inner hairs stout (Figs. 17.17a and
17.18)
Figs. 17.12–17.16 (12) Both the metathoracic hairs pectinate, (13) single metathoracic hair
pectinate, (14) position of posterior clypeal hair, (15a) position of posterior clypeal hair, (15b)
seta 4-M with three branches, (16) seta 4-M with two branches (Source: Tyagi 2020)
Figs. 17.17–17.18 (17a)

Filaments of palmate hair,
(17b) seta 9-T with few
branches, (17c) outer
submedio-dorsal caudal hairs.
(18) Inner and outer
submedio-dorsal caudal hairs
10 Outer clypeal hairs always simple; abdominal seta 1-I with three to five stephensi
(6) branches; setae 9,10-T both branched (Fig. 17.19a)
Inner and outer clypeal hairs finely frayed; filamentous of abdominal seta maculatus
1 with sharp point; seta 6-III with 20 or more branches (Fig. 17.20)
11 Seta 1-P with two to five branches; abdominal seta 1-II with filamentous tessellatus
(6) branches (Fig. 17.21a, b)
Innermost submedian prothoracic hair (1-P) with more than four baimaii
branches arising from a large root (Fig. 17.22)
(=dirus D)
12 Outer clypeal hairs with a large no. of long branches forming a broom- pallidus
(5) like tuft; posterior clypeal hairs with two to five branches; filament of
palmate hairs more than half or as long as blade of leaflet (Fig. 17.23a, b)
Outer clypeal hairs with a large no. of long branches forming a broom- philippinensis
like tuft; posterior clypeal hairs with seven to ten branches; filament
about ¼ length of leaflet (Fig. 17.24a)
Figs. 17.19–17.24 (19a) Abdominal seta 1-I with three to five branches, (19b) setae 9,10-T both
branched, (20) seta 6-III with 20 or more branches, (21a) seta 1-P with two to five branches, (21b)
abdominal seta 1-II with many branches, (22) 1-P with more than four branches, (23a) posterior
clypeal hairs with two to five branches, (23b) filaments of palmate hair, (24a) posterior clypeal hairs
with seven to ten branches, (24b) filaments of palmate hair (Source: Tyagi 2020)
17.2.2 Adults of Vector Mosquitoes
1 Scutellum evenly rounded; palpus about equal to the length of proboscis Anopheles
(Fig. 17.25a, b); abdomen with sterna and usually terga largely or wholly
devoid of scales
Fig. 17.25 Anopheles palpi

and proboscis (a) and
Anopheles scutellum (b)
Wings with four or more dark spots on costa (Fig. 17.26) (Subgenus Cellia)
1 Femur and tibia speckled (Fig. 17.27) 2
Femur and tibia not speckled (Fig. 17.28) 7
2(1) Hind tarsomere 5 not white (Fig. 17.28) 3
Hind tarsomere 5 white (Fig. 17.29) 6
3(2) Palpi with three pale bands (Fig. 17.30) 4
Palpi with four pale bands (Fig. 17.31) 5
4 Apical and subapical pale bands of palpi equal; palpi speckled (Fig. 17.32) stephensi
(3)
Apical and subapical pale bands of palpi unequal; palpi not speckled sundaicus
(Fig. 17.33)
5 Hind leg with a broad white band at the tibio-tarsal joint; presector dark mark baimaii
(3) on vein 1 without any pale interruption; apical pale band on hind tibia with a
longitudinal basal dark stripe on ventral aspect (Figs. 17.34 and 17.35)
(=dirus
D)
Hind leg with a broad white band at the tibio-tarsal joint; presector dark mark elegans
on vein 1 with one or more pale interruption; apical pale band on hind tibia
without a ventral dark stripe (Figs. 17.36 and 17.37)
6 Abdominal terga II–VIII shiny, with no pale scales (Fig. 17.38) pseudowillmori
(2)
Abdominal terga IV–VIII with a few pale scales (Fig. 17.39) maculatus
7 Hind tarsomere 5, 4 and 3 completely white; apex of hind tarsomere philippinensis
(1) 1 usually with white band; wing vein 5 mainly white, no dark spot at the
point of bifurcation (Fig. 17.40)
Hind tarsomere not white; fore tarsi with narrow pale bands (Figs. 17.41 8
and 17.42)
8 Wing vein 3 mainly dark; inner quarter costa usually with pale interruption culicifacies
(7) (Fig. 17.43)
Wing vein 3 mainly white (Fig. 17.44) 9
9 Female palpi with both apical and subapical pale bands as broad as or minimus
(8) broader than subapical dark band; basal third of costa with white
interruption; fore tarsomere 1–4 with very small dorso-apical pale patches
(Fig. 17.45)
Female palpi with subapical pale band, narrow and subapical dark band fluviatilis
much broader; vein 6 with two dark spots, distal half mainly dark; hind
tarsomeres uniformly dark (Fig. 17.46)
Figs. 17.26–17.31 (26) wings with four or more dark spots on costa, (27) femur and tibia
speckled, (28) femur and tibia not speckled, (29) Hind tarsomere 5 white, (30) palpi with three
pale bands, (31) palpi with four pale bands (Source: Tyagi 2020)
Figs. 17.32–17.37 (32) palpi with speckling, (33) palpi without speckling, (34) hindleg with
broad white band at tibio-tarsal joint, (35) presector dark mark on vein 1 without pale interruption,
(36) hind tibia without ventral dark stripe, (37) presector dark mark on vein 1 with pale interruption
Figs. 17.38–17.42 (38) abdominal terga II–VIII without pale scales, (39) abdominal terga IV–
VIII with few pale scales, (40) hind tarsomere 1 with white band, (41) wing vein 5 white no dark
spot at the point of bifurcation, (42) fore tarsi with narrow pale band (Source: Tyagi 2020)
Figs. 17.43–17.46 (43) wing vein 3 mainly dark, (44) wing vein 3 mainly white, (45) palpi-
subapical pale band narrow and subapical dark band broader, (46) hind tarsomere uniformly dark
17.3 Distinctive Taxonomic Characters of the World’s Two

Major Malaria Vectors in Desert Environments, Anopheles
stephensi Liston (1901) and Anopheles arabiensis Patton
(1905)
About ‘the identification of An. stephensi’, the world famous culicidologist Dr

S.R. Christophers, who composed his magnum opus on Tribe Anophelini under
the famous The British India series (Christophers 1933), ‘There is no species with
17.3 Distinctive Taxonomic Characters of the World’s Two Major Malaria. . . 297
which this can well be confused; it is the only Indian species with broad thoracic
scaling and a double broad pale band on the palpi in which the hind legs are not
conspicuously marked with white’. Notwithstanding irrefutable attributes of identi-
fication characters of An. stephensi, however, for reasons of posterity, it is consid-
ered highly opportune to give hereunder, as an example, a set of distinguishing
features of the two major desert specialists, An. stephensi and An. arabiensis, for a
better understanding and diagnosis. Both these species can be identified using
microscopy, Polymerase chain reaction (PCR method) and TaqMan single nucleo-
tide polymorphism genotyping (SNP).
17.3.1 Morphological
Anopheles stephensi is rather more characteristically distinguishable from the rest of

species, including An. arabiensis, by a combination of the following characters
(Christophers 1933): palpi apical segment all pale, forming, with apex of next
segment, a broad pale apical band; a broad apical and basal pale band at 3–4, the
dark intervening area narrower than either band; a narrow pale band at 2–3 and some
spots formed by patches of white or pale scales on dorsum of segment 3; dorsum of
thorax with a conspicuous mat of white scales; and legs with femur, tibia and tarsi
characteristically white-spotted (Fig. 17.47).
In contrast, Anopheles arabiensis, which was discovered from Aden Hinterland
(West Aden Protectorate = Yemen), belongs to the An. gambiae complex whose
members are morphologically indistinguishable from another, although it is possible
for larvae and adult females which exhibit different behavioural traits for each
species. Although close to An. stephensi in appearance, it is nevertheless distinguish-
able by a set of characteristic features on the head, thorax, wings and legs. Anopheles
arabiensis, together with other members of the group, can be identified using the
molecular methods of Fanello et al. (2002). Recently, a solution to more precise and
foolproof identification of An. arabiensis by TaqMan single nucleotide polymor-
phism genotyping (SNP) was offered by Walker et al. (2007).
17.3.2 Chromosomal
Anopheles stephensi has a 2n = 6 (two pairs of autosomes and one pair of heteroga-
mous sex chromosomes, X and Y). The chromosomes exist as five units, the
telocentric X chromosome and two metacentric autosomes. Chromosome 2 has
arms of unequal lengths. Chromosome 3 has arms of equal lengths (Sharma et al.
1969). The mosquito has three major gene-rich chromosomes (X, 2, 3) and a gene-
poor, heterochromatic and smaller Y chromosome (Chakraborty et al. 2021). The
best identification markers are offered by polytene chromosomes. These are most
readably produced from the late 3rd/early 4th instar larval salivary glands and the
ovarian germinal cell line.
Fig. 17.47 Three major distinguishable characteristics of An. stephensi: (a) Apical and subapical
white bands of equal length, (b) broad-scaled dorsum of thorax, and (c) all legs pronouncedly white-
speckled (in view hindleg) (Source: Tyagi et al. 1991)
17.3.3 Polymerase Chain Reaction (PCR)
In many countries An. stephensi has been subjected to polymerase chain reaction
(PCR) for confirming the species and/or its subspecies/sibling species. In Eastern
Ethiopia Balkew et al. (2020) sampled a total of 2231 morphologically identified An.
stephensi and resorted to further confirmation through a molecular approach
incorporating both PCR endpoint assay and sequencing of portions of the internal
transcribed spacer 2 (ITS2) and cytochrome c oxidase subunit 1 (cox1) loci and
eventually confirmed the identity of the An. stephensi in most cases (119/124; where
119 were PCR confirmed out of the morphologically identified An. stephensi, 124).
17.5 Clinical Diagnosis 299
Khan et al. (2020, 2022) identified the members of the China’s laboratory-reared An.
stephensi species complex using genetic markers such as AnsteObp1 (An. stephensi
odourant binding protein 1), mitochondrial oxidases subunit 1 and 2 (COI and COII)
and nuclear internal transcribed spacer 2 locus (ITS2). Chavshin et al. (2014), in
Iran, molecularly characterized biological forms and sporozoite rate of Anopheles
stephensi. They first identified biological forms on the basis of number of egg ridges
and then sequenced the mitochondrial cytochrome oxidase subunit I and II (mtDNA-
COI/COII). Further employing species-specific nested PCR method diagnosis of
Plasmodium infection was confirmed in the wild female specimens.
17.4 Parasite Diagnosis
17.4.1 Microscopic
Despite huge advancements in diagnosing malarial parasites, microscopy is still

considered of super value, ‘the Golden Standard’, in the realms of parasitic diagno-
sis. Several stains of varying attributions are used to highlight morphological
features in stark contrasting manner. The most common stain used in dying the
parasite is Giemsa stain. It is the preferred method for thick smear where the focus is
to easily detect the parasite of parasite and to increase the sensitivity, while
Leishman stain is recommended for thin smears for identification of species. In
India, and in its Thar Desert ecosystem, a combination of stains named JSB, after its
discoverers, Jaswant Singh and Bhattacharji, is used with absolute caution for pH of
stains (7.2) (Fig. 17.48). The microscopy is used all over the world, albeit availabil-
ity of other fast-result yielding tools.
17.4.2 Rapid Diagnostic Test
For almost four decades the rapid diagnostic tests (RDTs) have been in use for
detecting quickly the presence of a given malaria parasite in an infected human
blood, especially P. falciparum, because of requirement of an early decision to
manage the case. Rapid diagnostic tests (RDTs) for malaria assist in the diagnosis
of malaria by detecting evidence of malaria parasites (antigens) in human blood.
These tests require a drop of peripheral blood, normally collected from a finger or
heel prick. Visual read-outs are available typically within 20 mins or less.
17.5 Clinical Diagnosis
Malaria is one of the main motives for outpatient consultation and hospitalization
worldwide, especially the desert nations or regions due to operational constraints in
the inhospitable environments including the mobile and hard-to-reach human
populations with inherent migratory attributions. However, its incidence remains
Fig. 17.48 A thick blood smear using JSB stain showing ring and other stages of Plasmodium
falciparum (marked with arrows) (Source: Dr. B.K. Tyagi, personal archive)
unclear because of diagnostic problems and insufficient epidemiological data.

Lekweiry et al. (2009) studied on malaria incidence in 237 febrile outpatients
attending the two main hospitals of Nouakchott city, Mauritania, during April–
August 2007. They diagnosed malaria in patients through the gold standard method
of finger prick to prepare thick and thin films and blood-dried filter paper samples for
performing nested PCR for malaria parasite species identification and density. The
clinical symptoms of fever and other malaria suggestive symptoms recorded by
clinicians for initiating ‘presumptive treatment’ further suggested the accuracy of
diagnosis. Entomological investigations based on morphological and molecular
characterization of anopheline species were conducted in Dar Naïm district. The
prevalence of malaria in patients was 25.7%, which mostly comprised Plasmodium
vivax 70.5% (43/61), followed by P. ovale 24.6%. Of the total individuals enrolled in
the survey, 97.5% were clinically diagnosed malaria and treated accordingly. How-
ever, only 26.4% of the clinically diagnosed cases were tested positive. Thus, false-
positive cases (73.6%) among the clinically diagnosed malaria cases were obvious in
their investigation.
The search for mosquito vectors in Dar Naïm district allowed morphological and
molecular identification of Anopheles arabiensis and An. pharoensis.
Malaria Immunity in Desert Populations
and Development of Resistance in Parasites 18
against Antimalarials
18.1 Introduction
Although several virgin deserts have in recent past exhibited several outbreaks of
malaria, yet very few scientific investigations were made on immunity level of the
affected communities in such arid environments—the terra incognita for malaria
infection—so far and the level of susceptibility/resistance in malarial parasites
against the antimalarials in vogue! To understand the mechanism behind the process
of immunity development in humans, it is inevitably indispensable to first compre-
hend the biology of malaria parasite in response to the human immunity (Burrows
et al. 2013, 2017a, b) (Fig. 18.1).
All people living in malaria endemic areas across the world do get infected by a
positive mosquito bite, but the response by individuals, and sometimes specific
communities (vide supra), against the malaria parasites may vary a great deal,
depending largely on the Plasmodium species, load of infection and host factors,
including the level of immunity of the host whose extent of past exposure to the
parasite is the driving force behind falling prey or otherwise to the mosquito bite.
Many a time persons who got an infective mosquito bite do not exhibit any
symptoms of the disease, albeit being positive, and then such people are called
asymptomatic carriers. Such masses of silent infection carriers, although possibly
immune to pathologic consequences of the malarial parasitic infection, are a danger-
ous source of future regulation of parasite within the community, if a strongly
anthropophilic mosquito like An. gambiae, An. arabiensis or An. stephensi is
occurring among them. Uncomplicated malaria in individuals is something which
is easily treatable, and the affected persons can go home after successful treatment.
However, the most threatening of all is the severe (complicated) malaria which
inevitably requires timely hospitalization and treatment procedure followed under
constant care of specialist medical personnel. Often severe malaria turns out to be
deadly. Severe anaemia and multi-organ damage in varying manners, including
cerebral malaria, are brought about by microvascular obstruction by the infected
Ltd. 2023
302 18 Malaria Immunity in Desert Populations and Development of Resistance. . .
Fig. 18.1 The life cycle of malaria parasites in the mosquito (sexual phase) and in the human host
(asexual phase), according to present views on the exo-erythrocytic schizogony (Free Wikipedia)
red blood in finer capillaries—a characteristic feature for P. falciparum, but also
likely in case of P. vivax.
18.2 Malaria Endemicity and Immunity Development
Among all vector-borne human diseases, malaria offers a well-defined pathway for
evolution of immunity in the affected person or community, albeit repetitive recur-
rence of episodes by malaria particularly engineered by Plasmodium vivax which
can remain dormant in the liver cells for weeks, months or even years (Bruce-Chwatt
1985). Malaria is also one of the oldest communicable diseases known to human
being inhabiting especially the tropical and subtropical regions of the world. Due to
long exposure to malaria infections the affected communities, such as those in Africa
and in India’s state of Odisha (old name Orissa) where proportion of P. falciparum
among infected people is more than 90%, peoples’ immunity against the infection
rose a very great deal. Malaria has in fact been eventful in dictating the psyche of
nations reeling under its catastrophic impacts making people physically weak,
mentally feeble and economically impoverished, and despite maximum global and
national campaigns to wipe it off from the face of the world, it still continues to be
one of the most serious, life-threatening infectious diseases.
18.3 Biology of Malaria Parasites
Five protozoan parasites cause malaria to humans, viz. the Plasmodium vivax,
P. falciparum, P. malariae, P. ovale and P. knowlesi, implying different immunity
types by them in the affected communities. Globally P. vivax is the most common
parasite responsible for the largest public health burden particularly in Asia and
South America; in Africa it is P. falciparum which abounds and causes maximum
18.3 Biology of Malaria Parasites 303
illnesses and deaths especially among children below 5 years of age and the pregnant
women.
During a blood meal on a healthy human being—the main and final host—an
infected Anopheles mosquito bite introduces, along with the saliva having
anticoagulating properties, the malaria parasite (sporozoite stage of Plasmodium)
into the human blood vascular system. As soon as sporozoites—spindle-shaped,
motile and infective—enter the human body, a large proportion is either destroyed
by phagocytes or other mechanism; however those, still in thousands, are able to
complete their peregrination within 30–60 minutes. These sporozoites, which are
injected in to thousands per bite, encounter an array of challenges for their survival in
the human body. Genetically guided to reach their earliest destination,
i.e. hepatocytes, sporozoites travel a lot crossing over the skin, lymphatics and
other organs and finally into the liver. Here sporozoites, by a process of asexual
binary fission (schizogony), transform into round-shaped bodies called (primary)
schizonts harbouring tens of thousands of smaller form of the parasite, the
merozoites (the stage that results from multiple of a sporozoite within the body of
the host). Upon reaching a stage of maturation these schizonts burst out due to
growing inner pressure of fissions and release merozoites into the bloodstream where
they, by a very intricately designed modus operandi, enter red blood cells to
complete an important part of the parasite biology, heralding the symptomatic
stage of the disease. Symptoms develop 4–8 days after the initial red blood cell
invasion. The replication cycle of the merozoites within the red blood cells lasts
36–72 hours (from red blood cell invasion to haemolysis). Thus, in synchronous
infections (infections that originate from a single infectious bite), fever occurs every
36–72 hours, when the infected red blood cells lyse and release endotoxins en masse.
Here in the red blood cells merozoites live and replicate (erythrocytic schizogony) on
the cost of haemoglobin, causing severe anaemia in people with heavy infection, on
one hand, and a fraction of them (i.e. those that are inherently bound to commit
sexually later in the vector mosquito’s body) differentiate and mature into male and
female gametocytes, ready to be picked up by the mosquito during feeding and infect
the new host, mosquito. The transcription factor AP2-G regulates the commitment to
gametocytogenesis. The duration of gametogenesis differs by species.
After completing a highly fascinating extrinsic (sporogony) stage of its life cycle
in the mosquito host, the male (following a spectacular event of exflagellation, a
phenomenon producing eight microgametes after three rounds of mitosis) and
female (attaining more or less a receptive roundish form called macrogamete)
gametocytes fuse to form a diploid zygote in mosquito that soon transforms to a
motile and injectable parasite stage able to bore through the inner wall of the gut. The
parasite then moves further across the wall to form round-shaped oocysts on the
outer wall of the gut. Each oocyst is generating tens of fine, spindle-shaped
sporozoites. When these oocysts burst, the sporozoites are released into an unknown
world of body cavity (hemocoel), but they make it to their final destination in the
invertebrate host, the salivary glands. The maturation of sporozoites in the gut of the
mosquito is highly temperature-dependent. The entire duration of extrinsic cycle
may take about 7–15 days depending on temperature and other abiotic factors.
18.4 Clinical Symptoms and Treatments
The clinical symptoms of malaria, after a successful infective mosquito bite, may
generally appear in 7–10 days. Typical initial symptoms are low-grade fever,
shaking chills, muscle aches and, in children, digestive symptoms. These symptoms
can present suddenly (paroxysms) and then progress to drenching sweats, high fever
and exhaustion. Malaria paroxysmal symptoms manifest after the haemolysis of
Plasmodium spp.-invaded red blood cells. The human malaria parasites P. vivax and
P. ovale also have dormant stages called hypnozoites or secondary schizonts which
can be activated and emerge from the liver months or even years after the initial
infection, leading to relapse of the infection if not treated properly.
The 4-aminoquinoles (e.g. chloroquine) are administered to treat erythrocytic
stages of parasites, and 8-minoquinolones (e.g. primaquine), under strict instructions
of the physician, are provided to treat liver schizont (primary and secondary) as well
as the gametocyte stages of Plasmodium vivax. In case of an infection with P. vivax,
a 3-day chloroquine and 14-day primaquine are administered. When infection is by
P. falciparum, then the patient is treated with ACT-L (artemether-lumefantrine), in
northeastern states of India, and ACT-SP (artesunate + sulphadoxine pyrimeth-
amine) in the rest of India. Intramuscular (IM) administration of selective
antimalarials such as quinine (or quinidine) and/or injectable form of artemisinin
derivatives, e.g. artesunate (AS) and artemether (AM), may be used for the manage-
ment of severe and complicated malaria cases (adults and non-pregnant women
only) in the dosage given below: artesunate, 2.4 mg/kg bw IM/IV followed by
1.2 mg/kg bw after 12 hours and then 1.2 mg/kg bw once daily for total duration
of 5 days. Only qualified clinician is to decide the course of treatment.
18.5 Parasite Resistance against Antimalarials
The parasite is considered susceptible if no parasite is found on day 6 following

chloroquine treatment and none is present on day 7, provided there is complete
failure of parasites to reappear by day 28 on a month-long follow-up. If asexual
parasites disappear for at least 2 consecutive days following treatment but return and
are present on day 7, they are resistant at Ri level (7 day test); any recrudescence of
asexual parasites within 28 days (extended test) also indicates an Rl response. In
present context, a parasite is said to be resistant only when it shows resistance at the
level of Riii (Table 18.1).
There is very little information available on the development of resistance in
P. falciparum against any antimalarial drug in the deserts, and the Thar Desert region
is no exception, and what is known till date is but for chloroquine (Sharma et al.
1995; Tyagi and Chaudhary 1997). Earliest in vivo investigations carried out in
south-western Rajasthan between 1981 and 1984 indicated 100% parasite suscepti-
bility to chloroquine 600 mg base (Khatri 1991). As presented in Table 18.1,
however, the parasite was shown to have developed resistance in course of time in
many desert districts at all of the Ri, Rii and Riii levels, besides in some non-desert
18.5 Parasite Resistance against Antimalarials 305
Table 18.1 Chloroquine sensitivity results against P. falciparum in the Thar Desert districts
District Year No. tested No. susceptible S/R Ri Rii Riii % Riii
Bikaner 1992 20 5 10 5 0 0 0
Jodhpur 1991 11 0 0 5 2 4 36.4
Jaisalmer 1990 20 9 2 90 0 0 0
1994 12 0 2 0 0 0
Barmer 1990 59 11 4 38 2 4 3.8
1992 33 0 29 1 2 1 3.0
1994 12 0 8 0 4 0 0
Jalore 1993 35 6 7 18 4 0 0
S = Susceptible; R = Resistant; R i-iii = Resistant status
Table 18.2 Results of a study on chloroquine resistance development in P. falciparum carried out
in certain Thar Desert districts in October 1994
District PHC No. of cases examined S/Ri (%) Rii (%) Riii (%)
Barmer Baitu 12 8 (66.6) 4 (33.3) 0 (0.0)
Jaisalmer Pokaran 12 12 (100,0) 0 (0.0) 0 (0.0)
districts as well (Sharma et al. 1995). In as far as Thar Desert is concerned,

P. falciparum resistance development against chloroquine was demonstrated in at
least five districts, viz. Barmer, Bikaner, Jaisalmer, Jalore and Jodhpur. In two of
these, namely, Barmer and Jodhpur districts, all the Ri–Riii level resistance had been
detected, although the Riii, in particular, was on an average more strongly
represented in Jaisalmer district (36.4%) than in Barmer district (3.3%). While
frequency of resistance development in P. falciparum appeared stronger in Jalore
district with both Ri and Rii already manifested, it is still restricted to Ri level in both
Jaisalmer and Bikaner districts.
Recently, in 1994, in a small sample of 12 cases studied in both Barmer and
Jaisalmer (Table 18.2), 100% susceptibility was observed in the latter district, while
66.6% susceptibility and 33.3% Ri level were obtained in the former (cf. Sharma
et al. 1995).
In spite of availability of above data, it has been argued if the drug resistance had
actually evolved in the parasite. Two observations worth considering are:
(i) These results were based on small samples, and therefore it is difficult to
implicate marked degree of resistance development; also all these observations
were based on in vivo studies which might not be free from certain natural
deficiencies generally encountered in field investigations.
(ii) Many of these studies have been done with 1500 mg of chloroquine while the
prescribed dose for presumptive treatment of malaria is only 600 mg of chloro-
quine. Even so there is no room for complacency with respect to low level of
drug resistance in the Thar Desert district because many of the neighbouring
non-desert districts exhibit even Riii level of resistance in P. falciparum which
can easily disseminate to the Thar region.
18.6 Malaria Treatment and Immunity
Extremely few studies have so far been made on the subject of treatment manage-
ment of malaria, particularly falciparum malaria, and the role of immunity in the
rural Thar Desert community in combating the invasion of disease (Bhu 1972;
Panagaria and Mehta 1975; Tamboli and Bolya 1981). While general chemoprophy-
laxis of malaria in Rajasthan was highlighted by Chandra (1981), ways to manage
severe falciparum malaria in children were discussed by Mathur (1990). While
treating cerebral malaria patients in Bikaner, Kochar (2001) had suggested that
intramuscular injection of phenobarbitone helped reduce the incidence of
convulsions from 12.3% to 2.9% in comparison to 23% in those who did not receive
phenobarbitone. Kochar et al. (1999) also studied the effect of intramuscular
arteether (150 mg daily for 3 days) on electrocardiogram in 16 patients from Bikaner
suffering with falciparum malaria (three patients having jaundice, three with cerebral
malaria and ten uncomplicated malaria). Before treating with arteether five patients
had tachycardia. The mean RR interval before starting the treatment was 0.59 sec
which increased progressively till the third day after the treatment. No significant
differences were detected in the mean corrected QT interval, PR interval, QRS
duration and diastolic BP before initiating the treatment and at the end of the
treatment on the third day. The profile of ECG changes did not differ between
patients of uncomplicated and complicated malaria. It was advocated, therefore,
that absence of any significant effect on BP and ECG changes precludes the signifi-
cant effect of arteether on the cardiovascular system when compared to quinine
which might cause hypotension, arrhythmia and QTc prolongation. That falciparum
malaria presenting with bilateral gangrene of feet could develop arrhythmia/ventric-
ular fibrillation after subjecting to the quinine therapy was discussed by Kochar et al.
(1998a, b, c).
The true status of immunity level of the Thar population is not known, although
malaria has been existing there for decades. Following the massive 1994 outbreak of
malaria in the Thar Desert, Sharma (1995) had suggested that the onslaught on the
immune system of the local population was responsible for large number of deaths in
the desert. His theory is based or the fact of isolation and sequencing of the knob
protein gene that induces protuberances on the surface of infected erythrocytes
through which they adhere to the cerebral capillaries and are thus partly responsible
for cerebral malaria. The knob protein gene shows that there are at least two alleles of
the gene in the Indian P. falciparum isolates. One of these alleles is rare whereas the
other has a frequency of at least 1:8. The major sequence variations occur in the
immunogenic domain, but there are also certain random point mutations. A fool-
proof correlation of these alleles with the strain of cerebral malaria in the Thar Desert
or even Rajasthan state is yet to be established.
Malaria and Climate Change
19
19.1 Introduction
Climate change is a global phenomenon which has affected virtually everything

biotic and abiotic on earth. In context with public health the phenomenon of climate
change is always seen from the angle of human intervention called anthropization
comprising an array of activities such as population explosion, migration en masse,
massive forest fire, long-time pesticide deployment in agro-forestry and public
health programmes, devastating droughts and floods, tsunamis and earthquakes,
etc. Human population boom is the root cause of many ill-effects that emerged out
of schemes otherwise planned for human development and growth. It is notable that,
in contrast to resources available for sustenance, the human population has rapidly
grown particularly since 1950, from 2.5 billion to 7.8 billion in 2020, viz. the overall
burden of population has increased by 206.8%, with their pets and those in the wild,
having multiplied even more, but at the same time many of which are essential for
maintaining life cycle of a large number of hematophagous vectors and even
zoonoses. Under the pressure of population build-up, the climate has directly or
indirectly affected human behaviour per force and driven humans to, besides
mushrooming urbanization, multilevel buildings, development schemes such as
hydro-agriculture, quarry-mining, etc., practise container-associated water-storing
habits—a major reason for attraction to several human health-related issues
correlated to vector- and water-borne diseases, food and drinking water insuffi-
ciency, and heatstroke, respiratory and mental health-related disorders arising out
of natural disasters, e.g. tsunamis, earthquakes, droughts, floods, etc. (Patz et al.
2014).
Temperature is the most important of all abiotic factors influencing the epidemi-
ology of vector-borne diseases. Therefore, it is not surprising to correlate an explo-
sive expansion of Aedes albopictus, along with chikungunya it transmitted
virulently, from Asia and Africa to most of Europe and the Americas post-2005/
2006 epidemics in the Indian Ocean island territories, perhaps in the wake of a
temperature rise by merely 1 °C. A similar inference involving anthropization-driven
Ltd. 2023
308 19 Malaria and Climate Change
climate change can be drawn for recent expansion of the malaria vector, Anopheles
stephensi, an Indian species, towards Sri Lanka in south and to Africa in west during
the past one decade—all these nations being terra incognita for the species until
early 2000. Sri Lanka which was declared malaria-free recently is threatened by a
relapse of the disease, whereas African countries which have witnessed the unwel-
come entry of An. stephensi, credited for its high potential for Plasmodium
falciparum transmission, fear unprecedented exacerbation of malaria cases, with
severe epidemics, in several nations adjoining the Horn of Africa (Sinka et al. 2020).
Malaria, being an important public health problem in spite of considerable
success achieved in reducing the disease burden over the years, particularly in a
hyperendemic country like India where 100 million cases, and about 100,000 deaths,
used to occur every year by the first quarter of the twentieth century, is highly
sensitive to environmental vicissitudes and is often irreversibly influenced by the
dynamic climate change (Caminade et al. 2014; Parham and Michael 2010). Climate
change affects both the density build-up and distribution of malaria vectors. Malaria
vectors’ feeding and transmission patterns of parasites may also be affected by the
climate change particularly in exophagic climate generalists. As a consequence of
global warming, the ambient temperature on an average basis has already risen by
around 1 °C since pre-industrial times. Worldwide emissions of greenhouse gases
(GHGs), aerosols, large-scale deforestation and changes in land use and land cover
(LULC) are significant non-stationary drivers for the climate change, which in turn
substantially altered the atmospheric composition and consequently the planetary
energy balance in favour of the spread of vector-borne diseases, especially malaria.
A temperature increase could, however, also increase malaria transmission in colder
regions such as the plateaus of East Africa (Kifle et al. 2019). Post-1950 climatic
oscillations intensified many environmental phenomena to their extremes such as
heat waves, droughts, severe cyclones, changes in precipitation and wind patterns,
acidification of the global oceans, melting of sea ice and glaciers, rising sea levels
and changes in marine and terrestrial ecosystems, etc. Desert ecosystems, too, have
been highly vulnerable to climate change, and any alteration in either temperature or
rainfall in the Thar Desert’s IGNP (Indira Gandhi Nehar Pariyojana) command area,
endowed with copious greenery and water, is clearly discernible in context with life
cycles of both vectors and parasites involved in vector-borne and zoonotic diseases,
of which malaria is the deadliest.
As far as deserts are concerned, desert margins, where millions of people live in
tropical Africa, Asia and South America, are the most vulnerable ecosystems for
malaria parasite and vector population development under the impact of seasonal
environmental conditions. Desert marginal areas are also highly susceptible to
seasonal epidemic malaria. These desert margins are actually buffer areas between
rain-deficient arid and rain-abundant non-desert regions. Although, due to high
temperature and low humidity in these marginal areas, the development and produc-
tivity of both vectors and the parasites within it is generally limited, nevertheless the
climate variability brings about the highest potential to strongly impact disease
dynamics in the desert margins. Thus, climate variability is the key to the
19.2 The Sahara Desert 309
fulmination or exacerbation of malaria in the desert margins where they can be used
as early-warning tools.
Long-time data assimilation on impact of climate on malaria may be developed
into important malaria early warning systems (MEWS). Multiyear non-stationarities
of various interventions in malaria control such as that in India, where improved
socio-economic conditions and disease control policies involving use of rapid
diagnostic kits and indoor residual spraying (IRS) have been revised every few
years, are often reflected in the shifting patterns of malaria incidence, hence a
challenge to predictability or early warning mechanisms. Land-use change
associated with irrigation projects like the famous Indira Gandhi Nehar Pariyojana
(IGNP) is an important driver of malaria non-stationarity in arid northwest India
which has enhanced the extent of multi-vector environment in varied breeding sites.
To develop an operational early warning system, which itself functions on multiple
time scales, all the relevant factors including interventional efforts and socio-
economic conditions, in addition to vector bioecology, need to be considered.
More studies need to be done on the underlying factors, both abiotic and biotic,
which facilitate a commensurate rate of development of vectors as well as parasites
within the invertebrate host. Baeza et al. (2013), citing the phenomenal works of
Bouma and van der Kaay (1994, 1995, 1996), Bouma et al. (1994a, b), Tyagi
(1995a) and Tyagi et al. (1995, 2002), have made a very interesting observation
pertaining to long-lasting transition towards sustainable elimination of desert malaria
under irrigation development, with special reference to the Thar Desert in western
India. They deduced that in arid areas, people living in the proximity of irrigation
infrastructure are potentially exposed to a higher risk of malaria due to changes in
ecohydrological conditions that lead to increased vector abundance, blood-feeding
and breeding galore. However, irrigation provides a pathway to economic prosperity
that over longer time scales is expected to counteract these negative effects, provided
all involved stakeholders play their roles meticulously and keep malaria at bay
through proper water management (Tyagi 2004a, b).
19.2 The Sahara Desert
Climate change will probably alter the spread and transmission intensity of malaria
in Africa. Driven by humongous greenhouse gas and land-use changes in Africa, it is
being constantly felt that climate changes will in recent future significantly affect the
spread of malaria in tropical Africa well before 2050, impacting the vast ranges of
Sahara as well. The geographic distribution of areas where malaria is epidemic might
have to be significantly altered in the coming decades (Ermert et al. 2012). Indirect
effects of climate change on malaria might be more important than direct effects
(Saugeon et al. 2009). The sensitivity of vector-borne diseases like malaria to climate
continues to raise considerable concern over the implications of climate change on
future disease dynamics. The problem of malaria vectors shifting from their tradi-
tional locations to invade new zones is of important concern, e.g. Anopheles
arabiensis, which probably originally belonged to the Arabian deserts, and An.
stephensi, an Indian mosquito which invaded Africa during last decade only. A
mathematical model incorporating rainfall and temperature is constructed to study
the transmission dynamics of malaria. The reproduction number obtained is applied
to gridded temperature and rainfall datasets for baseline climate and future climate
with aid of GIS. Gething et al. (2011) highlighted the transmission intensity of
falciparum malaria in context with geographic patterns and observed highest trans-
mission intensity in the tropics as well as the coastal areas of East Africa as compared
to subtropics where low levels of transmission intensity occurred.
19.3 The Thar Desert
The Thar Desert is among the youngest deserts in the world as well as built over the
once probably a sea coast meeting the mouth of a unified and richly flowing
Saraswati river, now completely extinct, together with currently partially extant
Ghaggar river on the northeastern margin of the desert and the distantly drifted
eastwardly Yamuna river, now bracing scores of kilometres away the capital city
Delhi. Yet, the Thar Desert hides within its expansive breadth rare and copious
antiquities revelation of which is gradually surfacing to comprehend the extent of
metamorphosis the desert has so far undergone.
19.3.1 Physical Transformation in the Thar Desert Climate
Thar Desert of today was certainly not so in the remote past; its topography, ecology
and physiography vastly changed during the last 60–80 years following the entry of
three major canal water systems that converted the desertic surroundings of the
desert, in the canal-water rich areas, into verdure, greatly affecting the epidemiology
of a disease like malaria.
19.3.1.1 Rainfall
The Thar Desert, like most other deserts of world, endured truly desertic and arid
environments till the close of first quarter of the twentieth century whereafter, owing
largely to initiation of hydro-agriculture development programmes to bring water
from Punjab to the Thar Desert for mainly improving land productivity for agricul-
ture and quenching the thirst of its inhabitants, transformed at least partially into a
verdant area attracting higher amount of rainfall, lowering of ambient temperature
and enhancing per capita income in Sri Ganganagar district that surpassed any of the
other desert districts. In contradiction to the findings by Winstanley (1973a, b), Pant
and Hingane (1988) analysed rainfall and temperature during 1901–1982 and found
an increasing trend in mean annual rainfall (141.3 mm for 100 years) and a
decreasing trend in air temperature (-0.52 °C for 100 years). Later, Ramakrishana
and Rao (1991) studied increase in the mean decadal rainfall in a canal-irrigated
district for a considerable period.
19.3 The Thar Desert 311
Three of the 12 desert districts have been greatly benefitted with the supply of
canal waters since the beginning, viz. Sri Ganganagar (irrigating 708,775 ha of land),
Bikaner (irrigating 37,022 ha of land) and Jaisalmer (irrigating 84 ha of land), with
the Gang Canal and the Indira Gandhi Canal projects aiming to utilize 7.59 MAF of
water to irrigate about 1.143 mill-ha area (Roy 1983). Sri Ganganagar district which
earlier received an annual rainfall of 243 mm per year, following the mega IGNP
project in the Thar Desert, enjoyed an increasing trend of rainfall, at the rate of
1029 mm year/year, during the period 1926–1993.
19.3.1.2 Air Temperature

Due to change in rainfall and its trend over a considerable area in the IGNP
command area, air temperature too presented generally a decreasing trend in
Ganganagar (by 0.0393 °C year-1), Bikaner (by 0. 0233 °C year-1) and at Jaisalmer
(by 0.0093 °C year-1) (Rao 1996).
19.3.1.3 Relative Humidity

High rainfall and lower ambient temperature trends also influenced humidity which
was recorded 5–10% higher in the IGNP’s cropped surfaces at 1 m height in the
irrigated villages compared to that in the unirrigated cropped surfaces (Rao 1996).
In conclusion, it is more than obvious that the Thar Desert has undergone a
considerable change in its physiography particularly after the initiation of the three
major canalized irrigation systems, particularly the IGNP, although Tewari (2021)
has sounded a warning in the wake of global warming and suggested on the grounds
of a joint study conducted by the Birbal Sahni Institute of Palaeosciences, Lucknow,
and Jawaharlal Nehru University, Delhi, that the climate change had already resulted
in the monsoon shifting towards a drier Thar Desert in Rajasthan and Gujarat leading
to frequent floods in the two states along with erratic rainfall events over all the
places. Bouma and Van Der Kaay (1995), on the other hand, highlighted the role of
El Nino in accentuating the malaria incidence and emergence of outbreaks in the
Thar Desert. Tyagi et al. (1995) disagreed with the El Nino theory and instead put
forth their theory of ‘vectorism’, i.e. co-occurrence of multiple vectors (e.g. An.
stephensi, An. culicifacies and An. subpictus) in a single ecosystem otherwise
harbouring nominal representation (e.g. An. stephensi).
19.3.2 Malariological Transformation in the Thar Desert Climate
The Thar Desert region was defined as an area with low and unstable malaria with
occasional outbreaks. After initiation of the three major canal systems, viz. Gang
Canal (1923), Sirhind Canal (1955) and the Indira Gandhi Canal (1958; water began
to flow only in 1962), the ecology and physiography of the canal-impacted region
(10–15% of the Thar land) greatly altered, triggering an anthropization-linked
permanent changes in the climate pattern which favoured the formation of the
extensive mosquito breeding habitats of varying nature, high-vector densities and
intrusion of new malaria mosquitoes earlier unknown for the region. Consequently,
having changed a great deal for the worse malariologically, the Thar Desert
witnessed a high prevalence of disease, with several epidemics, reported in the
desert during last 30 years. It is evident from data for the period 1961–1994 that
not only has the slide positivity rate in the desert region increased 3.5-fold, but
Plasmodium falciparum incidence also increased as much. Along with Anopheles
stephensi, the traditional malaria vector in the xeric environment, another significant
vector of the Indian mainland, An. culicifacies, has also established itself in the areas
extensively irrigated through canals.
To prove point that malaria is influenced by anthropogenic activity-driven climate
change, Tyagi et al. (1994) conducted entomological and parasitological
investigations in four Thar Desert villages, viz. Madassar and Awai (ambient
temperature and relative humidity about 22 °C and 50–60%, respectively), situated
in the IGNP command area in the Jaisalmer district, and Kanasar and Khetusar (with
ambient temperatures and the relative humidity in summer averaging around 35–40 °
C and 25–30%, respectively), scores of kilometres away from the Indira Gandhi
canal in the uncanalized area (Fig. 19.1). To conduct socio-epidemiological studies,
in the outset itself all the houses in the study villages were numbered, population per
house enumerated and family details recorded on pretested proformas (Black 1968).
19.3.2.1 Entomological Investigations

(i). Results on Immature Surveys
For sampling larvae from shallow sources of water, a long handle dipper was used
(10 dips); larvae were then transferred to enamel trays for calibration, and the fourth
instar and/or pupae were transferred to individual test tubes with small amount of
water for allowing emergence. The test tubes were closed at the mouth with a piece
of cotton to prevent escape of the emerged adult. The larvae were sampled from
‘Tanka’ and ‘Beri’ with the help of a 5 lit. Bucket (Tyagi 1998a, b). Immatures were
identified using Puri (1960).
Larval instars belonging to An. culicifacies, An. stephensi, An. subpictus and An.
annularis were sampled from a variety of breeding habitats including irrigation
canals, ponds, ‘khadin’, ‘nadi’, ‘tanka’ and ‘beri’. Only An. stephensi bred in the
‘tanka’ and ‘beri’, while An. culicifacies was dominant in irrigation channels,
stagnant water along the canals and the swamp. Anopheles subpictus was found
breeding in the post-monsoon open-ground pools and the cement tanks filled with
water for cattle drinking.
(ii). Results of Indoor and Outdoor Resting Vector Mosquitoes
Indoor and outdoor sampling of adult mosquitoes was carried out in randomly
selected six human dwellings and six cattle sheds in each of the four villages
between 0600 h and 1000 h, using mouth-operated aspirators and torch lights
(Fig. 19.2). A small field laboratory was set up for preparing parasitological
microslides, dissecting mosquitoes and identifying microscopically both the vectors
and parasites by species. While the adults were processed for specific identification
Fig. 19.1 Location of study villages in the IGNP command area (1 = Madassar village, 2 = Awai
village) in Jaisalmer and desertic non-command area (3 = Kanasar village, 4 = Khetusar village) in
Jodhpur districts, in the Thar Desert, north-western Rajasthan (India)
following Christophers (1933) and Harrison and Scanlon (1975), they were also
additionally classified for their abdominal (unfed or fully fed) condition and follicu-
lar status to determine parity rate. Malaria parasites were diagnosed on the basis of
characteristic features of different parasitic stages particularly the ring and
gametocytes. A report on diagnosis of positive cases was passed on to the auxiliary
nurse midwife (ANM) for dealing with these cases.
A total of eight Anopheles species were sampled from all types of collection
(Table 19.1) among which Anopheles stephensi dominated the collection from
human dwellings and cattle sheds in all the villages in irrigated and unirrigated
villages, followed by An. culicifacies, An. subpictus, An. annularis, An. nigerrimus,
An. vagus, An. splendidus and An. d’thali. Anopheles nigerrimus pronouncedly
oriented during dusk in collections in the vicinity of the forest along the Indira
Fig. 19.2 Adults of Anopheles stephensi captured in the Thar Desert villages during (a) dawn and
(b) dusk (Source: Dr. B.K. Tyagi, personal archive)
Gandhi main canal, as it was attracted towards the light of torches and vehicle
headlights. The relative density, expressed as the number of females collected by one
man during a 1 h period, is graphically presented in Fig. 19.3. The average density
per man-hour of An. stephensi (17.1; range 0.0–47.2) was the highest, with maximum
density in April and minimum in January. Another important vector, A. culicifacies
(average pmh 3.3; range 0.0–14.1), showed maximum density during the monsoon
Table 19.1 Females of anopheline species collected in the irrigated and unirrigated villages
(HD = human dwelling; CS = cattle shed; PMH = per man-hour density; other species =
Anopheles vagus, An. splendidus and An. d’thali)
Indoor collection PMH Indoor collection PMH
Species HD CS Total (%) Density HD CS Total (%) Density
An. 635 588 1223 (29.6) 23.8 230 200 430 (10.4) 8.1
stephensi
An. 316 342 658 (15.9) 13.5 0 0 0 0.0
culicifacies
An. 479 606 1085 (26.2) 22.6 24 31 55 (1.3) 1.1
subpictus
An. 257 236 493 (11.9) 10.2 0 0 0 0.0
annularis
An. 29 23 52 (1.2) 1.0 0 0 0 0.0
nigerrimus
Other 99 47 146 (3.5) 2.8 0 0 0 0.0
species
50
40
Per man-hour density
30
20
10
0
Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar
Month
Fig. 19.3 Comparison of the relative density (per man-hour density) among Anopheles stephensi,
A. culicifacies and A. subpictus in the irrigated and unirrigated villages (1993–1994);
An. stephensi; A. culicifacies; A. subpictus; An. stephensi A. culicifacies;
A. subpictus (Source: Tyagi 2002)
months of July–September. Anopheles subpictus rose in density with the onset of the
monsoon in late June due to the existence of rainwater-fed surface breeding habitats
and remained abundant until December (average pmh 11.6; range 9.7–33.1).
Anopheles stephensi is conspicuous by its constant presence in unirrigated
villages despite extremes of ambient temperature (average pmh 7–0; range
0.0–18.7). In these villages An. subpictus also occurred in low densities between
August and December (average pmh 1.1; range 0.0–7.0), but An. culicifacies was
characteristically absent throughout.
Table 19.2 Anopheline Number of females collected

species collected simulta-
Species Man (%) Cattle (%)
neously from man and cat-
tle to show anthropophily/ Anopheles stephensi 151 (52.2) 138 (47.8)
zoophily of five of the eight Anopheles culicifacies 78 (26.8) 213 (73.2)
species Anopheles annularis 2 (3.7) 51 (96.3)
Anopheles subpictus 11 (4.8) 215 (95.2)
Anopheles nigerrimus 71 (98.6) 1 (1.4)
(iii). Simultaneous Collection of Biting Mosquitoes from Cattle and Humans
In order to establish proclivity for feeding on either animals, humans or both,

adult females were simultaneously captured prior to initiate feeding on a human
volunteer who was made to lie down on a cot near a buffalo calf tethered at a distance
of 3 m, between 1900 h and 2100 h. Collection of pre-biting female adults from a
human volunteer and a buffalo calf was carried out by two different insect collectors.
Results of collections showed An. stephensi was collected about equally from each
(Table 19.2). Surprisingly, An. nigerrimus showed the strongest preference for
orientation on the human, but only in the presence of flashlights. It did not, however,
feed preferably on human blood. Anopheles culicifacies proved to be zoophilic, like
An. annularis and An. subpictus.
(iv). All-Night Human Biting Collection of Mosquitoes
Further, in order to determine peak biting periods of the various vector

mosquitoes, sampling of biting mosquitoes was also made overnight
(1800–0600 h) from two sleeping volunteers. The overnight collection per human
volunteer was made by two insect collectors, taking turns to not exceed 2 hours of
collection per insect collector at a stretch. Four species, namely, An. stephensi,
An. culicifacies, An. subpictus and An. Nigerrimus, were captured during the night
biting collection. Characteristically both An. stephensi and An. culicifacies exhibited
two feeding peaks, one early in the night and the other just before the dawn
(Fig. 19.4), the knowledge of which carry a great epidemiological significance
from control point of view. Anopheles culicifacies fed earlier than An. stephensi
and stayed in higher densities until just before drawn. In contrast, An. stephensi
exhibited a better adjustment to ambient temperature and remained active throughout
the night. Apparently attracted to the flashlights, Anopheles nigerrimus was col-
lected in large numbers in the early hours of the night only. Diagnosis of blood meal
indicated An. stephensi to have a greater preference for human blood (58.2%)
compared to that of either An. culicifacies (23.4%) or An. subpictus (13.4%).
(v). Vector Incrimination with Malaria Parasite
The female mosquitoes (total # 2625) belonging to eight Anopheles species were
processed for vector incrimination. For this, they were dissected in normal saline for
the examination of parasitization in either or both gut and the salivary glands. The
60
50
No. of females collected
40
30
20
10
0
18–19 19–20 20–21 21–22 22–23 23–24 24–01 01–02 02–03 03–04 04–05 05–06
Hour duration
Fig. 19.4 Graph showing orientation of four important anopheline species for anthropophily
during all-night human-bait collection (note characteristic twin peaks for orientation of the vector
Anopheles stephensi and A. culicifacies, in particular); An. stephensi; A. culicifacies;
A. subpictus; A. nigerrimus (Source: Tyagi 2002)
Table 19.3 Anopheline species naturally incriminated with malaria parasite (SG +ve = salivary
gland positive for sporozoite; G +ve = gut positive for oocyst)
No. SG G No. SG G
Species dissected +ve +ve Total dissected +ve +ve Total
Anopheles 850 3 0 3 102 1 1 2
stephensi
Anopheles 938 1 6 7 0 0 0 0
culicifacies
Anopheles 451 1 1 2 284 0 1 1
subpictus
Anopheles 40 0 0 0 0 0 0 0
nigerrimus
infected mosquitoes were preserved for future reference. Only An. stephensi,
An. culicifacies and An. subpictus, sampled during dawn and dusk collections,
could be incriminated (for salivary glands, p-test or ϰ2 = 1.768; for gut,
ϰ2 = 0.36) (Table 19.3).
Anopheles stephensi is a truly original desert species, ecologically best adapted to
arid environments of the Thar Desert (Zahar 1990a, b; Tyagi 1994a, 1995a, 2002).
Although A. culicifacies, A. subpictus and A. annularis were reported earlier from
the urban limits of Bikaner (MacDonald 1931), none were parasitologically proved
then to be a vector in the desert. For the first time, therefore, An. culicifacies has been
shown to be a vector in the highly canal-irrigated Sri Ganganagar district (Tyagi and
Verma 1991), while An. stephensi was proved to be the sole vector in the xeric
Jodhpur district (Tyagi and Yadav 1994). Anopheles subpictus, occurring in both
irrigated and unirrigated villages, was incriminated only in the IGNP command area
in the eastern Jaisalmer (Tyagi 1996g). This situation calls for a strong effort to
annihilate vector populations before the situation worsens.
19.3.2.2 Parasitological Investigations

To determine the load of malaria parasitic infection in the rural community, monthly
fever surveys of all febrile cases were conducted in all villages. Blood sample, using
finger-prick method involving a fresh medical lancet, was collected from febrile
cases contacted door to door, with history of their sickness recoded. The slides with
both thick and thin blood films were stained either in Giemsa or JSB (Jaswant Singh-
Bhattacharji) for differential characterization of parasites. Later, after confirmation
of positive blood sample, the concerned patient was also given radical treatment
according to the national policy through either the auxiliary nurse midwife (ANM)
or the multi-purpose worker (MPW) present in the village.
A clear impact of canalized irrigation in the desert was visible after a careful
scrutiny of results. Following a rapid mass blood survey immediately after the
epidemic in the late autumn of 1992 in the two IGNP command villages (Pv
11.1%, Pf 88.7%) and two unirrigated villages (Pv 17.1%, Pf 82.7%), fever surveys
were conducted in all the four desert villages during April 1993–March 1994.
Results showed a slightly higher slide positivity rate in the IGNP villages (32, 3%)
than in the unirrigated villages (25, 5%), but a significantly higher proportion of
P. falciparum in the IGNP villages (76.6%) compared to that in the unirrigated
villages (16.6%) (Table 19.4). Plasmodium falciparum exhibited two distinct peaks:
first, during the summer months of March–April and, second, during December–
January (Fig. 19.5). Mixed infections were common in all villages, with a marginally
higher proportion in the unirrigated villages (11.5%) than the other two villages
(3.2%). Notably the IGNP command villages harboured more gametocyte carriers
(16, 17.8%) compared to the unirrigated villages (2, 8.3%). Cumulatively, 73.7% of
all the positive cases were found in children of less than 14 years of age. The male
population (68.4%) suffered more than the females (31.5%).
Male human population was found more parasitized than the females in all
villages regardless of the irrigation facility. The reason for more males suffering
with infection may be due to their different sleeping and clothing habits, as they
prefer to sleep outdoors at night, with fewer clothes covering their skin, as compared
to females who essentially sleep indoors while more or less completely covered with
the traditional clothes they wear. This difference in sleeping and clothing habits
determines the extent and magnitude of exposure of a person to the biting vectors
during sleep. Similarly, the adolescent and the adult working age groups were found
more positive than the other preceding age groups (Table 19.4).
19.3
The Thar Desert
Table 19.4 Results of fever surveys in the four study villages from April 1993 to March 1994 (BSC/BSE—blood slide collected/examined; Pf—Plasmodium
falciparum; Pv—Plasmodium vivax; M—male; F—female; ABER - annual blood examination rate, i.e. slides examined as % of population; API—annual parasite
incidence, i.e. slide positive cases per 1000 population; m—month; yr—year)
Prevalence of positives by age groups
BSC/ Positive Mix Gametocyte 12– 5–9 10–14
Village BSE (%) Pf (%) Pv (%) (%) (%) <11 m 23 m 2–4 yr yr yr >15 yr M (%) F (%) ABER API
Madassar 177 52 42 8 (15.3) 2 (3.8) 12 2 3 (5.7) 8 (15.3) 7 16 16 36 16 7.1 20.8
(29.3) (80.0) (23.0) (3.8) (13.4) (30.7) (30.7) (69.2) (30.7)
Awai 101 38 27 10 1 (2.6) 4 3 (3.8) 3 (3.8) 5 (13.1) 11 6 (15.7) 10 23 15 8.8 32.9
(37.6) (71.0) (26.6) (10.5) (28.9) (26.3) (60.5) (39.4)
Kanasar 65 18 4 13 1 (5.5) 2 7 0 (0.0) 1 (5.5) 6 2 (11.1) 2 (11.1) 14 4 4.4 12.2
(27.6) (22.2) (72.2) (11.6) (38.8) (33.3) (77.7) (22.2)
Khetusar 29 6 0 (0.0) 5 (83.3) 1 0 0 (0.0) 2 (33.3) 0 (0.0) 12 1 (16.6) 2 (33.3) 5 (83.3) 1 2.4 5.0
(20.6) (16.6) (0.0) (16.6) (16.6)
372 114 73 36 5 (4.3) 18 12 8 (7.5) 14 25 25 30 8 (68.4) 36 5.9 18.0
(30.6) (64.0) (31.5) (15.8) (10.5) (12.2) (21.9) (21.9) (26.3) (31.5)
Source: Tyagi and Yadav (2001a, b)
319
16
14
12
10
Cases
8
6
4
0
Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar
Month
Fig. 19.5 Graph showing the relative number of Plasmodium vivax and P. falciparum cases in
both irrigated and unirrigated villages (note the high prevalence of P. falciparum in the irrigated
villages), during 1993/1994; P. falciparum: ( ) irrigated villages, ( ) unirrigated villages;
P. vivax: ( ) irrigated villages, ( ) unirrigated villages (Source: Tyagi 2002)
19.4 Where Is the Thar Desert Heading to Malariologically

under Climate Change
Epidemiologically, the Great Indian Thar Desert had been regarded as a region with
low and unstable malaria with occasional outbreaks (Sharma 1986a, b). Tyagi et al.
(1995), Tyagi et al. (1995), and Tyagi and Chaudhary (1997), however, carried out
thorough investigations into the transformation of Thar Desert’s eco-physiography,
in the wake of extensive canalized irrigation, particularly the Indira Gandhi Nehar
Pariyojana—the largest in Asia with approximately 10,000 km of network of
distributaries when completed fully and one of its kind in the whole world in a
desert ecosystem—and its impact on malaria conflagration with cyclic epidemics
and exceptionally high morbidity and mortality due to P. falciparum, in recent years.
Tyagi (2004a) pointed out that the mismanagement of water under the IGNP was a
major factor for exacerbating malaria in the Thar Desert. Bouma and Van Der Kaay
(1995) inferred that the El Nino phenomenon in the Pacific Ocean played a key role
in erring the monsoon trend in India, and the highly erratic rainfall in the Thar Desert
had actually accentuated possibilities of the unwelcome outbreaks. Tyagi et al.
(1995) questioned the validity of Bouma-van der Kaay’s El Nino Southern Oscilla-
tion (ENSO) theory as an early warning system for future epidemics and instead
propounded their own theory of ‘vectorism’—a phenomenon that has mushroomed
from the ‘desert malaria’—being responsible behind a series of malaria epidemics in
the Great Indian Thar Desert in western Rajasthan, India (Tyagi 1997b).
During the early twentieth century when the whole country was reeling under the
catastrophic impact of malaria epidemics, the Thar Desert in western Rajasthan
reported fragmentary cases now and then. In fact, the earliest report of malaria
19.4 Where Is the Thar Desert Heading to Malariologically under Climate Change 321
cases from any part of Rajasthan is from 1909 when 134 hospital admissions were
registered, of which 10% were P. falciparum (Green 1911). Sri Ganganagar district
in the northern Thar Desert was the first to experience the first major outbreak during
1983/1984. Following heavy rains (average 450 mm; maximum 960 mm) in 1990,
the southern parts of the Thar including Barmer, Jodhpur and Pali districts faced a
severe malaria epidemic and heavy rains and floods were blamed for the disease
outbreak (Mathur et al. 1992; Tyagi et al. 1995; Tyagi 2002). ‘Vectorism’ in the
southwestern districts of the Thar Desert built up so heavily in a short time that once
again a very severe epidemic broke out in 1992 in the Jodhpur, Bikaner and
Jaisalmer districts under the IGNP command area (Tyagi 1994a). The worst of all
malaria epidemics in the entire history of the Thar Desert happened in 1994 when
more than 300 people succumbed to malaria and several thousands of people became
sick due to malaria, mostly P. falciparum (Tyagi 1995a, b). Ever since the Thar
Desert has been reporting malaria epidemics and reporting considerable cases
every year.
Lack of sustained vector control efforts through indoor residual insecticide
spraying has been a major drawback, coupled with a moderate to high degree of
tolerance/resistance by vector species to DDT, the only insecticide used extensively
over the past three decades in the Thar Desert. Taking account of the fact that the
Thar Desert is a very different ecosystem from the rest of the country where mostly
the local folks suffering with malarial fevers are hard to approach and deliver health
care in time, the problem of malaria control has to be tackled with an improvised
vector containment methodology which must essentially suit the local conditions,
including human behaviour, but must also effectively dissipate vector populations
and the disease burden.
Anopheles stephensi: The First Vector
to Show an Evolutionary Response to Rapid 20
Climate Change
20.1 Introduction
Anopheles stephensi Liston (1901), described primo temporis from its type locality,
Ellichpur* (Amroati district, Central Provinces*; Ellichpur is currently known as
Achalpur, a city and a municipal council in Amravati district in the state of
Maharashtra), India, was regarded by Christophers (1933) as ‘Indian’ and not
‘Oriental’ or even ‘Asian’, in terms of origin, notwithstanding its appreciable
range extending eastwards through the Malay states and the East Indies and west-
wards through Southern Mesopotamia (present-day Iraq and Kuwait and parts of
present-day Iran, Syria and Turkey) to as far as the Horn of Africa (Rao 1984;
Surendran et al. 2019; Sinka et al. 2020; Dev 2020a, b) (Fig. 20.1).
The incursion of An. stephensi into Africa is particularly worrying; over 40% of
sub-Saharan Africans live in urban environments, prompting the World Health
Organization (WHO) to issue a vector alert: ‘Anopheles stephensi . . . a major threat
to malaria control and elimination in Africa. . .’, putting urban populations at signifi-
cantly increased and potentially new risk of malaria transmission. With African
cities growing at an extraordinary rate and 43% of Africans now living in urban
areas, the movement of people into urban sites and the observation that An. stephensi
are spreading via key transportation routes, meaning it is not inconceivable that this
species could be transported large distances and that this may not remain a problem
centred on the Horn of Africa. Sinka et al. (2020) felt many cities across the whole of
Africa contain potentially suitable habitats for An. stephensi. For example, due to its
high population density, Nigeria, appears to be particularly suitable. The most
invasive, incursive and ‘silent’ malaria vector mosquito on earth is on the move,
and once established, An. stephensi is difficult to control. If it invades large cities,
such as Khartoum, Sudan; Mombasa, Kenya; and Dar es Salaam, the region could
face malaria outbreaks of unprecedented size. The traditional mosquito interventions
via indoor residual spraying and treated bed nets are notably more difficult to
implement in cities, and the crepuscular biting habits of An. stephensi suggest they
may have less impact on this species than the dominant African vectors.
Ltd. 2023
324 20 Anopheles stephensi: The First Vector to Show an. . .
Fig. 20.1 Geographic range of Anopheles stephensi expanding southwards to Sri Lanka, eastwards
through the Malay states and the East Indies, as well as westwards to Southern Mesopotamia and
recently far beyond to the Horn of Africa (Source: Adapted and modified from Dev 2020a, b)
Taking cues from the postulation put forth by Christophers (1933), I am of the
opinion that there seems to be enough prima facie proof of evidence to propose here
in following pages a theory about the cradle of An. stephensi in the Thar Desert in
northwest India (see Chap. 10).
20.2 The Principle
Despite a well-recognized geographic expansion to the far-off new regions (Sinka

et al. 2020), a terra incognita thus far for the species Anopheles stephensi, the main
factor behind its extraterritorial distribution, i.e., anthropically driven or
urbanization-based zoogeography, has never been highlighted or focused upon in
context with climate change. Urbanization is regarded humongous concentration of
humans and habitats, often in multilevel buildings, with enormous load on water
intake and, consequently, container-water storage to tide over shortfall in ground-
water supply or availability. Thus, diametric or radial mushrooming of new urban
centres around the Thar Desert (western India) evolved as a precursor to attraction to
An. stephensi for outward peregrinations to explore for establishment in new areas,
sometimes eco-physiographically dissimilar to the point of origin. For the first time,
therefore, a new adaptive evolution theory implicating direct relationship between
the malaria vector, An. stephensi and climate change-impacted urbanization phe-
nomenon is being propounded to explain the possible pathways and genetics of
dispersal of the vector species. In this manner, the inextricable relationship between
An. stephensi and urbanization also offers a direct evidence to the ongoing dynamic
20.3 The Basis 325
change in the climate, which carries significant ramifications for future understand-
ing of vector distribution and malaria epidemics in the hitherto non-malarious areas
of the world.
20.3 The Basis
Earlier, the only other mosquito—also the first ever animal model—which exhibited
a direct linkage with climate change or global warming was Wyeomyia smithii,
invariably breeding in the pitcher plant, Sarracenia purpurea Linn. (Bradshaw and
Holzapfel 2001, 2010). The pitcher-breeding mosquito W. smithii has moved from
the eastern America to the central and western parts of North America with the
shifting of the plant, S. purpurea—by using the length of day (photoperiodism) to
anticipate and prepare for seasonal transitions of major events in its biology. In case
of ectotherms like W. smithii, or in our case even An. stephensi, photoperiod ensures
successful utility of available events in distant time or space such as thermal
environment, food and other ecological conditions which become a reality in open
ambience, e.g. swarming, mating, blood-feeding, egg-laying, etc. Anopheles
stephensi, a strictly container breeder likewise, utilizes its adaptive prowess to
photoperiodism, especially with reference to the Thar Desert’s ‘Tanka’ and ‘Beri’,
to migrate, reproduce, develop and prosper numerally to sustain. A few advanta-
geous factors An. stephensi absorbs during the inevitable contained environment of
‘Tanka’ and ‘Beri’ are:
(i) While the temperature and humidity remain almost invariant, the mosquito, An.
stephensi, appears to sense photoperiodism or the day length and, therefore,
provides a highly dependable anticipatory cue for future seasonal conditions
(cf. Tyagi and Yadav 1996a, b, c).
(ii) Anopheles stephensi, with its three subspecies on the evolutionary pathway, is
capable to overwinter or aestivate during extreme ambient temperatures—a
clearly specific photoperiodic response based on selection through evolutionary
time for the optimal development, migration, reproduction and/or dormancy.
(iii) Being contained over long periods of time, An. stephensi inherently follows, via
‘a genetic switch’, the go/no-go response of photoperiodism and is able to
regulate optimally all its physiological, developmental or reproductive pro-
cesses after the completion of the seasonal event under selection pressure.
(iv) Being an ectotherm and adapted to spend a good deal of contained lifetime in
the ‘Tanka’ or ‘Beri’, the desert specialist species, An. stephensi, has also learnt
to fine-tune the actual timing of the seasonal event in a thermal environment
(i.e. under thermal stress) that varies from year to year.
(v) Anopheles stephensi is able to respond to both total and dynamic
photoperiodism.
(vi) Chronobiologically, the external environmental cues reset the internal body
clock, and, thus, the naturally occurring light is the strongest zeitgeber
(i.e. environmental time cues such as sunlight, alarm clocks or social interaction
that helps trigger an organism to entrainment to a 24-h cycle) for An. stephensi,
which can adopt both circadian (endogenously generated biological rhythm
with a period length approximating to 1 day) and circannual (endogenously
generated biological rhythm with a period length approximating to 1 year)
rhythmicities corresponding with hard periods to keep track of seasonal time,
for example, a winter hibernacula, during migration through changed physiog-
raphy of territorial zones.
A major trait of W. smithii by which it can be paralleled with An. stephensi is the
common character of ‘container’ breeding. However, unlike W. smithii, the Indian
mosquito, An. stephensi, exercises a great diversity in breeding habitats in and
around human habitations such as wells, borewells, underground and overhead
water tanks, cisterns, roof gutters in factories, barrels, buckets, ornamental tanks,
pitchers and vases, besides of course ‘Beri’ and ‘Tanka’ in the Thar Desert (Rao
1984; Tyagi 2002), which give the vector species an additional power to diverge and
adapt in the changed climate. Anopheles stephensi finds it convenient to explore new
niches and habitats with the growing urbanization where water-storing practice in a
variety of containers is spontaneously acquired due to immense pressure on the
drinkable groundwater sources. Kerala state in peninsular India presents a glittering
example to this rule.
Kerala had been the first state in the country to achieve the eradication of malaria
as early as 1965. However, the euphoria was short-lived, and the slackening of
vector-control activities and the importation of malaria from other states
re-introduced the disease in Kerala soon thereafter, and from 1975 onwards malaria
once again became a regular illness in the state. Through the early twentieth century
Kerala enjoyed a vibrant accumulation of 44 perennial rivers, but after almost a
century, by 2001, it began to witness only three live rivers. Thiruvananthapuram, the
capital city, located near its southern tip, had likewise plenty of water at the doorstep
of the inhabitants in the past, however, by 1980s, it fell gravely short of groundwater
so much that, for the first time in Kerala’s history, people began to store water in pots
to meet out their daily chores! The opportunistic An. stephensi, which had already
intruded Kerala through Kasaragod district in the north, soon found out commensu-
rate environment to breed prolifically in Thiruvananthapuram, not without ushering
the first ever malaria outbreak on close heels! Additionally, it is now well
documented that An. stephensi has subsequently invaded Lakshadweep ils. (India)
in the Arabian sea and the Rameswaram il. (India) and the neighbouring country of
Sri Lanka in the Indian Ocean. In all above examples, urbanization with water-
storing habits by people was the single most dominating character common to all.
20.4 Population, Urbanization, Anthropization and Climate Change in the Thar Desert 327
20.4 Population, Urbanization, Anthropization and Climate

Change in the Thar Desert
Thar Desert constitutes the eastern end of the great Saharo-Arabian mid-latitude
desert belt that owes its existence to the anti-cyclonic, subsiding dry continental air
regime (Roy and Pandey 1970). Till recently widely divergent views prevailed
regarding the antiquity of the Thar—some making it a recent phenomenon and
some as old as the Miocene (Dhir and Singhvi 2012). While Wadia (1960)
postulated about post-glacial aridity for Central Asia, including the Thar Desert,
Piggot (1950) and several others used the presence of flourishing Harappan and
subsequent civilizations within the Thar some 5000 to 2000 years ago as an evidence
of a recent origin of the Thar Desert. The mention in the scriptures of a mighty river
in the Thar in the Vedic times and the same as a dying river later reinforced this view
further. Bryson and Barreis (1967) advocated a more younger age for the Thar by
attributing its formation to rainfall prevention by dust in the atmosphere originating
from degradation of landscape caused by intense biotic pressure. Whatever the
antiquity the Thar Desert appears to be a much recent happening, just like An.
stephensi which is likely still evolving with the three subspecies or races. Consider-
ing that An. stephensi was born in the Thar Desert, an attempt is made here to
demonstrate that population boom in urban centres around it in India, mainland or
islands and far off to distant Sri Lanka, the Mesopotamia, Arabian Peninsula and,
finally, the Africa continent galvanized the vector species to gravitate into their
contained water environment.
Demographic annals of yore hint at a very low population of possibly two to five
persons per square kilometres and human population influx into the Thar Desert,
called Marusthali, started soon after the famous battle between the invader Alexan-
der of Greece and the Indian king, Porus, of Punjab in 327 BC (Dhir 2003). Since
then human settlements have made inroads from the less inhospitable eastern margin
to the more desert westward. However, right up to the beginning of the twentieth
century, the population was thin, with hardly any growth (Dhir 1982; Dhir and
Kolarkar 1977). Since 1921 the population doubled in the next 35 years and doubled
again in less than three decades. The growth rate was all the time higher than that of
the Rajasthan state as a whole or the country (Fig. 20.2). By 2001 the Thar Desert
emerged as the most widely populated desert in the world, with a population density
of 110 people per km2 (Dhir 2005; Singh 2007).
It is to be reminded here that An. stephensi, in which Ross (1897) has noticed
primo temporis the spectacular black bodies, the round-shaped oocysts of the
malaria parasite, on the outer gut wall, and laboriously discovered an inextricable
link between mosquito and malaria parasite, whereby he founded his irrevocable
theory that mosquito transmits malaria which ultimately won him the Nobel Prize in
1902, was till the beginning of the twentieth century the only anopheline mosquito in
the Thar Desert (Tyagi 2004a, b). Now, if the population growth trend in the Thar
Desert is carefully examined, it will become more than clear that the mosquito, An.
stephensi, tended to diverge from the penetralium of the Thar first towards the
eastern edge of the desert where human settlements sprang up early. While
Fig. 20.2 Human population growth over the years (Census Year 1901 = 100). Note that the arid
zone (Thar Desert) has recorded a far greater growth than in the Rajasthan state or India (Source:
Tyagi and Baqri 2005)
urbanization in the rural xeric environments was still unheard by the close of the first
quarter of the last century, elsewhere in India, including Rajasthan’s non-desertic
lands, urbanization phenomenon had already set in as towns and cities, some of them
soon to be metamorphosed into metropolises (23) and/or megapolises by the end of
the twentieth century (Bombay, Calcutta, Madras and Delhi all of which, except
Delhi, were rechristened recently as Mumbai, Kolkata and Chennai). The turning
point in this transformation from a majority rural India converting into a dominant
urban India came in by the late 1990s when the urban population surpassed the rural
population. At present, India has 48 cities with >1 mill. people, 405 cities with
100,000 and 1 million people and 2500 cities with between 10,000 and 100,000
people. Mumbai is the largest city (megapolis) in India with a population of
12,691,836, followed closely by Delhi with 10,927,986 people. Both these
megapolises, together with Chennai and Kolkata, are known from the early twentieth
century having a An. stephensi-transmitted malaria (Covell 1928; Christophers et al.
1928; Simmons and Upholt 1951; Watts 1999) (Fig. 20.3).
The rate and growth of population in India has been phenomenal. The total
population of India in 1901 was about 238 million which catapulted to 361 million
in 1951 and 843 million in 1991, whereas in 2001 India’s population was 1027
million which rose to 1210 million in 2011. While during 1901–1911 the decadal
growth rate was only 5.75%, the same had shot up to 17.64% during 2001–2011.
Bigger cities mean huge population, which not only generate ‘heat islands’ in urban
centres but also essential water-storing practice due to excessive pressure on ground-
water resources and, consequently, shortage in public supply. Thus, the urbanization
scenarios set a perfect stage for attracting An. stephensi.
20.5 Urbanization-Driven Climate Change and Effluxes of Anopheles. . . 329
Fig. 20.3 Hot Thar Desert (arid) and semi-arid regions, along with cold desert, with important
mountain ranges as barriers in the distribution of Anopheles stephensi from the penetralium in the
Thar Desert (red spot) to other parts undergoing swift process of urbanization within India
20.5 Urbanization-Driven Climate Change and Effluxes

of Anopheles stephensi from the Thar Desert to In-Country
and Extraterritorial Regions
The efflux of Anopheles stephensi from the Thar Desert to several other in-country as
well as extraterritorial regions is attributed to the favourable conditions created by
rapid social development and urbanization, with inbuilt excessive water storage
practices.
Table 20.1 Chronology of in-country and extraterritorial expansion of the desert specialist malaria
vector Anopheles stephensi in the post-1950 era
Year of India Outside India expansion

entry Mainland Islands in countries References
1970s Goa Sharma and
Hamzakoya (2001)
1980s Kanyakumari Sharma and
Hamzakoya (2001)
1992 Kochi Raveendran et al.
(Kerala) (2016)
1956 Eastern Saudi Arabia Al Kuriji et al.
(2007)
2001 Rameswaram B.K. Tyagi (pers.
il. observation)
2001 Lakshadweep Sharma and
ils. Hamzakoya (2001)
2012 Djibouti Faulde et al. (2014)
2016 Ethiopia Carter et al. (2018)
2016 Sri Lanka Dharmasiri et al.
(2017)
2019 Sudan Ahmed et al. (2021)
The Thar Desert’s aridity stretches quite close to Delhi; therefore when Delhi was
being transformed into New Delhi by shifting India’s capital from Kolkata in 1911,
the mosaic town witnessed a huge expanse of building construction, establishment of
industries and, consequently, phenomenal rise in population. It seems, therefore, that
An. stephensi first intruded Delhi since the Thar Desert connected with it well. Also
any divergence attempt by the mosquito was likely thwarted by the parallelly
running Aravalli mountain ranges (Table 20.1).
As far as Mumbai (old Bombay, Maharashtra state) is concerned, it can be most
commensurably assumed that the vector, An. stephensi¸ might have soon inveigled
into the city through Ellichpur (Achalpur) in Amravati (also in Maharashtra state)
where it was discovered (Liston 1901), largely because of the sprawling port
township with essentially water-storing practices and the rains in plenty. Whatever
time lapsed between the cities was possibly due to a natural barrier in the form of
Vindhyachal mountain and Satpura mountain ranges which ecologically transact the
country into north and south India. To Chennai and Kolkata, the species had likely
moved from either Achalpur, Delhi or Mumbai, in that order. It arrived Goa in the
1970s, Kanyakumari in 1980s and lastly, outside the mainland and east of Kerala,
the Lakshadweep islands in the Arabian Sea in 2001. Anopheles stephensi is still not
recorded from Andaman and Nicobar ils., but in view of the intrusive behaviour of
the species, it is safely presumed that it is but a matter of time before the island will
make an addition to the growing list of invasion by the vector.
Having established deeply in both Kerala and Tamil Nadu, it seems the species
has made headways to Rameswaram island township during early 2000s (pers.
20.6 Conclusion 331
observ.), either solely or in association with the species already prospering in these
states, taking the advantage of heavy human movement during pilgrimage.
The island of Mannar in the Northern Province of Sri Lanka is only 125 km from
Rameswaram, and a lot of people’s movement is regularly happening between the
two countries, hence a rather belated but sure first time entry into the country in
2016. Soon, however, the vector intruded the neighbouring Jaffna city in 2018 in the
pearl island nation, with a genotype consistent with an origin in Tamil Nadu
(Surendran et al. 2019).
Even though Thar is connected thinly with the Saharo-Arabian deserts, An.
stephensi was already present in the historical Mesopotamia (Iraq and Kuwait and
parts of Iran, Syria and Turkey) before the construction of Suez Canal in 1869, to
connect Mediterranean Sea with the Red Sea. The Suez Canal site was not only
malaria-free, but it also entertained no Anopheles species, albeit presence of
mosquitoes of the genus Culex and possibly Aedes (Ross 1903). During the past
nearly two decades, An. stephensi has invaded several countries in Africa and
Arabian Peninsula such as in Saudi Arabia in 1956—first in the Riyadh’s eastern
region in 2007 and subsequently in the western region in 2008. After intrusion to the
Arabian Peninsula, An. stephensi invaded Djibouti, a developing seaport township in
the Horn of Africa loaded with heavy transportation of goods and movement of
refugees returning from Oman. Next in line of invasion soon were Ethiopia, Somalia,
Sudan, Eritrea etc. Sinka et al. (2020) have worked on global data of prevalence and
distribution of An. stephensi and postulated a large number of neighbouring
countries and millions of African population reeling under the continuous threat of
descendance of the vector in the next few decades.
20.6 Conclusion
There is clear evidence that urbanization affects anopheline species in the

environment—diversity, numbers, survival rates, infection rates with
P. falciparum and the frequency of biting people, all are influenced.
Invasion by An. stephensi in Sri Lanka and Africa during the past one decade,
besides a couple of island territories in India, has attracted global attention, and the
World Health Organization issued an alert for the future. Mushrooming urbanization
with inextricable water-storage practices by the urban population is singularly the
most plausible cause of attraction to An. stephensi in all these new areas otherwise
terra incognita for the species in past.
Africa’s case of An. stephensi intrusion is particularly interesting due to arid
environments of the expansive Sahara Desert in the northern African region, which,
to some extent, is parallelable to that of the Thar Desert. Therefore, the constantly
changing desert physiography (e.g. recently Sahara Desert experienced snowfall
after nearly four decades), with mushrooming urban centres with populations there
exerting unprecedented pressure on drinking groundwater resources and to sustain
cultivating the inseparable water-storing habits, has clearly brought about a change
that is commensurate to the breeding of the stubbornly insular breeder, An. stephensi.
Thus, when for the first time, Faulde et al. (2014) reported An. stephensi from
Djibouti, in the Horn of Africa, where this species’ occurrence was linked to an
unusual streak of urban malaria outbreaks dominated by P. falciparum, first in 2013
and subsequently in 2013, the factor mostly behind invasion by An. stephensi was
understood to be the initiation of new structures all over with abundance of container
water all around. Positive tests for P. falciparum circumsporozoite antigen in two of
six female An. stephensi trapped in homes of malaria patients in March 2013 are
evidence that autochthonous urban malaria transmission by An. stephensi has
occurred. Anopheles stephensi was confirmed both microscopically and molecularly,
the latter by sequencing of the barcode cytochrome c-oxidase I (COI) gene and the
rDNA second internal transcribed spacer (ITS2). Taking cognizance of the fact that
P. falciparum is prodigiously transmissible by An. stephensi may pose a significant
future health threat. Further, An. stephensi is well known for its tolerance of urban
habitats which alludes towards increased malaria outbreaks in African cities in the
future.
Incidentally An. stephensi is not the first malaria vector to invade a new continent.
For posterity it is noteworthy here that An. arabiensis, a member of the An. gambiae
complex, has much earlier established in the city of Natal, north-eastern Brazil. Both
An. stephensi and An. arabiensis, despite being distant geographically, share
between them certain remarkable behavioural attributes.
Trans-Border Migration and Malaria
in Desert Populations 21
21.1 Introduction
Human movement such as migration, displacement, refuge, military personnel in

war or on leave in peace, tourists, etc. has on many times an irrevocable impact on
malaria prevalence, the former actually serving as fuel for the pernicious malarial
fevers (Pousibet-Puerto et al. 2021; Walz et al. 2019). When humans from
non-endemic or less malarious regions such as deserts move to areas endemic for
malaria, they are exposed to malaria infections, on one hand, and/or, if already
infected in the past, create new antigenic combinations, on the other, that continu-
ously confound the immune systems of the more sessile existing residents of
endemic sites, and they complicate measures for the control of malaria (Prothero
2001; Rajagopalan et al. 1984, 1986). Additionally, labourer force at the irrigational
development projects, many of which might have hailed from different malaria-
endemic states, stands a much greater chance to create fundamental malaria-
promoting environment besides physical, economic and social changes in the
mismanaged irrigation development site (Rajagopalan et al. 1984, 1986). In context
with deserts, Indira Gandhi Nehar Pariyojana (IGNP) in the Thar Desert in western
India is a vibrant example of de novo entry into the arid ecosystem an array of exotic
vectors, e.g. Anopheles fluviatilis, and the malaria parasite, Plasmodium falciparum.
Transmission potential of malaria, often drug-resistant malaria, from across the
international border or the hyperendemic malarious states within the country has
been adequately emphasized from time to time (Wangdi et al. 2015; Pousibet-Puerto
et al. 2021; Tyagi 2002). While the significance of population movements is
recognized, they and other human factors (e.g. distribution and composition of
population, social organization and economic activities) have not received attention
comparable to that given to malaria parasites and vectors.
Ltd. 2023
334 21 Trans-Border Migration and Malaria in Desert Populations
21.2 Human Movement in Search of Fodder for Cattle
Changes in agricultural productivity due to changes in climate could provoke

migration and might lead to increased urbanization, which results in lower transmis-
sion rates (Hay et al. 2005; Keiser et al. 2004). Western Rajasthan with almost
entirely covered by the Thar Desert, being a rain-deficient area, can offer fodder for
livestock only during monsoon season which is scanty, irregular and erratic. In the
event of the failure of monsoon, particularly so during the drought, the situation
worsens and the cattle breeders do not find enough pasture lands to graze their
livestock. Under these adverse circumstances, the cattle and sheep breeders have
developed a definite pattern of migration with their livestock to areas where suffi-
cient grazing ground or pasture is available. These migratory routes are followed
year after year by the livestock raisers. They take away their domestic animals from
their native places to such distant areas as Madhya Pradesh, Uttar Pradesh, Gujarat,
Punjab and Haryana where enough pasture is generally available. Incidentally, all
these new areas with pasture are highly endemic to malaria with a high proportion of
P. falciparum. Sometimes, the cattle and sheep breeders remain away from their
native places for several months or even years and return to their homeland only
when favourable conditions return to their homeland for their animals to graze, but
more often than not heavily malariated from their sojourn in the malaria-endemic
areas. The traditional migration routes for sheep and cattle, together with their
owners, are as given below (Fig. 21.1).
21.3 Malaria Transmission across International Borders
Border malaria is a serious issue in many countries engaged in disease elimination.

Bracing differentially endemic nations across it, the international border poses
specific challenges to policy makers and disease controllers due to its high porosity
in many cases. As a consequence, many peoples cross over these borders legally or
illegally, in the latter case almost always without any malariological inspection.
Since the ecology of areas across the border is contiguously similar, peoples on both
sides of the border frequently mix on one account or another (e.g. marriage rituals,
marts and or hunting) reinforcing transfer of parasites through the local vectors
(Al Zahrani et al. 2018). Nomadic settlers often migrate under the devastating impact
of droughts and are vulnerable to fresh malaria infection in the endemic country of
their settlement. This pattern of human movement across international borders may
complicate achieving malaria elimination in the neighbouring countries which are
often at different stages of the control-to-elimination pathway. India is one of those
counties at risk from human movement across the Thar Desert’s nearly 1500 km
international border bracing with Pakistan, a country overladen with malaria burden.
It is noteworthy that India is one of those 34 countries which have declared a time
frame for a malaria-free state by 2027 (Wangdi et al. 2015). People living on the
international border, sometimes an usually difficult terrain and hard-to-reach
communities, are often comparatively impoverished with poor treatment-seeking
21.3 Malaria Transmission across International Borders 335
Fig. 21.1 (a) Human migration with cattle and sheep across the Thar Desert border to other
(malaria hyperendemic) states in India and (b) human migration with camel across the desert border
to neighbouring non-desert (malaria hyperendemic) districts in the state
behaviour. Since the marginalized populations have only lower access to health
services, they have higher malaria and remain untreated usually. For above reasons
surveillance activities for rapid identification of any importation or reintroduction of
malaria are also very poor, and there is an urgent need to deploy satellite-based
spatial decision support systems and other advanced communication technologies
such as mobile phone technology which can be used to capture the movement of
people in the border areas and likely sources of malaria importation. Additionally,
the governments in the neighbouring countries across the border may undertake joint
collaboration to prevent and control malaria transportation by reinforcement of early
diagnosis and prompt treatment.
21.3.1 The Saudi-Yemeni Border
The malaria problem is serious at the Saudi-Yemeni border with higher rates of
transmission intensity on the Yemeni side of the border compared to the Saudi side.
For instance, between 2012 and 2014, when a total of 91,676 people were examined
for malaria in their blood in the bordering Jazan region, only three infections (0.003%)
could be found out which were all imported from Yemen. Yemen exhibited a preva-
lence rate of 4.6% during a survey in Hajjar Governorate bordering Saudi Arabia, in
2013. In Yemen, between 2008 and 2015, a period of rapid economic development in
Jazan and Aseer regions and moderately low rainfall, the incidence kept lower than 2.5
per 100,000 population per year, but a year later in 2016, with a moderately high
rainfall, the incidence escalated dramatically to 7.5. Earlier between 1956 and 1979 in
Aseer and Jazan regions, three major malaria parasites, viz. P. falciparum (6.4%),
P. vivax (1.5%) and P. malariae (0.2%), respectively, were reported. In contrast, in a
survey made in two bordering Governorates of Yemen, i.e. Hajjar and Sa’dah, between
1962 and 1977, a higher prevalence of the parasites, i.e. P. falciparum (13.8%) and
P. malariae (1.2%), was diagnosed, save for P. vivax (0.8%) which was relatively
lower. The scenario by 2020 had entirely changed since of all the cases detected
indigenously in Yemen nearly 99% were pure P. falciparum. It is noteworthy that
Plasmodium ovale was always wanting in any survey in either country.
21.3.2 The Jordan-Iraq Border
Malaria in the northern borders between Jordan and Iraq was mainly transmitted by
Anopheles superpictus. By the 1970s the vector mosquito was eliminated and active
transmission was interrupted in that region. However, malaria continued to ravish
the Red Sea facing areas infested by the deadly An. arabiensis and An. sergentii
which sustained transmission. Generally malaria erupted during the Hajj time along
the routes followed by pilgrims. Therefore, the health personnel, as early as the
1970s, targeted these households for indoor residual spraying (IRS) using
dichlorodiphenyltrichloroethane (DDT) and larviciding all the positive breeding
sites. Simultaneously all malaria cases were searched through active surveillance
and treated with chloroquine.
21.3 Malaria Transmission across International Borders 337
21.3.3 Malaria Status of Countries Bordering India
India shares land border with Afghanistan, Bangladesh, Bhutan, China, Myanmar
and Pakistan. Currently, Pakistan and Afghanistan are the most populous countries
affected by P. vivax malaria (WHO 2016). By 2016, P. vivax was the most prevalent
species in the area especially alongside regions bordering the neighbouring
Afghanistan, exhibiting same genetic background (Karim et al. 2016). The preva-
lence of P. vivax in Afghanistan is the highest (95%) among all the bordering
countries of India. The WHO (2016) revealed that the prevalence of P. vivax in
the other bordering countries of India was highest in Pakistan (81%), China (79%),
Nepal (78%), and Bhutan (60%), while its prevalence in Myanmar and Bangladesh
was 34 and 7%, respectively. However, P. falciparum was predominant in
Bangladesh (93%) followed by Myanmar (66%), Bhutan (40%), Nepal (22%),
Pakistan (19%), China (11%) and Afghanistan (5%). These results suggested that
the high prevalence of P. falciparum in Bangladesh and Myanmar was likely to
contribute to its prevalence (67%) in the northeast region of India. In addition, the
high prevalence of P. vivax in Afghanistan, Pakistan, China, Nepal and Bhutan was
also likely to contribute to its incidence in the west and north regions of India.
Therefore, the cross-country collaboration to control malaria is urgently needed
(Park et al. 2018).
21.3.4 Ethiopia and Sudan
Both countries suffer from malaria attacks on regular basis along the border. Death
and illness from diseases like malaria, leishmaniasis and tuberculosis are excessive,
and the areas are remote and hard to access by the health-care delivery facilities in
the countries. The spread of malaria disease is exacerbated by frequent population
movement. Ethiopia and Sudan joined forces to beat border health hazards (Anon.
2000).
21.3.5 Border Malaria in the Thar Desert
In case of the Thar Desert, besides some well-documented man-made means, natural
calamities like floods and droughts also play a significant role in enforcing inter-state
human migration. In not far distant time, in second half of the twentieth century, the
Thar Desert had two major droughts, the first in 1976–1977 and the second in 1987,
while two severe floods hailed one each in 1990 and 1994, respectively.
Four desert districts, namely Sri Ganganagar, Bikaner, Jaisalmer and Barmer,
brace for about 1048 km with the international border along Pakistan, in Sindh and
Punjab provinces, on north-western flank of Rajasthan state, while the other nine
desert districts touch the boundaries with Gujarat, Haryana and Punjab, besides the
non-desert districts in the state. Very little information exists on the issue of border
malaria, although the fact remains that border malaria, be it inter-state or
international, definitely plays an important role in defining the endemicity level of

the disease of the Thar Desert (Anonymous 1976). Some of the most vulnerable
desert districts are discussed below:
1. Sri Ganganagar District
This northernmost desert district borders with Punjab and Haryana states for
190 km of length. During the mid-1970s work of construction of the main Indira
Gandhi canal had greatly increased, with the plans to launch the Indira Gandhi Nahar
Pariyojana (IGNP) soon. The mega project obviously attracted a vast labour force
from near and far states. Malaria prevailed in the settled work force during all years
but more in 1974 and 1975 than in 1976. It is comprehensible that P. vivax alone was
present in the border population of the two states, while P. falciparum was already
represented in Sri Ganganagar unit population for period 1974–1976. The year 1975
experienced an epidemic since slide positivity rate (SPR) shot up to 10.56% from
6.86% in the preceding year, besides nearly four-times increase in the P. falciparum
cases. The API for Haryana was significantly high during 1974–1976, being 28.0,
29.1 and 28.0, respectively, which was on an average nearly double to that of the
Ganganagar unit (15.0) during the epidemic year of 1975. There had been a greater
degree of importation of malaria cases (48) against 23 exported cases in 1975, and
three against two exported cases in 1976. The contribution of different states in
importing positive cases to Sri Ganganagar during 1975 ranged from 2.08% to
35.41% (Table 21.1; Fig. 21.2). The intensity of transmission within the 16 km
border belt area was very high since a total of 340 positive cases, all of P. vivax
malarial parasite, were detected from as many as 18 sections of Punjab (31.17%) as
against 13 sections of Haryana (68.83%).
Reasons accounted for rise in malaria cases, compounded by the migration of
infected patients across the border (Table 21.2), included irregular spraying with
only DDT 50% wdp, but sometimes also 75% wdp, insufficient supplies of the
insecticide, shortage of spray pumps, and lack of fully and long-time operative
vehicles.
2. Churu District
This north-eastern desert district borders with Haryana state for 72 km of length.
Save for the year 1975, when ABER was about 8.2%, ABER was very poor in each
1974 and 1976 being less than 4. The API was appreciably high in 1975, but only 2.3
in 1976 and 1.0 in 1974. Plasmodium falciparum was present in the belt area only in
1975. This clearly indicated that there was an epidemic in 1975, which is further
corroborated by the fact that in 1975 the positive cases which were far high by about
six- and threefolds from that of 1974 and 1976 in both the belt and Churu unit area
(Table 21.2).
There appeared to have been a good movement of the malaria positive cases
across the border to or from Haryana, Gujarat, Punjab, Uttar Pradesh and Madhya
Pradesh since about 80% of the cases had travelled to Haryana in 1975 and 1976. In
21.3
Table 21.1 Malariometric data for Sri Ganganagar district along the border during 1974–1976 (P = Punjab, H = Haryana; Unit = refer to the part of the
district)
Belt/Area/ Blood slide examined Positives Species
(State)/
Year Unit Active Passive Mass Total Active Passive Mass Total Pv Pf M Total ABER API
1974 Belt(P) 15,873 9322 732 25,927 917 955 3 1875 1875 – – 1875 13.7 10.2
Belt(H) 3818 1028 429 5275 632 446 – 1078 1078 – – 178 12.7 28.0
Unit 148,865 35,176 3863 187,875 5653 7271 31 12,955 12,866 88 1 12,955 12.3 8.6
1975 Belt(P) 19,626 13,518 399 33,537 1306 928 – 2234 2234 – – 2234 18.1 12.2
Belt(H) 4346 1326 193 5865 612 490 1 1103 1103 1103 14.9 29.1
Malaria Transmission across International Borders
– –
Unit 156,975 50,807 5667 213,450 10,805 11,672 77 22,554 22,189 361 4 22,554 13.9 15.0
1976 Belt(P) 7532 4976 2072 14,580 109 125 – 234 234 – – 234 6.8 1.2
Belt(H) 1836 498 – 2334 61 45 – 106 106 – – 106 6.2 2.8
Unit 53,071 16,223 4253 73,547 2318 3173 33 5424 5244 175 5 5424 4.6 3.6
339
Fig. 21.2 Relative movement of positive cases across the border of Sri Ganganagar district to and
from Punjab and Haryana as well as other distant states (Source: Tyagi 2022)
the 16 km border belt along Haryana, a total of 84 cases of P. vivax were detected
during 1976 which pointed out towards a high borderline prevalence of malaria.
Reasons for rise in malaria cases in the border area were the same as for Sri
Ganganagar district.
(i). Sikar Districts
This district borders with Haryana along its 52 km-long north-eastern boundary.
The year 1975 can be singled out as an epidemic year with an appreciably high API
(7.9) in the belt area comparable to 9.0 in the Sikar unit area. The main attraction to
the labour force was the Khetri copper plant in Sikar from across the border where
malaria epidemic broke out in 1975 with a total of 1222 positive cases in 1975. In
Sikar, the epidemic had affected 953 villages (population 12,72,574), while in the
16 km belt along the border, 29 villages (population 44,599) were affected. In this
border belt a total of 282 positive cases (P. vivax) were detected from as many as ten
sections (Table 21.3). It may be highlighted here that about 10,000 people were
estimated to have moved across the border between Haryana and Sikar every year.
Reasons attributable to rise in cases between 1973 and 1975 included infrequent
and irregular rounds of indoor residual insecticide spraying, besides the fact that the
Sikar unit was under maintenance phase since 1967.
(ii). Barmer and Jaisalmer Districts
Of the two desert districts, only Barmer has common border with Gujarat for
about 50 km. Together they had a population of 737,775. Of this population
Jaisalmer constituted only 6.3%. There was no exportation or importation of positive
cases across the border, even though approximately 7684 people had migrated in and
out of the desert districts to the Gujarat state. A focal outbreak of malaria was
nevertheless identifiable. Predominated by P. vivax, an epidemic in Barmer and
Jaisalmer districts was definitely there in 1975 when the positive cases were three to
six times more than those in 1974 or even 1976. Interestingly P. falciparum was
almost invariably present in the district unit area, but it was present in a very
insignificant number in the Gujarat state belt (Table 21.4).
21.3
Table 21.2 Malariometric data on the belt area population in Haryana belt and the Churu unit population
Belt area Blood slide examined Positives Species
(State)/
Year Unit Active Passive Mass Total Active Passive Mass Total Pv Pf M Total ABER API
1974 Belt 1315 37 134 2386 37 – – 37 37 – – 37 3.8 1.0
Unit 102,420 24,037 3977 130,414 2162 1625 – 3787 2162 1625 – 3787 8.6 2.5
1975 Belt 2869 32 226 3127 207 2 – 209 206 3 – 209 8.2 6.3
Unit 123,696 37,665 5618 167,179 12,372 10,574 38 22,984 22,687 284 13 22,984 11.0 15.7
1976 Beit 1213 4 – 1217 84 – – 84 84 – – 84 3.4 2.3
Unit 40,819 13,558 546 54,923 3108 3070 4 6182 6165 14 3 6162 3.7 4.2
341
342
Table 21.3 Malariometric data on the belt area population in Haryana belt and the Sikar unit population
21
Belt area Blood slide examined Positives Species

(State)/
Year Unit Active Passive Mass Total Active Passive Mass Total Pv PF M Total ABER API
1974 Belt 10,672 43 – 10,715 131 – – 131 130 1 – 131 8.8 1.0
Unit 150,778 12,263 8006 171,047 2229 1246 35 3510 3462 45 3 3510 7.6 1.6
1975 Belt 14,305 366 – 14,677 931 67 2 980 971 7 2 980 12.0 7.9
Unit 190,100 30,872 11,546 232,518 1268 7496 17 8781 19,843 329 23 20,195 9.9 9.0
1976 Belt 4757 112 – 4869 255 27 – 282 282 – – 282 4.0 2.3
Unit 63,688 11,874 1310 76,872 3158 3422 5 6585 6551 33 1 6585 3.3 2.9
Trans-Border Migration and Malaria in Desert Populations
21.3
Table 21.4 Malariometric data on the belt area population in Gujarat and the desert districts, Barmer and Jaisalmer, in Rajasthan
Belt Blood slide examined Positives Species
area
(State)/
Year Unit Active Passive Mass Total Active Passive Mass Total Pv PF M Total ABER API
1974 Belt 19 – – 179 – – – – – – – – 4.03 –
Unit 60,886 7357 1568 84,230 2035 616 36 2687 2570 105 12 2687 9.2 3.6
1975 Belt 332 – – 332 36 – – 36 33 3 TV 36 7.47 0.8
Unit 113,293 24,549 4155 141,992 10,017 4409 26 14,596 12,755 1780 61 14,596 18.7 19.8
1976 Belt 48 – 48 – – – – – – – – 1.1 –
Unit 31,647 4770 1187 37,604 3107 966 27 4100 3812 255 33 4100 4.8 5.6
343
Total lack of spraying in 1973 and partial spraying of DDT in 1974 and 1975,
besides difficult desertic terrain and the piecemeal budget, were identified as main
reasons for rise in cases.
Malaria Management Including Vector
Control in Major Deserts 22
22.1 Introduction
Malaria is a life-threatening disease of public health importance globally. Save for

Plasmodium knowlesi, all other four have been reported from the malaria-endemic
deserts worldwide, although P. vivax and P. falciparum predominate the scenario
(Tyagi 2002). There are about four to five dozens of anopheline species (including
complexes of species) occurring in the arid environments, but only half a dozen of
them are serious vectors of malaria in the desert ecosystems (e.g. Anopheles
arabiensis, An. sergentii, An. Stephensi, etc.). Regarding invasive potential of An.
stephensi, the original desert species, the Asian mosquito has emerged in recent
decades as the most threatening vector both in urban agglomerations and also, due to
its increasing presence, in the rural environments (Ahmed et al. 2021).
There are four major means to prevent and/or control infection from malaria,
namely:
1. Vaccination in malaria-endemic countries to protect communities from infection.

The World Health Organization (WHO) has in late 2021 recommended wide-
spread use of the RTS,S/AS01 (RTS,S) malaria vaccine among children in
sub-Saharan Africa and in other regions with moderate to high P. falciparum
malaria transmission. The recommendation is based on results from an ongoing
pilot programme in Ghana, Kenya and Malawi that has reached more than
800,000 children since 2019. Malaria remains a primary cause of childhood
illness and death in sub-Saharan Africa. More than 260,000 African children
under the age of 5 die from malaria annually. It is hoped that using this vaccine on
top of existing tools will help to prevent malaria from affecting tens of thousands
of young lives each year. This vaccine will at some point of time in the future will
also be deployed in the malaria-sensitive countries in the Sahara Desert.
2. Early case detection and treatment with antimalarial drugs are life-saving and
very effective (Gupta 1961). However, the adaptation of parasites to most of
conventional antimalarials has so far limited the effect of these interventions. The
Ltd. 2023
346 22 Malaria Management Including Vector Control in Major Deserts
emergence of resistance against drugs requires in response a steady stream of new

interventions and strategies.
Up to the beginning of this millennium, most sub-Saharan African countries have
been using chloroquine (CQ) as the first-line antimalarial drug, which had to be
replaced with sulphadoxine-pyrimethamine (SP) after resistant parasites had
rendered CQ ineffective. Currently the first-line treatment of malaria consists of
combination therapy which includes an artemisinin derivative. The current
approach appears robust, but history has taught us to be alert and to expect
resistance to emerge. There is a pressing need to develop and deploy complimen-
tary strategies. Adding a protective vaccine to the existing control tools for
malaria holds great promise in the future.
3. Indoor residual spray (IRS) and long-lasting impregnated bed nets (LLIN) are
well-defined vector control tools across the malaria-endemic countries. Unfortu-
nately, many vectors of malaria have developed strategies such as shifting
behaviour to exophily and exophagy, to evade their contact with the insecticide
sprayed on walls or impregnated in bed nets. Consequently, the need for devel-
oping new and effective tools (e.g. genetically modified mosquitoes, Wolbachia-
guided vector populations) is becoming increasingly inevitable (Tyagi 2021).
Antilarval measures include use of larvicides such as temephos for An. stephensi
(and also Aedes aegypti, the vector for Dengue, chikungunya and Zika virus, etc.)
in urban ecosystems. This based on the susceptibility levels of vector population
against a given larvicide (Bansal and Singh 2001).
Although genetic control of malaria through vector control using transgenic or
genetically modified mosquito and Wolbachia—the microbial manipulator of
arthropod reproduction—is foreseeable in the near future, they are still to be
approved for open public use (Stouthamer et al. 1999). Interestingly, in An.
stephensi, Wolbachia strain wAlbB displays both perfect maternal transmission
and the ability to induce high levels of cytoplasmic incompatibility. Seeding of
naturally uninfected An. stephensi populations with infected females repeatedly
resulted in Wolbachia invasion of laboratory mosquito populations.
4. Repellents of various different types and formulations (e.g. DEET, DMP, DEPA,
etc.) provide safety from hematophagous mosquitoes, including vectors, up to 8 h
(Tyagi 2015; Kandasamy 2021). However, development of partial tolerance of
Aedes aegypti against DEET has warranted an urgent need to look for some
repellent materials from natural resources (Rutledge et al. 1994). Plant-based
repellents are particularly preferred due to their favourable cost, availability,
storage, effectiveness and transportability.
22.2 Malaria Control in the Desert 347
22.2 Malaria Control in the Desert
22.2.1 Sahara and Arab Peninsula Deserts
Despite presence of vectors like An. arabiensis and An. sergenti, most countries in
the United Arab Emirates (UAE) region as well as the Saharan region have either
eliminated or are at the verge of eliminating malaria. Along with the sub-Saharan
region, malaria continues to remain a huge public health issue with complex
challenges in the Saharan region particularly fringe areas with potential of large
epidemics and morbimortality. There is a rising need to investigate escalation of
drug and insecticide resistance, in parasites and vectors, respectively. One of the
major constraints, however, is low coverage of existing preventive strategies, scar-
city of safe and effective vaccines and weakness of public health systems to the
generally mobile and difficult to reach populations and communities, notwithstand-
ing the fact that malaria prevalence surveillance, one of the key cornerstones for
achieving malaria control and elimination, is the third pillar for moving closer to
malaria elimination by assessing the effects of intervention measures and progress in
reducing the malaria burden.
In most of the malaria-free countries in both the Sahara and Arab Peninsula desert
regions, elimination of malaria has been achieved through disciplined and strict
antimalarial campaigns involving timely and systematic distribution of antimalarials
to the affected persons, subsequent follow-up of the cases and surveillance of their
movements, not to mention in the least the ample coverage of human dwellings and
cattle sheds by both the indoor residual spraying of an effective insecticide without
lapses and, wherever needed, distribution of long-lasting insecticide-impregnated
bed nets (LLIN). In certain situations even mosquito repellents were also resorted
to. In spite of all this, new tools for monitoring malaria control and elimination are
urgently needed to eliminate malaria from a few countries in these two regions of
desert.
22.2.2 Malaria Control in the Desert
22.2.2.1 Malaria Control Policy

The control policy for malaria in the Thar Desert, or for that matter in the whole of
Rajasthan state, is that defined by the National Vector Borne Disease Control
Programme (NVBDCP) of the National Anti-Malaria Programme (NAMP). Major
modus followed including annihilation of vector mosquitoes through residual insec-
ticide spraying (as in rural areas) or larviciding the breeding sites (as in the cities and
towns) and by eliminating the malaria parasites from the community through
antimalarials. Though quite many research publications exist on national level,
there is absolutely no scientific study in sight on the subject from the Thar Desert,
except probably the views and/or recommendations made by Sharma et al. (1995).
22.2.2.2 Diagnosis and Treatment

Surveillance embodying early diagnosis and prompt treatment of malaria patients in
the community constitutes the mainstay activity of the Global Malaria Control
Strategy (WHO 1993a, b). In India, under the NAMP, the disease surveillance is
accomplished through:
1. Active case detection (ACD), i.e. to effect early detection and treatment, regular
fever surveys assisted often with mobile malaria clinics are made by specific
health and medical personnels to every door.
2. Passive case detection (PCD), i.e. from every patient attending a government
health facility, a blood slide is, in principle, taken for subsequent confirmation
through microscopy at the primary health centre and/or general hospital. Though
blood slide collection through PCD has generally been less than that of the ACD,
nonetheless the yield of passive slide collection was higher in terms of detection
of positive cases of malaria (Table 22.1).
Sharma et al. (1995), however, had cautioned that generally only those patients
who had fever presented themselves to the hospital or the health centres, making
these patients subjected to PCD a selective population which could not be a true
representative of the malaria-related suffering in the community. On the contrary, the
active case detection has the advantage of suggesting a magnitude of the problem in
the community and thus directly helps to identify focus of infection. Owing to the
highly inhospitable climate and difficult terrain of the Thar Desert, both the ACD
and PCD have suffered on account of one or another reason but mainly the field staff,
particularly the male health workers who were mainly responsible for blood slide
collections (Sharma et al. 1995). Like the rest of the state, in the Thar Desert, too, the
malaria control programme is assisted by the large network of family health workers
such as the auxiliary nurse midwife (ANM) or the multi-purpose worker (MPW)
who distribute antimalarial drug, chloroquine, as a presumptive treatment to all fever
cases in the community (Brandson et al. 1994; Sharma et al. 1995).
In spite of several impressive trials with modern diagnostics like polymerase
chain reaction (PCR), indirect fluorescent antibody test (IFA) and the ParaSight™-F
and other similar dipstick tests for diagnosis of P. falciparum carried out in different
parts of the country, none of these diagnostic methods have ever been put into use in
Table 22.1 Quantum of blood slides collected through PCD and ACD (1995–1998)
Passive case detection Active case detection
Positive
Blood slides Positive slides Blood slides slides
Year collected found collected found
1995 2,221,213 169,443 2,538,593 67,080
1996 3,154,062 211,500 2,932,610 71,207
1997 2,790,478 199,323 2,825,584 64,860
1998 2,160,642 59,046 2,552,799 14,956
Table 22.2 Basic state data on demography and malaria-related administrative staff
Demographic/administrative features Data/figures
Population 3,41,08,292
– Rural population 2,69,67,871
– Urban population 71,40,421
No. of regions 5
No. of districts 27
No. of villages 35,795
No. of towns 199
No. of blocks 237
No. of deputy chief medical and health officers (malaria) 27
No. of assistant malaria officers 30
No. of malaria inspectors 214
No. of sector supervisors 926
No. of senior multi-purpose workers 695
No. of multi-purpose workers 3761
No. of squads for spraying 978
the Thar Desert mainly due to very high operational costs as well as infeasibility.
Therefore, still the standard method to diagnose malaria is the microscopic exami-
nation of blood film for malaria parasites.
The timely and appropriate treatment is an indispensable component of control
activities in malaria. The standard treatment policy followed is that formulated by the
NAMP (Sharma 1986a, b; Sharma et al. 1996a, b). So far only P. falciparum
resistance to chloroquine has been detected in vivo in the Thar Desert (Khatri
1991; Sharma et al. 1995). The parasite is still susceptible in large areas of the
Thar, although resistance up to Riii level has been found in some selective parts of
the desert. Sharma et al. (1996a, b) have thrown adequate light on the prevalence of
chloroquine-resistant P. falciparum infection during epidemics in Rajasthan state in
the mid-1990s. Although personal chemoprophylaxis is discouraged, nevertheless
free sale of nearly all types of antimalarial drugs in the local pharmacies and those
prescribed by private practitioners is considered important factors in accentuating the
risk of development of drug resistance in the malaria parasite.
Although the Government of India had set up an Anti-Malaria Organization in
Ajmer in Rajasthan state in 1948, a well-planned and organized initiative to control
malaria in the Thar Desert could be started only in 1954–1955 with the establishment
of one of the two units under the National Malaria Control Programme. The National
Malaria Eradication Programme (NMEP), which was launched in 1958, actually got
off in Rajasthan in 1959 with the establishment of 17 units, which were later
increased first to 26 units under the aegis of Modified Plan of Operation in 1977
and, subsequently, with the addition of Dholpur, to 27 units in 1983.
At the 1981 level the administrative/demographic composition of the state staff
responsible for control of malaria is given in Table 22.2, with a view to comprehend
logistics associated with the control programme at present when, according to Jain
(1994), Sharma et al. (1995), and, more recently, Anonymous (2002d), several
important positions/posts have continued to remain unfilled, though the population
of Rajasthan state has since been risen one- and-half times more and as many people
are at risk of malaria infection.
22.2.2.3 Vector Control through Insecticides

Indoor spraying with residual insecticides has been the main methodology to control
adult vector population in the rural areas in the Thar Desert, whereas in the urban
setups larviciding the vector breeding sites stayed as the major means of mosquito
control. Insecticide spraying in the whole of Rajasthan was initiated on a regular
basis in 1989. As an insecticide of choice, DDT had been applied indoors at the rate
of 1–2 g (active ingredient) /m2 twice a year, although HCH and deltamethrin have
also been employed occasionally for emergent spraying in the border villages of Sri
Ganganagar and Jaisalmer districts. In the Thar Desert, insecticide spraying with
DDT has been very irregular and far from satisfactory on account of various reasons
(Sharma et al. 1995). Recently, Tyagi (1994d) has stressed the need for training of
the spray squads and discouraging ad hoc employment of unskilled labourers. As
observed by Sharma et al. (1995), untenable and ad hoc policies about spray
operations, as come about following promulgation of the Malariogenic Stratification
policy, clearly hampered the control programme in the whole of Rajasthan state.
They had noted that while, on one hand, only 10.6 of the targeted population was
covered in the first round in some districts in the state during the state-wide epidemic
year of 1994, the second round scheduled for first August–15th October could not be
started in time and, subsequently, the spray operations were undertaken by the
district collector and his staff through teachers, revenue staff, school boys and
members of the community, in October 1994. Lack of adequate vehicles for
transporting insecticides, spray squads and drugs as well as for supervision and
monitoring of malaria control activity was considered a major constraint. Applica-
tion of low doses of insecticides for a long time, coupled with faulty and inadequate
coverage of sprayed areas, often leads to development of resistance in the target
vector species (Tyagi 1992a).
Singh and Bansal (2001) have tested susceptibility of most of conventional
insecticides being deployed in various parts of Rajasthan state, including the Thar
Desert districts.
As an alternative control approach, Tyagi (1994g) and Tyagi et al. (2001a, b),
while investigating a focal outbreak of malaria in about a dozen villages in close
vicinity of the main Indira Gandhi canal in Jaisalmer district during the mid-1999,
used deltamethrin-impregnated bed nets to suppress the vector population in one
village, Sadhna. After employment of the impregnated bed nets, the vector popula-
tion in the village was substantially decreased with the cooperation of the village
community which adopted the technology with a high degree of certitude. Similar
results were obtained in a ‘dhani’ (hamlet) near Madassar village in Jaisalmer under
similar physiographic situations where the per pan-hour density of An. culicifacies
was reduced by 50% immediately after employment of the deltamethrin-
impregnated bed nets. it was observed that after 90 days of employment of the bed
Table 22.3 Laboratory bioassay with deltamethrin-impregnated bed nets against An. stephensi
and An. culicifacies
Mortality (%) in consecutive months following
exposure to deltamethrin-impregnated bed nets
No. of females tested Month
Species every time pooled) 1st 2nd 3rd 4th 5th 6th
Anopheles 120 75 72 67 60 60 55
stephensi (62.5) (60.0) (55.8) (50.0) (50.0) (45.8)
Anopheles 120 78 64 60 58 54 56
culicifacies (65.0) (53.3) (50.0) (48.3) (45.0) (46.6)
nets the vector had disappeared from the sampling. Based on the laboratory
bioassays and field observations, they also emphasized that the impregnated bed
nets stayed effective for 6–7 months at least (Table 22.3).
In an attempt to interrupt disease transmission by vector mosquitoes, Tyagi et al.
(1997, 1998) and Tyagi (2000) studied repellent properties of Tagetes minuta and
several grass species belonging to genus Cymbopogon, of which two species, viz.
C. schoenanthus and C. jwarancusa, occur in the Thar Desert region and made
attempts to develop certain formulations to repel vector mosquitoes transmitting
malaria in the Thar (e.g. An. stephensi). Tyagi and Shahi (2001) discovered that both
these species, particularly C. schoenanthus, offered an appreciable amount of
repellence against An. stephensi, when their essential oils were developed into
certain formulations.
In urban areas, malaria control activities are carried out under the Urban Malaria
Scheme in six major cities, two of which, Jodhpur and Bikaner, hail from the Thar
Desert region while consideration is being given to also include Sri Ganganagar
district. Scheme is implemented in the municipal areas of these cities. The vector
control is carried out by larviciding the breeding sites with temephos, fenthion
malaria oil (M.L.O.), kerosene and Paris green, etc. Save for Jodhpur city, and
possibly also Bikaner city, urban malaria is still not a major contributor to the
disease burden in the Thar Desert region, although more studies need to be made
to understand this phenomenon (Shahi et al. 1996; Tyagi et al. 1999).
22.2.2.4 Biological Control of Mosquitoes

The health department has often resorted to using mosquito fish (Gambusia affinis),
as well as other varieties, to control vector mosquitoes in large-sized ponds such as
those created in quarry mine areas. Unfortunately no scientific records are available
to document frequency and quantum of application of the biological agents in vector
control in the Thar Desert, although Tyagi (1991c, 1992c, 1994g), following
examples by Corbet (1962), has drawn attention towards an effective use of certain
odonate species (e.g. Bradinopyga geminata, Crocothemis servilia) for controlling
An. stephensi in some breeding sites at least. Verma and Tyagi (1991) found An.
stephensi infested with water mites and argued if the ectoparasites could be used as
Fig. 22.1 Water mites’ infestation of Anopheles subpictus
Table 22.4 Suppression of larval population of An. culicifacies by Bacillus thuringiensis var.
israelensis (Bti) at the rate of 1 g (in sachets) /m2 in the quarry mine pits on the outskirts of Jodhpur
township
Post-Bti release weekly estimation of larval density (expressed as
no. of larvae per ten dips)
Larval Pre-Bti release 1st 2nd 3rd 4th 5th 6th 7th 8th
instar larval density week week week week week week week week
I 189 160 50 0 0 0 0 11 47
II 144 110 66 2 0 0 0 1 12
III 88 33 23 5 0 0 0 0 4
IV 78 45 11 2 0 0 0 5 13
control agents. Such water mites may parasitize a large number of mosquito vectors
of different diseases (Fig. 22.1).
Tyagi and Yadav (pers. comm.) have successfully employed Bacillus
thuringiensis var. israelensis (Bti) at the rate of 1 g (in sachets) /m2 in both quarry
mine pits and the weeded pools near Indira Gandhi canal breeding An. culicifacies.
They found that the Bti was particularly effective against larval population in the
quarry mine areas and totally wiped off the breeding for nearly 6 weeks, although the
formulation became fully active slowly and only after nearly two weeks of applica-
tion (Table 22.4).
22.3 Research on Phytochemicals as Repellents against

Anopheles stephensi from the Thar Desert
Thar Desert though deficient in quantum and diversity of plant species, yet several of
these carry enormous biomedicinal and insecticidal properties (Bhandari 1978;
Tyagi 2016). Essential oil of Cymbopogon schoenanthus (L.) Spreng. (Family
22.3 Research on Phytochemicals as Repellents against Anopheles. . . 353
Table 22.5 Repellent effect of Tagetes minuta on the landing of three major vector species (1. An.
stephensi, 2. Cx. quinquefasciatus and 3. Ae. aegypti)
Test group Control group
Time period Vector species Average landing ( Vector species Average landing (
(in h) 1 2 3 ± SD) 1 2 3 ± SD)
1h 1 4 4 3.0 ± 1.73 67 87 60 71.3 ± 14.01
2h 4 2 12 6.0 ± 5.29 71 97 36 68.0 ± 30.61
6h 11 15 9 11.7 ± 3.06 81 95 36 70.7 ± 30.83
8h 25 32 25 27.3 ± 4.04 82 73 37 64.0 ± 23.81
80
%
70
L 60
A 50
N 40
30
D
20
I
10
N
0
G 2 hr 4 hr 6 hr 8 hr
An. stephensi Ae. aegyp Cx. quinquefasciatus
Time (in hours)
Fig. 22.2 Percent landing of An. stephensi, Aedes aegypti and Cx. quinquefasciatus on volunteer
(B.K. Tyagi) when tested for repellence efficacy of T. minuta (Source: Tyagi et al. 1998)
Poaceae), growing wildly in Jaisalmer, was studied for its chemical properties (Tyagi
2000; Shahi et al. 2000). The essential oil is rich in terpenoids up to 0.8% (v/w;
fr. Wt. basis), with major chemical constituents belonging to volatile
semiochemicals such as sesquiterpene oxygenated compounds (50%), sesquiterpene
hydrocarbons (17%) and limonene (20%). Most of the compounds are abundantly
used as odourants in perfumeries.
A common plant like Tagetes minuta (Family Compositae), growing abundantly
in the Thar Desert, too, was evaluated for its efficacy as a repellent against An.
stephensi, besides Culex quinquefasciatus and Ae. aegypti, in the Thar Desert (Tyagi
et al. 1997). Among the three vector mosquito species evaluated, the malaria vector,
An stephensi, was repelled maximally by the phytochemicals of the plant
(Table 22.5; Fig. 22.2).
Tagetes minuta essential oil was highly effective (94.4%) on An. stephensi for
4 hours but lost 50% effect by the tenth hour of exposure.
When essential oils of four species and two hybrid varieties of Cymbopogon
grasses were evaluated for their repellent properties against the major vector
mosquitoes, namely, Anopheles stephensi, Culex quinquefasciatus and Aedes
aegypti, sampled from Jodhpur in the Thar Desert, both in laboratory and field
% Landing
commutatus mar nii pendulus nardus CKP-25 Jamrosa

Cymbopogon spp.
( ) An. stephensi ( ) Cx. quinquefasciatus ( ) Ae. aegyp
Fig. 22.3 Percentage landings of the three major vector mosquitoes against the six Cymbopogon
essential oils in the laboratory evaluation (Source: Tyagi et al. 1998)
observations exhibited promising results against the malaria vector, in particular.

The magnitude of repellency in the Cymbopogon essential oils was found to be of
moderate to high order. All grass species protected completely from mosquito bites
for 4 hrs, whereas C. nardus provided protection for as much as 8–10 hrs overnight.
When the landing in the test alone was considered, maximum protection was
recorded against the group of CKP25 (40.4%), C. martinii (41.9%) and C. nardus
(43.9%), followed by another group of Jamrosa (45.5%), C. commutatus (45.9%)
and C. pendulus (47%) (Table 22.2). This was amply substantiated in another
evaluation when landings of vector species were compared with those in the control
(Fig. 22.3). By and large An. stephensi was easily repelled, particularly by C. nardus,
CKP25 and C. commutatus.
22.4 Role of Community and Future Scenario of Malaria Control

in the Thar Desert
Community-based antimalaria interventions depend on the ability of the operating

agency to overcome cultural barriers and to institutionalize new practices within the
village environment. Obstacles deriving from politics and a sense of personal
ownership and control may prove insuperable.
Inventions, Innovations and Discoveries
in Malaria in Desert Environments 23
23.1 Introduction
It is an irony that, for a vector-borne disease like malaria which is inseparably

associated with water, the cradle for the malaria parasite’s discovery had to be but
a desert country, Algeria, then a French territory, in the Sahara Desert. Thus, the first
ever human malaria parasite, Plasmodium malariae (which was later confirmed to be
P. falciparum, though certain stages of P. malariae also coexisted), was shown to the
world by a French physician, Dr. Charles Louis Alphonse Laveran, in 1880. Yet
again, more than a century later, the same African nation was to be declared free
from the clutches of malaria; in 2019 the World Health Organization certified
Algeria as one of the 38 malaria-free countries. The danger, however, has not
completely waded away, and the risk of malaria contraction continues to loom
large on many African countries largely due to the fact that both the major desert
vectors, viz. An. arabiensis and An. Sergentii, still exist, besides the deadliest An.
gambiae in desert-fringe areas. This threat has been further escalated by an unsolic-
ited and unwelcome entry in to some of the north-eastern African nations in recent
years. Under such stressful scenarios of malaria prevalence in the deserts of Arabian
Peninsula, Middle East/Central Asia/ West Asia and the Great Indian Thar Desert, a
streak of fascinating discoveries, inventions or innovations sprang up naturally,
some of which are elicited below.
23.2 Discovery of the First Human Malaria Parasite
Dr. Charles Louis Alphonse Laveran was a French military physician and an expert
in anatomic pathology as well as a prolific scientist writer, having authored a famous
‘Treatise on Military Diseases and Epidemics’ and 62 other scientific
communications. Upon his transfer to Algeria, then a French territory, he found
most of the military soldiers suffering by the lethal malarial fevers which also
affected army installations. A thorough, well-read and systematic in approach, he
Ltd. 2023
356 23 Inventions, Innovations and Discoveries in Malaria in Desert Environments
excellently dealt with histologic description of cerebral malaria in his regular and
copious admission of patients—prompting him to focus on striking at the root cause
of the causal agent of the deadening disease.
Laveran had no information either about the protozoan (protozoa are micro-
organisms that are single-celled, with a well-defined nucleus, and without cell
walls), parasite or the mosquito vector (which was later pinned down in 1897 by
Dr. Ronald Ross, a British army doctor working in India and for the first time
demonstrated the role of mosquito, an Anopheles, in transmitting the malaria parasite
to man) behind the malarial infection, and the more common hypothesis about the
malaria pathology then in vogue was the presence of a bacterium due largely to the
influence by several discoveries of Louis Pasteur which alluded that most infectious
diseases are caused by microbial germs (his ‘germ theory’). Laveran was also
influenced by the Italian hypothesis that malaria emerged from the marshes (Laveran
1884). Since malaria was rampant among soldiers, his mind was always occupied by
the thought of the disease. As a careful pathologist he developed a keen eye even for
the mildest change in his slides prepared from patients’ blood for examination in
routine. With a phlebotomist’s precision, he collected all information on lesions in
organs and in blood wherein he found a constant presence of granules of black
pigment in the blood, albeit at very different frequencies. Laveran conclusively
associated these pigmented granules, having origin in the blood, with malaria.
Subsequently, he soon discovered ‘crescents’—a very specific stage in biology of
the parasite pointing towards the male and female gametes of P. falciparum. On
6 November 1880, however, while examining the blood of a patient who had been
febrile for 15 days, he saw for the first time in the world the phenomenon of
‘exflagellation’ in a male gametocyte, wherein on the edges of a pigmented spherical
body filiform elements move with great vivacity, displacing the neighbouring red
blood cells. The enchanting phenomenon of motility of these elements immediately
convinced Laveran that he had discovered the agent causing malaria and that it was a
protozoan parasite and not a bacterium that was all along doctrine behind disease.
Laveran quickly dispatched two manuscripts to the Academy of Medicine, in
November and December 1880, respectively, on this ‘New Parasite Found in the
Blood of Several Patients Suffering from Marsh Fever’ (Laveran 1880). To his utter
dismay and disappointment there were hardly any established scientists who came
forward and appreciated his truly path-breaking and epochal research. In fact he was
squarely repudiated for his premature publication. The history of science is witness
that after a long gap of 27 years Dr. Laveran was to be awarded with the most
lucrative Nobel Prize 1907, in the field of Medicine and Physiology. Ironically
Laveran’s name was nominated by none other than Dr. Ronald Ross (winner of
the Nobel Prize 1902, for his discovery of malaria-mosquito relationship) who had
himself grown learning malaria under the shadow of Laveran’s discovery!
23.4 Discovery of ‘Tanka’ and ‘Beri’ as the Main Breeding Habitats. . . 357
23.3 Discovery of Entry of Anopheles stephensi in Africa’s

Sahara Desert
Anopheles stephensi Liston 1901 is a major malaria vector in South Asia and the
Middle East, including the Arabian Peninsula (Sinka et al. 2011), and is known to
transmit both the major malaria parasite species Plasmodium falciparum and
P. vivax (Korgaonkara et al. 2012; Thomas et al. 2017). Originated probably in the
Great Indian Thar Desert, the South Asian vector Anopheles stephensi was for the
first time discovered in Djibouti in the Horn of Africa in 2013 (Faulde et al. 2014).
Later, in 2016, it was found in Kebri Dehar (Somali region), Ethiopia, and raised
concerns about the impact on malaria transmission in the country and the rest of the
Horn of Africa. Seyfarth et al. (2019) confirmed the persistence of the invasive alien
species (IAS) in several parts of the Horn of Africa.
Since in field An. stephensi may confuse with An. arabiensis, the validity of
taxonomic status of the species was checked by molecular markers which settled the
issue that it was An. stephensi in Djibouti.
23.4 Discovery of ‘Tanka’ and ‘Beri’ as the Main Breeding

Habitats for Anopheles stephensi in the Thar Desert
‘Tanka’ and ‘Beri’ originated in India’s Thar Desert several hundred years ago as the
two main man-made engineering feats, to store and conserve water for long periods
of time ranging from months to years for meeting essential and vital livelihood
needs, on one hand, and tide over water-deficient non-rainy periods, on the other
(Anon. 2003; Mishra 2003). Both these water-storing facilities are built under-
ground. The beris are well-like semi-natural structures built in multitude in the
concavity of a seasonal pond at the periphery of the village. Underneath sometimes
some beris may merge together to form a bigger tank. Beris are always charged
naturally with the once-in several years rainwater. All the rainwater in the catchment
area of the dried pond gushes towards the pond with a natural gradient and fills the
beris. Contrary to it, tankas are entirely man-designed underground reservoir either
in solitary (when built with stone and cement inside dwelling area) or multitude
(when built, with partial assistance with stone and cement, in series outside the
village). Tankas are charged up both naturally through rainwater and man-fetched
water on camelback or camel cart from far off areas.
Both ‘Beri’ and ‘Tanka’ are essential parts of desert life in the Thar Desert.
Although Beris are specific to the Thar Desert so far, Tankas, notwithstanding
abundance in the Thar Desert region of Rajasthan, India, certainly exist in.
23.5 Invention of a ‘Tanka Lid’
During early 1998, inspired by his extensive malariological explorations of the

‘tanka’, the major source of breeding of malaria vector Anopheles stephensi, in Sri
Ganganagar district, north-western Thar Desert, between 1988 and 1990 (Tyagi and
Verma 1991), Dr. B.K. Tyagi, while heading as the Scientist ‘F’ and Officer-in-
Charge of Desert Medicine Research Centre (Indian Council of Medical Research),
designed and fabricated as well as assembled an ‘Anopheles stephensi breeding
preventer’ (Fig. 23.1). It was also limitedly tested in field to ascertain its foolproof
modus operandi to prevent the vector from entry or those inside from exit. In 2000
when a malaria outbreak struck in desert districts, he had suddenly received a
telephone call from the Jaisalmer district health authorities to help control mosquito
breeding in Tanka (cf. Tyagi 1995a, b). Dr. Tyagi immediately informed Mr. Rajat
Mishra, District Collector, Jaisalmer, of his invention and sent them a copy of the
drawings of the prototype so that they could replicate the same and get it deployed en
masse in desert villages.
Much later, first in 2014, during the Scientific Advisory Committee meeting of
the ICMR-National Institute of Malaria Research, Delhi, and second time, during the
12th Joint Annual Conference of Indian Society for Malaria and Other Communica-
ble Diseases and Indian Association of Epidemiologists, held on 1–3 September
2017 in Armed Forces Medical College, Pune, Dr. A.C. Dhariwal, the then Director
of National Vector Borne Diseases Control, conversed with Dr. Tyagi about the
unfailing utility of the ‘Tanka Lid’ in preventing vector, Anopheles stephensi,
breeding in the thousands of Tanka in the Thar Desert villages, and praised the
invention with much aplomb. He asserted that the invention has certainly resulted in
the overall reduction of malaria cases in Jaisalmer district. This most appropriate
compliment—a summa cum laude—apparently delighted Dr. B.K. Tyagi more than
any award for having done something useful to the Society!
Singh and Puri (1951) have emphasized on control of vector mosquitoes by
making modifications in certain breeding sites with the aid of engineering. Recently,
Singh et al. (2021a, b) have studied the utility of a ‘Tanka Lid’ in two villages,
namely, Ajasar (intervention) and Tota (control), with similar ecological features, for
the control of An. stephensi in ‘Tanka’ (97.8%).
23.6 Invention of a Mechanical Mosquito Sampler (Tyagi

Sampler)
Anopheles stephensi, the original and major malaria vector mosquito in the Thar
Desert, specializes to breed in ‘Tanka’ and ‘Beri’, the underground deep water
reservoirs in the arid environments of the Thar, on one hand, and relatively high
anthropophily and anthropophagy, i.e. resting and feeding indoors in human
dwellings, on the other. Keeping these behavioural attributes of the vector in
mind, Tyagi (1993) indigenously developed a mechanical mosquito sampler and
23.6 Invention of a Mechanical Mosquito Sampler (Tyagi Sampler) 359
Fig. 23.1 A prototype design of the ‘Tanka Lid’ (B.K. Tyagi 2020): various components of the
‘Tanka Lid’ (Source: Dr. B.K. Tyagi, personal archive)
tested in various different habitats for sampling resting adults of An. stephensi and
other mosquitoes (Fig. 23.2).
This mechanical mosquito sampler was specifically developed to sample
mosquitoes in the arid environments where it was >2.5 times superior to the
conventional mouth-operated aspirator. This is portable, non-hazardous, economical
Fig. 23.2 A mechanical mosquito sampler developed by B.K. Tyagi in the Thar Desert (Source:
Dr. B.K. Tyagi archive)
(Rs. 625.00 or US$ 31.25, at 1992 exchange level, per unit) and highly feasible in
conducting field sampling. It is also efficient, durable and reliable for data mining
and samples’ physiological fitness. This invention of mechanical mosquito sampler
was awarded an Indian Patent (No. 191635) in 2005.
23.7 Coining a New Classification System of the Thar Desert

Based on the Distribution of Malaria Vectors (Anopheles
stephensi and An. culicifacies)
Thar Desert’s malariological history is documented since 1975, although Najera

et al. (1998) have postulated of a far older records due to a nationwide epidemic in
1908. Epidemics in those times occurred in areas falling under the Luni river basin,
i.e. Barmer, Pali, Jalor and a part of Jodhpur, which being low-lying were flood-
prone during erratic heavy monsoon and were not yet accessible by the network of
distributaries under Indira Gandhi Nehar Pariyojana (IGNP). Following the opera-
tion of IGNP in the 1950s, the whole physiography, along with human settlement,
groundwater level, agriculture practices and surface water availability, has changed a
great deal favouring breeding of not only the desert mosquito, An. stephensi, but also
the new entrants like An. culicifacies and even An. fluviatilis, all of which have a
propensity for transmitting P. falciparum. The IGNP command area became the
epicentre for all epidemics, save for the 1990 epidemic which had an epicentre in
Barmer district (Tyagi 2002). On record at least 13 outbreaks are countable till 2002.
Many of these outbreaks were generally focal in nature covering often parts of a
district or two, save for those which occurred in 1990, 1992 and 1994.
Inter alia some of the epidemics particularly those of 1983–1985, 1990,
1992–1995, 1996 and 1999–2002, all of which were characterized with a high
proportion of P. falciparum (40–80%), appeared to have a strong correlation with
the progression of the IGNP irrigation activities. It is to be noted here that proportion
23.8 Hypothesis on the Cradle of Anopheles stephensi in the Thar Desert 361
of P. falciparum significantly grew after 1977, even though there was an appreciable
decline in overall malaria cases. Ironically, rise in annual parasite incidence and
percentage of P. falciparum in Jaisalmer, and to some extent in Jodhpur, since the
early 1990s, clearly coincided with the period of increase in volume of canalized
irrigation, implying that a likely outbreak could be professed in the near future.
Interestingly P. falciparum-dominated malaria outbreaks had struck Jaisalmer annu-
ally since 1992, especially two periods of 1994–1996 and 1999–2002. If all the
above referred chronological features of progression of epidemics and distribution of
two major vector species, An. stephensi and An. Culicifacies, since 1983 are taken
into consideration then it becomes more than clear that P. falciparum-dominated
malaria epidemics have spread from the northernmost Sri Ganganagar district to the
western and southern districts in the interior of the Thar Desert, more or less along
the course of the Indira Gandhi canal (Tyagi et al. 1995; Tyagi 2002). A malaria-
based classification of the Thar region based on distributional patterns of the malaria
vector species, An. stephensi and An. culicifacies, as well as the corresponding
distribution of malaria parasites, P. falciparum and P. vivax, is explained as follows:
1. The mixed An. Culicifacies–An. stephensi area: Being under the IGNP command
area, this is a canalized irrigation-rich area, covering only 11% of the entire Thar
Desert in Rajasthan that spans over Jaisalmer northwards including also the Sri
Ganganagar and Hanumangarh districts as well as parts of Jodhpur and Bikaner
constituting upper reaches of the ‘marusthali’ desert. Anopheles culicifacies and
An. stephensi jointly dominate the area, the former being in abundance. The area
has been experiencing annual epidemics with a high proportion of P. falciparum
cases.
2. The An. stephensi area: Falling under IGNP non-command area, this area
comprises arid environment in a true sense and occupies 78% of the Thar Desert
covering largely the districts of Churu, Jhunjunu, Nagaur, parts of Bikaner,
Jaisalmer and Jodhpur and Sikar. The desert specialist An. stephensi dominates
this area where P. vivax-dominated malaria occurs at a low intensity.
3. The An. culicifacies area: This area (including Barmer, Pali and Jalor districts) is
presently referred to as a non-IGNP area due to non-extension of canal water,
occupies 11% of the Thar Desert and largely falls within the flood-prone Luni
river basin. Being flood-prone area, it is An. culicifacies which is circumstantially
numero uno in the region. It is responsible for high malaria transmission follow-
ing heavy monsoonal rains in the Aravalli mountain catchment of the Luni river.
23.8 Hypothesis on the Cradle of Anopheles stephensi

in the Thar Desert
Hypothesis of Tyagi (this work) alluding to the cradle of Anopheles stephensi and its
chorogeography is propounded in this book, albeit certain limitations, with a view to
comprehend their implications in future malaria elimination at a global front.
23.9 Discovery of the Phenomenon of ‘Self-Immobilization’

in Anopheles stephensi
The phenomenon of ‘self-immobilization’ or thanatosis as a defence mechanism has

been observed in many different kinds of animals (Edmunds 1974; Humphreys and
Ruxton 2018), but it was Tyagi (1994) who for the first time discovered this
phenomenon in a mosquito, Anopheles stephensi. Thanatosis or self-immobilization
(death feigning) is a state that in some respects resembles shock and is characterized
by cessation of all voluntary activity and usually by assumption of a posture
suggestive of death and occurs in various insects when disturbed (tonic immobility,
TI). A fascinating anti-predator strategy adopted by larvae of An. stephensi, the
phenomenon has great evolutionary implications. Anti-predatory defences are cru-
cial to many aspects of behavioural ecology and, thus, are truly path-breaking in
mosquito science.
23.10 Hypothesis on Anopheles stephensi: A Sibling Species

Complex
For nearly a century the mosquito, Anopheles stephensi, has been regarded to
comprise three subspecies or races: the ‘Type’ form, the ‘Intermediate’ form, and
the ‘mysorensis’ form. Tyagi et al. (1991) hypothesized a possible sibling species
complex within the mosquito. More recently, Firooziyan et al. (2018) speculated
with a better evidence based on odourant binding protein 1 intron 1 sequence about
the possibility for a species complex under Anopheles stephensi.
23.11 Discovery of Cerebral Malaria Caused by Plasmodium vivax

in Adults
Organ dysfunction characteristic of Plasmodium falciparum malaria is unusual in

P. vivax infections. Cerebral malaria is a diffuse encephalopathy associated with
seizures and status epilepticus which can occur in up to one-third of patients with
severe malaria, particularly that caused by P. falciparum. Cerebral malaria is usually
secondary to P. falciparum infection. However, there are infrequent reports of
cerebral malaria associated with P. vivax infection. As regards an arid environment,
Kochar et al. (1998a, b, c, 2005, 2009, 2012) discovered and demonstrated the
phenomenon in a desert population for the first time that P. vivax infection can also
present as cerebral malaria. Clinical data provided by them indicated that P. vivax
could cause both sequestration-related and nonsequestration-related complications
of severe malaria, all of which are commonly associated with P. falciparum
infections (Sarkar and Bhattacharya 2008).
23.12 New Theory on Epidemics in the Thar Desert 363
23.12 New Theory on Epidemics in the Thar Desert
Tyagi (1995a, b, 1997a, b, 2002, 2020) interpreted a new ‘Vector’ theory on malaria
epidemics in the Great Indian Thar Desert and questioned the validity of the Bouma-
van der Kaay’s El Nino Southern Oscillation (ENSO) theory as an early warning
system for future epidemics.
Future Implications of Desert Malaria
in Global Elimination Campaign 24
24.1 Introduction
Deserts, covering nearly 33% of the earth’s land area (approximately 33.7 million
square kilometres) and inhabited by over 500 million people, are found in every
continent and are, therefore, truly global in representation. These are located on both
sides of the equator in the northern and the southern hemisphere (Goudie and
Wilkinson 1977). Deserts such as Saharan and Chilean-Peruvian deserts have
hyperaridity, followed by the Arabian, East African, Gobi, Australian and
South African Deserts, whereas Thar and North American deserts have lower aridity.
Both cold and hot deserts have arid environments with varying degrees of aridity
index. A desert is a barren area of landscape where little precipitation occurs and,
consequently, living conditions are hostile for plant and animal life which though
less diverse are, nevertheless, unique and rich in rare and endemic species despite
being often subject to vulnerability to extinction and environmental degradation
(Thornthwaite 1948; Louw and Seely, 1982; UNEP 2002; FAO 2019; Sher et al.
2004; Ezcurra et al. 2006). The scanty, erratic and variable precipitation/rainfall is
the basis of chronic shortage of available moisture/water for plants/animals resulting
from an imbalance between precipitation and evapotranspiration. This situation is
exacerbated by considerable variability in the timing of rainfall, influenced often by
the El Nino and La Nina phenomena in the Pacific Ocean, low atmospheric humid-
ity, high daytime temperatures and winds such as that in case of the Thar Desert
(Bouma and van der Kaay 1994, 1995). The Thar Desert environment is so dry that it
supports only extremely sparse vegetation; trees are usually absent, and, under
normal climatic conditions, shrubs or herbaceous plants provide only very incom-
plete ground cover such as the ‘Khejri’ tree (Prosopis cineraria) in the vast expanse
of the desert. A hot desert and its boundaries are varyingly defined either climato-
logically in context with arid and hyperarid areas or biologically as the ecoregions
wherein plants and animals are adapted to optimally survive in arid environments or
physiologically where exist humongous extensions of bare and contiguous soil with
Ltd. 2023
366 24 Future Implications of Desert Malaria in Global Elimination Campaign
Fig. 24.1 The desert biome defined by combined criteria, i.e. climatological, biological and
physiological (the intensity of the red colour on the map indicates congruence in the three criteria:
areas in intense red correspond to regions where the three criteria coincide, areas in intermediate red
highlight regions where two criteria coincide and areas in pale red show regions where only one
criterion operates) (Source: Ezcurra et al. 2006)
scarcely vegetated cover. Overlaying the areas defined by each of the three criteria
yields a composite definition of global deserts (Fig. 24.1).
A desert is, as a rule, thinly populated in its voluminous sandy and arid
environments. In contrast, margins of the desert, some of which include several of
the most endangered terrestrial ecoregions of the world, are faced with higher
pressures from human activities such as housing, tourism, transportation and agri-
culture. Apparently, barren-looking deserts are, in fact, complex arrangements of
diverse and fragile assemblages of species of flora and fauna. Malaria is mostly local
and focal in the desert, save for the desert margins at times. Mosquito vectors are
fewer in number and low in abundance. They breed in intra- or extradomiciliary
available ‘Tanka’ and ‘Beri’, the typical breeding sites of Anopheles stephensi in the
Thar Desert, or a variety of containers, puddles and other surface, fresh or even
turbid, water sources such as those of An. arabiensis in the African Sahara desert—
both in rural and urban environments.
24.2 Anthropization and Climate Change: The Major Triggers

for Malaria Exacerbation in the Desert
In as far as the world’s malariated deserts are concerned, it is singularly the human
intervention or anthropization tipped by changes in the climate and environment
which is regarded as the main reason behind malaria exacerbation in the otherwise
placid deserts. The Thar Desert in northwestern India has established itself as a
model to understand how canalized irrigation water drawn from outside into the
deserts, if not properly managed, could transform the nonmalarial arid environments
24.2 Anthropization and Climate Change: The Major Triggers for. . . 367
Fig. 24.2 Diagrammatic

representation of locations of
the three ecotypes of malaria
related to desert and the
intensity of affecting malaria
scenario at the periphery or in
neighbourhood of the desert
(Note: Fringe malaria tend to
affect the approximating areas
in non-desert region more
intensely, quickly and
widespread; the total impact
could be escalated if joined by
other ecotypes of malaria)
in the highly fulminant, often P. falciparum-dominated, malariated ecosystem

(Tyagi 1994a, b, 1995a, b, 1996a, b, c, d, e, f, g, 2002, 2003a, b, 2020; Tyagi
et al. 1995; Tyagi and Chaudhary 1997). This shift was attributable, more than
anything, to the drastic changes in the environment of the Thar Desert (Sikka and
Kulshrestha 2001). By nature of environment, as defined above, deserts are not the
places where either the mosquitoes or malaria parasites should generally find it
conducive to either sustain or breed. Yet, in the deserts like Sahara, Arabian
Peninsula, the Middle East/Central and West Asia and the Thar, both malaria and
their vectors thrive unabatedly, posing at the same time a discernible threat to the
neighbouring areas where the antimalaria campaign was being successfully
implemented (Tyagi 1995a, b) (Fig. 24.2).
The inter-relationship between climate, weather and human health under the
impact of malaria is quite intricate to comprehend (Bouma et al. 1994a, b). It is
now realized the world over that climatic changes across timescales influence
ecological systems through direct and indirect events, in turn affecting disease
conditions. Temperature and relative humidity, which are influenced by rainfall
pattern, are important determinants to the biology of malaria vectors. Therefore, to
understand the effect of variability in temperature on the development of disease-
transmitting mosquitoes, vector transmission potential and development of parasite
extrinsically in the intermediate host body of mosquito, Fig. 24.3 is referable.
Economically and politically unstable populations are most vulnerable under
extremes of climatic variabilities due to their inability to adapt or respond adequately
and rapidly to counteract the devastating outcomes during malaria epidemics.
Drastic ecological changes in non-immune or less-immune population-inhabited
ecosystems may often prove to be a certain major determinant of malaria epidemics
in a vulnerable area like the Sahara and the Thar Desert. In other words, whenever a
disturbance takes place in previously existing equilibrium of the ecological system
comprising human, parasite and vector populations in a particular environment
niche, an epidemic is imminent. After the epidemic had occurred, the ecological
equilibrium may or may not revert or even may give way to a new equilibrium with
Fig. 24.3 Effect of variability in temperature on the development of a mosquito and the develop-
ment of malaria parasites in its body
or without passing through a period of vicissitude, depending on resilience of the

ecosystem. The stability of equilibrium can be gauged simply by a combined
comprehension of the epidemiological background and results of a current study
on the situation of the epidemic-hit areas. As far as the Thar Desert is concerned, the
possible factors and pathways for evolution of epidemics have already been
explained in the foregoing pages, and presently there is an urgent need to compre-
hend the wide spectrum of climatic oscillations triggering off onset of the epidemics
and the tools to contain these before they result into heavy morbimortality.
24.3 Excessive Rainfall and Malaria Epidemics in the Thar

Desert
The spread of malaria may be influenced by a large number of factors of which

increased rainfall in unaccustomed areas as the Thar Desert region could also
increase malaria incidence (Gupta 1996). According to Akhtar and McMichael
(1996), there have been 5 flood years in the Thar Desert during 1908, 1917, 1944,
1990 and 1994, when the summer monsoon exceeded 500 mm. The last two of these
flood years coincided with the epidemics of malaria in the region. The rainfall in
western Rajasthan in the year after El Nino event was reported to be about 40%
higher than in El Nino year and 50% higher in the La Nina years (the opposite phase
of ENSO phenomenon). On examination of time series data for 1982–1994, the
relation between total rainfall, number of rainy days and annual malaria rate as well
as the percentage of total cases due to P. falciparum for the partly irrigated Jodhpur
24.4 Climate Variability: Impact of El Nino Southern Oscillation on. . . 369
district, they discovered a strong correlation (r = +0.72) between rainfall and malaria
incidence, particularly between number of rainy days and malaria incidence
(r = +0.68). In western Rajasthan during 1973–1984, the correlation between annual
rainfall and the annual malaria incidence was approximated 0.8. It was suggested
that variations in the annual rainfall cast a strong influence on malaria outbreaks in
the Thar Desert, which no longer remains a low-risk zone for malaria epidemics.
Contemporarily, Gupta (1996) had arrived at a similar conclusion after examining
various parameters like annual incidence of malaria particularly falciparum malaria,
annual and monthly rainfall and agriculture in Rajasthan, between 1980 and 1994.
The overall malaria incidence showed a moderate correlation (r = 0.48) with annual
rainfall, while the incidence of P. falciparum showed a strong correlation (r = 0.61).
It was stressed that higher and prolonged rainfall posed a greater risk in initiating
malaria epidemics, particularly dominated by falciparum malaria.
24.4 Climate Variability: Impact of El Nino Southern Oscillation

on Malaria Conflagration
Climatic changes in timescales are of different kinds and intensities, and the vector-
borne diseases particularly malaria are influenced in their occurrence and frequencies
(Tyagi 2001a, b). The El Nino seasonal variations occupy a special place in the
global weather formation, even though the ENSO (El Nino Southern Oscillation)
represents one of several natural variabilities. The ENSO, known for over 50 years,
is an unstable atmospheric system in the Pacific occurring roughly at an interval of
5 years. Its influence on global climate is second only to that of seasons, and it is
predictable. The impact of El Nino on the conflagration of certain vector-borne
diseases like malaria, in particular, in the Thar desert needs special attention to
comprehend climate-disease relationship (Nicholls 1993; Bouma and van der Kaay
1994). An El Nino event is a major change in the global climate system associated
with epidemic warming of the upper ocean layer in the eastern tropical Pacific
Ocean, lasting for 3 or 4 months. The El Nino events are linked with rainfall and
temperature extremes and are a major cause of inter-annual climate variability.
During 1990 El Nino event, a postulation was cast for heavy rains in northwestern
India, on one hand, while in case of the 1997 El Nino event an increased risk of
serious drought was forecast in India, on the other. It is noteworthy that the Thar
Desert had unprecedented heavy rains (>1000 mm in some areas) during 1990, but
also experienced a string of serious droughts for 3 consecutive years during
1998–2000! Climatically, the transmission of malaria is affected by rainfall patterns,
triggered in turn by the El Nino patterns (Bouma et al. 1994a, b). Studies have
already proved a strong correlation between outbreaks of malaria in certain parts of
the Indian Subcontinent and Sri Lanka and the ENSO (Bouma and van der Kaay
1996), although it remains debatable whether all epidemic episodes in the Thar
Desert were actually consequent to the ENSO (Bouma and van der Kaay 1994;
Bouma et al. 1994b; 1997a, b).
24.5 The Phenomenon of ‘Inundative Vectorism’
It is a well-acknowledged fact that in the arid areas the vector mosquitoes cannot
breed easily and their lifespan is restricted, reducing the chances for the mosquito to
become infective after completion of the sexual cycle of the malaria parasite.
Working on the causes for the widespread malaria epidemic of 1994 in the Thar
Desert, Bouma and van der Kaay (1994) refuted the basic hypothesis emphasizing
that the epidemic, which seemed to be a repeat of the epidemic in 1990, was likewise
caused by heavy monsoon rains and cuts in India’s budget for malaria control. The
monsoon rainfall in India is affected by the ENSO, and years with a low and high
precipitation—and thus low and high risk years, respectively, for malaria
epidemics—can be forecast. The relation between the ENSO and the rainfall was
found more stronger in the Thar Desert region where 22 of the 25 ENSO events
between 1875 and 1980 had below average rainfall. The two massive epidemics in
the Thar Desert during 1990 and 1994 emerged 3 and 2 years after the ENSO events
during 1987 and 1992, respectively. Tyagi (1997a, b), on the other hand,
propounding a new theory of ‘inundative vectorism’, agreed but partially with the
above ENSO-malaria theory as being applicable to only a small part of the Thar
Desert region in the lower reaches of the Luni river basin, particularly the Barmer
district. According to Tyagi et al. (1995), repeated malaria epidemics in the IGNP-
irrigated areas in the Thar Desert during 1990s were due to the phenomenon of
inundative vectorism, defined as the sudden ushering of one or more vector species
in prodigious densities in new virgin areas, like the Thar Desert, when highly
conducive conditions were formed through extensive irrigation plans, like the
IGNP, for their effective survival and preponderance. In support of this theory, it
was advocated that malaria epidemics in the IGNP-irrigated areas could not have
occurred until:
1. either the existing desert species, An. stephensi, had modified its behaviour so as
to be able to breed in rain-filled water bodies after the monsoon and the seepage
water from the canals, or
2. the new entrant, An. culicifacies, highly adaptive to all kinds of open ground
freshwater sources, including rainwater, increased its density and biting rate
during and after the monsoon rains.
During the first half of this century, malaria epidemics did not occur in the Thar
Desert presently covered under the IGNP because (1) malaria parasites, including the
dangerous P. falciparum, naturally existed in a very low frequency; (2) mostly An.
stephensi occurred throughout the Thar Desert, as a dominant vector species which
bred characteristically in the intra-domestic earthen pits (‘tanka’ and ‘beri’) and
maintained a low adult density; and (3) the ecological conditions dominated by
extremes of temperature (about 0 °C in winter and 50 °C in summer) and low relative
humidity for most part of the year precluded possibilities of survival of both the
vector and the parasite. In areas under the IGNP in the Thar Desert, both, chrono-
logically the older vector, An. stephensi, and the new entrant in the desert along with
24.6 Malaria Control in Deserts 371
canalization, An. culicifacies, thrive abundantly for most part of the year. It implies
that these two proven vectors transmit malaria in the areas under the IGNP perpetu-
ally irrespective of unduly high rainfall. On the contrary, An. culicifacies in the
flood-prone Barmer area is largely dependent on monsoon rains and, therefore, is
only able to increase density and biting following unprecedented heavy rains in the
Luni river catchment areas of the Aravalli mountains. This argument stands good to
demonstrate that in the Thar Desert there are two well-demarcated situations in
which malaria epidemics could occur; first, an epidemic may essentially occur
irrespective of any rainfall such as in the irrigated areas under the IGNP
(e.g. Jaisalmer, Jodhpur and Bikanar districts with epidemics of 1994–1996,
1999–2001), and, secondly, an epidemic may occur in the flood-prone areas such
as the lower reaches of the Luni river basin (e.g. Barmer and Pali districts with the
epidemic of 1990).
24.6 Malaria Control in Deserts
While in Africa, particularly in the sub-Saharan region, following a long history of

antimalarials, larvicide and adulticide usage, along with the long-lasting insecticide-
impregnated bed nets (LLIN) in recent past, more than one million children in
Ghana, Kenya and Malawi have now received one or more doses of the world’s
first malaria vaccine, RTS,S/AS01 (RTS,S), most of the other countries with deserts
have been nearly completely relying on their strength of medical services embodying
Drug Distribution Centres (DDC), Fever Treatment Depots (FTD), Active Surveil-
lance, unique system of Integrated Disease Surveillance Project (IDSP), larviciding
in urban centres for An. stephensi control, residual spray (RS) in human dwellings
and cattle sheds with adult insecticides, long-lasting insecticide-impregnated bed
nets (LLIN) and, of course, a range of repellents, e.g. DEET, DEPA, etc.
Malaria control in the Thar Desert, a vast region with hostile climate and
topography. is beset with several challenges unseen anywhere else in the country,
just like in other arid environments. One of the major constraints, of course, is rather
very little knowledge of specific behaviour of the vector species, particularly its
breeding in ‘Tanka’ and ‘Beri’ in the Thar Desert (Tyagi 1992a, 1995a, b,
1996a, b, c, d, e, f, g, 2002, 2020; Tyagi and Verma 1991; Tyagi and Yadav
1996a, 2001a, b), and suspected attribute of overwintering. At the same time,
determination of immunity level of the desert population is important to realize the
counter potential of the local population against the malarial parasites. The human
populations in the Thar Desert, just like in other deserts, are mobile due to their ever-
growing need for food and fodder for the cattle and pet animals and hard to reach to
deliver medication on time. In case of most of malariated deserts of the world,
including the Thar Desert, highly fragmentary efforts have so far been made to find
out alternate vector control methods in view of insecticide resistance development in
the vectors, and virtually no research has been made to understand the health facility
seeking behaviour of the desert population, mainly the women-folk and more
particularly the pregnant women. Although residual insecticide operations have
been in vogue for several years, no major studies have been undertaken to quantify
its impact on reduction of the year-by-year incidence of malaria. In the Thar Desert,
since now the combined role of An. culicifacies and An. stephensi in malaria
transmission has been confirmed in different physiographic situations of the Thar
Desert, it would be interesting and highly useful to develop distributional maps of
the sibling species under An. culicifacies and An. stephensi, but also other less-
known primary (An. fluviatilis) and/or secondary (An. subpictus, An. annularis)
vectors.
Global policy makers need to keep an eye on the malariated deserts which have at
least one common feature; they have potential to exacerbate desert malaria and
impact malaria situation in the neighbouring regions where successful elimination
campaigns were continuing. India, for that matter, is facing a challenge from ‘Desert
Malaria’ since the Rajasthan state where it is mostly present is bracing along its
border with some highly endemic states such as Punjab, Haryana, Uttar Pradesh,
Madhya Pradesh and Gujarat where full-throated malaria elimination campaigns
have been progressing. It is noteworthy here to mention that India currently has a
National Framework for Malaria Elimination (NFME) in India 2016–2030, and the
country’s resolve to achieve this target can be realized only when efflux of malaria
cases from a region like the Thar Desert could be seriously taken into consideration
beforehand! Therefore, desert malaria is very important to the world policy makers,
disease managers and programme implementers on malaria elimination. Long-term
investigations are the need of the hour to comprehend the world’s deserts’ inherent
prowess to conflagrate malaria in the xeric environments.
Conclusion: Will Deserts Transform into
Malaria Hotspots Tomorrow? 25
Malaria is a mosquito-borne global disease which exerts a whopping disease burden

in terms of Disability Adjusted Life Years (DALYs = 56,200,201), mostly in
communities of sub-Sahara Africa, South America and Asia (Hay et al. 2017). As
far as the desert ecosystems worldwide are concerned, two vector mosquitoes can be
singled out for their great prowess to adapt to the xeric conditions, namely,
(1) Anopheles arabiensis, one of the eight-sibling species of the deadly Anopheles
gambiae complex and a major vector throughout Africa and parts of Arabian
Peninsula, and (2) An. stephensi, the enigmatic Asian vector mosquito about
which the taxonomic riddle whether it is a species complex or merely comprising
a few subspecies (forms or races) is yet to settle. The eco-biological behaviour of An.
arabiensis is well known for deciding the modus of implementation of the current
intervention tools.
However, the recent invasion of An. stephensi in urban Africa with different
habitats and breeding behaviour is an alert on the success of malaria vector control
efforts achieved so far (Sinka et al. 2020; Kweka 2022). Through a unique amal-
gamation of environmental, geographic, ecological and biological data, Sinka et al.
(2020) have predicted by constructing evidence-based maps, with particular refer-
ence to Africa, on a likely expansion of An. stephensi in the near future, if allowed to
spread (Fig. 25.1).
Results from the study by Sinka et al. (2020) have suggested over 126 million
people in cities across Africa could be at risk of malaria infection mainly mediated
by An. stephensi. Djibouti City on the Horn of Africa was the first site of intrusion by
An. stephensi, detected during an unusual outbreak of malaria in 2012 and invariably
followed cyclically by increasingly severe annual outbreaks thereafter.
Investigations into these episodes of outbreaks in the fast growing urban environ-
ment of Djibouti City revealed the presence of An. stephensi, thriving in all kinds of
potable waters. The gradual changes in land use, anthropogenic interventions and
climate changes are regarded as the major factors to have led to species shift and
re-distribution. From here the vector have travelled to Ethiopia, Sudan and Somalia
(Kweka, 2022; Balkew et al. 2020). The intrusion of An. stephensi in various
Ltd. 2023
374 25 Conclusion: Will Deserts Transform into Malaria Hotspots Tomorrow?
Fig. 25.1 Inclusive map: Environmental suitability map of An. stephensi using the updated
occurrence database including all African sites. Red indicates a higher probability of environmental
suitability, whereas the blue indicates environments with a lower probability, i.e. more likely to be
unsuitable for the species to occur. The environmental variables selected by the model as relevant to
An. stephensi habitat suitability, in descending order (based on correlation score): Ann. Mean
Temp. = 0.461, Human Popn Dens. = 0.370, EVI = 0.174, Precip (season) = 0.161,
TCW = 0.134, Irrigation = 0.130, Crop mosaic = 0.010. Turquoise circles indicate the location
of cities with a population > one million. The thumbnail map shows the coefficient of variation
calculated per pixel across the predicted range, indicating where the ensemble model provides the
most reliable (higher confidence: dark green) and least reliable (lower confidence: red) predictions
(Source: Sinka et al. 2012)
different places in Africa has been confirmed after the DNA molecular analysis
(Balkew et al. 2021). Sinka et al. (2020) overlaid zoogeographic data for An.
stephensi across its full range in Asia, Arabian Peninsula and Horn of Africa with
spatial models that identify the species’ preferred habitat, and provided futuristic
maps of the possible African locations where An. stephensi could establish. This
supports the WHO’s call for targeted An. stephensi control and prioritized surveil-
lance (WHO 2020, WHO 2021a, b).
Besides Africa as its new home far west of India, An. stephensi has made
intrusion in the Indian Ocean island country Sri Lanka in close approximation in
the south (Fig. 25.2). Fresh invasions such as these and others projected in the future
are being considered as a challenge for the management of An. stephensi in both
urban Africa and Sri Lanka, in addition to new sites within India, to retain the
achievement attained in malaria control. Within a short span of a decade only, the
chronology of zoogeography attained by An. stephensi is both interesting and
25 Conclusion: Will Deserts Transform into Malaria Hotspots Tomorrow? 375
Fig. 25.2 Global prevalence of Anopheles stephensi (purple), recent invasion to new countries
(green) and countries at risk (red) (Source: Surendran et al. 2019)
Table 25.1 Global Year No. of cases (in mill.) Deaths

malaria incidence between
2015 224 445,000
2017 and 2021
2016 229 451,000
2017 231 435,000
2018 228 405,000
2019 227 558,000
2020 241 627,000
Source: extracted from WHO Annual Reports 2016–2021
threatening at the same time! Anopheles stephensi was, in brief, discovered to be

established in 2012 or 2013 on the continent of Africa, in Djibouti on the Horn of
Africa, in 2016 in Ethiopia, in 2017 in Sri Lanka and in 2019 in the Republic of the
Sudan.
Being the largest hot desert ecosystem in the world, and the third largest overall
after the Antarctica and the Arctic, the Sahara Desert (9.2 million km2; approx. 8% of
the earth’s land area) is also the centre of major risk of malaria epidemics and
increased intensity of malaria transmission by the combination of two of the world’s
dreaded vectors, viz. the original desert vector An. arabiensis and the now
unwantedly inveigled An. stephensi. If the global data on malaria between 2017
and 2021 is any indication to remain ever alert and to not allow ephemeral success
predate our mind (Table 25.1), then it is extremely to map zoogeography of the
emerging and new vectors in the region, ‘especially in the light of the spread of the
distribution of some anopheline vectors into new locations’ (Dr Marianne Sinka,
pers. comm. 10.x.2022).
There have been an array of interventions directed towards control of various
vector species in Africa, including An. arabiensis in the Sahara Desert, and most of
Fig. 25.3 Alert on Anopheles stephensi vector occurrence; last updated 5/10/2022 (Source: WHO
2022, auto permitted with due acknowledgement)
the counties in the arid environments of the desert were either retrieved free from
malaria or were kept terra incognita for the disease in human memory. Timely and
widespread distribution of long-lasting insecticidal nets (LLINs) and increased
coverage by the indoor residual spray (IRS) and urban larval source techniques
managed vectors well for the past two decades with significant progress in
preventing malaria and related adverse outcomes. This progress is evidenced by
the fact that malaria mortalities were stalled from 2018 to 2019, though there was a
reversal through increase in 2020.
Notwithstanding spectacular success achieved in many countries, both in the
sub-Sahara region (SSA) and in the Sahara Desert region (SSD), the unprecedented
streak of malaria outbreaks first in Djibouti (2012) and subsequently in Ethiopia
(2016), Sudan (2019) and Somalia—all in the expanse of the Sahara Desert—
relayed an alert signal not merely to the African continent nations but the whole
world, in the recent invasion by An. stephensi, a highly competent vector of
Plasmodium falciparum and P. vivax. The introduction of An. stephensi in African
countries from Asia has alerted the national malaria control programmes in
re-designing vector control strategies. The WHO (2022) has also considered the
spread of An. stephensi to be a major potential threat to malaria control and
elimination in Africa and southern Asia. This vector alert has been developed to
urge WHO Member States and their implementing partners—especially those in and
around the Horn of Africa, the Republic of Sudan and surrounding geographical
areas and in Sri Lanka—to take immediate action (Fig. 25.3).
In fact, An. stephensi s.s., essentially a vector of urban agglomerations in Asia
(except the Thar Desert in western India), is entirely different from any of the vector
species native to Africa. While An. stephensi typically breeds in containers or
cisterns of variety with clean water and appears to quickly adapt itself to the local
environment, it also survives extremely high temperatures during the dry season,
when malaria transmission is at the low ebb. In the Thar Desert An. stephensi,
possibly its cradle, occurs throughout the year, daring the summer (months of
May–June) when the temperature is as high as 50 °C (aestivation) or in the winter

(months of December–January) as low as 0 °C (overwintering), in certain districts
thriving with the vector. There the vector species also exhibits certain quaint
behaviours, for example, thanatosis or reflex immobilization as a defence mecha-
nism, high reproductive plasticity to breed in both rural (Thar Desert) and urban
settings with equal aplomb and alacrity (Tyagi 2002) and the genetic makeup or
genome of An. stephensi with 29 previously hidden members of insecticide resis-
tance genes, unreported for any mosquito so far. The genetic configuration of the
vector species seems to also confer resistance to multiple insecticide classes, posing
potential challenges to its control.
For the above attributions of An. stephensi, it is absolutely inevitably essentially
desired to inventorize the main factors which are expected to be challenges in the
efforts to control the species in the countries where it was earlier not known. These
are hinted as follows:
1. In Africa An. stephensi is both taxonomically and molecularly confirmed to be

different from any of the native malaria vectors available.
2. Anopheles stephensi breeds mostly in habitats like containers, underground and
overhead water-storage tanks, vases, water coolers, cement tanks for animal water
drinking and wills.
3. In the Thar Desert, An. stephensi utilizes innovatively the underground water
reservoirs, ‘Tanka and ‘Beri’, for breeding and even resting. These water
reservoirs offer a unique situation for vector management since both these
reservoirs hold water for months or even years for drinking by men and cattle,
as well as for the agricultural purpose (Tyagi and Yadav 1996a, b, c).
4. Anopheles stephensi-owned ‘Tanka’ always has pure drinking water, but when,
for reasons of tear and wear and/or mismanagement, the An. stephensi leaves the
abode of ‘Tanka’, and Aedes aegypti, the well-known vector for dengue/
chikungunya/Zika/Yellow Fever virus, begins to breed there in the organically
polluted habitat (Tyagi and Hiriyan 2004). Both ‘Tanka’ and ‘Beri’ are difficult to
attend effectively for larviciding. In Sri Lanka the An. stephensi has been found
colonizing large water bodies of breeding sites including wells which pose a
likewise challenge to control vector (Dharmasiri et al. 2017; Surendran et al.
2019).
5. The rate at which An. stephensi has so far invaded new countries within a short
span of 6 years, it can be safely assumed that many more countries in the
neighbourhood could well be targeted in the near future, if allowed to disperse
unabated.
6. The vector has already exhibited development of resistance against insecticides
used in indoor residual spraying (IRS) and in long-lasting insecticide nets
(LLINs) in both Sudan and Ethiopia (Ahmed et al. 2021; Enayati et al. 2020;
Yared et al. 2020). Compared to An. stephensi, the local native vector, An.
arabiensis, is continuing to be susceptible to the insecticides in vogue. For the
deployment of preferred insecticide-related tools, it is important to know before-
hand the resistance or susceptible status of the vector.
7. In contrast with studies made on feeding and resting behaviour on An. stephensi
in Asia, particularly in India, only fragmentary information is available to its
range of feeding on human and bovine blood and resting indoors or outdoors in
Africa.
8. Much of Africa, just like that in Djibouti, Ethiopia Sudan and/or Somalia, is under
enormous change towards urbanization, that too most of it unplanned and unor-
ganized with little or insufficient drainage system, high rural-urban migration
between Saharan and sub-Saharan regions and emerging of urban agriculture at
the peripheral regions. Thus, it becomes highly desirable to monitor the impact of
these anthropogenic factors on the preponderance and distribution of the vectors
like An. arabiensis and An. stephensi, particularly the latter which is well known
to be urban and peri-urban malaria vector.
Taking cognizance of the above irrefutable challenges associated with the intrud-
ing An. stephensi, it is probably most opportune to say here that the Indian model for
controlling the vector An. stephensi in metropolises like Mumbai (old name
Bombay), Delhi, Chennai and Bengaluru (old name Bangalore) is considered highly
successful and must be adopted with modifications to justify present-day needs in
both Africa and Sri Lanka (Covell 1928). As a first step towards mosquito control in
a fast developing Bangalore metropolitan city in south India, Rajagopalan et al.
(1987) prepared a ‘Master Plan for Mosquito Control’. Similar master plans were
drafted for Chennai and Delhi later.
Since urban malaria is very tricky, unassuming and beset with many operational
bottlenecks, there is certainly no single panacea for the solution, and all available
ecological, biological, chemical, physical and environmental methodologies should
be integrated to target the vector elimination. A few suggestions are:
1. Foremost the entomological surveillance system, aided by modern tools, should

be strengthened with the ability to capture the presence of the invasive An.
stephensi mosquitoes.
2. Both African and Sri Lankan scientists have a great expertise in mosquito
taxonomy. They should take initiative to coordinate capacity building for labora-
tory and field entomologists in identification of An. stephensi and An. arabiensis
and any other anopheline mosquito involved in malaria transmission. Such an
expertise at every level of worker will ensure sustenance of achieved success on
the vector control.
3. Develop a master plan of the city based on breeding habitats, and thereby identify
the potential breeding habitats for An. stephensi in urban and peri-urban for
appropriate control design.
4. Since resistance development in An. stephensi is a serious constraint in the way of
its management, it is highly desirable to know vector mosquito’s profile of the
insecticide resistance in different places of its occurrence. This will help to avoid
wastage of time, labour and money in using ineffective insecticide-based strategy
in areas where resistant populations occur.
5. Sentinel sites should be established for continuous data collection in all zones.
These sentinels’ sites should operate on proposed standard operating procedures
for species sampling, identification and insecticide resistance status.
6. Awareness should be generated among communities through Self-Help Groups
(SHG) and ward-heads on the use of personal protection tools such as bed nets for
protection indoors and outdoors and repellents for protection outdoors.
‘Desert Malaria’, however, has a complicated epidemiology as it occurs in

different ecotypical situations, in different intensities and in different time periods.
Moreover more than one vector species can be responsible for malaria exacerbation
and outbreaks. Firstly, while ‘Desert Malaria’ per se in the penetralium of the desert
is triggered by An. stephensi, it is usually P. vivax-dominated malaria; however, it
could be dominated by P. falciparum if the primary malaria vector, An. culicifacies,
joined An. stephensi in the disease transmission in a heavily canal-irrigated Thar
Desert region; secondly, ‘Desert Oasis’ vectors may result in focal outbreaks in the
congregated communities generally undertaking movements or even migration
between sites of oases and those that are hyperendemic for malaria; and thirdly,
‘Desert Fringe’, being dependent on heavy rainfalls on the periphery of desert, can
really vector heavy epidemics exacting multiple deaths and health devastation.
These malaria ecotypes, especially, when conjoined or even solitary, may spill
malaria cases to the neighbouring areas where these may multiply unabatedly or
impair a successful control programme already in process. ‘The spread of the
vectors, and subsequently malaria, into new areas is something we need to keep
highlighting’ (Dr Marianne Sinka, pers. comm. 15.vi.2022).
Hot deserts, particularly the Sahara and the Thar, do not remain malaria-free any
longer. Contrarily these have become heavily malariated, due mostly to
anthropization, climate change and vector dispersal to newer areas. It is, therefore,
most important for the world countries, particularly those bracing the malarious
desert ecosystems, to keep a constant watch on the movements of both humans and
vectors, as well as the malariogenic factors in the deserts.
Glossary
ABER Annual blood examination rate. Slides examined as % of population over a

year period.
Abiotic factors The climatic characteristics (temperature, humidity, saturation def-
icit, rainfall, light, wind) and edaphic characteristics (type of soil, soil texture) of a
region or habitat.
ACD/PCD Active/passive case detection.
Aedeagus A finger-like evagination of the ventral body wall of male mosquito
enclosing the terminal section of the ejaculatory duct.
Allergy A state of hypersensitivity to a given material (called an allergen), acquired
through exposure; re-exposure to the Allergen shows altered reactivity.
Al Nina A phenomenon opposite of El Nino.
Antennae Paired appendage of head of insects and other arthropods. Usually with
many segments. Antennae carry chemosensory organs.
Anterior The front end.
Anterodorsal The front of the upper surface.
Anteroventral The front of the under surface.
Anthropophilic Man-biting (literally: liking man).
API Annual parasite incidence. The number of parasite-positive blood slides per
thousand population.
Apical At the tip or end of (APEX).
Arthropod An animal belonging to the phylum Arthropoda in the animal kingdom,
having a hard jointed exoskeleton and paired, jointed legs. The phylum includes,
among other classes, the Arachnida and the Insecta, many of which are important
medically as parasites or as vectors of organisms capable of causing disease in
man.
Attack phase (of a control programme) The phase in which all houses are treated,
regardless of whether or not the house was infested.
Biological control Control measures by means of living organisms.
Biology The science that deals with the phenomena of life and with living
organisms in general.
Bionomics The (quantitative) relation of the development, reproduction, and sur-
vival of an organism or population of organisms to factors in the environment.
Ltd. 2023
B. K. Tyagi, Desert Malaria, https://doi.org/10.1007/978-981-19-7693-3
382 Glossary
Biotic factors Factors connected directly with the organisms living in a given
environment, e.g. nature and availability of hosts, water quality, plant environ-
ment, etc.
Biotype A small topographic unit, including the biotic community.
BSC/BSE Blood slides collected/examined.
Bti Bacillus thuringiensis subsp. israelensis, a bacterium well known for its toxicity
against vector/pest mosquito larvae.
Chromosome A linear structure within the nucleus of a cell composed of proteins
and DNA which holds the genetic material or genes of an organism, the arrange-
ment of which is unique to each organism.
Control Of insects (or other undesirable animals), the restriction of the population
density of such insects to a level below that at which they can be harmful to the
interests of man.
Cytospecies Species which because of their morphological similarity have been
identified primarily by cytological characters, such as the banding patterns of the
chromosomes.
Cytotaxonomy The description of species based on a study of the banding patterns
of the chromosomes.
DDC Drug distribution centre.
Density (of flies) Number of flies per given area or other unit.
Density-dependent A term used to describe factors that vary according to the
population density, and provide a form of ‘negative feedback’ to stabilize popu-
lation numbers. All living populations must be limited by density-dependent
factors operating on either their birth rate or death rate (or both); otherwise their
populations would increase forever. ln some cases, however, populations can be
limited by density-independent factors, before density-dependent factors come
into operation.
Diptera An order of insects containing the two-winged flies which have only the
anterior pair of wings well developed.
Dispersion The movements of flies in and around a locality or area in which they
emerged or are found at a given time.
Diurnal Daytime—usually relating to a cycle of activity. The opposite of nocturnal.
Dorsal Upper surface or back.
Drug resistance in parasite The ability of a parasite strain to survive and/or
multiply despite the administration and absorption of a drug in doses equal to
higher than those usually recommended but within the limits of tolerance of the
subject.
Ecology The study of the inter-relationship between organisms and their environ-
ment (including other organisms).
Ectoparasite A parasite that lives on the external surface of an animal, e.g. fleas,
lice, mites, ticks.
El Nino A term used to describe anomaly in the flow of ocean waters along the west
coast of South America. This anomaly is the result of the nutrient-rich cold water
Glossary 383
of the coastal Humboldt Current being replaced by eastward flowing warm ocean
water (which is nutrient poor) from the equatorial Pacific.
EIR Entomological inoculation rate. The number of infectious mosquito bites a
person is exposed to in a certain time, typically a year. The EIR is the product of
the human biting rate (HBR) and sporozoite rate.
Endemic disease A disease that is caused by factors that are constantly present
within a given geographical area or population group.
Endophilic insects Insects that regularly enter houses and spend at least part of
their life indoors.
ENSO The ‘El Nino’ Southern Oscillation is a large-scale atmospheric ‘seesaw’
centred over the equatorial Pacific Ocean. The variation in pressure is
accompanied in surrounding areas by fluctuations in wind strengths, ocean
currents, sea surface temperatures, and precipitation. The Southern Oscillation
(SO) and the warm waters of the El Nino are part of the same climate phenome-
non referred to as ENSO (El Nino/Southern Oscillation). The ENSO triggers
several climatic vagaries: from heavy rainfall to flooding in arid areas (e.g., parts
of Asia, Africa, Australia and southern America), weakening of Summer Mon-
soon ( e.g., India) and winters becoming milder in western Canada and parts of
the northern USA. Overall, disasters triggered by drought are twice as frequent
worldwide during El Nino years.
Environment The sum total, at a given moment, of all external influences and
conditions to which an organism or object is subjected, including all physical,
chemical, and biological factors.
Epidemic A period of increased prevalence of a given disease in a population
(usually, but not necessarily, as a result of factors that are not constantly present
in the populations).
Epidemiology The study of the factors that determine the frequency and distribu-
tion of disease and of other health-related states in populations.
Eradication Complete removal or destruction (e.g. of an infectious agent in a given
geographical area).
Exophilic insects Insects that normally do not enter buildings.
Femur The third segment of an insect’s leg, distal to the trochanter.
FF/HF Fully engorged/partially engorged female mosquitoes; abdomen of female
mosquitoes showing state of engorgement due to blood fed on.
FTD Fever treatment depot.
Genetic A hereditary factor controlled by genes of the previous generation.
Genitalia The external genital organs of the insect; the gonads and their ducts and
all associated accessory organs.
Genus (plural, genera) a taxonomic category within a family, consisting of one or
more generally similar species.
GIS Geographical information systems.
Gonotrophic cycle The events between successive egg-laying, or the time interval
between them.
Gravid Swollen and full of mature or nearly mature eggs.
384 Glossary
G/SG Gravid/semi-gravid females. Females with fully or partially developed state

of eggs in ovaries.
Habitat The physical place (home) where an organism lives.
Haematophagous The term applied to an insect that feeds exclusively on blood; in
mosquitoes only females blood-feed.
Head The anterior region of an insect, which bears the mouthparts, eyes, antennae
and houses the brain.
Host The animal parasitized by a parasite or disease organism.
Humidity or relative humidity The content of water vapour in the air measured as
a percentage of the content of saturated air (100% RH).
Hyperendemic Heavily endemic.
IIBN Insecticide impregnated bed nets. A bed net that is treated with a fast-acting
and long-standing insecticide such as deltamethrin, permethrin, and
lambdacyhalothrin which is also safe for humans.
Immunity Resistance to parasites or other noxious agents or organisms in a given
time, e.g. a year.
Incidence Occurrence of new cases in a population over time.
Infection The invasion of a host by pathogenic microorganisms (establishing a
host-parasite relationship) and the subsequent multiplication of the latter within
the body of the host.
Infestation (1) The invasion of the surface of the body of the host by parasites,
(2) The harbouring of parasites on the surface of the body.
Insect development inhibitors (IDI) Chemicals which inhibit the development of
larvae or pupae.
Insecticide A chemical substance or a mixture of substances used to kill insects. It
may be applied as a liquid, powder, fine spray, or as vapour. The term ‘larvicide’
is usually applied to an insecticide that kills immature stages of insects, and the
term ‘adulticide’ to an insecticide that kills mature or adult forms.
Insecticide resistance A characteristic that renders a given population of an insect
species resistance to a given insecticide although the species is normally suscep-
tible to that being no longer controlled by the insecticide in the area concerned.
Insecticide resistance in vector Development of strength in a population of a given
vector species to counteract the effect of the conventional or even higher dose of a
given insecticide
Instar The stage of an insect’s life between successive moults, for example the first
instar is between hatching from the egg and the first moult.
Integrated control Applied pest control that contains and integrates chemical,
physical, and biological control measures (including the use of natural enemies
of pests).
Larva An immature form occurring in some animals after hatching, differing
markedly from the adult form.
Larvicides Chemicals which kill larvae directly or by preventing them from devel-
oping into adults.
Glossary 385
Life cycle Stages of development through which an organism passes between

fertilization of the egg of one generation and the same stage in the subsequent
generation. The term is sometimes used loosely to mean the number of days
between egg deposition and the attainment of sexual maturity.
Mesonotum The notum (tergum) of the mesothorax.
Metamorphosis In insects, the series of changes through which the insect passes in
its development from the larval through the pupal to the adult form. If the pupa is
inactive and does not feed, metamorphosis is said to be ‘complete’; if there is no
pupa, or if the pupa is active and feeds, it is said to be ‘incomplete’.
Microorganism Any microscopic or ultramicroscopic animal or plant, especially
any of the bacteria, protozoa, or viruses.
Mortality The action of death on populations; more specifically, the number of
deaths in a given population in a given period of time.
NAMP National Anti-Malaria Programme.
Natural host A host in which a given pathogenic microorganism (or parasite) is
commonly found and in which the pathogen can complete its development. The
term ‘natural host’ implies that the host is the usual one; it has the same meaning
as ‘typical host’.
NMEP National Malaria Eradication Programme.
Nomenclature The scientific (Latin) names given to species, genera, families, etc.
of animals and plants.
NP Nulliparous female mosquitoes, which have as yet not got opportunity to
oviposit eggs even once.
Nulliparous The term applied to a female mosquito that has not yet laid the eggs.
Oviposition The act of depositing eggs.
Parasite An organism which derives its nutrition by competing with its host, often
with deleterious results to the host, or by feeding upon its tissues.
Pathogen An organism which causes disease.
Pathogenic Causing or giving rise to disease.
Pathogens Microorganisms (germs) such as viruses, bacteria, protozoa, and eggs
and cysts of worms, which can cause disease if man is infected.
PCR Polymerase chain reaction. A method for amplifying DNA in vitro, involving
the use of oligonucleotide primers complementary to nucleotide sequences in a
target gene and the copying of the target sequences by the action of DNA
polymerase.
Pest Any mosquito species that is harmful in any way, biting or otherwise, or
present in sufficient numbers to be considered a nuisance by man.
Pesticide An agent or a substance or a mixture of substances used to kill species
regarded as pests by man.
Pf Plasmodium falciparum.
%Pf Slides with P. falciparum as % of all positive cases.
PMH Per man-hour density. Average number of vectors collected in human or
animal dwellings (or even outdoors shelters) by hand collection done by standard
methods by searches over fixed periods of time.
386 Glossary
Polytene chromosomes Chromosomes which have divided many times but have
not separated, thereby forming thick bundles of up to a thousand parallel strands.
After staining, their banding pattern can be seen under moderate magnification,
and they are therefore convenient for examination. They are found in the nuclei of
the cells of a few specialized tissues only.
Population density The number of individuals of a given population per unit area
or volume.
Potential Existing and ready for action, but not yet active.
Precipitin testing A serological technique whereby the source of a blood meal can
be identified by testing it with antibodies to blood from known host species.
Predator An animal which preys upon insects or other animals.
Preparatory phase (of a control programme) The planning phase, when areas are
mapped and surveyed for infestations, prior to the attack phase.
Prevalence Existing cases in a population (Point prevalence: cases at a certain point
of time; Period prevalence: cases during a period of time). The proportion of
individuals in a population having malaria parasites in the blood.
Proboscis The mouthparts of mosquito, which form a tube containing the stylets
which penetrate the host tissues in order to suck up the host fluids.
Pupa The free living, highly mobile but not feeding stage of development of a
mosquito that occurs between the larval and adult forms.
Pv Plasmodium vivax.
Residual treatments Treatments with insecticide formulations having a long-term
effect (weeks or months).
RS Remote sensing.
SFR Slide falciparum rate. The number of blood slides found with P. falciparum as
a percentage of those examined.
Sibling Very closely related. Literally means brothers or sisters. In taxonomy
means the species which make up a single species complex and usually cannot
be distinguished by morphological features.
Sibling species Good species which do not interbreed but are difficult to separate
purely on morphological basis.
Species The smallest unit of classification commonly used, i.e. the group whose
members have the greatest mutual resemblance are able to interbreed (if not
separated in space or time), but not to breed with organisms of other groups
(species). Species may be divided into subspecies which differ in certain genetic
characters but are able to interbreed.
Species complex A species complex consists of a number of species with almost
identical morphological characteristics but with differences in certain aspects of
their biology, behaviour, and distribution. In most cases, the distinction has to be
made using modern diagnostics such as the cytological tools or the PCR
techniques.
SPR Slide positivity rate. The number of blood slides found with Plasmodium
parasites as a percentage of those examined.
Glossary 387
Subspecies A geographical group of local populations, differing taxonomically

from the other groups of the same type forming part of the species under
consideration.
Surveillance Observation of a thing, an animal, or a person. The term also implies
supervision or inspection.
Survey To examine for some specific purpose; to inspect or consider carefully; to
review in detail.
Taxon (plural taxa) The basic taxonomical units. Often refers to species, but can
refer to an element of the classification at any level.
Taxonomy Classification of animals and plants divided into species, genera,
families, etc.
Terrestrial Living on the ground.
Thorax Flies and other insects are divided into three regions: head, thorax, and
abdomen. The thorax carries the legs and wings.
Tibia The fourth segment of an insect’s leg, distal to the femur.
UF Unfed female mosquitoes, which have not got a chance to feed on blood, say,
before sampling was done on them.
ULV Ultra-low-volume concentrate.
Vector An arthropod or other animal that carries a parasite from one host to another
host. The vector may or may not be essential for the completion of the life cycle or
the parasite. If it is not essential, it is referred to as a ‘mechanical vector’.
Vectorial capacity The number of infective bites a person receives in a given
period. A function of relative populations of mosquitoes and people, feeding
frequency of the mosquito, duration of the latent period in the vector, and the
survival of the vector.
Ventral Pertaining to the front or lower surface.
Wettable powder A water dispersible but insoluble, formulation of an insecticide,
in which the active ingredient is bound to an inert insoluble carrier material such
as talcum powder. Wettable powder formulations are mixed with water to be
sprayed, and usually have greater residual activity than liquid formulations of the
same insecticide.
Zoonosis A disease of animals that may be transmitted under natural conditions to
man.
Zoophilic Feeding on animals other than man.
References
Abai MR, Mehravaran A, Vatandoost H, Oshaghi MA, Javadian E, Mashayekhi M, Mosleminia A,

Piyazak N, Edallat H, Mohtarami F, Jabbari H, Rafi F (2008) Comparative performance of
imagicides on Anopheles stephensi, main malaria vector in a malarious area, southern Iran. J
Vector Borne Dis 45(4):307–312
Abdulsalam MQAM, Mohammed AKM, Ahmed AA, Fong MY (2010) Clinical situation of
endemic malaria in Yemen. Trop Biomed 27(3):551–558
Abhayawardana TA, Wijesuriya SR, Dilrukshi RK (1996) Anopheles subpictus complex: distribu-
tion of sibling species in Sri Lanka. Indian J Malariol 33:53–60
Abubakr M, Sami H, Mahdi I, Altahir O, Abdelbagi H, Mohamed NS, Ahmed A (2022) The
phylodynamic and spread of the invasive Asian malaria vectors, Anopheles stephensi, in Sudan.
Biology 11(3):409. https://doi.org/10.3390/biology11030409
Adelman ZN (2015) Genetic control of malaria and dengue. Academic Press. 457 pp
Ahmed A, Khogali R, Elnour M-AB, Nakao R, Salim B (2021) Emergence of the invasive malaria
vector Anopheles stephensi in Khartoum State, Central Sudan. Parasit Vectors 14:511. https://
doi.org/10.1186/s13071-021-05026-4
Ahmed A, Abubakr M, Ali Y, Siddig EE, Mohamed NS (2022) Vector control strategy for
Anopheles stephensi in Africa. Lancet Microbe 3(6):e403. https://doi.org/10.1016/S2666-5247
(22)00039-8
Akhtar R, McMichael AJ (1996) Rainfall and malaria outbreaks in Western Rajasthan. Lancet 348:
1457–1458. https://doi.org/10.1016/S0140-6736(04)70109-9
Akhtar R, Learmonth A, Keynes M (1977) The resurgence of Malaria in India 1965–76. GeoJournal
1:69–80. https://doi.org/10.1007/BF00188888
Alahmed AM, Munawar K, Khalil SMS, Harbach RE (2019) Assessment and an updated list of the
mosquitoes of Saudi Arabia. Parasit Vectors 12:356. https://doi.org/10.1186/s13071-019-
3579-4
Alam MT, Bora H, Das MK, Sharma YD (2008) The type and mysorensis forms of the Anopheles
stephensi (Diptera: Culicidae) in India exhibit identical ribosomal DNA ITS2 and domain-3
sequences. Parasitol Res 103:75–80. https://doi.org/10.1007/s00436-008-0930-7
Al-Awadhi M, Ahmad S, Iqbal J (2021) Current status and the epidemiology of malaria in the
Middle East Region and beyond. Microorganisms 9(2):338. https://doi.org/10.3390/
microorganisms9020338
Alkadi HO, Al-Maktari MT, Nooman MA (2006) Chloroquine-resistant Plasmodium falciparum
local strain in Taiz governorate, Republic of Yemen. Chemotherapy 52(4):166–170. https://doi.
org/10.1159/000093592. Epub 2006 May 24
Al Kuriji AM, Alahmed MA, Kheir SM (2007) Distribution and seasonal activity of mosquitoes
(Diptera: Culicidae) in Riyadh Region, Saudi Arabia. Biosci Biotech Res Commun 1:19–24
Alnwick D (2000) Roll back malaria—what are the prospects? Bull World Health Org 78:1377
Al Zahrani MH, Omar AI, Abdoon AMO, Ibrahim AA, Alhogail A, Elmubarak M, Elamin YE,
AlHelal MA, Alshahrani AM, Abdelgader TM, Saeed I, El Gamri TB, Alattas MS, Dahlan AA,
Assiri AM, Maina J, Li XH, Snow RW (2018) Cross-border movement, economic development
Ltd. 2023
B. K. Tyagi, Desert Malaria, https://doi.org/10.1007/978-981-19-7693-3
390 References
and malaria elimination in the Kingdom of Saudi Arabia. BMC Med 16:98. https://doi.org/10.
1186/s12916-018-1081-z
Amerasinghe FP (2004) Foreword. In: Tyagi BK (ed) The invincible deadly mosquitoes. Scientific
Publishers, Jodhpur, India. 265 pp
Amerasinghe PH, Amerasinghe FP, Konradsen F, Fonseka KT, Wirtz RA (1999) Malaria vectors in
traditional dry zone village in Sri Lanka. Am J Trop Med Hyg 60:421–429. https://doi.org/10.
4269/ajtmh.1999.60.421
Anand PK (2009) Factors associated with malaria in block Banar, district Jodhpur, Rajasthan, India,
2008. Submitted in partial fulfillment of the requirements for The degree of Master of Applied
Epidemiology (M.A.E.) of Sree Chitra Tirunal Institute for Medical Sciences and Technology,
Thiruvananthapuram. 64 pp
Anand PK, Swarn L, Yadav SP, Singh H (2011) Disease dynamics, distribution and surveillance of
malaria in arid ecology of Jodhpur, Rajasthan, India during 2002 to 2006. J Public Health
Epidemiol 3(7):301–307
Anonymous (1971) Frequency tables of daily rainfall of 342 selected stations (India). Mem Indian
Meteorol Dep xxxn(2):29–375
Anonymous (1976) National malaria eradication programme, Rajasthan: Inter-State Border Con-
ference (N.M.E.P.). In: Medicine, Health & Family Planning Directorate, Rajasthan, Jaipur
Anonymous (1981) National seminar on deserts, man and health. S.M.S. Medical College, Jaipur,
p 31
Anonymous (1987a) Rajasthan: the health scenario. Indian Institute of Health Management, Jaipur.
197 pp
Anonymous (1987b) Indira Gandhi Nahar Project. New Age Printing Press, Jaipur. 6 pp
Anonymous (1991a) Health impact of Indira Gandhi Nahar Project. Indira Gandhi Nahar Board,
National Council of Applied Economical Research, New Delhi. 44 pp
Anonymous (1991b) Prospects of Indira Gandhi Canal Project. Indian Council of Agricultural
Research, New Delhi
Anonymous (1992) Profile of Indira Gandhi Nahar Project. Indira Gandhi Nahar Board, Govern-
ment of Rajasthan, Jaipur. 38 pp
Anonymous (1994a) Resource atlas of Rajasthan. Department of Science & Technology, Govern-
ment of Rajasthan, Jaipur. 231 pp
Anonymous (1994b) A great venture of miraculous change in desert: Indira Gandhi Nahar. Indira
Gandhi Nahar Board, Government of Rajasthan, Jaipur. 4 pp
Anonymous (1994c) Medical, health and planning services, Government of Rajasthan. Annual
report 1994–1995. Medical and Health Directorate, Jaipur, 56 pp
Anonymous (1995) Expert Committee on Malaria: report. Medical and Health Department, Gov-
ernment of Rajasthan, Jaipur, 132 pp
Anonymous (2000) Ethiopia and Sudan join forces to beat border health hazards. WHO Press
Release, 29th June 2000
Anonymous (2001) India: Nation Action Programme to combat desertification in the context of
United Nations convention to combat desertification (UNCCD). Volume-1&2. Status of
Desertification. In: Ministry of Environment & Forests, Government of India, New Delhi.
394 pp. and 27 pp
Anonymous (2002a) Bees zeeley malaria ki chapet mein [Twenty districts under the impact of
malaria]. Dainik Bhaskar 239(1):10. (in Hindi)
Anonymous (2002b) Sanbhag mein unnees lakh llogoan ko malaria ka khatra. [Malaria risk to
nineteen lakhs people in (Jodhpur) region]. Dainik Bhaskar 240:15. (in Hindi)
Anonymous (2002c) Malaria Report. National Malaria Control Programme [Google Scholar],
Sana’a
Anonymous (2002d) Book review—malaria in the Thar Desert: facts, figures and future. By Tyagi
BK, published by Agrobios (India), Jodhpur, 2002, 268 pp. DownToEarth 11(23):57
References 391
Anonymous (2003) Water harvesting and management—improving land management in

Rajasthan. Swiss Agency for Development and Cooperation
Anonymous (2006) Vector control needs assessment and national action plan under the
GEF/EMRO project ‘Reduction of Reliance on Pesticides in Vector Control’. National Malaria
Control Programme, Sana’a
Anonymous (2019) Anopheles stephensi. Invasive species compendium (ISC). CABI (Centre for
Agriculture and Bioscience International). 2019-11-20. Retrieved 2022-01-22
Anonymous (2020) U.S. President’s Malaria Initiative in Niger. Malaria Operational Plan FY 2020
Asarin AE, Kravtsova VI, Mikhailov VN (2010) Amudarya and Syrdarya rivers and their deltas. In:
Kostianoy AG, Kosarev AN (eds) The Aral Sea environment. Springer, Heidelberg, pp 101–121
Ashima, Sheth ND (2005) Phalodi, the Oasis town in Thar. The Economic Times (e-Paper)
Baeza A, Bouma MJ, Dobson AP, Dhiman R, Srivastava HC, Pascual M (2011) Climate forcing
and desert malaria: the effect of irrigation. Malar J 10:190. https://doi.org/10.1186/1475-2875-
10-190
Baeza A, Boumab MJ, Dhiman RC, Baskervillea EB, Ceccatod P, Yadav RS, Pascuala M (2013)
Long-lasting transition toward sustainable elimination of desert malaria under irrigation devel-
opment. PNAS 110(37):15157–15162
Balkew M, Peter M, Dereje D, Gedeon Y, Dejene G, Solomon Y, Sheleme C, Matthew M,
Kristen G, Karen L, Daniel J, Hee CS, Joseph S, Seth RI, Tamar EC (2020) Geographical
distribution of Anopheles stephensi in eastern Ethiopia. Parasit Vectors 13:35. https://doi.org/
10.1186/s13071-020-3904-y
Balkew M, Mumba P, Yohannes G, Abiy E, Getachew D, Yared S, Worku A, Gebresilassie A,
Tadesse FG, Gadisa E, Esayas E, Ashine T, Ejeta D, Dugassa S, Yohannes M, Lemma W,
Yewhalaw D, Chibsa S, Teka H, Murphy M, Yoshimizu M, Dengela D, Zohdy S, Irish S (2021)
An update on the distribution, bionomics, and insecticide susceptibility of Anopheles stephensi
in Ethiopia, 2018–2020. Malar J 20:263
Bansal SK (1998) Prevalence of some major disease vectors and their control in semi-arid areas of
Thar Desert. Proc Acad Env Biol 7:17
Bansal SK, Singh KV (1993) Prevalence and seasonal distribution of anopheline fauna in district
Bikaner (Rajasthan). Indian J Malariol 30:119–125
Bansal SK, Singh KV (2001) Current status of larval susceptibility of Anopheles stephensi to some
important insecticides in district Bikaner (Rajasthan). Abstr pap fifteenth natl congr parasitol,
Jodhpur, pp 129–130
Barik TK, Sahu B, Swain V (2009) A review on Anopheles culicifacies: from bionomics to control
with special reference to Indian subcontinent. Acta Trop 109(2):87–97
Barnard P (1998) Biological diversity in Namibia: a clash of sea and land, fog and dust. Biodivers
Conservat 7:415–417
Bartholomew JG, Herbertson AJ (1899) Bartholomew’s physical atlas: an atlas of meteorology, vol
III. The Royal Geographical Society, Edinburgh
Basseri HR, Doosti S, Akbarzadeh K, Nateghpour M, Whitten Miranda MA, Ladoni H (2008)
Competency of Anopheles stephensi mysorensis strain for Plasmodium vivax and the role of
inhibitory carbohydrates to block its sporogonic cycle. Malar J 7:131. https://doi.org/10.1186/
1475-2875-7-131
Batra CP, Mittal PK, Adak T, Sharma VP (1999) Malaria investigation in district Jodhpur,
Rajasthan, during the summer season. Indian J Malariol 36:75–80
Beier JC, Beier MS, el Kordy EA, el Said S, Kenawy MA (1986) Colonization of the oasis malaria
vector, Anopheles sergentii, in Egypt. J Am Mosq Control Assoc 2:104–105
Bernabeu M, Gomez-Perez GP, Sissoko S, Niambélé MB, Haibala AA, Sanz A, Théra MA,
Fernandez-Becerra C, Traoré K, Alonso PL, Bassat Q, del Portillo HA, Doumbo O (2012)
Plasmodium vivax malaria in Mali: a study from three different: a study from three different
regions. Malar J 11:405. https://doi.org/10.1186/1475-2875-11-405
Bhandari MM (1978) Flora of the Indian Desert. Scientific Publishers, Jodhpur
Bhu N (1972) Malaria not yet out: it’s prophylaxis. Rajasthan Med J 11:225–226
392 References
Bian G, Joshi D, Dong Y, Lu P, Zhou G, Pan X, Xu Y, Dimopoulos G, Xi Z (2013) Wolbachia

invades Anopheles stephensi populations and induces refractoriness to Plasmodium infection.
Science 340(6133):748–751. https://doi.org/10.1126/science.1236192
Bin Mohanna MA, Bin Ghouth AS, Rajaa YA (2007) Malaria signs and infection rate among
asymptomatic schoolchildren in Hajr Valley, Yemen. East Mediterr Health J 1335–1340
Biswas S, Wattal B, Tyagi D, Kumar K (1980) Limitation of larval parasitic water mite infestation
in age-gradation of adult Anopheles. J Commun Dis 12(4):214–215
Black RH (1968) Manual of epidemiology and epidemiological services in malaria programmes.
World Health Organization, Geneva
Blanford WT (1876) Physical geography of the Great Indian Desert. J Asiatic Soc Bengal 45:86–
103
Bogreau H, Basco L, Boukhary AOMS (2019) Oasis malaria, Northern Mauritania. Emerg Infect
Dis 25(2):282–289
Bose A (2004) Malaria Deaths in Rajasthan Desert. Econ Polit Wkly 39(25):2557–2559
Bouma MJ, van der Kaay HJ (1994) Epidemic malaria in India and the El Nino Southern Oscilla-
tion. Lancet 334:1638–1639
Bouma MJ, van der Kaay HJ (1995) Epidemic malaria in India’s Thar Desert. Lancet 373:132–133
Bouma MJ, van der Kaay HJ (1996) The El Nino Southern Oscillation and the historic malaria
epidemics in the Indian sub-Continent and Sri Lanka: an early warning system for future
epidemics. Trop Med Int Health 1:86–96
Bouma MJ, Sondorp HE, van der Kaay HJ (1994a) Health and climate change. Lancet 343:302
Bouma MJ, Sondorp HE, van der Kaay HJ (1994b) Climate change and periodic malaria. Lancet
343:1440
Bradshaw WE, Holzapfel CM (2001) Genetic shift in photoperiodic response correlated with global
warming. PNAS 98(25):14509–14511. https://doi.org/10.1073/pnas.241391498
Bradshaw WE, Holzapfel CM (2010) Light, time, and the physiology of biotic response to rapid
climate change in animals. Annu Rev Physiol 72:147–166
Brancatelli GIE, Zalba SM (2018) Vector analysis: a tool for preventing the introduction of invasive
alien species into protected areas. Nat Conservat 24:43–63. https://doi.org/10.3897/
natureconservation.24.20607
Brandson RR, Garg RK, Tyagi BK (1994) Medical and health facilities. In: Moghe VB, Nahar KR,
Parmar AK (eds) Resource Atlas of Rajasthan. Department of Science & Technology, Govt. of
Rajasthan, Jaipur, pp 178–179
Breman JG, Alilio MS, Mills A (2004) Conquering the intolerable burden of malaria: what’s new,
what’s needed: a summary. Am J Trop Med Hyg 71:1–15
Brite E (2016) Irrigation in the Khorezm oasis, past and present: a political ecology perspective. J
Polit Ecol 23(1):1. https://doi.org/10.2458/v23i1.20177
Bruce-Chwatt LJ (1985) Essential malariology, 2nd edn. Heinemann, London. 452 pp
Bryson AA, Barreis D (1967) Possibilities of major climatic modifications and their implications:
Northwest India, A case study. Bull Am Meteorol Soc 48:136–142
Burrows JN, van Huijsduijnen RH, Möhrle JJ, Oeuvray C, Wells TNC (2013) Designing the next
generation of medicines for malaria control and eradication. Malar J. https://doi.org/10.1186/
1475-2875-12-187
Burrows JN, Duparc S, Gutteridge WE, Hooft van Huijsduijnen R, Kaszubska W, Macintyre F,
Mazzuri S, Möhrle JJ, Wells TNC (2017a) New developments in anti-malarial target candidate
and product profiles. Malar J 16:26. https://doi.org/10.1186/s12936-016-1675-x
Burrows JN, Duparc S, Gutteridge WE, van Huijsduijnen RH, Kaszubska W, Macintyre F,
Sébastien M, Möhrle JJ, Wells TNC (2017b) Erratum to: new developments in anti-malarial
target candidate and product profiles. Malar J 16:151. https://doi.org/10.1186/s12936-017-
1809-9
Caminade C, Kovats S, Rocklov J, Tompkins AM, Morse AP, Colón-González FJ, Stenlund H,
Martens P, Lloyd SJ (2014) Impact of climate change on global malaria distribution. Proc Natl
Acad Sci USA 111:3286–3291
References 393
Carter R, Mendis KN (2002) Evolutionary and historical aspects of the burden of malaria. Clin
Microbiol Rev 15:564–594
Carter TE, Yared S, Gebresilassie A, Bonnell V, Damodaran L, Lopez K, Ibrahim M,
Mohammed S, Janies D (2018) First detection of Anopheles stephensi Liston, 1901 (Diptera:
Culicidae) in Ethiopia using molecular and morphological approaches. Acta Trop 188:180–186
Cebrián-Camisón S, Martínez-de la Puente J, Figuerola J (2020) A literature review of host feeding
patterns of invasive Aedes mosquitoes in Europe. Insects 11(12):848. https://doi.org/10.3390/
insects11120848
Chakraborty M, Ramaiah A, Adolfi A, Halas P, Kaduskar B, Ngo LT, Jayaprasad S, Paul K,
Whadgar S, Srinivasan S, Subramani S, Bier E, James AA, Emerson JJ (2021) Hidden genomic
features of an invasive malaria vector, Anopheles stephensi, revealed by a chromosome-level
genome assembly. BMC Biol 19:28. https://doi.org/10.1186/s12915-021-00963-z
Chandra S (1981) Trends in morbidity and mortality from communicable diseases in Rajasthan.
Rajasthan Med J 20:95–100
Chanyalew T, Natea G, Amenu D, Yewhalaw D, Simma EA (2022) Composition of mosquito fauna
and insecticide resistance status of Anopheles gambiae sensu lato in Itang special district,
Gambella, Southwestern Ethiopia. Malar J 21(1):125. https://doi.org/10.1186/s12936-022-
04150-5
Chatterji PC, Vangani NS, Sharma ML (1985) Unmanaged drinking water source in arid areas of
Rajasthan. A case study of Nagaur district. Ann Arid Zone 24(1):47–55
Chavshin AR, Oshaghi MA, Vatandoost H, Hanafi-Bojd AA, Raeisi A, Nikpoor F (2014) Molecu-
lar characterization, biological forms and sporozoite rate of Anopheles stephensi in southern
Iran. Asian Pac J Trop Biomed 4(1):47–51. https://doi.org/10.1016/S2221-1691(14)60207-0
Chemison A, Ramstein G, Tompkins AM, Defrance D, Camus G, Charra M, Caminade C (2021)
Impact of an accelerated melting of Greenland on malaria distribution over Africa. Nat Commun
12:3971. https://doi.org/10.1038/s41467-021-24134-4
Cherlet M, Hutchinson C, Reynolds J, Hill J, Sommer S, von Maltitz G (eds) (2018) World atlas of
desertification. Publication Office of the European Union, Luxembourg
Christophers SR (1933) The fauna of British India, including Ceylon and Burma. Diptera: Family
Culicidae; Tribe Anophelini, vol 4. Taylor & Francis, London. 371 pp
Christophers SR, Sinton JA (1926) A malaria map of India. Indian J Med Res 14:173–178
Christophers SR, Sinton J, Covell G (1928) How to do a malaria survey? Government of India,
Central Publication Branch
Cohen B (2015) Urbanization, city growth, and the new United Nations development agenda.
Cornerstone Offic J World Coal Ind 3(2):4–7
Coleman M, Al-Zahrani MH, Coleman M, Hemingway J, Omar A, Stanton MC et al (2014) A
country on the verge of malaria elimination—the Kingdom of Saudi Arabia. PLoS One 9(9):
e105980. https://doi.org/10.1371/journal.pone.0105980
Corbet PS (1962) A biology of dragonflies. Witherby, London
Coulibaly MB, Traoré SF, Touré YT (2015) Considerations for disrupting malaria transmission in
Africa using genetically modified mosquitoes, ecology of anopheline disease vectors, and
current methods of control. Chapter 3. In: Adelman ZN (ed) Genetic control of malaria and
dengue. Academic Press, pp 55–67
Covell G (1927a) Report on an Inquiry into Malarial Conditions in the Andamans. Government of
India Press, Delhi
Covell G (1927b) A critical review of the data recorded regarding transmission of malaria by
different species of Anopheles, with notes on distribution, habits and breeding places. Indian
Med Res Mem 7:87–99
Covell G (1928) Malaria in Bombay. The Government Central Press, Bombay
Covell G (1949) Map of principal vectors of malaria in India. In: Boyd MF (ed) Malariology, vols. I
and II. Saunders, Philadelphia
Cox Francis EG (2010) History of the discovery of the malaria parasites and their vectors. Parasit
Vectors 3:5. http://www.parasitesandvectors.com/content/3/1/5
394 References
Craig MH, Sharp BL, Mabaso MLH, Kleinschmidt I (2007) Developing a spatial-statistical model
and map of historical malaria prevalence in Botswana using a staged variable selection proce-
dure. Int J Health Geogr 6:e44
Daggy RH (1959) Malaria in oases of Eastern Saudi Arabia. Am J Trop Med Hyg 8:223–291
Dam PK, Yadav SP, Tyagi BK (1997) Thar Maru-kschetra mein pai jane wali aushadhiyukta
vanashpatiyan: Ek avalokan (Medicinal Plants of Thar Desert: an overview). Abstract paper,
Rashtriya Vaigyanik Sanghoshthi, Lucknow, p 54 [in Hindi]
Dam PK, Ramnath T, Yadav SP, Tyagi BK (1999) Ethnomedicinal measures for controlling
malaria fevers and vector-biting in the rural Thar Desert, Rajasthan. Abstract paper fourth
international symposium of vectors & vector-borne diseases, Gwalior, p 36
Dam PK, Yadav SP, Tyagi BK (2000a) Thar Marukschetra mei aushadhiukta vanaspatiyan: ek
purvalokana [The medicinal plants of Thar Desert region: a review]. ICMR Patrika 14:61–65.
(in Hindi)
Dam PK, Ramnath T, Yadav SP, Tyagi BK (2000b) Use of ethnomedicinal practices in the Thar
Desert, North Western India. J Econ Taxon Bot 24:303–318
Darwin C (1859) On the origin of species by means of natural selection, or, the preservation of
favoured races in the struggle for life. J. Murray, London
Das BP, Rajagopal R, Akiyama J (1990) Pictorial key to the species of Indian Anophline
mosquitoes. Zoology 2:131–162
De Burca B (1939) Note on anti-malaria measures in Quetta Cantonment during 1938. J Malar Inst
India 2:121
Deida J, Tahar R, Khalef YO, Lekweiry KM, Hmeyade A, Khairy MLO, Simard F, Bogreau H,
Basco L, Boukhary AOMS (2019) Oasis malaria, Northern Mauritania. Emerg Infect Dis 25(2):
273–280. https://doi.org/10.3201/eid2502.180732
Dev V (2020) Vector biology and control—an update for Malaria Elimination Initiative in India.
The National Academy of Sciences, India. 272 pp
Dev V (2022) Battling malaria in North-East India: targeting interventions towards eliminationism.
ICMR - National Institute of Malaria Research, New Delhi, India, p 274
Devi SR, Dass S (1999) Environmental factors of malaria persistence: a study at Valiyathura,
Thiruvananthapuram City. Discussion Paper No. 3. Kerala Research Programme on local level
development center for development studies, Thiruvananthapuram. http://www.cds.ac.in/
krpcds/publication/Remadevi.html. Accessed 14 Jan 2022
Dharmasiri AGG, Perera AY, Jeevanie H, Herath H, Aravindan K, Jayasooriya HTR, Ranawaka
GR, Hewavitharane M (2017) First record of Anopheles stephensi in Sri Lanka: a potential
challenge for prevention of malaria reintroduction. Malar J 16(1):326. https://doi.org/10.1186/
s12936-017-1977-7
Dhir RP (1982) The human factor in ecological history—arid zone of Rajasthan. In: Spooner B,
Mann HS (eds) Desertification and development: dryland ecology in social perspectives.
Academic, London, pp 311–332
Dhir RP (2003) Ecological fluxes in the Thar Desert. In: Narain P, Kathju S, Kar A, Singh MP,
Praveen Kumar (eds) Human impact on desert environment. Scientific Publisher, Jodhpur,
India, pp 1–11
Dhir RP (2005) Some natural and anthropogenic specificities of the Thar. In: Tyagi BK, Baqri QH
(eds) Changing faunal ecology in Thar Desert. Scientific Publisher, Jodhpur, India, pp 27–36
Dhir RP, Kolarkar AS (1977) Genesis and evolution of arid zone oils. J Indian Soc Soil Sci 25:260–
264
Dhir RP, Singhvi AK (2012) The Thar Desert and its antiquity. Curr Sci 102(7):1001–1008
Dia I, Ba H, Ould Mohamed SA, Diallo D, Lo B, Diallo M (2009) Distribution, host preference and
infection rates of malaria vectors in Mauritania. Parasit Vectors 2:61
Doelhomid S (1982) Rainwater cistern system in Indonesia. In: Proc. 1st international conference
on rain water cistern systems, Honolulu, Hawaii, USA, p 9
Dossou-yovo J, Donnanio J, Riviere F, Duval J (1994) Rice cultivation and malaria transmission in
Bouake city (Cote d’Ivoire). Acta Trop 57:91–94
References 395
Doumbe-Belisse P, Kopya E, Ngadjeu CS, Sonhafouo-Chiana N, Talipouo A, Djamouko-

Djonkam L, Awono-Ambene HP, Wondji CS, Njiokou F, Antonio-Nkondjio C (2021) Urban
malaria in sub-Saharan Africa: dynamic of the vectorial system and the entomological inocula-
tion rate. Malar J 20:364. https://doi.org/10.1186/s12936-021-03891-z
DownToEarth (2003) Malaria in the Thar Desert: facts, figures and future—book review. Centre for
Science and Environment, New Delhi
Edmunds M (1974) Defense in animals. Longman, Harlow
Enayati A, Hanafi-Bojd AA, Sedaghat MM, Zaim M (2020) Hemingway J (2020) Evolution of
insecticide resistance and its mechanisms in Anopheles stephensi in the WHO Eastern Mediter-
ranean region. Malar J 19(1):1–12. https://doi.org/10.1186/s12936-020-03335-0
EPHI (Ethiopian Public Health Institute) (2016) Ethiopia National Malaria Indicator Survey 2015.
Ethiopian Public Health Institute, Addis Ababa. https://www.ephi.gov.et/images/pictures/
download2009/MIS-2015-Final-Report-December-_2016.pdf. Accessed 30 June 2017
Ermert V, Fink AH, Jones AE, Morse AP (2011a) A new version of the Liverpool Malaria
Model. I. Review of the parameter setting and model structures. Malar J. https://doi.org/10.
1186/1475-2875-10-35
Ermert V, Fink AH, Jones AE, Morse AP (2011b) A new version of the Liverpool Malaria Model.
II. Calibration and validation for West Africa. Malar J 10:62. https://doi.org/10.1186/1475-
2875-10-62
Ermert V, Fink AH, Morse AP, Paeth H (2012) The impact of regional climate change on malaria
risk due to greenhouse forcing and land-use changes in tropical Africa. Environ Health Perspect
120(1):77–84. https://doi.org/10.1289/ehp.1103681
Ezcurra E, Mellink E, Wehncke E, González C, Morrison S, Warren A, Dent D, Driesse P (2006)
Natural history and evolution of the world’s deserts. In: Ezcurra E (ed) Global deserts outlook.
United Nations Environment Programme (UNEP), Nairobi, Kenya, pp 1–26
Fanello C, Santolamazza F, Torre AD (2002) Simultaneous identification of species and molecular
forms of the Anopheles gambiae complex by PCR-RFLP. Med Vet Entomol 16(4):461–464.
https://doi.org/10.1046/j.1365-2915.2002.00393.x
Fantini B (1994) Anophelism without malaria: an ecological and epidemiological puzzle.
Parassitologia 36(1–2):83–106. PMID: 7898963
FAO (2019) The state of the world’s biodiversity for food and agriculture. In: Bélanger J, Pilling D
(eds) FAO Commission on genetic resources for food and agriculture assessments, Rome, 572
pp
Faraj C, Adlaoui E, Ouahabi S, Rhajaoui M, Fontenille D, Lyagoubi M (2009) Entomological
investigations in the region of the last malaria focus in Morocco. Acta Trop 109:70–73. https://
doi.org/10.1016/j.actatropica.2008.09.021
Farid MA (1958) The implications of Anopheles sergentii for malaria eradication programmes east
of the Mediterranean. Bull World Health Organ 15:821–828
Faulde MK, Leopoldo MR, Bouh AK (2014) First record of the Asian malaria vector Anopheles
stephensi and its possible role in the resurgence of malaria in Djibouti, Horn of Africa. Acta
Trop 139:39–43
Firooziyan S, Djadid ND, Gholizadeh S (2018) Speculation on the possibility for introducing
Anopheles stephensi as a species complex: preliminary evidence based on odorant binding
protein 1 intron I sequence. Malar J 17:366
Foley DH, Rueda LM, Wilkerson RC (2007) Insight into global mosquito biogeography from
country species records. J Med Entomol 44(4):554–567. https://doi.org/10.1093/jmedent/44.
4.554
Folmer O, Black M, Hoeh W, Lutz R, Vrijenhoek R (1994) DNA primers for amplification of
mitochondrial cytochrome c oxidase subunit I from diverse metazoan invertebrates. Mol Mar
Biol Biotechnol 3:294–299
Fontenille D, Simard F (2004) Unravelling complexities in human malaria transmission dynamics
in Africa through a comprehensive knowledge of vector populations. Comp Immunol Microbiol
Infect Dis 27(5):357–375
396 References
Gad AU (1967) U.A.R. Mosquito News 27:171

Gayan Dharmasiri AG, Perera AY, Harishchandra J et al (2017) First record of Anopheles stephensi
in Sri Lanka: a potential challenge for prevention of malaria reintroduction. Malar J 16:326.
https://doi.org/10.1186/s12936-017-1977-7
Gemperli A, Vounatsou P, Sogoba N, Smith T (2006) Malaria mapping using transmission models:
application to survey data from Mali. Am J Epidemiol 163:289–297
Gerensea H, Teklay H (2017) Pattern and trend of malaria morbidity and mortality in Tigray
Region, Ethiopia from 2011/12–2014/15. J Bioanal Biomed 9(2):114–117
Getachew D, Balkew M, Tekie H (2020) Anopheles larval species composition and characterization
of breeding habitats in two localities in the Ghibe River Basin, Southwestern Ethiopia. Malar J
19(1):1–13
Gething PW, Patil AP, Smith DL, Guerra CA, Elyazar IRF, Johnston GL, Tatem AJ, Hay SI (2011)
A new world malaria map: Plasmodium falciparum endemicity in 2010. Malar J 10:378. https://
doi.org/10.1186/1475-2875-10-378
Geyh MA, Ploethner D (2008) Origin of a fresh groundwater body in Cholistan, Thar Desert,
Pakistan. Geol Soc Lond Spec Publ 288:99–109. https://doi.org/10.1144/SP288.8
Ghasemian A, Nafiseh T, Rahimi SS, Karim M (2016) Malaria prevalence in the Middle East.
Avicenna J Clin Microbiol Infect 3. https://doi.org/10.17795/ajcmi-35761
Gill CA (1921) The role of meteorology in malaria. Indian J Med Res 8:633–693
Gill CA (1923) The prediction of malaria epidemics. Indian J Med Res 10:1136–1143
Goodwin WJ, Paltrinieri AB (1959) Oasis malaria in Libya. In: Proc. second regl conf malaria
eradication, Addis Ababa, 16–21 November, 1959, EM/ME-Tech. 2/8, pp 1–8
Goudie A, Wilkinson J (1977) The warm desert environment. Cambridge University Press,
Cambridge
Green JS (1911) Malaria in Nasirabad. J R Army Med Corps 26:44
Green CA, Miles SJ (1980) Chromosomal evidence for sibling species of the malaria vector
Anopheles (Cellia) culicifacies Giles. J Trop Med Hyg 83:75–78
Greenwood B (1999) Malaria mortality and morbidity in Africa. Bull World Health Org 77:617–
618
Griffin JT, Ferguson NM, Ghani AC (2014) Estimates of the changing age-burden of Plasmodium
falciparum malaria disease in sub-Saharan Africa. Nat Commun 5:1–10
Guerra CA, Gikandi PW, Tatem AJ, Noor AM, Smith DL, Hay SI, Snow RW (2008 Feb) The limits
and intensity of Plasmodium falciparum transmission: implications for malaria control and
elimination worldwide. PLoS Med 5(2):e38
Gupta KD (1961) Chemotherapy of malaria. Rajasthan Med J 1:103–109
Gupta R (1996) Correlation of rainfall with upsurge of malaria in Rajasthan. J Assoc Phys India 44:
385–389
Gupta RK (1975) The landscape and land forms. In: Gupta RK, Prakash I (eds) Environmental
analysis of the Thar Desert. English Book Depot, Dehradun, pp 1–21
Gupta UC, Kataria ML (1993) Plasmodium falciparum hepatitis during malaria epidemic. J Assoc
Phys India 41:292
Gupta A, Malhotra MS, Banbory P (1987) Clinical pattern of complicated malaria in North West
India. J Assoc Phys India 35:15
Hammadi D, Boubidi SC, Chaib SE, Saber A, Khechache Y, Gasmi M, Harrat Z (2009) Le
paludisme au Sahara algérien [Malaria in Algerian Sahara]. Bull Soc Pathol Exot 102(3):
185–192. French. PMID: 19739417 [in French]
Hanafi-Bojd A, Vatandoost H, Philip E, Stepanova E, Abdi A, Safari R, Mohseni GH, Bruhi MI,
Peter A, Abdulrazag SH, Mangal G (2010) Malaria situation analysis and stratification in bandar
abbas county, southern Iran, 2004-2008. Iran J Arthropod Borne Dis 4(1):31–41
Harbach RE (2011) Genus Anopheles Meigen, 1818. Mosquito Taxonomic Inventory. Book Genus
Anopheles Meigen, 1818 Mosquito Taxonomic Inventory
Harrison BA, Scanlon John E (1975) The subgenus Anopheles in Thailand (Diptera: Culicidae).
Medical Entomology Studies – II. Contrib Amer Ent Inst 12(1):1–307
References 397
Hay SI, Rogers DJ, Toomer JF, Snow RW (2000) Annual Plasmodium falciparum entomological
inoculation rates (EIR) across Africa: literature survey, internet access and review. Trans R Soc
Trop Med Hyg 94(2):113–127
Hay SI, Guerra CA, Tatem AJ, Noor AM, Snow RW (2004) The global distribution and population
at risk of malaria: past, present, and future. Lancet Infect Dis 4:327–336
Hay SI, Guerra CA, Tatem AJ, Atkinson PM, Snow RW (2005) Urbanization, malaria transmission,
and disease burden in Africa. Nat Rev Microbiol 3:81–90
Hay SI, Guerra CA, Gething PW, Patil AP, Tatem AJ, Noor AM, Kabaria CW, Manh BH, Elyazar
IR, Brooker S, Smith DL, Moyeed RA, Snow RW (2009) A world malaria map: Plasmodium
falciparum endemicity in 2007. PLoS Med 6(3):e1000048
Hay SI, Okiro EA, Gething PW, Patil AP, Tatem AJ, Guerra CA, Snow RW (2010a) Estimating the
global clinical burden of Plasmodium falciparum malaria in 2007. PLoS Med 7(6):e100029
Hay SI, Sinka ME, Okara RM, Kabaria CW, Mbithi PM, Tago CC, Benz D, Gething PW, Howes
RE, Patil AP, Temperley WH, Bangs MJ, Chareonviriyaphap T, Elyazar IR, Harbach RE,
Hemingway J, Manguin S, Mbogo CM, Rubio-Palis Y, Godfray HC (2010b) Developing global
maps of the dominant Anopheles vectors of human malaria. PLoS Med 7:e1000209
Hay SI, Abajobir AA, Abate KH, Abbafati C, Abbas KM, Abd-Allah F, Abdulkader RS, Abdulle
AM, Abebo TA, Abera SF, Aboyans V, Abu-Raddad LJ, Ackerman IN, Adedeji IA,
Adetokunboh O, Afshin A, Aggarwal R, Agrawal S, Agrawal A, Ahmed MB, Aichour MTE,
Aichour AN, Aichour I, Aiyar S, Akinyemiju TF, Akseer N, Al Lami FH, Alahdab F, Al-Aly Z,
Alam K, Alam N, Alam T, Alasfoor D, Alene KA, Ali R, Alizadeh-Navaei R, Alkaabi JM,
Alkerwi A’a, Alla F, Allebeck P, Allen C, Al-Maskari F, AlMazroa MAA, Al-Raddadi R,
Alsharif U, Alsowaidi S, Althouse BM, Altirkawi KA, Alvis-Guzman N, Amare AT, Amini E,
Ammar W, Amoako YA, Ansha MG, Antonio CAT, Anwari P, Ärnlöv J, Arora M, Al Artaman,
Aryal KK, Asgedom SW, Atey TM, Atnafu NT, Avila-Burgos L, Avokpaho EFGA, Awasthi A,
Awasthi S, Azarpazhooh MR, Azzopardi P, Babalola TK, Bacha U, Badawi A, Balakrishnan K,
Bannick MS, Barac A, Barker-Collo SL, Bärnighausen T, Barquera S, Barrero LH, Basu S,
Battista R, Battle KE, Baune BT, Bazargan-Hejazi S, Beardsley J, Bedi N, Béjot Y, Bekele BB,
Bell ML, Bennett DA, Bennett JR, Bensenor IM, Benson J, Berhane A, Berhe DF, Bernabé E,
Betsu BD, Beuran M, Beyene AS, Bhansali A, Bhatt S, Bhutta ZA, Biadgilign S, Bicer BK,
Bienhoff K, Bikbov B, Birungi C, Biryukov S, Bisanzio D, Bizuayehu HM, Blyth FM, Boneya
DJ, Bose D, Bou-Orm IR, Bourne RRA, Brainin M, Brayne C, Brazinova A, Breitborde NJK,
Briant PS, Britton G, Brugha TS, Buchbinder R, Bulto LNB, Bumgarner BR, Butt ZA,
Cahuana-Hurtado L, Cameron E, Campos-Nonato IR, Carabin H, Cárdenas R, Carpenter DO,
Carrero JJ, Carter A, Carvalho F, Casey D, Castañeda-Orjuela CA, Castle CD, Catalá-López F,
Chang J-C, Charlson FJ, Chaturvedi P, Chen H, Chibalabala M, Chibueze CE, Chisumpa VH,
Chitheer AA, Chowdhury R, Christopher DJ, Ciobanu LG, Cirillo M, Colombara D, Cooper
LT, Cooper C, Cortesi PA, Cortinovis M, Criqui MH, Cromwell EA, Cross M, Crump JA, Dadi
AF, Dalal K, Damasceno A, Dandona L, Dandona R, das Neves J, Davitoiu DV, Davletov K, de
Courten B, De Leo D, De Steur H, Defo BK, Degenhardt L, Deiparine S, Dellavalle RP,
Deribe K, Deribew A, Des Jarlais DC, Dey S, Dharmaratne SD, Dhillon PK, Dicker D,
Djalainia S, Do HP, Dokova K, Doku DT, Dorsey ER, dos Santos KPB, Driscoll TR,
Dubey M, Duncan BB, Ebel BE, Echko M, El-Khatib ZZ, Enayati A, Endries AY, Ermakov
SP, Erskine HE, Eshetie S, Eshrati B, Esteghamati A, Estep K, Fanuel FBB, Farag T, Farinha
CSES, Faro A, Farzadfar F, Fazeli MS, Feigin VL, Feigl AB, Fereshtehnejad S-M, Fernandes
JC, Ferrari AJ, Feyissa TR, Filip I, Fischer F, Fitzmaurice C, Flaxman AD, Foigt N, Foreman
KJ, Franklin RC, Frostad JJ, Fullman N, Fürst T, Furtado JM, Futran ND, Gakidou E, Garcia-
Basteiro AL, Gebre T, Gebregergs GB, Gebrehiwot TT, Geleijnse JM, Geleto A, Gemechu BL,
Gesesew HA, Gething PW, Ghajar A, Gibney KB, Gillum RF, Ginawi IAM, Gishu MD,
Giussani G, Godwin WW, Goel K, Goenka S, Goldberg EM, Gona PN, Goodridge A, Gopalani
SV, Gosselin RA, Gotay CC, Goto A, Goulart AC, Graetz N, Gugnani HC, Gupta PC, Gupta R,
Gupta T, Gupta V, Gupta R, Gutiérrez RA, Hachinski V, Hafezi-Nejad N, Hailu AD, Hailu GB,
Hamadeh RR, Hamidi S, Hammami M, Handal AJ, Hankey GJ, Hao Y, Harb HL, Hareri HA,
398 References
Haro JM, Harun KM, Harvey J, Hassanvand MS, Havmoeller R, Hay RJ, Hedayati MT,
Hendrie D, Henry NJ, Heredia-Pi IB, Heydarpour P, Hoek HW, Hoffman HJ, Horino M,
Horita N, Hosgood HD, Hostiuc S, Hotez PJ, Hoy DG, Htet AS, Hu G, Huang JJ, Huynh C,
Iburg KM, Igumbor EU, Ikeda C, Irvine CMS, Islam SMS, Jacobsen KH, Jahanmehr N,
Jakovljevic MB, James P, Jassal SK, Javanbakht M, Jayaraman SP, Jeemon P, Jensen PN,
Jha V, Jiang G, John D, Johnson CO, Johnson SC, Jonas JB, Jürisson M, Kabir Z, Kadel R,
Kahsay A, Kamal R, Kar C, Karam NE, Karch A, Karema CK, Karimi SM, Karimkhani C,
Kasaeian A, Kassa GM, Kassaw NA, Kassebaum NJ, Kastor A, Katikireddi SV, Kaul A,
Kawakami N, Keiyoro PN, Kemmer L, Kengne AP, Keren A, Kesavachandran CN, Khader
YS, Khalil IA, Khan EA, Khang Y-H, Khoja AT, Khosravi A, Khubchandani J, Kiadaliri AA,
Kieling C, Kim YJ, Kim D, Kimokoti RW, Kinfu Y, Kisa A, Kissimova-Skarbek KA,
Kissoon N, Kivimaki M, Knudsen AK, Kokubo Y, Kolte D, Kopec JA, Kosen S, Kotsakis
GA, Koul PA, Koyanagi A, Kravchenko M, Krohn KJ, Kumar GA, Kumar P, Kyu HH, Lager
ACJ, Lal DK, Lalloo R, Lallukka T, Lambert N, Lan Q, Lansingh VC, Larsson A, Leasher JL,
Lee PH, Leigh J, Leshargie CT, Leung J, Leung R, Levi M, Li Y, Li Y, Liang X, Liben ML, Lim
SS, Linn S, Liu PY, Liu A, Liu S, Liu Y, Lodha R, Logroscino G, Looker KJ, Lopez AD,
Lorkowski S, Lotufo PA, Lozano R, Lucas TCD, Lunevicius R, Lyons RA, Macarayan ERK,
Maddison ER, El Razek HMAMA, El Razek MMA, Magis-Rodriguez C, Mahdavi M,
Majdan M, Majdzadeh R, Majeed A, Malekzadeh R, Malhotra R, Malta DC, Mamun AA,
Manguerra H, Manhertz T, Mantovani LG, Mapoma CC, March LM, Marczak LB, Martinez-
Raga J, Martins PHV, Martins-Melo FR, Martopullo I, März W, Mathur MR, Mazidi M,
McAlinden C, McGaughey M, McGrath JJ, McKee M, Mehata S, Meier T, Meles KG,
Memiah P, Memish ZA, Mendoza W, Mengesha MM, Mengistie MA, Mengistu DT, Mensah
GA, Meretoja TJ, Meretoja A, Mezgebe HB, Micha R, Millear A, Miller TR, Minnig S,
Mirarefin M, Mirrakhimov EM, Misganaw A, Mishra SR, Mitchell PB, Mohammad KA,
Mohammadi A, Mohammed MSK, Mohammed KE, Mohammed S, Mohan MBV, Mokdad
AH, Mollenkopf SK, Monasta L, Hernandez JCM, Montico M, Moradi-Lakeh M, Moraga P,
Morawska L, Mori R, Morrison SD, Moses M, Mountjoy-Venning C, Mruts KB, Mueller UO,
Muller K, Murdoch ME, Murthy GVS, Murthy S, Musa KI, Nachega JB, Nagel G, Naghavi M,
Naheed A, Naidoo KS, Nangia V, Nasher JT, Natarajan G, Negasa DE, Negoi RI, Negoi I,
Newton CR, Ngunjiri JW, Nguyen CT, Le Nguyen Q, Nguyen TH, Nguyen G, Nguyen M,
Nichols E, Ningrum DNA, Nong VM, Norheim OF, Norrving B, Noubiap JJN, Nyandwi A,
Obermeyer CM, O’Donnell MJ, Ogbo FA, Oh I-H, Okoro A, Oladimeji O, Olagunju AT,
Olagunju TO, Olsen HE, Olusanya BO, Olusanya JO, Ong K, Opio JN, Oren E, Ortiz A,
Osborne RH, Osgood-Zimmerman A, Osman M, Ota E, Owolabi MO, Mahesh PA, Pacella RE,
Panda BK, Pandian JD, Papachristou C, Park E-K, Parry CD, Parsaeian M, Patil ST, Patten SB,
Patton GC, Paudel D, Paulson K, Pearce N, Pereira DM, Perez KM, Perico N, Pesudovs K,
Peterson CB, Petri WA, Petzold M, Phillips MR, Phipps G, Pigott DM, Pillay JD, Pinho C,
Piradov MA, Plass D, Pletcher MA, Popova S, Poulton RG, Pourmalek F, Prabhakaran D,
Prasad N, Purcell C, Purwar M, Qorbani M, Quintanilla BPA, Rabiee RHS, Radfar A, Rafay A,
Rahimi K, Rahimi-Movaghar A, Rahimi-Movaghar V, Rahman MHU, Rahman MA,
Rahman M, Rai RK, Rajsic S, Ram U, Ranabhat CL, Rangaswamy T, Rankin Z, Rao PV,
Rao PC, Rawaf S, Ray SE, Reiner RC, Reinig N, Reitsma M, Remuzzi G, Renzaho AMN,
Resnikoff S, Rezaei S, Ribeiro AL, Rivas JC, Roba HS, Robinson SR, Rojas-Rueda D, Rokni
MB, Ronfani L, Roshandel G, Roth GA, Rothenbacher D, Roy A, Rubagotti E, Ruhago GM,
Saadat S, Safdarian M, Safiri S, Sagar R, Sahathevan R, Sahraian MA, Salama J, Saleh MM,
Salomon JA, Salvi SS, Samy AM, Sanabria JR, Sanchez-Niño MD, Santomauro D, Santos JV,
Santos IS, Santric Milicevic MM, Sartorius B, Satpathy M, Sawhney M, Saxena S,
Schelonka K, Schmidt MI, Schneider IJC, Schöttker B, Schutte AE, Schwebel DC,
Schwendicke F, Seedat S, Sepanlou SG, Servan-Mori EE, Shaheen A, Shaikh MA,
Shamsipour M, Sharma R, Sharma J, She J, Shi P, Shibuya K, Shields C, Shifa GT, Shiferaw
MS, Shigematsu M, Shiri R, Shirkoohi R, Shirude S, Shishani K, Shoman H, Siabani S, Sibai
AM, Sigfusdottir ID, Silberberg DH, Silva DAS, Silva JP, Silveira DGA, Singh JA, Singh OP,
References 399
Singh NP, Singh V, Sinha DN, Skiadaresi E, Slepak EL, Smith DL, Smith M, Sobaih BHA,
Sobngwi E, Soljak M, Sorensen RJD, Sousa TCM, Sposato LA, Sreeramareddy CT,
Srinivasan V, Stanaway JD, Stathopoulou V, Steel N, Stein DJ, Steiner C, Steinke S, Stokes
MA, Stovner LJ, Strub B, Subart M, Sufiyan MB, Sunguya BF, Sur PJ, Swaminathan S, Sykes
BL, Sylte D, Szoeke CEI, Tabarés-Seisdedos R, Tadakamadla SK, Taffere GR, Takala JS,
Tandon N, Tanne D, Tarekegn YL, Tavakkoli M, Taveira N, Taylor HR, Tegegne TK, Tehrani-
Banihashemi A, Tekelab T, Terkawi AS, Tesfaye DJ, Tesssema B, Thakur JS, Thamsuwan O,
Theadom AM, Theis AM, Thomas KE, Thomas N, Thompson R, Thrift AG, Tobe-Gai R,
Tobollik M, Tonelli M, Topor-Madry R, Tortajada M, Touvier M, Traebert J, Tran BX,
Troeger C, Truelsen T, Tsoi D, Tuzcu EM, Tymeson H, Tyrovolas S, Ukwaja KN, Undurraga
EA, Uneke CJ, Updike R, Uthman OA, Chudi Uzochukwu BS, van Boven JFM, Varughese S,
Vasankari T, Veerman LJ, Venkatesh S, Venketasubramanian N, Vidavalur R, Vijayakumar L,
Violante FS, Vishnu A, Vladimirov SK, Vlassov VV, Vollset SE, Vos T, Wadilo F, Wakayo T,
Wallin MT, Wang Y-P, Weichenthal S, Weiderpass E, Weintraub RG, Weiss DJ, Werdecker A,
Westerman R, Whiteford HA, Wijeratne T, Williams HC, Wiysonge CS, Woldeyes BG, Wolfe
CDA, Woodbrook R, Woolf AD, Workicho A, Xavier D, Xu G, Yadgir S, Yaghoubi M,
Yakob B, Yan LL, Yano Y, Ye P, Yihdego MG, Yimam HH, Yip P, Yonemoto N, Yoon S-J,
Yotebieng M, Younis MZ, Yu C, Zaidi Z, Zaki MES, Zegeye EA, Zenebe ZM, Zhang X,
Zheng Y, Zhou M, Zipkin B, Zodpey S, Zoeckler L, Zuhlke LJ, Murray CJL (2017) Global,
regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and
healthy life expectancy (HALE) for 195 countries and territories, 1990–2016: a systematic
analysis for the Global Burden of Disease Study 2016. Lancet 390(10100):1260–1344. https://
doi.org/10.1016/S0140-6736(17)32130-X
Heggenhougen HK, Veronica H, Pramila V (2003) An introduction and annotated bibliography: an
introduction and annotated bibliography. TDR/STR/SEB/VOL/03.1, pp 1–214
Hehir P (1927) Malaria in India. Humphrey Milford, Oxford University Press, London. 490 pp
Heron AM (1938) On the physiography of Rajaputana. In: Abstr. pap Indian sci cong assoc,
Calcutta, p 8
Herrel N, Amerasinghe FP, Ensink J, Mukhtar M, van der Hoek W, Konradsen F (2001) Breeding
of Anopheles mosquitoes in irrigated areas of south Punjab, Pakistan. Med Vet Entomol 15:236–
248
Hoshen MB, Morse AP (2004) A weather-driven model of malaria transmission. Malar J 3:32.
https://doi.org/10.1186/1475-2875-3-32
Humphreys RK, Ruxton GD (2018) A review of thanatosis (death feigning) as an anti-predator
behaviour. Behav Ecol Sociobiol 72(2):22. https://doi.org/10.1007/s00265-017-2436-8
Hunt RH, Coetzee M, Fettene M (1998) The Anopheles gambiae complex: a new species from
Ethiopia. Trans Roy Soc Trop Med Hyg 92(2):231–235. https://doi.org/10.1016/S0035-9203
(98)90761-1
Igweh JC (2012) Biology of malaria parasites. In: Okwa OO (ed) Malaria parasites. IntechOpen,
London [Online]. Available from https://www.intechopen.com/books/971. https://doi.org/10.
5772/1477
Ishtiaq F, Swain S, Kumar SS (2021) Anopheles stephensi (Asian Malaria Mosquito). Trends
Parasitol 37(6):571–572. https://doi.org/10.1016/j.pt.2021.03.009
Islam J, Zaman K, Duarah S, Raju PS, Chattopadhyay P (2017) Mosquito repellents: an insight into
the chronological perspectives and novel discoveries. Acta Tropica 167:216–230. https://doi.
org/10.1016/j.actatropica.2016.12.031
IvyPanda (2022) The epidemiology of human malaria in Africa. https://ivypanda.com/essays/
analytical-epidemiological-literature-review-malaria-an-epidemic-in-africa/
Jain R (1994) Mosquitoes storm the desert: a cerebral malaria epidemics in Rajasthan has its source
in the Indra Gandhi Canal. Down To Earth, Nov. 30, pp 5–7
Jairajpuri MS (1991) Animal resources of India: protozoa to mammalia—State of Art. Zoological
Survey of India. 691 pp
400 References
Jaswant Singh SAS (1933) Some observations on the mosquitoes and sandflies of Rajputana. Rec
Malar Surv India 3:579–581
Jones AE, Morse AP (2010) Application and validation of a seasonal ensemble prediction system
using a dynamic malaria model. J Climate 23:4202–4215
Jude PJ, Dharshini S, Vinobaba M, Surendran SN, Ramasamy R (2010) Anopheles culicifacies
breeding in brackish waters in Sri Lanka and implications for malaria control. Malar J 9(1):106
Kandasamy C (2021) DEPA (N,N-diethyl phenylacetamide): commercial journey of India’s first
indigenous mosquito repellent with novel properties. In: Tyagi BK (ed) Genetically modified
and other innovative vector control technologies eco-bio-social considerations for safe applica-
tion. Springer, Singapore, pp 369–378. 449 pp
Kar I, Subbarao SK, Eapen A, Ravindran J, Satyanarayana TS, Raghavedra K, Nanda N, Sharma
VP (1999) Evidence for a new malaria vector species, species E, within the Anopheles
culicifacies complex (Diptera: Culicidae). J Med Entomol 36(5):595–600. https://doi.org/10.
1093/jmedent/36.5.595. PMID: 10534953
Karim AM, Hussain I, Malik SK, Lee JH, Cho IH, Kim YB, Lee SH (2016) Epidemiology and
clinical burden of malaria in the war-torn area, Orakzai Agency in Pakistan. PLoS Negl Trop Dis
10:e0004399. https://doi.org/10.1371/journal.pntd.0004399
Kaur SD, Singh L (2017) Identification of mosquitoes, nature of diseases and treatment in early
Sanskrit literature. Indian J Hist Sci 52(3):243–250. https://doi.org/10.16943/ijhs/2017/v52i3/
49156
Keiser J, Utzinger J, de Castro MC, Smith TA, Tanner M, Singer BH (2004) Urbanization in
sub-Saharan Africa and malaria control. Am J Trop Med Hyg 71(2 suppl):118–127
Khan J, Gholizadeh S, Zhang M, Zhang D, Wu Y, Zheng X, Zhongdao W (2020) Morphological
and molecular characterization of ‘var. mysorensis’ form of Anopheles stephensi. Res
Sq. https://doi.org/10.21203/rs.3.rs-52599/v1
Khan J, Gholizadeh S, Zhang D, Wang G, Guo Y, Zheng X, Wu Z, Wu Y (2022) Identification of a
biological form in the Anopheles stephensi laboratory colony using the odorant-binding protein
1 intron I sequence. PLoS One 17(2):e0263836. https://doi.org/10.1371/journal.pone.0263836
Khatri TD (1991) Chloroquine resistant Plasmodium falciparum malaria in Rajasthan. J Assoc Phys
India 39:926–928
Kiauta B (1968) Variation in size of the dragonefly m-chromosome, with considerations on its
significance for the chorogeography and taxonomy of the order odonata, and notes on the
validity of the rule of Reinig. Genetica 39:64–74. https://doi.org/10.1007/BF02324456
Kibret S, Wilson GG, Tekie H, Petros B (2014) Increased malaria transmission around irrigation
schemes in Ethiopia and the potential of canal water management for malaria vector control.
Malar J 13:360. https://doi.org/10.1186/1475-2875-13-360. PMID: 25218697; PMCID:
PMC4182787
Kifle MM, Teklemariam TT, Teweldeberhan AM, Tesfamariam EH, Andegiorgish AK, Kidane EA
(2019) Malaria risk stratification and modeling the effect of rainfall on malaria incidence in
Eritrea. J Environ Public Health 2019(1D):1–11. https://doi.org/10.1155/2019/7314129
Kiszewski A, Mellinger A, Spielman A, Malaney P, Sachs SE, Sachs J (2004) A global index
representing the stability of malaria transmission. Am J Trop Med Hyg 70:486–498
Kiszewski AE, Teffera Z, Wondafrash M, Ravesi M, Pollack RJ (2014) Ecological succession and
its impact on malaria vectors and their predators in borrow pits in western Ethiopia. J Vector
Ecol 39(2):414–423. https://doi.org/10.1111/jvec.12117. PMID: 25424271
Kochar DK (2001) Cerebral malaria in Indian adult: a prospective study of 441 patients from
Bikaner (Northwestern India). Abstr pap fifteenth natl congr parasitol, Jodhpur. p 191
Kochar DK, Subhakaran, Kochar SK, Vyas SP (1997a) Vitreous haemorrhage in falciparum
malaria. J Assoc Phys India 45:670
Kochar DK, Kumawat BL, Subhakaran, Kochar SK, Agarwal RP (1997b) Severe and complicated
malaria in Bikaner (Rajasthan), western India. South East Asia J Trop Med Public Health 28:
259–267
References 401
Kochar DK, Kumawat BL, Thanvi I, Subhakaran, Agarwal N (1998a) Importance of blood glucose
level at the time of admission in severe and complicated malaria. J Assoc Phys India 46:923–925
Kochar DK, Subhakaran, Kumawat BL, Kochar SK (1998b) Falciparum malaria presenting with
bilateral gangrene of feet who developed arrhythmia/ventricular fibrellation after quinine
therapy. Q J Med 91:246
Kochar DK, Subhakaran, Kumawat BL, Thanvi I, Joshi A, Vyas SP (1998c) Ophthalmoscopic
abnormalities in adults with falciparum malaria. Q J Med 91:845–852
Kochar DK, Shubhakaran, Kumawat BL, Thanvi I, Agrawal N (1999) Cerebellar syndrome in
Plasmodium falciparum malaria. QJM: Int J Med 92(4):233–234. https://doi.org/10.1093/
qjmed/92.4.233
Kochar DK, Subhakaran BL, Kumawat, Vyas SP (2000) Prognostic significance of eye-changes in
cerebral malaria. J Assoc Phys India 48:473–477
Kochar DK, Saxena V, Singh N, Kochar SK, Kumar SV, Das A (2005) Plasmodium vivax malaria.
Emerg Infect Dis 11(1):132–134. https://doi.org/10.3201/eid1101.040519
Kochar DK, Sirohi P, Kochar SK, Budania MP, Lakhotia JP (2007) Dynamics of malaria in
Bikaner, Rajasthan, India (1975–2006). J Vector Borne Dis 44:281–284
Kochar DK, Das A, Kochar SK, Saxena V, Sirohi P, Garg S, Kochar A, Khatri MP, Gupta V (2009)
Severe Plasmodium vivax malaria: a report on serial cases from Bikaner in northwestern India.
Am J Trop Med Hyg 80(2):194–198. PMID: 19190212
Kochar DK, Das A, Kochar A, Middha S, Acharya J, Tanwar GS, Gupta A, Pakalapati D, Garg S,
Saxena V, Subudhi AK, Boopathi PA, Sirohi P, Kochar SK (2010a) Thrombocytopenia in
Plasmodium falciparum, Plasmodium vivax and mixed infection malaria: a study from Bikaner
(Northwestern India). Platelets 21(8):623–627. https://doi.org/10.3109/09537104.2010.505308
Kochar DK, Tanwar GS, Khatri PC, Kochar SK, Sengar GS, Gupta A, Kochar A, Middha S,
Acharya J, Saxena V, Pakalapati D, Garg S, Das A (2010b) Clinical features of children
hospitalized with malaria—a study from Bikaner, northwest India. Am J Trop Med Hyg
83(5):981–989. https://doi.org/10.4269/ajtmh.2010.09-0633
Kochar DK, Tanwar GS, Agrawal R, Kochar S, Tanwar G, Kochar FS, Kochar A, Middha S,
Kochar SK (2012) Platelet count and parasite density: independent variable in Plasmodium
vivax malaria. J Vector Borne Dis 49(September):191–192
Kochar DK, Das A, Kochar A, Middha S, Acharya J, Tanwar GS, Pakalapati D, Subudhi AK,
Boopathi PA, Garg S, Kochar SK (2014) A prospective study on adult patients of severe malaria
caused by Plasmodium falciparum, Plasmodium vivax and mixed infection from Bikaner,
northwest India. J Vector Borne Dis 51(3):200–210
Koné D, Coulibaly D, Doumbo O, Fall I-S, Kibuchi E, Mitto B, Sang G, Kyalo D, Snow RW, Noor
AM (2015) An epidemiological profile of malaria in Mali. Programme National de Lutte contre
le Paludisme (PNLP), Ministère de la Santé, Bamako, Mali; Malaria Research and Training
Center, University of Sciences, Techniques and Technologies, Bamako, Mali; The INFORM
Project (www.inform-malaria.org) Kenya Medical Research Institute - Wellcome Trust
Programme Nairobi, Kenya. 88 pp
Konradsen F, Amerasinghe FP, van der Hoek W, Amerasinghe PH (2000) Malaria in Sri Lanka:
current knowledge on transmission and control. International Water Management Institute,
Colombo. 77 pp
Korgaonkara MS, Cooperb NJ, Williamsa LM, Grievea SM (2012) Mapping inter-regional con-
nectivity of the entire cortex to characterize major depressive disorder: a whole-brain diffusion
tensor imaging tractography study. NeuroReport 23:566–571
Krishnan MS (1952) Geological history of Rajasthan and the present day conditions. Bull Natl Inst
India 1:19–31
Krishnan KS (1954) Malaria vectors of India. IV. Anopheles stephensi Liston, 1901. Bull Natl Soc
India Malar Other Mosq Borne Dis 2:97–109
Kumar A, Sharma VP, Thavaselvami D, Sumodan PK (1995) Control of Anopheles stephensi
breeding in construction sites and abandoned overhead tanks with Bacillus thuringiensis var.
israelensis. J Am Mosq Control Assoc 11(1):86–89
402 References
Kumar NP, Rajavel AR, Natarajan R, Jambulingam P (2007) DNA barcodes can distinguish species
of Indian mosquitoes (Diptera: Culicidae). J Med Entomol 44:01–07
Kweka EJ (2022) Anopheles stephensi: a guest to watch in urban Africa. Trop Dis Travel Med
Vaccines 8. https://doi.org/10.1186/s40794-022-00165-7
Lal S, Sonal GS, Phukan PK (2000) Status of malaria in India. J Indian Acad Clin Med 5(1):19–23
Laneri K, Bhadra A, Ionides EL, Bouma M, Dhiman RC et al (2010) Forcing versus feedback:
epidemic malaria and monsoon rains in Northwest India. PLoS Comput Biol 6(9):e1000898.
https://doi.org/10.1371/journal.pcbi.1000898
Languillon J (1957) Epidemiological map of malaria in Cameroon [in French]. Bull Soc Exot Pathol
Exot Its Subsidiaries 50:585–601
Laveran A (1880) Note sur un nouveau parasite trouvé dans le sang de plusieurs malades atteints de
fièvre palustres. Bull Acad Med 9:1235–1236
Laveran A (1884) Traitè des Fièvres Palustres. Doin, Paris
Lekweiry KM, Abdallahi MO, Ba H, Arnathau C, Durand P, Trape J-F, Salem AOM (2009)
Preliminary study of malaria incidence in Nouakchott, Mauritania. Malar J 8:92. https://doi.
org/10.1186/1475-2875-8-92
Lekweiry KM, Basco L, Salem MSOA, Hafid JE, Marin-Jauffre A, Bouchiba H, Gaillard T,
Wurtz N, Weddih AO, Briolant S, Bogreau H, Pradines B, Rogier C, Pages F, Cotteaux C
(2011) Malaria prevalence, morbidity and drug resistance in Nouakchott, Mauritania. Trop Med
Int Health 16 Suppl 1:136–137
Lekweiry KM, Salem MSOA, Basco LK, Briolant S, Hafid J, Boukhary AOMS (2015) Malaria in
Mauritania: retrospective and prospective overview. Malar J 14:100. https://doi.org/10.1186/
s12936-015-0607-5
Lemrabott OMA, Le Goff G, Kengne P, Ndiaye O, Costantini C, Lekweiry KM, Salem OMSA,
Robert V, Basco L, Simard F, Boukhary AOMS (2020) First report of Anopheles (Cellia)
multicolor during a study of tolerance to salinity of Anopheles arabiensis larvae in Nouakchott,
Mauritania. Parasit Vectors 13:522. https://doi.org/10.1186/s13071-020-04400-y
Lewis RA (1966) Early irrigation in west Turkestan. Ann Assoc Am Geogr 56:467–491
Lindsay SW, Martens WJM (1998) Malaria in the African highlands: past, present and future. Bull
World Health Org 76(1):33–45
Liston WG (1901) A year’s experience of the habits of Anopheles in Ellichpur. The description of
the species found in Ellichpur during the year. Ind Med Gaz 36:361–366
Louw GN, Seely MK (1982) Ecology of desert organisms, vol VI. Longman, London, 194 pp
Lucose NC (1972) Palynology of the sub-surface sediment of Manfera Tibba structure, Jaisalmer,
Western Rajasthan. Palaeobotanist 21:285–297
MacDonald G (1931) Report on a malaria survey in Bikaner State. Rec Malar Surv India 2:603–617
MacDonald G (1957) The epidemiology and control of malaria. Oxford University Press, London
MacDonald G, Cuellar CB, Foll CV (1968) The dynamics of malaria. Bull World Health Org 38(5):
743–755. PMID: 5303328; PMCID: PMC2554677
Mack SR, Samuels S, Vanderberg JP (1979) Hemolymph of Anopheles stephensi from uninfected
and Plasmodium berghei-infected mosquitoes. 2. Free amino acids. J Parasitol 65(1):
130–136. PMID: 376812
Malaria Atlas Project (MAP). https://malariaatlas.org/. Accessed 1 Sept 2020
Malhotra SP (1988) Man and the desert. In: Prakash I (ed) Desert ecology. Scientific Publishers,
Jodhpur, pp 37–64
Malhotra PR, Jatav PC, Chauhan RS (2000) Surface morphology of the egg of Anopheles stephensi
stephensi sensu stricto (Diptera, Culicidae). Ital J Zool 67(2):147–151. https://doi.org/10.1080/
11250000009356307. Taylor & Francis
Manguin S (2013) Anopheles mosquitoes—new insights into malaria vectors. InTech, Croatia.,
813 pp. https://doi.org/10.5772/3392
Mann HS (1978) The Indian desert—a profile. In: Mann HS (ed) Arid zone research in India.
Central Arid Zone Research Institute, Jodhpur, pp 1–6
References 403
Manouchehri AV, Javadian E, Eshghy N, Motabar M (1976) Ecology of Anopheles stephens Liston
in Southern Iran. Trop Geogr Med 28:228–232
Mathur HC (1990) Management of severe falciparum malaria in children. Rajasthan Med J 29:195–
196
Mathur KK, Harpalani G, Kalra NL, Murthy GG, Narasimham MV (1992) Epidemic of malaria in
Barmer district (Thar desert) of Rajasthan during 1990. Indian J Malariol 29(1):1–10
Mattingly PF, Knight KL (1956) The mosquito of Arabia I. Bull Br Mus (Nat Hist) Entomol 4:91–
141
Maurice J, Pearce AM (1987) Tropical disease research: a global partnership. World Health
Organization, Geneva
May JM (1951) Map of the world distribution of malaria vectors. Geogr Rev 41:638–639
Medlock JM, Hansford KM, Schaffner F, Versteirt V, Hendrickx G, Zeller H, Bortel WV (2012) A
review of the invasive mosquitoes in Europe: ecology, public health risks, and control options.
Vector Borne Zoon Dis 12:435–447
Mehravaran A, Vatandoost H, Oshaghi MA, Abai MR, Edalat H, Javadian E, Mashayekhi M,
Piazak N, Hanafi-Bojd AA (2012) Ecology of Anopheles stephensi in a malarious area,
southeast of Iran. Acta Med Iran 50(1):61–65
Mehta SC (1962) The National Malaria Eradication Programme—an introductory speech.
Rajasthan Med J 2:219–221
Memish ZA, Alzahrani M, Alhakeem RF, Bamgboye EA, Smadi HN (2014) Toward malaria
eradication in Saudi Arabia: evidence from 4-year surveillance in Makkah. Ann Saudi Med
34(2):153–158. https://doi.org/10.5144/0256-4947.2014.153
Mishra A (2003) Water use: traditional systems and practices. Water Harvesting and Management,
Swiss Agency for Development and Cooperation
Mnzava A, Monroe AC, Okumu F (2022) Anopheles stephensi in Africa requires a more integrated
response. Malar J 21:156. https://doi.org/10.1186/s12936-022-04197-4
Mohanna K, Chambers R, Wall D (2007) Developing your teaching style: increasing effectiveness
in healthcare teaching. Postgrad Med J 83(977):145–147. https://doi.org/10.1136/pgmj.2006.
054106
Molvaer RK (1982) Processes of change involving appropriate technology. UNICEF CARU,
Nairobi, Kenya
Mouchet J, Carnevale P, Coosemans M, Julvez J, Manguin S, RichardLenoble D, Sircoulon J
(2004) Biodiversité du paludisme dans le monde Montrouge. John Libbey Eurotext, France
Moukah MO, Ba O, Ba H, Khairy MLO, Faye O, Bogreau H, Simard F, Basco LK (2016) Malaria
in three epidemiological strata in Mauritania. Malar J 15:204. https://doi.org/10.1186/s12936-
016-1244-3
Mukhamdejanov AR (1994) Economy and social system in Central Asia in the Kushan Age. In:
Harmatta J, Puri BN, Etemadi GF (eds) The history of civilizations of Central Asia, vol. II: the
development of sedentary and nomadic cultures. UNESCO, Paris, pp 265–290
Mukhopadhyay S, Tiwari R, Shetty P, Gogtay NJ, Thatte UM (2019) Modeling and forecasting
Indian malaria incidence using generalized time series models. Commun Stat Case Stud Data
Anal Appl 5(2):111–120. https://doi.org/10.1080/23737484.2019.1580629
Murdoch D (2021) Diseases potentially acquired by travel to North Africa. UpToDate. Literature
review current through: Apr 2022. | This topic last updated: Feb 24, 2021. https://www.
wolterskluwer.com/en/know/clinical-effectiveness-terms
Mutero CM, Blank H, Konradsen F, van der Hoek W (2000) Water management for controlling the
breeding of Anopheles mosquitoes in rice irrigation schemes in Kenya. Acta Trop 3:253–263
Mwakalinga VM, Sartorius BKD, Limwagu AJ, Mlacha YP, Msellemu DF, Chaki PP, Govella NJ,
Coetzee M, Dongus S, Killeen GF (2018) Topographic mapping of the interfaces between
human and aquatic mosquito habitats to enable barrier targeting of interventions against malaria
vectors. R Soc Open Sci 5(5):161055. https://doi.org/10.1098/rsos.161055
404 References
Naddaf SR, Oshaghi MA, Vatandoost H, Assmar M (2003) Molecular characterization of Anophe-
les fluviatilis species complex in the Islamic Republic of Iran. East Mediterr Health J 9(3):
257–265
Nair CP, Samnotra KG (1967) A note on urban malaria, Broach Town Gujrat State, India. Bull Natl
Soc India Malar Mosq Borne Dis 4:285–295
Najera E, Liese BH, Hammer J (1992) Malaria, new patterns and perspectives. World Bank
Technical Paper No. 183
Najera JA, Kouznetzsov RL, Delacollette C (1998) Malaria epidemics : detection and control;
forecasting and prevention. WHO/MAL/98. 1084, 81 pp
Nauen R (2007) Insecticide resistance in disease vectors of public health importance. Pest Manag
Sci 63:628–633
Nazari N, Hamzavi Y, Rezaei M, Khoshbo P (2022) A brief review of malaria epidemiological
trend in Kermanshah province, Iran, 1986–2014. J Med Life 15(3):393–396. https://doi.org/10.
25122/jml-2021-0374
Ndiath MO, Cailleau A, Orlandi-Pradines E, Bessell P, Pagès F, Trape Jean-François, Rogier C
(2015) Emerging knock-down resistance in Anopheles arabiensis populations of Dakar,
Senegal: first evidence of a high prevalence of kdr-e mutation in West African urban area.
Malar J 14: 364. https://doi.org/10.1186/s12936-015-0898-6
Nema S, Ghanghoria P, Bharti PK (2020) Malaria elimination in India: bridging the gap between
control and elimination. Indian Pediatr 57(7):613–617. https://doi.org/10.1007/s13312-020-
1888-5
Neogi BP, Sen AK (1962) Anopheles stephensi as a carrier in rural Bengal. Indian J Malarial 10:
183–197
Nicholls N (1993) El Nino Southern Oscillation and vector borne diseases. Lancet 343:1284–1285
NMEP (1985) In-depth evaluation report of the modified plan of operation under National Malaria
Eradication Programme of India. NMEP, Ministry of Health & Family Planning, Government of
India, Delhi. 52 pp
Oshaghi MA, Shemshad K, Yaghobi-Ershadi MR, Pedram M, Vatandoost H, Abaie MR,
Akbarzadeh K, Mohtarami F (2007) Genetic structure of the malaria vector Anopheles
superpictus in Iran using mitochondrial cytochrome oxidase (COI and COII) and morphologic
markers: a new species complex. Acta Trop 101:241–248. https://doi.org/10.1016/j.actatropica.
2007.02.006
Padhiary KN, Behera BG, Parida G, Das SP (1996) Neurological complications of falciparum
malaria. J Assoc Phys India 44:910–911
Pampana E (1969) Textbook of malaria eradication, 2nd edn. Oxford University Press, Oxford
Panagaria S, Mehta SR (1975) Modern trends in therapy of malaria. Rajasthan Med J 15:1–3
Pant G, Hingane LS (1988) Climatic changes in and around the Rajasthan desert during the 20th
century. J Climatol 8:391–401
Parham PE, Michael E (2010) Modeling the effects of weather and climate change on malaria
transmission. Environ Health Perspect 118:620–626
Park KS, Malik SK, Lee JH, Karim AM, Lee SH (2018) Commentary: malaria elimination in India
and regional implications. Front Microbiol 9. https://doi.org/10.3389/fmicb.2018.00992
Patz JA, Frumkin H, Holloway T, Vimont DJ, Haines A (2014) Challenges and opportunities for
global health. JAMA 312(15):1565–1580. https://doi.org/10.1001/jama.2014.13186
Pavillupillai JJ, Ramasamy R, Surendran SN (2014) Bionomic aspects of the Anopheles subpictus
species complex in Sri Lanka. J Insect Sci 14(1):97. https://doi.org/10.1093/jis/14.1.97
Perkins LB, Nowak RS (2013) Invasion syndromes: hypotheses on relationships among invasive
species attributes and characteristics of invaded sites. J Arid Land 5:275–283. https://doi.org/10.
1007/s40333-013-0161-3
Piggot S (1950) Prehistoric India. Penguin Books, Harmondsworth
Pousibet-Puerto J, Lozano-Serrano AB, Soriano-Pérez MJ et al (2021) Migration-associated
malaria from Africa in southern Spain. Parasit Vectors 14:240. https://doi.org/10.1186/
s13071-021-04727-0
References 405
Prajapati M, Vangani NS, Ahuja LD (1973) In dry rangelands of western Rajasthan ‘Tanka’ can be
the answer. Indian Fmg 23(11):27–32
Price RN, von Seidlein L, Valecha N, Nosten F, Baird J, White NJ (2014) Global extent of
chloroquine-resistant Plasmodium vivax: a systematic review and meta-analysis. Lancet Inf
Dis 14(10):982–991. https://doi.org/10.1016/S1473-3099(14)70855-2
Prothero RM (2001) Migration and malaria risk. Health Risk Soc 3:19–38
Protopopoff N, Van Bortel W, Speybroeck N, Van Geertruyden J-P, Baza D, D’Alessandro U,
Coosemans M (2009) Ranking malaria risk factors to guide malaria control efforts in African
highlands. PLoS One 4(11):e8022. https://doi.org/10.1371/journal.pone.0008022
Pruthi HS, Bhatia DR (1952) Peculiarities of the insect fauna of the Rajasthan desert and the share
of insects in the maintenance of the desert. In: Proceedings of the symposium on the Rajputana
desert, pp 241–245
Puri IM (1949) Anophelines of the oriental region. In: Boyd MF (ed) Malariology. W.B. Sunders,
New York, pp 483–505
Puri IM (1955) The distribution of anopheline mosquitoes in India. Health Bulletin No. 17; Malaria
Bureau No. 7, Government of India, 104 pp
Puri IM (1960) Synoptic keys for the identification of the full grown larvae of the Indian anopheline
mosquitoes. Health Bulletin No. 16, Malaria Bureau No. 7, Government of India Press, Calcutta.
104 pp
Rajagopalan PK, Jambulingam P, Sabesan S, Krishnamoorthy K, Rajendran S, Gunasekaran K,
Kumar NP (1984) Population movement and malaria persistence in Rameswaram Island. ICMR
Bull 14(11):125–133. PMID: 12340211
Rajagopalan PK, Jambulingam P, Sabesan S, Krishnamoorthy K, Rajendran S, Gunasekaran K,
Kumar NP, Prothero RM (1986) Population movement and malaria persistence in Rameswaram
Island. Soc Sci Med 22(8):879–886. https://doi.org/10.1016/0277-9536(86)90242-x
Rajagopalan PK, Das PK, Kalyanasundaram M, Tyagi BK, Arunachalam N, Somachary N, Reddy
CBS, Reddy CMR (1987) Bangalore mosquito control project: master plan. Vector control
Research Centre, Pondicherry. 309 pp
Rajesh V, Elamaran M, Vidya S, Gowrishankar M, Kochar DK, Das A (2007) Plasmodium vivax:
genetic diversity of the apical membrane antigen-1 (AMA-1) in isolates from India. Exp
Parasitol 116(2007):252–256
Ramaiah TH (1980) Cost-benefit analysis of malaria control and eradication programme in India.
PSG Monograph No. 26, Public System Group. Indian Institute of Management, Ahmedabad.
78 pp
Ramakrishana YS, Rao AS (1991) Climatic features of the Indira Gandhi Canal region. In: Abrol IP,
Venkateshvaralu J (eds) Prospects of Indira Gandhi Canal Project. ICAR, New Delhi, pp 1–10
Ramnath T, Mathur ML, Lakshminarayana J (1995) Baseline Health Survey in three districts of
Rajasthan (1986-87). Desert Medicine Research Centre, Jodhpur. 184 pp
Ramsdale CD, de Zulueta J (1983) Anophelism in the Algerian Sahara and some implications of the
construction of a trans-Saharan highway. J Trop Med Hyg 86(2):51–58. PMID: 6887315
Randolph SE, Rogers DJ (2010) The arrival, establishment and spread of exotic diseases: patterns
and predictions. Nat Rev Microbiol 8:361–371
Ranjha R, Sharma A (2021) Forest malaria: the prevailing obstacle for malaria control and
elimination in India. BMJ. Global Health 6:e005391. https://doi.org/10.1136/bmjgh-
2021-005391
Rao TR (1984) The anopheline of India (revised edition). Malaria Research Centre, Indian Council
of Medical Research, New Delhi. 518 pp
Rao AS (1996) Climatic changes in the irrigated tracts of Indira Gandhi Canal region of arid western
Rajasthan, India. Ann Arid Zone 35:111–116
Rattanarithikul R, Konishi E, Linthicum KJ (1996) Detection of Plasmodium vivax and Plasmo-
dium falciparum circumsporozoite antigen in anopheline mosquitoes collected in southern
Thailand. Am J Trop Med Hyg 54:114–121
406 References
Raveendran S, Rakesh PS, Dev S, Prasannakumar P, Vijayakumar N (2016) Investigation of an

outbreak of malaria in a non-endemic coastal area, Kerala, Southern India. Int J Community
Med Public Health 3(12):3581–3583
Reeves LE, Medina J, Miqueli E, Sloyer KE, Petrie W, Vasquez C, Burkett-Cadena ND (2021)
Establishment of Aedes (Ochlerotatus) scapularis (Diptera: Culicidae) in Mainland Florida,
With Notes on the Ochlerotatus Group in the United States. J Med Entomol 58(2):717–729.
https://doi.org/10.1093/jme/tjaa250. PMID: 33225354
Reid JA (1966) A note on Anopheles subpictus Grassi and A. indefinitus Ludlow (Diptera:
Culicidae). J Med Entomol 3:327–331
Reinig WF (1938) Elimination und Selektion. Fischer, Jena
Reinig WF (1939) Die genetisch-chorologischen grundlagen der gerichteten geographischen
variabilität. Zeitschr indukt Abstamm u Vererb l 76:260–308
Reuben R, Kalyanasundaram M, Suguna SG (1984) Salinity tolerance of sibling species in the
taxon Anopheles subpictus Grassi, 1899. Indian J Med Res 80:67–70
Ross R (1897) On some peculiar pigmented cells found in two mosquitoes fed on malaria blood. Br
Med J 2:1786–1788
Ross R (1903) The extirpation of Culex at Ismailia. Nature 68:246–247. https://doi.org/10.1038/
068246e0
Roy TK (1983) Impact of Rajasthan canal project on social, economic and environmental
conditions. NCEAR, New Delhi. 179 pp
Roy BB, Pandey S (1970) Expansion or contraction of the Great Indian Desert. Proc Indian Natl Sci
Acad B36:331–343
Roy RG, Joy CT, Hussain CM, Ismail MK (1978) Malaria in Lakshadweep Islands. Indian J Med
Res 67:924–925
Roy M, Bouma M, Dhiman RC, Pascual M (2015) Predictability of epidemic malaria under
non-stationary conditions with process-based models combining epidemiological updates and
climate variability. Malar J 14:419. https://doi.org/10.1186/s12936-015-0937-3
Ruiz GM, Carlton JT (eds) (2003) Invasive species: vectors and management strategies. Island
Press, Washington, DC. xiii + 520 pp
Russell PF (1938) Malaria due to defective and untidy irrigation. A preliminary discussion. J Malar
Inst India 1:339–349
Russell PF, Menon MK (1942) A malario-economic survey in rural South India. Indian Med Gazz
77:167–180
Russell PF, Rao HR (1940) The Anopheles of rice fields in South Eastern Madras. J Malar Inst India
3:427–446
Russel PF, Knipe FW, Rao TR, Putnam P (1944) Some experiments on flight range of Anopheles
culicifacies. J Exp Zool 97:135–163
Rutledge LC, Gupta RK, Piper GN, Lowe CA (1994) Studies on the inheritance of repellent
tolerances in Aedes aegypti. J Am Mosq Control Assoc 10:93–100
Safi NHZ, Ahmadi AA, Nahzat S, Ziapour SP, Nikookar SH, Fazeli-Dinan M, Enayati A,
Hemingway J (2017) Evidence of metabolic mechanisms playing a role in multiple insecticides
resistance in Anopheles stephensi populations from Afghanistan. Malar J 16:100. https://doi.org/
10.1186/s12936-017-1744-9
Sarkar S, Bhattacharya P (2008) Cerebral malaria caused by Plasmodium vivax in adult subjects.
Indian J Crit Care Med 12(4):204–205. https://doi.org/10.4103/0972-5229.45084. PMID:
19742268; PMCID: PMC2738327
Sarkar S, Gangare V, Singh P, Dhiman RC (2019) Shift in potential malaria transmission areas in
India, using the fuzzy-based climate suitability malaria transmission (FCSMT) model under
changing climatic conditions. Int J Environ Res Public Health 16(18):3474. https://doi.org/10.
3390/ijerph16183474
Satvalekar SD (1958) Atharvaveda. Swadhaye Mandal, Pardi, p 1958
References 407
Saugeon C, Baldet T, Akogbeto M, Henry MC (2009) Will climate and demography have a major
impact on malaria in sub-Saharan Africa in the next 20 years? Med Trop 69(2):203–207.
[in French]
Sautet J, Ranque J, Vuillet F, Vuillet J (1948) Quelques notes parasitologiques sur le paludisme et
l’anophélisme en Mauritanie. Med Trop 8:32–39
Schaffner F, Medlock JM, Van Bortel W (2013) Public health significance of invasive mosquitoes
in Europe. Clin Microbiol Infect 19(8):685–692. https://doi.org/10.1111/1469-0691.12189
Schapira A, Boutsika K (2012a) Malaria ecotypes and stratification. Adv Parasitol 78:97–167
Schapira A, Boutsika K (2012b) Malaria ecotypes: their usefulness for stratification in current
malaria control and modeling. Malar J 11:P13. https://doi.org/10.1186/1475-2875-11-S1-P13
Service MW, Townson H (2002) The Anopheles vector. In: Gilles HM, Warrell DA (eds) Essential
malariology, 4th edn. Arnold, London, pp 59–84
Severini C, Menegon M, Di Luca M, Abdullaev I, Majori G, Razakov SA, Gradoni L (2004) Risk of
Plasmodium vivax malaria reintroduction in Uzbekistan: genetic characterization of parasites
and status of potential malaria vectors in the Surkhandarya region. Trans R Soc Trop Med Hyg
98:585–592. https://doi.org/10.1016/j.trstmh.2004.01.003
Seyfarth M, Khaireh BA, Abdi AA, Bouh SM, Faulde MK (2019) Five years following first
detection of Anopheles stephensi (Diptera: Culicidae) in Djibouti, Horn of Africa: populations
established-malaria emerging. Parasitol Res 118:725–732
Shahi AK, Chandra S, Tyagi BK, Kaul BL (1996) Conservation strategies for Cymbopogon species
of Indian Thar Desert. Abstr. Pap. XIV national symposium on agronomy, environment and
food security for 21st century. Indian Society for Agronomy and CCS Haryana Agr. Univ.,
Hissar, Dec. 11–13, 1996, pp 14–15
Shahi AK, Tyagi BK, Chaudhary RC, Kaul BL (2000) Cymbopogon schoenanthus (L.) Spreng.
(Poaceae)—a versatile aromatic and medicinal plant of Indian Thar Desert. Flavour Fragrance
Assoc India J 1:31–33
Sharma VN (1967) NMEP—a brief review for professional colleagues. Rajasthan Med J 7:43–47
Sharma GK (1986a) Malaria and its control in India, vol I. Directorate of National Malaria
Eradication Programme, Delhi. 347 pp
Sharma GK (1986b) Malaria and its control in India, vol III. Directorate of National Malaria
Eradication Programme, Delhi. 617 pp
Sharma YD (1995) Malaria menace. Nature 373:279
Sharma V (1996a) Malaria: cost to India and future trends. Southeast Asia J Trop Med Public
Health 27:4–14
Sharma VP (1996b) Re-emergence of malaria in India. Indian J Med Res 103:26–45
Sharma VP (1998) Fighting malaria in India. Curr Sci 75:1127–1140
Sharma VP (1999) Current scenario of malaria in India. Parasitologica 41:349–353
Sharma SK, Hamzakoya KK (2001) Geographical Spread of Anopheles stephensi, vector of urban
malaria, and Aedes aegypti, vector of dengue/DHF, in the Arabian Sea islands of Lakshadweep,
India. Dengue Bull 25:88–91
Sharma VP, Mehrotra KN (1986) Malaria resurgence in India: a critical study. Soc Sci Med 22:835–
845
Sharma GP, Parshad R, Narang SL, Kitzmiller JB (1969) The Salivary chromosomes of Anopheles
stephensi stephensi. J Med Ent 6(1):68–71
Sharma VP, Srivastava A, Nagpal BN (1994) A study of the relationship of rice cultivation and
annual parasite incidence of malaria in India. Soc Sci Med 38:165–178
Sharma R, Jagdev DK, Gehlot GS, Kothari K, Gupta SD, Jain TP, Kothari D (1995) Expert
committee on malaria: report. Medical & Health Department, Government of Rajasthan, Jaipur,
p 132
Sharma RS, Sharma GK, Dhillon GPS (1996a) Epidemiology and control of malaria in India.
National Malaria Eradication Programme (Directorate General of Health Services), Ministry of
Health & Family Welfare, Government of India, Delhi, 752 pp
408 References
Sharma YD, Biswas S, Pillai ER, Ansari MA, Adak T, Devi CU (1996b) High prevalence of
chloroquine resistant Plasmodium falciparum infection in Rajasthan epidemic. Acta Tropica 62:
135-MI
Sharma M, Devi SS, Laskar RH (2020) Automatic detection of malaria infected erythrocytes based
on the concavity point identification and pseudo-valley based thresholding. IETE J Res. https://
doi.org/10.1080/03772063.2020.1787238
Shayo FK, Keiko N, Al-Sobaihi S, Kaoruko S (2021) Is the source of domestic water associated
with the risk of malaria infection? Spatial variability and a mixed-effects multilevel analysis. Int
J Infect Dis 104:224–231. https://doi.org/10.1016/j.ijid.2020.12.062
Sher AA, Goldberg DE, Novoplansky A (2004) The effect of mean and variance in resource supply
on survival of annuals from Mediterranean and desert environments. Oecologia 141:353–362
Shukla RP, Pandey AC, Mathur A (1995) Investigation of malaria outbreak in Rajasthan. Indian J
Malariol 32(3):119–128
Sikka DR, Kulshrestha SM (2001) Climate and health studies: status and scope in India. Centre for
Ocean-Land-Atmosphere Studies/Centre for the Application of Research on the Environment,
Joint COLA/CARE Technical Report No. 5; 66 pp
Simmons SW, Upholt WM (1951) Insecticides in disease control; review of the literature. Boletin
de la Oficina Sanitaria Panamericana. Pan American Sanitary Bureau. 31
Singh P (2007) Report of the Task Force on Grasslands and Deserts. Wayback Machine, Govern-
ment of India Planning Commission, New Delhi
Singh KV, Bansal SK (2001) Present situation of insecticide resistance among anopheline vector
species in different parts of Rajasthan. Abstr. pap. fifteenth national congress of parasitology,
Jodhpur. 143 pp
Singh J, Puri IM (1951) Malaria incidental to engineering construction. Health Bulletin
No. 32, Malaria Bureau No. 12. Government of India Press, New Delhi. 62 pp
Singh N, Nagpal BN, Sharma VP (1985) Mosquitoes of Kutch, Gujarat. Indian J Malariol 22(1):
17–20. PMID: 2863183 101–12
Singh N, Mishra SS, Singh MP, Sharma VP (2000) Seasonality of Plasmodium vivax and
P. falciparum in tribal villages in central India (1987–1995). Ann Trop Med Parasitol 94(2):
101–112. https://doi.org/10.1080/00034980057446
Singh OP, Mishra S, Sindhania A, Kaur T, Sreehari U, Das MK, Sharma G (2021a) Evaluation of
odorant-binding protein-1 as a molecular marker for identifying biological forms and
delimitating sibling species of Anopheles stephensi. bioRxiv. https://doi.org/10.1101/2021.12.
03.470951
Singh H, Gupta SK, Vikram K, Saxena R, Sharma A (2021b) The impact of mosquito proof lids of
underground tanks “tanka” on the breeding of Anopheles stephensi in a village in western
Rajasthan, India. Malar J 20:412. https://doi.org/10.1186/s12936-021-03939-0
Singhvi AK, Kar A (1992) Thar Desert in Rajasthan: land, man and environment. Geological
Survey of India, Bangalore. 191 pp
Sinka ME (2013) Global distribution of the dominant vector species of malaria. Chapter 4. In:
Manguin S (ed) Anopheles mosquitoes—new insights into malaria vectors. Intech, Croatia, pp
109–144. https://doi.org/10.5772/54163
Sinka ME, Bangs MJ, Manguin S, Coetzee M, Mbogo CM, Hemingway J, Patil AP, Temperley
WH, Gething PW, Kabaria CW, Okara RM, Van Boeckel T, Godfray HCJ, Harbach RE, Hay SI
(2010) The dominant Anopheles vectors of human malaria in Africa, Europe and the
Middle East: occurrence data, distribution maps and bionomic précis. Parasit Vectors 3:117.
https://doi.org/10.1186/1756-3305-3-117
Sinka ME, Bangs MJ, Manguin S, Chareonviriyaphap T, Patil AP, Temperley WH, Gething PW,
Elyazar IR, Kabaria CW, Harbach RE, Hay SI (2011) The dominant Anopheles vectors of
human malaria in the Asia-Pacific region: occurrence data, distribution maps and bionomic
précis. Parasit Vectors 4:89. https://doi.org/10.1186/1756-3305-4-89
Sinka M, Bangs MJ, Manguin S, Rubio-Palis Y, Chareonviriyaphap T, Coetzee M, Mbogo CM,
Hemingway J, Patil AP, Temperley WH, Gething PW, Kabaria CW, Burkot TR, Harbach RE,
References 409
Hay SI (2012) A global map of dominant malaria vectors. Parasit Vectors 5:69. https://doi.org/
10.1186/1756-3305-5-69
Sinka ME, Pironon S, Massey NC, Longbottom J, Hemingway J, Moyes CL, Willis KJ (2020) A
new malaria vector in Africa: predicting the expansion range of Anopheles stephensi and
identifying the urban populations at risk. Proc Natl Acad Sci USA 117(40):24900–24908.
https://doi.org/10.1073/pnas.2003976117
Sinton JA (1935) What malaria costs India. Health Bull26; Malaria Bureau 13. Govt. of India Press,
Delhi
Sinton JA (1936) What malaria costs India, nationally, socially and economically? Rec Malar Surv
India 6(1):91–169
Smith DL, Dushoff J, Snow RW, Hay SI (2005) The entomological inoculation rate and Plasmo-
dium falciparum infection in African children. Nature 438(7067):492–495. https://doi.org/10.
1038/nature04024
Snow RW, Amratia P, Zamani G, Mundia CW, Noor AM, Memish ZA, Al Zahrani MH, Al
Jasari A, Fikri M, Atta H (2013) The malaria transition on the Arabian Peninsula: progress
toward a malaria-free region between 1960-2010. Adv Parasitol 82:205–251. https://doi.org/10.
1016/B978-0-12-407706-5.00003-4
Spielman A (2003) Foreword. In: Kristian HH, Veronica H, Pramila V (eds) An introduction and
annotated bibliography: an introduction and annotated bibliography. TDR/STR/SEB/VOL/03.1
Spielman A, D’Antonio M (2001) Mosquito: the story of man’s deadliest foe. Faber & Faber,
London. vi+247 pp
Sriwichai P, Longley R, Sattabongkot J (2016) Chapter 4—Ecology of malaria vectors and current
(nongenetic) methods of control in the Asia region. In: Adelman ZN (ed) Genetic control of
malaria and dengue. Academic, New York, pp 69–80. https://doi.org/10.1016/B978-0-12-
800246-9.00004-1
Subbarao SK (1988) The Anopheles culicifacies complex and control of malaria. Parasitol Today
4(3):72–75
Subbarao SK, Sharma VP (1997) Anopheline species complexes and malaria control. Indian J Med
Res 106:164–173
Subbarao SK, Vasantha K, Adak T, Sharma VP, Curtis CF (1987) Egg-float ridge number in
Anopheles Stephensi—ecological variation and genetic analysis. Med Vet Entomol 1:265–271.
https://doi.org/10.1111/J.1365-2915.1987.TB00353.X
Subbarao SK, Vasantha K, Raghuvendra K, Sharma VP, Sharma GK (1988) Anopheles culicifacies
sibling spaces composition and its relationship to malaria incidence. J Am Mosq Control Assoc
4:29–33
Subbarao SK, Nanda N, Raghavendra K (1999) Malariological stratification of India using Anoph-
eles culicifacies sibling species prevalence. ICMR Bull 29:75–80
Subbarao SK, Nanda N, Rahi M, Raghavendra K (2019) Biology and bionomics of malaria vectors
in India: existing information and what more needs to be known for strategizing elimination of
malaria. Malar J 18:396. https://doi.org/10.1186/s12936-019-3011-8
Suguna SG (1982) Cytological and morphological evidences for sibling species in Anopheles
subpictus Grassi. J Commun Dis 14:1–8
Suguna SG, Rathinam KG, Rajavel AR, Dhanda V (1994) Morphological and chromosomal
descriptions of new species in the Anopheles subpictus complex. Med Vet Entomol 8:88–94.
https://doi.org/10.1111/j.1365-2915.1994.tb00392
Surendran SN, Abhayawardana TA, De Silva BG, Ramasamy R, Ramasamy MS (2000) Anopheles
culicifacies Y-chromosome dimorphism indicates sibling species (B and E) with different
malaria vector potential in Sri Lanka. Med Vet Entomol 14(4):437–440
Surendran SN, De Silva BG, Srikrishnaraj KA, Ramasamy MS, Ramasamy R (2003) establishment
of species E, not B as the major vector of malaria in the Anopheles culicifacies complex in the
country. Proc Sri Lanka Assoc Adv Sci 59:18
410 References
Surendran SN, Singh OP, Jude PJ, Ramasamy R (2010) Genetic evidence for malaria vectors of the
Anopheles sundaicus complex in Sri Lanka with morphological characteristics attributed to
Anopheles subpictus species B. Malar J 9:343
Surendran SN, Sivabalakrishnan K, Gajapathy K, Arthiyan S, Jayadas Tibutius TP, Karvannan K,
Raveendran S, Parakrama Karunaratne SHP, Ramasamy R (2018) Genotype and biotype of
invasive Anopheles stephensi in Mannar Island of Sri Lanka. Parasit Vectors 11:3
Surendran SN, Sivabalakrishnan K, Sivasingham A, Jayadas TTP, Karvannan K,
Santhirasegaram S, Gajapathy K, Senthilnanthanan M, Parakrma Karunaratne SHP, Ramasamy
R (2019) Anthropogenic factors driving recent range expansion of the malaria vector Anopheles
stephensi. Front Public Health 7:53
Stouthamer R, Breeuwer JAJ, Hurst GDD (1999) Wolbachia pipientis: microbial manipulator of
arthropod reproduction. Annu Rev Microbiol 53:71–102
Sweet WC, Rao BA (1937) Races of Anopheles stephensi type and A. stephensi var. mysorensis. Ind
Med Gaz 72:665–674
Tamboli BL, Bolya YK (1981) Scope of immunoprophylaxis in malaria. Rajasthan Med J 20:184–
190
Tanwar GS, Khatri PC, Chahar CK, Sengar GS, Kochar A, Tanwar G, Chahar S, Khatri N,
Middha S, Acharya J, Kochar SK, Pakalapati D, Garg S, Das A, Kochar DK (2012) Thrombo-
cytopenia in childhood malaria with special reference to P. vivax monoinfection: a study from
Bikaner (northwestern India). Platelets 23(3):211–216
Tesfay K, Assefa B, Addisu A (2019) Malaria outbreak investigation in Tanquae, Abergelle district,
Tigray region of Ethiopia: a case–control study. BMC Res Notes 12:645. https://doi.org/10.
1186/s13104-019-4680-7
Tewari M (2021) Shift in monsoon pattern may make Thar desert greener, says BSIP-JNU study.
Times of India, 9 June 2021, Lucknow. http://timesofindia.indiatimes.com/articleshow/8335321
9.cms?utm_source=contentofinterest&utm_medium=text&utm_campaign=cppst. Accessed
9 June 2021
Tewari DD, Braimoh LA, Bokana KG (2009) Factors affecting malaria epidemics and its economic
impacts on households in Ajegunle, Lagos State, Nigeria. J Interdiscip Econ 21(1):79–96.
https://doi.org/10.1177/02601079X09002100107
Thakare A, Ghosh C, Alalamath T, Kumar N, Narang H, Whadgar S, Paul K, Shrotri S, Kumar S,
Soumya M, Rao R, Chakraborty M, Choudhary B, Ghosh SK, Subramani S, Swain S,
Srinivasan S (2022) The genome trilogy of Anopheles stephensi, an urban malaria vector,
reveals structure of a locus associated with adaptation to environmental heterogeneity. Sci
Rep 12(1):3610. https://doi.org/10.1038/s41598-022-07462-3
Thomas S, Ravishankaran S, Justin JA, Asokan A, Mathai MT, Valecha N, Thomas MB, Eapen A
(2016) Overhead tank is the potential breeding habitat of Anopheles stephensi in an urban
transmission setting of Chennai, India. Malar J 15(1):274. https://doi.org/10.1186/s12936-016-
1321-7
Thomas S, Ravishankaran S, Justin NAJA, Asokan A, Mathai MT, Valecha N, Montgomery J,
Thomas MB, Eapen A (2017) Resting and feeding preferences of Anopheles stephensi in an
urban setting, perennial for malaria. Malar J 16:111. https://doi.org/10.1186/s12936-017-
1764-5
Thornthwaite CW (1948) An approach towards a rational classification of climate. Geogr Rev 38
Trowell HC (1960) Non-infective disease in Africa. Edward Arnold, London. 481 pp
Tyagi BK (1984) Observations of the reflex immobilization behaviour of the mosquito Anopheles
subpictus Grassi, 1899 in some villages of the south Gujarat, India. Geobios New Rep 3:161–
162
Tyagi BK (1991a) Indoor resting habits of mosquitoes in Ganganagar (Rajasthan), assessed through
abdominal condition and age composition. Abstr. pap. fourth national symposium on growth,
development and control technology of insect pests, Muzaffarnagar, p 49
Tyagi BK (1991b) Role of non-target organisms in determining the safe dose—limits of chemical
agents for vector mosquito larval control. Abstr. pap. international symposium of odonatology,
Trevi, Italy, p 31
References 411
Tyagi BK (1991c) Control of vector mosquitoes by dragonflies—a myth or fact? Abstr. pap.
international symposium of odonatology, Trevi, Italy, p 31
Tyagi BK (1992a) Control of malaria vectors of India. Indian Rev Life Sci 12:211–238
Tyagi BK (1992b) Malaria control in India, with particular reference to the desert region in
Rajasthan State: Prospective alternate vector control strategies. Abstr pap first confr impact
app zool res food production and environment, Cuttack, pp 52–53
Tyagi BK (1992c) Prospective role of biological agents in controlling vector mosquitoes transmit-
ting human infections. Abstr. pap. IV South Asian symposium of odonatology, Allahabad, p 14
Tyagi BK (1993) An indigenously developed mechanical device for sampling the resting adults of
mosquitoes. J. App Zool Res 4:180–184
Tyagi BK (1994a) Distribution of arthropod vector-borne communicable diseases and control of
their vectors in India. Indian Rev Life Sci 14:223–243
Tyagi BK (1994b) Impact of extensive canalization on the distribution of malaria vectors in the
north-western Rajasthan. Abstr. pap. Indian sci. cong. assoc., Jaipur, pp 39–40
Tyagi BK (1994c) A note on the breeding of vector mosquitoes in cement tanks and pit latrines. J
App zool Res 5:149–151
Tyagi BK (1994d) Need for imparting training to personnel undertaking insecticide spraying for
vector control, with special reference to xeric conditions in western Rajasthan. Abstr. pap. IV
international symposium on vector & vector-borne diseases, Bhubneshwar, p 82
Tyagi BK (1994e) Distribution of malaria transmitting mosquitoes (Culicidae: Anophelinae;
Anophelini) in the Thar Desert, western Rajasthan, India. Abstr. pap. meeting of experts on
gaps in researches on the faunal diversity in the Thar Desert, Jodhpur, p 37
Tyagi BK (1994f) Thanatosis as an adaptive defense mechanism in Anopheles stephensi larvae
breeding in “Tanka” and “Beri” in the desert villages of Rajasthan. Geobios New Rep 13:132–
135
Tyagi BK (1994g) Alternative control strategies for mosquito vectors of human diseases in
India. In: Perspectives in entomological research. Scientific Publishers, Jodhpur, India, pp
359–372. 406 pp
Tyagi B (1994h) Chronological and spatial distribution of anopheline vectors of malaria in the Thar
Desert. In: Ghosh AK, Baqri QH, Prakash I (eds) Faunal diversity in the Thar Desert. Scientific
Publishers, Jodhpur, pp 227–240
Tyagi BK (1995a) Malaria in the Thar Desert: a critical review. ICMR Bull 25:85–91
Tyagi BK (1995b) Ecology and control of the primary malaria vector, Anopheles stephensi Liston,
in the Thar Desert, north-western India. Abstr pap nineth European meet soc vector ecol, Prague
(Czech Republic), pp 32–33
Tyagi BK (1996a) Changing scenario of malaria prevalence in desert Rajasthan. Geobios 23:176–
184
Tyagi BK (1996b) Major vector-borne human diseases in the Thar Desert, India. Ann Med Entomol
5(1 & 2):13–19
Tyagi BK (1996c) Emerging and re-emerging vector-borne diseases in the Great Indian Thar desert.
WHOSEARO Regl Health Forum 2:9–15
Tyagi BK (1996d) Thar Marusthal mein malaria: ek vivechanatmaka sameeksha [in Hindi]. Arogya
Sandesh, pp 915, 22
Tyagi BK (1996e) Chronological and spatial distribution of anopheline vectors of malaria in the
Thar Desert. In: Ghosh AK, Baqri QH, Prakash I (eds) Faunal diversity in the Thar Desert—
gaps in research. Scientific Publishers, Jodhpur, India, pp 227–240. 410 pp
Tyagi BK (1996f) Malaria in the Thar Desert: a bird’s eye-view. Abstr. poster 63rd ann. meet Indian
acad sci, Jodhpur
Tyagi BK (1996g) Phenology of Anopheles subpictus Grassi, an unusual vector of malaria in the
Thar Desert, India. Abstr pap XX intern. cong. Entomol, Firenze, Italy
Tyagi BK (1997a) Emerging and re-emerging vector-borne diseases in the Great Indian Thar
Desert. WHO-SEARO Reg Health Forum 2:9–15
412 References
Tyagi BK (1997b) Malaria epidemics in the Great Indian Thar Desert and the validity of the Bouma-
van der Kaay’s El Nino Southern Oscillation theory as an early warning system for future
epidemics. Ann Med Entomol 6:19–24
Tyagi BK (1998a) Malaria and its vectors in the Thar Desert, northwestern Rajasthan (India). In:
Goel SC, Sharma SK, Malhotra PR, Tandon N, Tyagi BK (eds) Advances in medical entomol-
ogy & human welfare. The Uttar Pradesh Zoological Society, Muzaffarnagar, India, pp 1–10
Tyagi BK (1998b) Major vector-borne human diseases in the Thar desert, with special reference to
the changing climate. Abstr. pap. seminar on research & development priorities of arid zone
beyond 2000 A.D., Cazri, Jodhpur. 11 p
Tyagi BK (2000) Muzaffar NagarSignificance of genus Cymbopogon in the formulation of mos-
quito repellents. National symposium on prospects and potentials of plant biotechnology in
India in 21st century & 23rd meeting PTCA, Jodhpur, Oct. 18–21, 2000, p 146
Tyagi BK (2001a) Malaria conflagration under the impact of changing Thar Desert environment
(north-western Rajasthan, India). In: Symposium on the impact of human activities on Thar
Desert environment, CAZRI, Jodhpur, p. 109
Tyagi BK (2001b) Major vector-borne human diseases in the Thar Desert, with special reference to
the changing climate. In: Verma SK, Nahar NM, Raj-Bhansali R, Jindal SK, Satya Vir (eds)
Priorities of research for development of arid regions. Scientific Publishers, Jodhpur, India, pp
103–112
Tyagi BK (2002) Malaria in the Thar Desert: facts, figures and future. Agrobios (India), 162 pp
Tyagi BK (2003a) Malaria conflagration under the impact of changing Thar Desert environment. In:
Narayanan P, Kathju S, Kar A, Singh MP, Praveen Kumar (eds) Human impact on Desert
environment. Arid Zone Research Association of India & Scientific Publishers (India), Jodhpur,
pp 60–73
Tyagi BK (2003b) Medical entomology: a handbook of medically important insects and other
arthropods. Scientific Publishers, Jodhpur, India, p 265
Tyagi BK (2004a) A review of the emergence of Plasmodium falciparum dominated malaria in
irrigated areas of the Thar Desert, India. Acta Trop (Special Issue: Malaria & Agriculture) 89:
227–239. https://doi.org/10.1016/j.actatropica.2003.09.016
Tyagi BK (2004b) The invincible deadly mosquitoes. Scientific Publishers, Jodhpur, India, p 265
Tyagi BK [First and Final Draft and Compilation for World Health Organization] (2015) Biosafety
for human health and the environment in the context of the potential use of genetically modified
mosquitoes (GMMs)—a tool for biosafety training based on courses in Africa, Asia and Latin
America, 2008–2011. World Health Organization, p 242
Tyagi BK (2016) Advances in vector mosquito control technologies, with particular reference to
herbal products. In: Vijay Veer, Gopalakrishnan R (eds) Herbal insecticides, repellents and
biomedicines: effectiveness and commercialization. Springer, New Delhi, pp 1–9. https://doi.
org/10.1007/978-81-322-2704-5_1
Tyagi BK (2017) Anopheles stephensi liston: distribution and malaria transmission in India. India -
Michigan State University partnership workshop on biological control of malaria vector in
India, TERI, New Delhi
Tyagi BK (2018) Anopheles stephensi Liston, 1901: systematics, distribution, malaria transmission
and control in India. Abstr. pap. intl. workshop on “Wolbachia-based dengue and malaria
control”, Sun-Yat-sen University-Michigan State University Jt. Center of Vector Control for
Teropical Diseases, Guangzhou, China, 3 pp
Tyagi BK (2020) Mosquito hunters: a history of hostilities against man’s deadliest foe—the
mosquito—since 1881. Scientific Publishers, Jodhpur, India. 474 pp
Tyagi BK (2021) Genetically modified and other innovative vector control technologies eco-bio-
social considerations for safe application. Springer, Singapore. 449 pp
Tyagi BK (2022) The Great Indian Thar Desert’s malaria prevention and control in mobile and hard
to reach populations. Pap. abstr. symposium on malaria prevention and control in mobile and
hard to reach populations, Paramaribo, April 6–8, 2022, p 34
References 413
Tyagi BK, Baqri QH (2005) Changing faunal ecology in the Thar Desert. Scientific Publishers,
Jodhpur, India, p 367
Tyagi BK, Chaudhary RC (1996) Geographical diversification of human plasmodia and malaria
syndrome in the Thar desert. In: Ghosh AK, Baqri QH, Prakash I (eds) Faunal diversity in the
Thar Desert—gaps in research. Scientific Publishers, Jodhpur, India, pp 25–36. 410 pp
Tyagi BK, Chaudhary RC (1997) Outbreak of falciparum malaria in the Thar Desert with particular
emphasis on physiographic changes brought about by extensive canalization and their impact on
vector density and dissemination. J Arid Env 36:541–555
Tyagi BK, Hiriyan J (2004) Breeding of dengue vector, Aedes aegypti (Linnaeus) in the rural Thar
Desert, north western Rajasthan, India. Dengue Bull 28:220–222
Tyagi BK, Shahi AK (2001) Evaluation of repellent potential of Cymbopogon species (Poaceae),
endemic to the Tar Desert, against major vector mosquitoes. Abstr. paper international confer-
ence on globalization of Indian essential oils, Agra
Tyagi BK, Verma KVS (1991) Anopheline mosquitoes of Sri Ganganagar district (Rajasthan)
transmitting malaria parasite. J App Zool Res 2:85–91
Tyagi BK, Yadav SP (1994) Impact of agricultural patterns and water management on the
distribution of disease transmitting mosquitoes. Abstr. pap. meeting of experts on gaps in
researches on the faunal diversity in the Thar Desert, Jodhpur, p 37
Tyagi BK, Yadav SP (1996a) Malariological and sociological significance of ‘tanka’ and ‘beri’ in
the Thar desert, western Rajasthan (India). J Arid Environ (U.K.) 33:497–501
Tyagi BK, Yadav SP (1996b) Awareness of rural community towards malaria and vector control in
the Thar desert following an epidemic. WHOSEARO Reg Health Forum 1:41–45
Tyagi BK, Yadav SP (1996c) Correlation of irrigation and flood water management with malaria in
the Thai desert. WHOSEARO Reg Health Forum 2:5–11
Tyagi BK, Yadav SP (1998) Impact of paddy cultivation on the prevalence of malaria and vector
mosquitoes in the Thar desert—a possible forecasting indicator for future epidemics. In: Joint
annual conference of ISCD and IAE, Delhi, p 17
Tyagi BK, Yadav SP (2000) Paddy cultivation and the prospect of malaria in the Thar Desert, India:
a review. J App Zool Res 11:41–47
Tyagi BK, Yadav SP (2001a) Bionomics of malaria vectors in two physiographically different areas
of the epidemic-prone Thar Desert, north-western Rajasthan (India). J Arid Environ 47:161–172
Tyagi BK, Yadav SP (2001b) Evolution of pathways of vectorism and malaria epidemics in the
Thar Desert, northwestern India. Abstr pap 15th national congress of parasitology, Jodhpur, pp
71–72
Tyagi BK, Bansal SK, Verma KVS (1991) Intra-specific morphological variations in two ecotypes
of Anopheles stephensi Liston in north-western Rajasthan (Diptera: Culicidae). Ann Entomol 9:
85–89
Tyagi BK, Verma KVS, Bansal SK (1992) To study the role of Anopheles stephensi Liston in
transmitting malaria in the desert villages of Rajasthan. Ann Rep Desert Med Res Cent, Jodhpur.
41 pp
Tyagi BK, Singh KV, Bansal SK, Yadav SP (1994) Malaria epidemic in some villages of north-
western desert Rajasthan. J App Zool Res 5:152–155
Tyagi BK, Chaudhary RC, Yadav SP (1995) Epidemic malaria in Thar Desert, India. Lancet 346:
634–635
Tyagi BK, Ramnath T, Shahi AK (1997) Evaluation of repellency of Tagetes minuta (Family:
Compositae) against the vector mosquitoes Anopeles stephensi Liston, Culex quinquefasciatus
Say and Aedes aegypti (L.). Int Pest Cont 39:184–185
Tyagi BK, Shahi AK, Kaul BL (1998) Evaluation of repellent activities of the Cymbopogon
essential oils against mosquito vectors of malaria, filariasis and dengue fever in India.
Phytomedicine 5:324–329
Tyagi BK, Yadav SP, Dam PK, Ramnath T (1999) Enhanced breeding of malaria/dengue fever
transmitting vector mosquitoes (Anopheles stephensi Liston/Aedes aegypti Linnaeus) in
multistorey buildings of Jodhpur township: prospective problems and remedies. Abstr. pap.
414 References
UGC national seminar on multi-storey buildings of growing towns—problems & remedies,

Jodhpur (Mar. 4–6, 1999), p 45
Tyagi BK, Yadav SP, Dam PK, Ramnath T (2000) Enhanced breeding of malaria/dengue vector
mosquitoes, Anopheles stephensi Liston/ Aedes aegypti Linn., in a fast growing Jodhpur
township: future prospects and control methodologies. In: Sethia MR, Gupta AK (eds)
Multistorey buildings of growing towns—problems and remedies. Department of Structural
Engineering, MBM Eng. Coll., Fac. of Engineering, JNV Univ., Jodhpur, pp 373–380
Tyagi BK, Yadav SP, Sachdev R, Dam PK (2001a) Malaria outbreak in the IGNP command area in
Jaisalmer district, Thar Desert, India. J Commun Dis 33(2):88–95
Tyagi BK, Singh KV, Bansal SK, Yadav SP, Dam PK (2001b) Thar Marukschetra mein malaria ka
prakop wa uska nidaan [Malaria conflagration in the Thar Desert region and its control]. Abstr
pap symp Vgyan Pradyogiki Ke Naye Aayaam, Jodhpur, pp 66–69 (in Hindi)
Tyagi BK, Sharma JR, Yadav SP (2002) Irrigated agriculture and exacerbation of P. falciparum
dominated malaria in the Thar Desert, North western Rajasthan. Pap. Abstr. SIMA special
Seminar on Malaria in irrigated agriculture at ICID’s 18h Intern. Congr. on Irrigation and
Drainage, Montreal, Canada, July 18–28, Zool, p 43
Tyagi BK, Hiriyan J, Philip Samuel P, Tewari SC, Paramasivan R (2006) Dengue in Kerala: a
critical review. ICMR Bull 36(4–5):13–22
Tyagi BK, Munirathinam A, Krishnamoorthy R, Venkatesh A (2012) A field-based handbook of
identification keys to mosquitoes of public health importance in India. Volume 1. Taxonomy
and biodiversity cell. Centre for Research in Medical Entomology, Madurai, 55 pp
Tyagi BK, Munirathinam A, Krishnamoorthi R, Baskaran G, Venkatesh A, Kalimuthu M,
Govindarajan R (2014) A field-based handbook of identification keys to 4th instar larvae of
mosquitoes of public health importance in India. Volume 2; Taxonomy and biodiversity cell.
Centre for Research in Medical Entomology, Madurai. 45 pp
Tyagi BK, Munirathinam A, Venkatesh A (2015) A catalogue of Indian mosquitoes. Int J Mosq Res
2(2):50–97
Tyagi BK, Bhattacharya S, Reddyanaik B (2020) Dr Ronald Ross: mosquito, malaria, India and the
Nobel Prize – an untold story of the First Indian Nobel Laureate. Scientific Publishers (India),
258 pp
UNEP (2002) Assessing human vulnerability due to environmental change: concepts, issues,
methods and case studies. UNEP/DEWA/RS.03-5 United Nations Environment Programme,
Division of Early Warning and Assessment, Kenya
Valenzuela JG, Francischetti IMB, Van My P, Garfield MK, Ribeiro JMC (2003) Exploring the
salivary gland transcriptome and proteome of the Anopheles stephensi mosquito. Insect
Biochem Mol Biol 33(7):717–732. Elsevier. https://doi.org/10.1016/s0965-1748(03)00067-5
van den Berg H, Velayudhan R, Ejov M (2013) Regional framework for surveillance and control of
invasive mosquito vectors and re-emerging vector-borne diseases 2014–2020. World Health
Organization Regional Office for Europe, pp 1–18
Vangani NS, Sharma KS, Chatterji PC (1988) Tanka—a reliable system of rainwater harvesting in
the Indian desert. Central Arid Zone Research Institute, Jodhpur. 16 pp
Van Verkvoorden R (1982) Rainwater collectors for villages in west Java, Indonesia. In: Proc. 1st
international conference on rain water cistern systems, Honolulu, Hawaii, USA
Vatandoost H, Shahi H, Abai MR, Hanafi-Bojd AA, Oshaghi MA, Zamani G (2004) Larval habitats
of main malaria vectors in Hormozgan Province and their susceptibility to different larvicides.
Southeast Asian J Trop Med Public Health 35(Suppl 2):22–25
Vatandoost H, Oshaghi MA, Abaie MR, Shahi M, Yaaghoobi F, Baghaii M, Hanafi-Bojd AA,
Zamani G, Townson H (2006) Bionomics of Anopheles stephensi Liston in the malarious area of
Hormozgan province, southern Iran, 2002. Acta Trop 97(2):196–203. https://doi.org/10.1016/j.
actatropica.2005.11.002
Veer V, Bhattacharya S, Naik Reddya B (2021) Professor Dr Brij Kishore Tyagi—on his 70th
birthday. J Med Arthropodol Public Health 1(1):149–184
Verma KVS, Tyagi BK (1991) A brief report on mite infestation of Anopheles stephensi Liston in
the desert villages of Rajasthan. J Indian Soc Health Environ Res 1:73–75
References 415
Verma KVS, Joshi V, Bansal SK (1991) Studies on mosquito vector species in indoor habitats of
desert and non-desert regions of Rajasthan. J Commun Dis 23:263–269
Vipinya C, Shamna AK, Sumodan PK (2022) Distribution pattern of Anopheles stephensi (Diptera:
Culicidae) in north Malabar region of Kerala and its potential role in malaria transmission. Int J
Entomol Res 7(5):72–74
Viswanathan DK (1950) Malaria and its control in Bombay State. Aryabhushan, Poona
Wadia DN (1960) The post-glacial desiccation of Central India. Monograph of National Institute of
Sciences of India, p 1
Waite JL, Suh E, Lynch PA, Thomas MB (2019) Exploring the lower thermal limits for develop-
ment of the human malaria parasite, Plasmodium falciparum. Biol Lett 15:20190275. https://
doi.org/10.1098/rsbl.2019.0275
Walker ED, Thibault AR, Thelen AP, Bullard BA, Huang J, Odiere MR, Bayoh NM, Wilkins EE,
Vulule JM (2007) Identification of field caught Anopheles gambiae s.s. and Anopheles
arabiensis by TaqMan single nucleotide polymorphism genotyping. Malar J 6:23. https://doi.
org/10.1186/1475-2875-6-23
Walter Reed Biosystematics Unit (2022) Anopheles stephensi Liston, 1901. Walter Reed Biosyste-
matics Unit Website. http://wrbu.si.edu/vectorspecies/mosquitoes/stephensi. Accessed
22 July 2022
Walz EJ, Volkman HR, Adedimeji AA, Abella J, Scott LA, Angelo KM et al (2019) Barriers to
malaria prevention in US-based travellers visiting friends and relatives abroad: a qualitative
study of West African immigrant travellers. J Travel Med. https://doi.org/10.1093/jtm/tay163
Wangdi K, Gatton ML, Kelly GC, Clements AC (2015) Cross-border malaria: a major obstacle for
malaria elimination. Adv Parasitol 89:79–107. https://doi.org/10.1016/bs.apar.2015.04.002.
Epub 2015 May 8. PMID: 26003036
Warren A, Sud YC, Rozanov B (1996) The future of deserts. J Arid Environ 32:75–89
Wattal BL (1963) Keys to the Anopheles of the world. 5. Southern and northern Asia. In: Russell
PF, West LS, Manwell RD, MacDonald G (eds) Practical malariology, 2nd edn. Oxford
University Press, London, pp 680–696
Wattal BL, Kalra NL (1961) Region-wise keys to the females of Indian Anopheles. Bull Natl Soc
India Malar Other Mosq Borne Dis 10:55–138
Watts S (1999) British development policies and malaria in India 1897-c.1929. Past Present 165:
141–181
Whitney WD (1971) The Atharvaveda Samhita. Motilal Banarsi Dass, Delhi
WHO (1956) The World Health Organization and malaria eradication. World Health Organization,
Geneva
WHO (1993a) A global strategy for malaria control. World Health Organization, Geneva, pp 1–30
WHO (1993b) Implementation of the global malaria control strategy. World Health Organization,
Geneva
WHO (2000) Fifty third world health assembly: provisional agenda item A53/43 – The world health
report 2000; Health systems: improving performance. World Health Organization, Geneva
WHO (2008) World health statistics 2008. World Health Organization, Geneva
WHO (2009) World malaria report 2009. World Health Organization, Geneva. http://whqlibdoc.
who.int/publications/2009/9789241563901_eng.pdf. Accessed 30 Mar 2010
WHO (2011) World malaria report 2011. World Health Organization, Geneva
WHO (2016) Malaria Country profiles 2016. World Health Organization, Geneva. Available
online at: http://www.who.int/malaria/publications/country-profiles/en/
WHO (2019a) World malaria report 2019. World Health Organization, Geneva
WHO (2019b) Vector alert: Anopheles stephensi invasion and spread. https://www.who.int/news-
room/detail/26-08-2019-vector-alert-anopheles-stephensi-invasion-and-spread
WHO (2019c) Vector alert: Anopheles stephensi invasion and spread—horn of Africa, the Republic
of the Sudan and surrounding geographical areas and Sri Lanka. Information Note
WHO (2020) World malaria report, 2020: 20 years of global progress and challenges. World Health
Organization, Geneva
416 References
WHO (2021a) World malaria report 2021. World Health Organization, Geneva
WHO (2021b) Malaria threats map: tracking biological challenges to malaria control and elimina-
tion. https://apps.who.int/malaria/maps/threats/?. Accessed 22 July 2022
WHO (2022) WHO initiative to stop the spread of Anopheles stephensi in Africa. WHO/UCN/
GMP/2022.06. World Health Organization, Geneva
WHO Regional Office for South-East Asia (2007) Anopheline species complexes in South and
South-East Asia. WHO Regional Office for South-East Asia. https://apps.who.int/iris/handle/10
665/204779
Winarto (1982) Rural rainwater cistern design in Indonesia. In: Proceedings of the international
conference on rain water cistern systems, Honolulu, pp 294–298
Winstanley D (1973a) Rainfall patterns and general atmospheric circulation. Nature 245:190–194
Winstanley D (1973b) Recent rainfall trends in Africa. The Middle-East & India. Nature 243:464–
466
Wong ML, Liew JWK, Wong WK, Pramasivan S, Hassan NM, Sulaiman WYW, Jeyaprakasam
NK, Leong CS, Low VL, Vythilingam I (2020) Natural Wolbachia infection in field-collected
Anopheles and other mosquito species from Malaysia. Parasit Vectors 13:414. https://doi.org/
10.1186/s13071-020-04277-x
Yadav SP, Tyagi BK (2000) Responses of women with malaria history in relation to family
management and support in the Thar Desert, India under constant threat of increasing
malariogenic conditions. Ann Med Entomol 9:32–41
Yadav SP, Tyagi BK, Dam PK (1998) Socio-environmental linkages with malaria-induced econ-
omy in the rural community of the Thar Desert, India. In: XIII annual congress of NESA,
Gulberga, p 23
Yadav SP, Tyagi BK, Ramnath T (1999) Knowledge, attitude and practice towards malaria in rural
communities of the epidemic-prone Thar Desert, north-western India. J Commun Dis 31:127–
136
Yadav SP, Tyagi BK, Dam PK, Ramnath T (2000) On some socioeconomic aspects of inhabitants
of multi-storey buildings of Jodhpur city. In: Sethia MR, Gupta AK (eds) Multi-storey buildings
of growing towns—problems and remedies. Department of Structural Engineering, MBM
Engineering College, JNV University, Jodhpur, p 57. 513 pp
Yadav SP, Tyagi BK, Dam PK, Sachdev R (2001) A study of association between socio-economic
and malaria in rural part of Indian Thar Desert. In: Symposium on the impact of human activities
on Thar Desert environment, CAZRI, Jodhpur, pp 141–142
Yared S, Gebressielasie A, Damodaran L, Bonnell V, Lopez K, Janies D, Carter TE (2020)
Insecticide resistance in Anopheles stephensi in Somali region, eastern Ethiopia. Malar J
19(1):1–7. https://doi.org/10.1186/s12936-020-03252-2
Zahar AR (1985) Vector bionomics in the epidemiology and control of malaria. Part 1. The WHO
African Region and the Southern WHO Eastern Mediterranean Region. Section III: Vector
bionomics, malaria epidemiology and control by geographical areas. (D) East Africa.
(E) Eastern outer islands. (F) Southwestern Arabia. Division of Vector Biology and Control
& World Health Organization, Malaria Action Programme, Geneva
Zahar AR (1988) Vector bionomics in the epidemiology and control of malaria. Pt. II. WHO
European Region and WHOERMR, Vol. I. Vector laboratory studies. WHO/VBC 88.5 – MAP
88.2, 228 pp
Zahar AR (1990a) Vector bionomics in the epidemiology and control of malaria. Part II, The WHO
European region and the WHO Eastern Mediterranean region. Volume II. Applied field studies
Asia west of India. World Health Organization, Geneva; WHO/VBC/90.3
Zahar AR (1990b) Vector bionomics in the epidemiology and control of malaria. Pt. II WHOER and
WHOERMR. Vol. 2 An overview of the recent malaria situation and current problems, Sec.
II. Vector distribution. World Health Organization, Geneva; WHOA/BC 90.1 MAL 90.1. 90 pp
Zhou G, Minakawa N, Githeko AK, Yan G (2004) Association between climate variability and
malaria epidemics in the East African highlands. Proc Natl Acad Sci U S A 101:2375–2380

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B. K.

ISBN 978-981-19-7692-6 ISBN 978-981-19-7693-3 (eBook)

being 2,86,091, which is a year-on-year decrease of approximately 45%. Yet, there

Parasitology Department, Universiti Malaya Indra Vythilingam

Vellore, India B. K. Tyagi

1 ‘Desert Malaria’: An Emerging New Paradigm . . . . . . . . . . . . . . . . 1

4.2.3 Desert Fringes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80

7.7 Biting Behaviour and Host Preference of the Anopheline

10.7.2 The Basis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179

14 Urban Malaria in the Desert . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255

18 Malaria Immunity in Desert Populations and Development of

22.3 Research on Phytochemicals as Repellents against Anopheles

Malaria is an age-old vector-borne disease that is transmitted to humans by

# The Author(s), under exclusive license to Springer Nature Singapore Pte 1

One or more indigenous cases Certified malaria free after 2000

Malaria (məˈlɛːrɪə) is deﬁned as an intermittent and remittent infectious disease

1.1.2 Malaria Symptoms

1. Plasmodium falciparum (Welch 1897)

1.1.4 Malaria Vectors

1.1.4.1 The Americas

(i) An. albimanus

(vi) An. marajoara

(i) An. arabiensis

(i) An. aconitus

1.2 Deserts, Arid Environments, and Malaria

areas. Long-term investigations into risk of malaria exacerbation in the light of

1.3 Ecotypes of Malaria in the Desert Environments

1. Malaria of the African Savannah

Globally malaria is associated with a melange of ecotypes, and the intensity of

1.4 Desert-Based Malaria

1.4.1 The Problem

and occasionally supported by empirical observations of incidence and prevalence of

1.4.2 Types of Desert-Based Malaria Paradigms

1.4.2.1 Desert Oasis Malaria

1.4.2.2 Desert Fringe Malaria

1.4.2.3 Desert Malaria

Anopheles stephensi, the only desert mosquito specialized to breed in these

2.1 Global Malaria Scenario

# The Author(s), under exclusive license to Springer Nature Singapore Pte 19

2.2 Desert-Driven Malaria

2.2.1 Malaria in African Sahara Desert

southern Eritrea and north-western Djibouti. Anopheles arabiensis, a member of the

2.2.2 Malaria in Arabian Peninsula Desert

2.2.3 Malaria in the Middle East/Central and West Asian Deserts

2.2.4 Malaria in the Great Indian Thar Desert

2.2.4.1 Brief History of Malaria in India

there is a trend towards increasing proportion of Plasmodium falciparum cases than

(6) Institutional and management capacity building, trained manpower devel-

(xii) National Framework for Malaria Elimination (2016–2030) & Integrated

2.2.4.2 Malaria Situation in Rajasthan State

Population Blood slides Blood slides Positive Pf

Malaria Situation During Pre-1966 Period

Malaria Situation During 1967–1976

One of the important developments in the malaria control operations through

Malaria Situation During 1977–1995

Malaria Situation During 1996–2020

Malaria Situation in the Great Indian Thar Desert

Model’ is good also in further understanding how an effective, or otherwise,

Milestones on Malaria Research in the Thar Desert

Table 2.8 Milestones in the malaria research in the Thar Desert

# The Author(s), under exclusive license to Springer Nature Singapore Pte 41

3.2 Desert Environments, Man, and Malaria

Table 3.1 A complete list of hot deserts of the world