{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T23:57:07Z","timestamp":1792022227839,"version":"4.4.0"},"reference-count":40,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T00:00:00Z","timestamp":1770595200000},"content-version":"unspecified","delay-in-days":8,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"National Centre for Vector Borne Diseases Control (NCVBDC), Ministry of Health and Family Welfare, Government of India, through the Global Fund to Fight AIDS, Tuberculosis and Malaria","award":["16\/4-2024\/NCVBDC\/GFATM\/MEP-3"],"award-info":[{"award-number":["16\/4-2024\/NCVBDC\/GFATM\/MEP-3"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,1,20]]},"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Malaria remains a major public health challenge in India, with transmission dynamics varying widely across ecological, epidemiological, sociobehavioural and health system contexts. Achieving the national malaria elimination target by 2030 requires integrated, context-specific evidence to design effective interventions. This study aims to generate a comprehensive understanding of malaria transmission and factors surrounding it across diverse eco-epidemiological settings in India by assessing malaria burden, identifying determinants of transmission, evaluating health system performance and equity, characterising vector bionomics and insecticide resistance, and examining the influence of environmental drivers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This longitudinal, multicentric study will be conducted in collaboration with the national programme in 12 districts spanning 10 states in India, covering a population of around 25\u2009000 individuals representing varied ecological contexts (urban, periurban, rural, forest-foothill and coastal) and malaria endemicity levels. In each district, two clusters (villages) with a population of 1000 individuals will be included. A baseline mass survey will estimate malaria prevalence using bivalent rapid diagnostic tests (RDTs) and blood smear microscopy, with low-density parasitaemia detected by PCR in a subset of RDT-negative samples. Participants will be followed for 1 year, with monthly screening of symptomatic individuals using RDT and microscopy, and testing a subset of asymptomatic individuals to detect subclinical infections. Sociobehavioural data will be collected through structured interviews and household observations, with purposive inclusion of vulnerable groups, pregnant women, migrants, elderly persons, individuals with disabilities and tribal populations to assess equity dimensions through mixed-methods approaches. Health system performance will be evaluated through key informant interviews with programme officials, health workers, patients, private practitioners and traditional healers. Entomological surveillance will document vector species composition, density, infection rates and assessment of susceptibility status and intensity of insecticide resistance to commonly used public health insecticides. Environmental variables, including temperature, rainfall and humidity, will be linked with entomological and epidemiological data to explore spatiotemporal relationships.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The protocol was approved by the Institute Human Ethics Committee of ICMR-Vector Control Research Centre (IHEC 03-0125\/N\/F). All standard ethical practices will be adhered to. The findings will be shared with stakeholders and published in reputed open-access journals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-111645","type":"journal-article","created":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T15:45:48Z","timestamp":1770651948000},"page":"e111645","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Multicentric longitudinal study on malaria burden, vector bionomics and health system assessment in diverse eco-epidemiological settings in the context of malaria elimination in India: study protocol"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2383-8482","authenticated-orcid":false,"given":"Arya","family":"Rahul","sequence":"first","affiliation":[{"name":"ICMR - Vector Control Research Centre, Indira Nagar, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kannan","family":"Thiruvengadam","sequence":"additional","affiliation":[{"name":"ICMR - Vector Control Research Centre, Indira Nagar, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohit","family":"Sharma","sequence":"additional","affiliation":[{"name":"ICMR - Vector Control Research Centre, Indira Nagar, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4503-4867","authenticated-orcid":false,"given":"Muhammed","family":"Jabir","sequence":"additional","affiliation":[{"name":"ICMR - Vector Control Research Centre, Indira Nagar, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anju","family":"Viswan","sequence":"additional","affiliation":[{"name":"ICMR - Vector Control Research Centre, Indira Nagar, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8889-579X","authenticated-orcid":false,"given":"Priskilla Johnson","family":"Jency","sequence":"additional","affiliation":[{"name":"ICMR - Vector Control Research Centre, Indira Nagar, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikhil","family":"Bharadwaj","sequence":"additional","affiliation":[{"name":"ICMR - Vector Control Research Centre, Indira Nagar, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subramanian","family":"Muthukumaravel","sequence":"additional","affiliation":[{"name":"ICMR - Vector Control Research Centre, Indira Nagar, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ananganallur Nagarajan","family":"Shriram","sequence":"additional","affiliation":[{"name":"ICMR - Vector Control Research Centre, Indira Nagar, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hari Kishan","family":"Raju","sequence":"additional","affiliation":[{"name":"ICMR - Vector Control Research Centre, Indira Nagar, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sriram","family":"Kannan","sequence":"additional","affiliation":[{"name":"ICMR - Vector Control Research Centre, Indira Nagar, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manpreet","family":"Singh","sequence":"additional","affiliation":[{"name":"National centre for Vector Borne Disease Control, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pranab Jyoti","family":"Bhuyan","sequence":"additional","affiliation":[{"name":"National centre for Vector Borne Disease Control, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanu","family":"Jain","sequence":"additional","affiliation":[{"name":"National centre for Vector Borne Disease Control, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0932-0935","authenticated-orcid":false,"given":"Manju","family":"Rahi","sequence":"additional","affiliation":[{"name":"ICMR - Vector Control Research Centre, Indira Nagar, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,2,9]]},"reference":[{"key":"2026062610405122000_16.2.e111645.1","unstructured":"World malaria report 2024 [internet]. 2024. Available: https:\/\/www.who.int\/teams\/global-malaria-programme\/reports\/world-malaria-report-2024"},{"key":"2026062610405122000_16.2.e111645.2","unstructured":"Malaria:: national center for vector borne diseases control (ncvbdc) [internet]. 2023. Available: https:\/\/ncvbdc.mohfw.gov.in\/index1.php?lang=1&level=1&sublinkid=5784&lid=3689"},{"key":"2026062610405122000_16.2.e111645.3","unstructured":"The data explorer - ind-m-nvbdcp [internet]. 2025. Available: https:\/\/data.theglobalfund.org\/grant\/IND-M-NVBDCP\/4\/overview"},{"key":"2026062610405122000_16.2.e111645.4","doi-asserted-by":"crossref","DOI":"10.1016\/j.lansea.2022.04.005","article-title":"Malaria control initiatives that have the potential to be gamechangers in India\u2019s quest for malaria elimination","volume":"2","author":"Rahi","year":"2022","journal-title":"Lancet Reg Health Southeast Asia"},{"key":"2026062610405122000_16.2.e111645.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.pt.2023.03.006"},{"key":"2026062610405122000_16.2.e111645.6","doi-asserted-by":"crossref","DOI":"10.1101\/cshperspect.a025601","article-title":"Malaria Transmission and Prospects for Malaria Eradication: The Role of the Environment","volume":"7","author":"Castro","year":"2017","journal-title":"Cold Spring Harb Perspect Med"},{"key":"2026062610405122000_16.2.e111645.7","doi-asserted-by":"crossref","DOI":"10.1186\/s12936-019-3011-8","article-title":"Biology and bionomics of malaria vectors in India: existing information and what more needs to be known for strategizing elimination of malaria","volume":"18","author":"Subbarao","year":"2019","journal-title":"Malar J"},{"key":"2026062610405122000_16.2.e111645.8","doi-asserted-by":"crossref","DOI":"10.1186\/s12936-017-1833-9","article-title":"Malaria epidemiology in an area of stable transmission in tribal population of Jharkhand, India","volume":"16","author":"Das","year":"2017","journal-title":"Malar J"},{"key":"2026062610405122000_16.2.e111645.9","doi-asserted-by":"crossref","unstructured":"Verma AK , Shrivastava S , Saxena N . 2025 Malaria and malnutrition in tribal areas of India: implications for paediatric health. Front Gastroenterol 4. doi:10.3389\/fgstr.2025.1526806","DOI":"10.3389\/fgstr.2025.1526806"},{"key":"2026062610405122000_16.2.e111645.10","doi-asserted-by":"publisher","DOI":"10.4103\/0971-5916.159510"},{"key":"2026062610405122000_16.2.e111645.11","first-page":"86","article-title":"Role of migratory population in keeping up endemicity of malaria in metropolitan cities of India","volume":"22","author":"Sethi","year":"1990","journal-title":"J Commun Dis"},{"key":"2026062610405122000_16.2.e111645.12","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.14-0834"},{"key":"2026062610405122000_16.2.e111645.13","doi-asserted-by":"crossref","first-page":"1585","DOI":"10.4269\/ajtmh.22-0025","article-title":"Active Engagement of Private Healthcare Providers Is Needed to Propel Malaria Elimination in India","volume":"106","author":"Rahi","year":"2022","journal-title":"Am J Trop Med Hyg"},{"key":"2026062610405122000_16.2.e111645.14","doi-asserted-by":"crossref","first-page":"472","DOI":"10.4269\/ajtmh.23-0830","article-title":"Toward Malaria Elimination: Understanding Awareness, Prevention, and Health-Seeking Patterns in Odisha, India","volume":"111","author":"Jabir Mm","year":"2024","journal-title":"Am J Trop Med Hyg"},{"key":"2026062610405122000_16.2.e111645.15","doi-asserted-by":"crossref","DOI":"10.1016\/j.heliyon.2022.e11902","article-title":"Insecticide resistance status of malaria vectors in the malaria endemic states of India: implications and way forward for malaria elimination","volume":"8","author":"Raghavendra","year":"2022","journal-title":"Heliyon"},{"key":"2026062610405122000_16.2.e111645.16","doi-asserted-by":"crossref","DOI":"10.1007\/s12038-021-00200-3","article-title":"Analysis of drug resistance marker genes of Plasmodium falciparum after implementation of artemisinin-based combination therapy in Pune district, India","volume":"46","author":"Ozarkar","year":"2021","journal-title":"J Biosci"},{"key":"2026062610405122000_16.2.e111645.17","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc1713777"},{"key":"2026062610405122000_16.2.e111645.18","unstructured":"Preparing for certification of malaria elimination, second edition [internet]. 2025. Available: https:\/\/www.who.int\/publications\/i\/item\/9789240062009"},{"key":"2026062610405122000_16.2.e111645.19","unstructured":"World Health Organization . Monitoring the Building Blocks of Health Systems: A Handbook of Indicators and Their Measurement Strategies.2010. Available: https:\/\/iris.who.int\/handle\/10665\/258734"},{"key":"2026062610405122000_16.2.e111645.20","unstructured":"MESA . Malaria matchbox tool [internet]. 2025 Available: https:\/\/mesamalaria.org\/resource-hub\/malaria-matchbox-tool\/"},{"key":"2026062610405122000_16.2.e111645.21","doi-asserted-by":"crossref","DOI":"10.1016\/j.lansea.2022.05.001","article-title":"A systematic review and meta-analysis on sub-microscopic Plasmodium infections in India: Different perspectives and global challenges","volume":"2","author":"Deora","year":"2022","journal-title":"Lancet Reg Health Southeast Asia"},{"key":"2026062610405122000_16.2.e111645.22","doi-asserted-by":"publisher","DOI":"10.2307\/2280236"},{"key":"2026062610405122000_16.2.e111645.23","first-page":"463","volume-title":"The Fauna of British India, Including Ceylon and Burma. Diptera: Family Culicidae; Tribes Megarhinini and Culicini","volume":"5","author":"Barraud","year":"1934"},{"key":"2026062610405122000_16.2.e111645.24","unstructured":"Christophers SR . The Fauna of British India, Including Ceylon and Burma. Diptera: Family Culicidae; Tribe Anophelini. Taylor & Francis, 1933:4."},{"key":"2026062610405122000_16.2.e111645.25","first-page":"85","article-title":"Region wise keys to the female Indian anophelines","volume":"9","author":"Wattal","year":"1961","journal-title":"Bulletin of the National Society for Indian Malaria Mosquito Diseases"},{"key":"2026062610405122000_16.2.e111645.26","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0166768","article-title":"Control of Aedes aegypti Breeding: A Novel Intervention for Prevention and Control of Dengue in an Endemic Zone of Delhi, India","volume":"11","author":"Nagpal","year":"2016","journal-title":"PLoS One"},{"key":"2026062610405122000_16.2.e111645.27","unstructured":"Organization WH . Pictorial identification key of important disease vectors in the WHO South-East Asia Region, 2020. Available: https:\/\/www.who.int"},{"key":"2026062610405122000_16.2.e111645.28","first-page":"563","article-title":"An agar-gel diffusion method for identification of mosquito blood meal","volume":"29","author":"Crans","year":"1969","journal-title":"Mosq News"},{"key":"2026062610405122000_16.2.e111645.29","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.1999.60.687"},{"key":"2026062610405122000_16.2.e111645.30","doi-asserted-by":"publisher","DOI":"10.1016\/0035-9203(88)90130-7"},{"key":"2026062610405122000_16.2.e111645.31","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiy484"},{"key":"2026062610405122000_16.2.e111645.32","unstructured":"World Health Organization . World Health Organization. Informal Consultation on Methodology to Distinguish Reinfection from Recrudescence in High Malaria Transmission Areas: Report of a Virtual Meeting, 17\u201318 May 2021.2021. Available: https:\/\/www.who.int\/publications\/i\/item\/9789240038363"},{"key":"2026062610405122000_16.2.e111645.33","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijregi.2024.100428","article-title":"A historical perspective of malaria policy and control in India","volume":"12","author":"Sam","year":"2024","journal-title":"IJID Reg"},{"key":"2026062610405122000_16.2.e111645.34","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2022-008431","article-title":"What India can learn from globally successful malaria elimination programmes","volume":"7","author":"Sharma","year":"2022","journal-title":"BMJ Glob Health"},{"key":"2026062610405122000_16.2.e111645.35","doi-asserted-by":"crossref","first-page":"163","DOI":"10.4103\/ijmr.ijmr_2128_22","article-title":"Burden of tuberculosis & malaria among tribal populations & implications for disease elimination in India","volume":"157","author":"Narain","year":"2023","journal-title":"Indian J Med Res"},{"key":"2026062610405122000_16.2.e111645.36","doi-asserted-by":"publisher","DOI":"10.1016\/j.epidem.2014.12.001"},{"key":"2026062610405122000_16.2.e111645.37","doi-asserted-by":"crossref","DOI":"10.1186\/s12936-022-04400-6","article-title":"A qualitative study on community perceptions on quality of healthcare services they received in the Malaria Elimination Demonstration Project in district Mandla, India","volume":"21","author":"Singh","year":"2022","journal-title":"Malar J"},{"key":"2026062610405122000_16.2.e111645.38","doi-asserted-by":"crossref","first-page":"101489","DOI":"10.1016\/j.cegh.2023.101489","article-title":"Socio-ecological determinants of malaria transmission risk among population residing in an endemic area of southern province of Karnataka, India","volume":"25","author":"Gopika","year":"2024","journal-title":"Clin Epidemiol Glob Health"},{"key":"2026062610405122000_16.2.e111645.39","doi-asserted-by":"crossref","first-page":"100064","DOI":"10.1016\/j.joclim.2021.100064","article-title":"Meteorological linkage of Malaria cases in the eastern state of India","volume":"5","author":"Kumar","year":"2022","journal-title":"The Journal of Climate Change and Health"},{"key":"2026062610405122000_16.2.e111645.40","doi-asserted-by":"crossref","first-page":"226","DOI":"10.4269\/ajtmh.24-0011","article-title":"For Malaria Elimination, India Needs to Integrate Its Research and Control Arms","volume":"111","author":"Rahi","year":"2024","journal-title":"Am J Trop Med Hyg"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2025-111645","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T17:42:29Z","timestamp":1782495749000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2025-111645"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":40,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2,9]]},"published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1136\/bmjopen-2025-111645"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2025-111645","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2]]}}}