From Malaria to Dengue: A Comprehensive Review of Disease Transition in Rajasthan

Abstract

Rajasthan, a historically malaria-prone state in India, is undergoing a profound epidemiological shift, with dengue emerging as a significant public health challenge while malaria incidence demonstrates a commendable decline. This comprehensive review synthesizes existing literature, incorporating illustrative data, to explore the dynamics, drivers, and implications of this disease transition. We examine the historical epidemiology of malaria, noting its peak burdens in the mid-20th century and its subsequent decline, exemplified by an over 95% reduction in annual parasite incidence (API) from 2000 to 2020. Concurrently, we trace the dramatic rise of dengue, with reported cases in Rajasthan escalating from a few hundred annually in the early 2000s to over 15,000 cases in epidemic years like 2017 and 2021, predominantly concentrated in urban centers like Jaipur. The review details the complex interplay of environmental, climatic (e.g., changing rainfall patterns and rising minimum temperatures), socio-economic (e.g., rapid urbanization at an average annual rate of over 3%), and public health factors contributing to this shift. It also assesses current strategies, identifies gaps in surveillance and control, and discusses challenges posed by co-circulation and diagnostic complexities. Ultimately, this paper underscores the urgent need for integrated, adaptive, and proactive vector-borne disease control programs in Rajasthan that account for the evolving epidemiological landscape and prepare for future challenges posed by climate change and demographic shifts.