A 35-year-old woman from a malaria-endemic district in Odisha presents with fever, chills, and headache for 3 days. Rapid diagnostic test (RDT) is positive for Plasmodium vivax. Regarding NVBDCP-recommended management and vector control for P. vivax malaria in India, all of the following are correct EXCEPT:

Explanation

## NVBDCP Management of P. vivax Malaria ### Correct Statements (Options 0, 1, 3) **Option 0 — Drug Regimen:** - Chloroquine (1500 mg base over 3 days) is first-line for P. vivax in India - Primaquine eliminates hypnozoites (dormant forms in liver) and prevents relapse - This is standard NVBDCP protocol **Option 1 — Primaquine Dosing & Safety:** - Primaquine 0.5 mg/kg/day for 14 days is the standard NVBDCP regimen - **G6PD screening is mandatory** before primaquine to prevent haemolytic anaemia - This reflects current NVBDCP guidelines (revised post-2015) **Option 3 — Indoor Residual Spraying (IRS):** - IRS is the cornerstone of NVBDCP vector control for malaria - Anopheles mosquitoes (vectors of P. vivax) are endophilic (rest indoors) - IRS with pyrethroids or organophosphates is highly effective - This is the primary intervention under NVBDCP ### Incorrect Statement (Option 2) — Why It Is Wrong **Key Point:** The vector ecology statement in Option 2 is **geographically and taxonomically imprecise**. **High-Yield:** - **Anopheles stephensi** is primarily an **urban and periurban vector** associated with cities and towns (e.g., Delhi, Mumbai) - **Anopheles culicifacies** is a **rural vector** but is associated with **P. falciparum**, not P. vivax - **Anopheles fluviatilis** and **Anopheles minimus** are the primary rural vectors for **P. vivax** in India - The statement conflates vector species with malaria parasite type **Clinical Pearl:** Vector control strategy must match the vector species present in the endemic area. Misidentifying vectors leads to ineffective control measures. ### Vector Ecology Table | Vector Species | Habitat | Primary Parasite | NVBDCP Role | |---|---|---|---| | Anopheles stephensi | Urban/periurban | P. falciparum, P. vivax | Secondary urban vector | | Anopheles culicifacies | Rural | **P. falciparum** (not vivax) | Rural P. falciparum vector | | Anopheles fluviatilis | Rural foothills | **P. vivax** | Primary rural P. vivax vector | | Anopheles minimus | Rural foothills | **P. vivax** | Primary rural P. vivax vector | **Mnemonic:** **ACF** — Anopheles Culicifacies = Falciparum (rural); Anopheles Fluviatilis & Minimus = Vivax (rural)