Health Impact Assessment of Indira Sagar Project: a paramount to studies on Water Development Projects.

Background: Very limited studies on Health Impact Assessment (HIA) of Water Development Projects (WDP) in relation to mosquito-borne diseases have been carried out in India. The current study focuses on using HIA as a tool for finding impact of Indira Sagar Project, Madhya Pradesh on human health in relation to mosquito borne diseases, and emphasizing its incorporation as an integral part of any WDP.

Methods: Screening, scoping, assessment, recommendation, reporting, and evaluation were carried out in selected study areas. Entomological, epidemiological, socio-economic and knowledge, attitudes and practices data related to malaria transmission in three dam components: Submergence (SUB), Command (CMD) and Resettlement and Rehabilitation (RR) colonies were generated for the period of January 2013-December 2014. Statistical analysis was attempted to compare data among dam components and to identify risk factors. Component-specific mitigation measures were suggested based on observations.

Results: Anopheles culicifacies was the dominating species in all three dam components and its man-hour density in CMD areas was higher compared to SUB and RR. The odds of finding a positive malaria case was much higher in CMD compared to SUB (OR 1.24, CI 95% 0.71-2.43) and RR (OR 5.48, CI 95% 0.73-40.63). Respondents of CMD stated more previous episodes of malaria (81.8%) compared to RR (61.4%) and SUB (55.7%). The canonical discriminant analysis concluded that distance from reservoir/Indira Sagar canal had the highest discriminating ability of malaria cases in different components followed by treatment-seeking behaviour and malaria history. The analysis identified these risk factors with 70% accuracy.

Conclusion: Engineering manipulations may be carried out in CMD areas to control seepage and RR colonies should be established beyond 3 km from reservoir/Indira Sagar canal considering the flight range of A. culicifacies. Strengthening of surveillance with early detection and complete treatment was recommended for CMD areas. To avoid future transmission in other areas and projects HIA should be carried out at planning stage for planning better control activities.