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National Vector Borne Illness Control Programme (NVBDCP)

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National Vector Borne Disease Control Program (NVBDCP)

National Vector Borne Illness Control Plan (NVBDCP)

ane. Dr. KAILASH NAGAR Dept. Customs HEALTH NATIONAL VECTOR BORNE DISEASE Control PROGRAM:
2. INTRODUCTION • Launched in 2003-04 by merging NAMP,NFCP & Kala Azar Control programmes .Japanese B Encephalitis and Dengue/DHF have as well been included in this Plan • Directorate of NAMP is the nodal agency for prevention and command of major Vector Borne Diseases
three. Historical perspective • National Malaria Eradication Programme (NMEP) which was being implemented in the land since 1958, was reviewed in 1977 and revised guidelines for Modified Plan of Operation (MPO) were issused to all States & UTs
4. • Due to various outbreaks in the country malaria state of affairs was reviewed in 1994 by an Expert Committee. • In pursuance of the Good Committee's recommendations, the Directorate of NMEP brought out operational transmission for Malaria Activeness Plan (MAP) in 1995 Historical perspective
five. • The Directorate of NMEP was renamed every bit Directorate of National Anti Malaria Program (NAMP) in March, 1999. • Directorate of NAMP was dealing with three centrally sponsored schemes namely Malaria, Filaria and Kala-azar control and in addition, was looking after the prevention and control of Dengue and Japanese Encephalitis. Historical perspective
six. • With a view to converge Dengue/Dengue Haemorrhagic feverand Japanese Encephalitis with the iii on-going centrally sponsored schemes [National Anti-Malaria Programme (NAMP), National Filaria Command Program (NFCP) and Kala-azar Control Programme], the integrated scheme was renamed as National Vector Borne Affliction Control Programme (NVBDCP) from 2d December, 2003. Historical perspective
7. • In 2006, Chikungunya re-emerged in the land and this was also brought within the purview of Directorate of NVBDCP. Historical perspective
eight. NVBDCP – National Vector Borne Disease Control Programme • NVBDCP is an umbrella plan for prevention and control of 6 vector borne diseases namely: Malaria Dengue Chikungunya Japanese Encephalitis Kala-Azar Filaria (Lymphatic Filariasis)
nine. • It is an integral component of NHM and is implemented under the overall umbrella of NHM • The Programme is monitored at the National level through the mechanisms established under NHM. NVBDCP
10. NVBDCP • The Directorate is responsible for framing technical guidelines & policies as to guide u.s. for implementation of Programme strategies. • Responsible for budgeting and planning the logistics pertaining to primal sector. • Monitoring of implementation through regular reports and returns of MIS is washed.
xi. NVBDCP • The Directorate carries out evaluation of Program implementation from time to time. • The resource gap is also assessed as to provide an equitable support based on the magnitude of the problem. • Under the Wedlock Ministry building of H&FW, GoI, 17 ROH & FW are performance.
12. NVBDCP • Every state has state vector borne diseases control component under the Directorate of Health Services • There is a system of coordination between the land and middle for constructive implementation and monitoring of Plan.
xiii. NVBDCP • At the commune level, District Malaria Offices have been established under District Chief Medical and Wellness Offices by usa. • Fundamental unit of measurement for planning and monitoring of Program under a technical officeholder. • Now, 565 District Malaria Units are functioning.
14. Mission argument • Integrated accelerated action towards – reducing bloodshed on account of Malaria, Dengue and JE by half – Elimination of Kala-azar past 2010 – emptying of lymphatic filariasis past year 2015. fifteen
15. Program objectives and strategies • NVBDCP strategies comprise Early diagnosis, prompt and complete handling Integrated vector management including promotion of personal protective measures and biological measures BCC, capacity edifice through integrated training at all tiers of health care delivery organisation
16. • Partnerships Other national health programs Non-health sector departments Civil social club organizations (NGOs, CBOs, self- help groups, panchayati raj institutions) Corporate sectors Medical academia and professional bodies Monitoring and evaluation Program objectives and strategies
17. Having efficacy of iii-5 years have been introduced Plan objectives and strategies
18. • Improve efficiency and quality of services at chief, secondary and third levels • Main level ASHA under NHM, Anganwadi workers of ICDS and Community Volunteers of NGOs would be trained to serve Fever Treatment Depots (FTDs) PHCs, CHCs: equipped to manage PF malaria Lab surveillance enhanced Program objectives and strategies
xix. • Improve efficiency and quality of services at primary, secondary and tertiary levels • Secondary level Training of Medical Officers, Lab Technicians and Community Volunteers of public and private sector District level hospitals: equipped with ventilators and lab services Medical inspect Program objectives and strategies
twenty. • Improve efficiency and quality of services at primary, secondary and third levels • Tertiary level Medical college hospital: manage all referrals Undertake therapeutic efficacy studies of combi-pack and effectiveness of rapid diagnostic kits Rapid diagnosis for management of severe malaria cases Program objectives and strategies
21. • Ecology Management Proper drainage and sanitation Program objectives and strategies
22. • Government of India provides technical support as well as logistics • State governments ensure plan implementation • The centre and united states monitor the plan closely and high-risk areas are identified for focused attention Program objectives and strategies
23. MALARIA • The plan aims to maintain Annual Claret Test Rate (ABER) of > 10% by active and passive surveillance and bring down Annual Parasite Incidence (API) to one.iii or less by 2012 • 25% reduction in morbidity and mortality by 2010 and 50% by 2012 (baseline year 2006)
24. 25 India's contribution to Malaria Bharat contributes to 71% of total malaria
25. Malaria – problematic states • Chattisgarh, Jharkhand, Maharashtra, West Bengal and Orissa – have registered maximum malaria cases in India (since 2007) • Out of them, Orissa and Maharashtra have contributed to most of the deaths due to malaria • Other high malaria brunt states – MP, Up, Gujarat, Rajasthan, Karnataka
26. MALARIA • To strengthen malaria command, GoI is providing cash help to states for engaging multi- purpose workers (MPWs) on contractual basis in virtually 200 identified loftier endemic districts during the Xi Five Year Programme
27. MALARIA • Provision has been fabricated under external assistance for positioning Malaria Technical Supervisors (MTS) in loftier endemic areas to strengthen supportive supervision and micro- level monitoring • Each MTS to cover a population of 2.5 lacs in selected areas of the high endemic districts
28. MALARIA • Under NVBDCP, all fever cases are required to be immediately examined • Positive cases are provided prompt and complete treatment • Incentives have been considered for ASHAs for performing Rapid Diagnostic Tests (RDTs), grooming of slides and administering consummate treatment
29. MALARIA • ASHA can too arrange to transport astringent malaria cases to the referral centers with the expenditure borne out of funds from untied grants of NHM • Funds available with the Village Wellness and Sanitation Commission (VHSC) can too be utilized (this grant may also exist utilized for source reduction of mosquito breeding sites)
xxx. GUIDELINES Nether NVBDCP: MALARIA • Surveillance and example management Conventional diagnostic method through microscopy remains the gold standard However, rapid diagnostic kits (Pf kits) are provided for quick treatment in difficult and inaccessible areas with P. falciparum predominance
31. • Integrated Vector Control Direction IRS: two rounds of DDT/synthetic pyrethroid or 3 rounds of malathion based on the insecticide resistance studies and epidemiological information. IRS to exist washed in all areas with (Annual Parasite Index) API>2 or higher up. Priority of spray to be given to loftier gamble areas with API or SPR 5 and above GUIDELINES UNDER NVBDCP: MALARIA
32. • Integrated Vector Control Management (contd.) Apply of ITMN Reduction of breeding sites: use of larvivorous fish – Gambusia and Poecilia (Guppy) GUIDELINES Nether NVBDCP: MALARIA
33. • Epidemic preparedness and Response (EPR) Objectives are early identification and control of epidemic Early on warning signals which include epidemiological & entomological parameters , climatic factors (rain fall, temperature and humidity), operational factors (inadequacy and lack of trained manpower) are monitored GUIDELINES UNDER NVBDCP: MALARIA
34. • Epidemic preparedness and Response (EPR) Proper linkage with Integrated Diseases Surveillance Programme (IDSP) at district level for obtaining early warning signals on regular basis Commune should have rapid response team consisting of epidemiologist, entomologist, lab technician, Medical Officer, health workers, supervisors, community volunteers GUIDELINES Under NVBDCP: MALARIA
35. • Supportive interventions Preparation and capacity building Integrated preparation plan accept been designed for different categories of health care functionaries GUIDELINES UNDER NVBDCP: MALARIA
36. • Supportive interventions Behaviour Change Advice Empowers people to take rational and informed decisions through appropriate cognition Inculcates necessary skills and optimism Stimulates pertinent action Reinforces the same through peers and influencers. GUIDELINES Nether NVBDCP: MALARIA
37. • Supportive interventions Inter-sectoral Collaboration Anti Malaria Month is being observed with enhanced level of candidature just before the peak transmission season GUIDELINES UNDER NVBDCP: MALARIA
38. • Innovations/modifications accept been proposed to be intensified during Xi Five Twelvemonth Plan For focused interventions, 206 districts accept been identified equally loftier malaria endemic Of which, 100 districts – high API and Pf charge per unit>thirty% Further out of these 100, 61 districts identified as very high malaria endemic districts GUIDELINES Under NVBDCP: MALARIA
39. • Innovations/modifications have been proposed to be intensified during 11 Five Year Plan Geographical Information Organization (GIS) mapping for focused intervention in high risk prioritized districts GUIDELINES UNDER NVBDCP: MALARIA
40. • Innovations/modifications accept been proposed to exist intensified during 11 V Year Program Linkage with NHM and utilize of NHM Institutions for prevention and control of VBDs Up-scaling utilise of bed nets /Long Lasting Insecticide Treated Nets (LLINs) GUIDELINES Under NVBDCP: MALARIA
41. • Innovations/modifications accept been proposed to be intensified during 11 Five Year Programme Early diagnosis and handling by Strengthening of human resources Scaling up of Rapid Diagnostic Kit (RDK) Scaling upwardly of Artemisinin-based Combination Therapy (Act) GUIDELINES UNDER NVBDCP: MALARIA
42. • Monitoring of drug resistance and insecticide resistance: 15 studies are conducted in a twelvemonth through Pf monitoring teams through ROH&FWs and National Institute of Malaria Research (NIMR) at different places Based on their written report, resistance areas are identified and their drug policy changed GUIDELINES UNDER NVBDCP: MALARIA
43. NationalNational Filaria Control ProgramFilaria Control Program • Ethnic cases have been reported from about 250 districts in twenty states/Spousal relationship Territories.
44. Magnitude of the problem • Filariasis has been a major public health problem in Republic of india next only to malaria. The discovery of microfilariae (mf) in the peripheral blood was made start by Lewis in 1872 in Calcutta (Kolkata). • The North-Western States/UTs are known to exist gratis from indigenously acquired filarial infection.
45. FILARIA (endemicity)
46. FILARIA (endemicity) • Ethnic filaria cases take been recorded from Andhra Pradesh, Assam, Bihar, Chhattisgarh, Goa, Jharkhand, Karnataka, Gujarat, Kerala, Madhya Pradesh, Maharashtra, Orissa, Tamil Nadu, Uttar Pradesh, West Bengal, Pondicherry, Andaman & Nicobar Islands, Daman & Diu, Dadra & Nagar Haveli and Lakshadweep.
47. FILARIA (endemicity) • States gratis from indigenously caused filarial infection: North-Western States/UTs namely Jammu & Kashmir, Himachal Pradesh, Punjab, Haryana, Chandigarh, Rajasthan, Delhi and Uttaranchal and North-Eastern States namely Sikkim, Arunachal Pradesh, Nagaland, Meghalaya, Mizoram, Manipur and Tripura
48. 49 Signs and symptoms of Filariasis • Recurrent fever intermittent or remittent with ofttimes double rise • loss of appetite, pallor and weight loss with progressive emaciation • weakness • Splenomegaly – spleen enlarges rapidly to massive enlargement, usually soft and nontender • Liver – enlargement not to the extent of spleen, soft, smooth surface, sharp edge
49. 50 Contd. • Lymphadenopathy – not very mutual in Bharat • Skin – dry, thin and scaly and hair may exist lost. Light colored persons bear witness grayish discoloration of the skin of easily, feet, abdomen and face which gives the Indian proper noun Kala-azar meaning "Black fever" • Anemia – develops quickly • Anemia with emaciation and gross splenomegaly produces a typical appearance of the patients
50. 09/03/18 51 National Filaria Control ProgramNational Filaria Control Programme • This program was started in 1955This program was started in 1955 • In 1998 the operational component wasIn 1998 the operational component was merged with Urban Malaria Schememerged with Urban Malaria Scheme • In 2003 -04 it was merged withIn 2003 -04 it was merged with NVBDCPNVBDCP • Filariasis has been a major public health problem inFilariasis has been a major public health problem in India side by side only to malaria.India side by side just to malaria. • Indigenous cases have been reported from aboutIndigenous cases have been reported from well-nigh 250 districts in 20 states/Union Territories.250 districts in 20 states/Matrimony Territories.
51. 09/03/18 52 Revised Filaria Control StrategyRevised Filaria Command Strategy • The National Health Policy 2002 aims at EliminationThe National Wellness Policy 2002 aims at Elimination of Lymphatic Filariasis by 2015of Lymphatic Filariasis by 2022 • REVISED STRATEGYREVISED STRATEGY – Almanac Mass Drug Administration with singleAnnual Mass Drug Assistants with unmarried dose of Diethyl carbamazine(December)was taken up asdose of Diethyl carbamazine(December)was taken up every bit a pilota airplane pilot – During 2004 about 400 million population wereDuring 2004 about 400 million population were brought under MDA.brought under MDA. – This strategy is to be connected for five years orThis strategy is to be continued for 5 years or more to the population excluding children belowmore to the population excluding children below two years, pregnant women and seriously illtwo years, pregnant women and seriously ill persons in affected areas to interruptpersons in affected areas to interrupt manual of disease.manual of illness.
52. 09/03/18 53 Contd. • Vector control through anti larval spray at weekly intervals. • Biological control through larvivorous fishes • Environmental engineering science through source reduction and water direction • Information, education and communication
53. NFCP • Population living in endemic countries is now covered with annual MDA with Dec + Albendazole, with aim of elimination of Filaria by 2022 • Patients suffering from hydrocele are motivated for surgery • ASHA and other volunteers, later on due training, would be involved in MDA by the local wellness authority
54. • ELF by 2015: LF ceases to be a public health problem i.e. the number of microfilaria carriers is less than one per cent in endemic population Children born after initiation of ELF are free from circulating antigenaemia. Absenteeism of antigenaemia among children is considered equally evidence for absenteeism of transmission and new infection. FILARIA
55. GUIDELINES Nether NVBDCP: FILARIA • National Filaria Control Program is beingness implemented in the state through 206 filaria control units, 199 filaria clinics and 27 survey units • Strategies under NFCP: Detection and handling to the patients with anti-filaria drug Anti-larval work in urban areas covered nether NFCP
56. • Filaria has been targeted for emptying globally past 2022 • National Health Policy (2002) aims to eliminate lymphatic filariasis (ELF) by 2022 • MDA existence implemented since 2004 in 250 districts in 15 states and 5 UTs MDA to be undertaken by District Malaria Officeholder or District Vector Borne Illness Command Officer with staff and officials of NFCP GUIDELINES UNDER NVBDCP: FILARIA
57. Major activities under ELF • Sensitization and training of district and country level officers • Media sensitization and District Co-ordination Committee meeting nether the chairmanship of district collector • Microfilaria survey past trained technicians (especially for collection of claret in the night and its examination) before MDA in sentinel and random sites in each district
58. • Identification of manifestations (lymphedema or hydrocele), line-list of cases and updating every year with addition or deletion on yearly ground to provide services for morbidity management • Collection, compilation and analysis of data and feedback to land as well as centre • Assessment through involvement of medical college faculty, ROH&FW and ICMR institutions Major activities nether ELF
59. • Hydrocele operations for relief of the patients • Preparation on home based treat morbidity management • Vector control: 1 or two rounds of IRS with Dichloro-diphenyl-trichloroethane (1g/m2 ) in owned areas • Anti-larval measures: temphos in h2o tanks every week and application of Mineral Larvicidal Oils (MLO) on water surface • Biological control; Ecology engineering Major activities under ELF
60. Kala Azar endemicity
61. Kala Azar endemicity • Endemic in eastern States of India namely Bihar, Jharkhand, Uttar Pradesh and West Bengal • 48 districts endemic; sporadic cases reported from a few other districts • Estimated 129 million population at risk in iv states • Mostly poor socio-economical groups of population primarily living in rural areas are affected
62. KALA AZAR • Annual incidence of Kala Azar will be reduced to less than 1 per ten,000 population at sub- district level with the aim of eliminating Kala Azar past 2010 • Kala Azar Technical Supervisors (KTS) are provided in affected districts to strengthen early detection, consummate treatment and prevention and command including residual spray (supported under World Bank assisted projection)
63. • It is proposed that ASHA workers will exist involved in identification of Kala azar cases and ensuring their complete handling. KALA AZAR
64. GUIDELINES UNDER NVBDCP: KALA AZAR • Main strategic components for elimination: Case detection and treatment: done through the existing Chief health care organization supplemented by periodic annual active searches (Kala azar fortnight) Suspension of transmission through vector control: undertaking 2 rounds of Ddt spray annually in PHC areas reporting kala azar incidence nether direct supervision and monitoring by NHM institutions
65. • First round of IRS: february-march • Second circular: may-june But before the onset of monsoon as some parts of Bihar become inaccessible in monsoon • IRS (with Dichloro-diphenyl-trichloroethane 50%) is supplemented with efforts to ameliorate sanitation • In addition, environmental measures and personal protection from sandfly bites are encouraged GUIDELINES UNDER NVBDCP: KALA AZAR
66. • IEC & inter-sectoral convergence • Diagnosis: Suspected cases as per the standard instance definition are referred for clinical case exam and tested with rapid dipstick exam rK39 GUIDELINES UNDER NVBDCP: KALA AZAR
67. • Treatment: every bit per the drug policy of GoI, Sodium Stibo Gluconate (SSG) is the first line treatment of Kala azar The oral drug, Miltefosine has been introduced on a pilot footing in 6 districts of Bihar and ii districts each of Jharkhand and West Bengal Paramomycin has also been approved GUIDELINES Nether NVBDCP: KALA AZAR
68. • Vector control: Selection of areas to be sprayed: all villages within a PHC which reported Kala azar cases in the past 5 years; all villages which reported cases during the year of spray Dosage: 1g/m2 of the wall surface; upto half-dozen feet acme Cattle sheds and kala azar positive and suspected cases to be given priority GUIDELINES Nether NVBDCP: KALA AZAR
69. Kala azar – Patient Coding Scheme • The patient and his relatives are counseled properly at the time of registration at the health institution (CHC/PHC/district hospital) about the importance of total treatment • The coding would be arranged in the order of Country Code cum Land Code- District Code- PHC Code, Sub-Centre / NGO Code- Patient Code.
70. • As per the patient coding scheme, each Kala- azar case will take the country code IND along with the state code and have a 10 digit numerical code. (IND2-01-01-01-001...... IND2- 01-01-01-999). • No ii patients will have the same x digit numerical code during a period of v years / Kala-azar Emptying Program menstruum. Kala azar – Patient Coding Scheme
71. Instance of Patient Coding Arrangement
72. Dengue endemicity
73. • Disease is prevalent throughout India in most of the metropolitan cities and towns • Outbreaks have also been reported from rural areas of Haryana, Maharashtra & Karnataka Dengue endemicity
74. GUIDELINES UNDER NVBDCP: DENGUE/DHF • Early example reporting and management Disease surveillance through grass root level wellness workers, picket surveillance sites with laboratory support Example management including early referral of cases Epidemic preparedness and rapid response No specific anti-viral drug; symptomatic Rx
75. • Integrated vector direction: Larval surveys – entomological surveillance Source reduction Personal protection GUIDELINES UNDER NVBDCP: DENGUE/DHF
76. • Larval surveys: containers in house-holds are examined for presence of mosquito larvae and pupae • Four indices:  House alphabetize: percentage of houses infected = no. of houses infected with larvae/pupae x 100 no. of houses inspected GUIDELINES Under NVBDCP: DENGUE/DHF
77. • Larval surveys: Container index: percentage of h2o holding containers infected with larvae/pupae = no. of positive containers x 100 no. of containers inspected GUIDELINES UNDER NVBDCP: DENGUE/DHF
78. • Larval surveys: Breteau Alphabetize: no. of positive containers per 100 houses inspected = no. of positive containers x 100 no. of houses inspected GUIDELINES UNDER NVBDCP: DENGUE/DHF
79. • Larval surveys: Pupae Index: no. of pupae per 100 houses = no. of pupae 10 100 no. of houses inspected GUIDELINES UNDER NVBDCP: DENGUE/DHF
80. • An HI >5% &/or a BI >20 for whatsoever locality is an indication that the locality is dengue sensitive and therefore acceptable preventive measures should be taken GUIDELINES UNDER NVBDCP: DENGUE/DHF
81. • Adult surveys: Landing/biting collection: presence of aedes aegypti mosquito can be reliable indicator of clear proximity to subconscious larvae habitats Laborious Expressed in terms of landing/biting counts per homo hour GUIDELINES UNDER NVBDCP: DENGUE/DHF
82. • Adult surveys: Resting drove: mosquitoes typically balance indoors, specially in bedrooms and more often than not in dark places, such as material closets and other sheltered sites Mosquito searched with the aid of flashlight Recorded as number of adults per firm per homo hour of human being efforts GUIDELINES UNDER NVBDCP: DENGUE/DHF
83. • Adult surveys: Oviposition traps: Ovitraps are devices used to detect presence of Aedes aegypti where population density is low (BI < 5) (urban areas) Used to evaluate bear upon of adulticidal infinite spraying on female developed mosquito population GUIDELINES Under NVBDCP: DENGUE/DHF
84. • Following points were emphasized in the strategic action programme: Suspected cases should be referred at the earliest for diagnosis and its proper direction Strengthening through 110 Sentinel Surveillance Hospitals (SSHs) and 13 Noon Enquiry Laboratories (ARLs) GUIDELINES UNDER NVBDCP: DENGUE/DHF
85. • Following points were emphasized in the strategic activity plan (contd.): Diagnostic kits are supplied by NIV (Pune), for which the toll is borne past NVBDCP Monitoring of larval density of Aedes mosquitoes in urban and rural areas regularly GUIDELINES Nether NVBDCP: DENGUE/DHF
86. • Following points were emphasized in the strategic activity programme (contd.): Involvement of NHM institutions namely Rogi Kalyan Samiti for facilitating emergency cases in referral and transportation Interest of VHSC for comeback in sanitation and reduction in breeding sites ASHA should exist involved in educating the community to avoid the stagnation of stored water kept in and around houses GUIDELINES UNDER NVBDCP: DENGUE/DHF
87. • Legislative measures Model borough by-laws: fine/punishment is imparted, if breeding is detected. Strictly imposed by Mumbai, Navi Mumbai, Chandigarh and Delhi Municipal Corporations. Building construction regulation act: for overhead/undercover tanks, etc. In Mumbai, builders deposit a fee for controlling mosquitogenic weather condition at site GUIDELINES UNDER NVBDCP: DENGUE/DHF
88. • Legislative measures Ecology Health Human action: by-laws for proper disposal/storage of junk, discarded tins, erstwhile tyres and other debris Wellness Impact Assessments: prior to any development projects/major constructions GUIDELINES UNDER NVBDCP: DENGUE/DHF
89. CHIKUNGUNYA • No specific anti-viral drug; symptomatic Rx • Strategies for prevention and control are the same equally for dengue
xc. Japanese encephalitis endemicity
91. JE - Extent of trouble • JE viral activity has been widespread in Republic of india. • The commencement show of presence of JE virus dates back to 1952. • First case was reported in 1955 • During contempo past (1998-2004), fifteen states and Matrimony Territories accept reported JE incidence
92. GUIDELINES Nether NVBDCP: JE • Early on diagnosis and case direction Strengthening of referral services: available at district/sub-commune levels Proper case management: No specific anti-viral drug for JE and cases are managed symptomatically Improved care by medical and para-medical health intendance providers, improved lab services for diagnosis, availability of drugs
93. • Proper case management (contd.): Management of sequel: rehab at district Epidemic preparedness and rapid response: team constituted in all JE endemic districts • Vaccination: Vaccination of children between i-xv yrs historic period: Initiated since 2006 with unmarried dose live attenuated SA-14-14-2 vaccine under UIP in a phased way GUIDELINES Under NVBDCP: JE
94. • Integrated vector Direction Fogging with Malathion for outdoor is recommended during outbreaks for immediate killing of infected mosquitoes Anti- larval operations Personal protective measures for using insecticides treated bed nets and curtains, wearing full sleeve clothes during evening hours etc. Biological command using larvivorous fishes GUIDELINES Under NVBDCP: JE
95. • Supportive interventions: Training and capacity building Through training of clinicians and nurses in instance management and laboratory technicians and laboratory in charge/microbiologists in all lookout laboratories in diagnosis by MAC ELISA method in a phased manner. GUIDELINES Nether NVBDCP: JE
96. • Supportive interventions: Behaviour Alter Communication Early case reporting and early referral of patients Increasing awareness of clinical signs Personal protection including segregation of pigs abroad from human population Mosquito proofing of pigsties GUIDELINES Nether NVBDCP: JE
97. • Supportive interventions: • Supervision and monitoring Periodic reviews/reports and field visits for proper monitoring for JE GUIDELINES UNDER NVBDCP: JE
98. Incentives to ASHAs under NVBDCP
99. Southward.No Activities Incentive Remarks one Grooming of slides Rs.five/- per slide Irrespective of RDT based or slide based confirmation 2. Taking slides to PHC laboratories, getting reports and providing complete handling to malaria positive case Rs.5O/- per positive case for complete Treatment This incentive is to facilitate the transportation cost three. RDT testing and complete treatment of Pf malaria cases Rs.xx/-per positive Pf malaria case for consummate treatment In remote and inaccessible areas, for consummate treatment of Pf malaria cases
100. Incentives for filaria • Under the ELF program, MDA is administered by wellness workers (male person/female) and volunteers • ASHAs could as well be involved past local health authorities • Payment of Rs.100/- to each volunteer/worker/ASHA for drug distribution to 250 persons in approx 50 houses
101. Incentives for Kala azar • Identification of instance – Rs. 50/- per instance • For follow up and ensuring complete handling – Rs. 150/- per instance • From funds allocated for operational costs under cash grant of NVBDCP (kala azar) funds
102. Dengue/Chikungunya/JE • The untied funds available with the subcentres for referral to district hospitals tin be utilized for transportation of the severe cases to the identified referral centres
103. Public Private Partnership • Categories: NVBDCP initiatives for PPP are classified into 2 categories Category 1: with local self government (panchayat) or panchayat level CBO (population coverage – minimum 5000 population) Category 2: block level NGO/FBO (population coverage – minimum 100000 population)
104. Public Private Partnership • Schemes: • Provision of EDPT Scheme one: Provision of outreach services – Fever Handling Depot & Drug Distribution Middle Scheme 2: Provision of microscopy and handling services Scheme three: Hospital based treatment and care of astringent complicated malaria cases
105. Public Individual Partnership • Integrated Vector Control Scheme 4: Promotion of ITMN, insecticide handling of customs endemic bed nets and distribution of ITMN in selected areas Scheme 5: Promotion of larvivorous fish Scheme six: Indoor Residual Spray
106. Periodical/ RESEARCH ABSTRACTS • Brunt of Malaria in India: Retrospective and Prospective View • Am. J. Trop. Med. Hyg., 77(6_Suppl), 2007, pp. 69-78 Copyright © 2007 by The American Club of Tropical Medicine and Hygiene • Ashwani Kumar, Neena Valecha, Tanu Jain, AND Aditya P. Dash National Institute of Malaria Research, Field Station, Panaji, Goa, Republic of india; National Found of Malaria Research, Delhi, Republic of india • In India, nine Anopheline vectors are involved in transmitting malaria in diverse geo-ecological paradigms. About 2 million confirmed malaria cases and 1,000 deaths are reported annually, although xv 1000000 cases and 20,000 deaths are estimated by WHO Due south East Asia Regional Part. India contributes 77% of the full malaria in Southeast Asia. Multi-organ involvement/dysfunction is reported in both Plasmodium falciparum and P. vivax cases.
107. • Most of the malaria brunt is borne past economically productive ages. The states inhabited past ethnic tribes are entrenched with stable malaria, particularly P. falciparum with growing drugresistance. The profound impact of complicated malaria in pregnancy includes anaemia, abortions, low birth weight in neonates, however births, and maternal mortality. Retrospective analyses of burden of malaria showed that inability adapted life years lost due to malaria were 1.86 million years. Price–benefit analysissuggests that each Rupee invested by the National Malaria Control Programme pays a rich dividend of nineteen.7 Rupees.
108. BIBLIOGRAPHY: Park.G, Textbook of prevention and social medicine. 20th edition. Jabalpu,India: M/s Banarsidas Bhanot publications; 2009. KK Gulani. Customs Health Nursing- Principles & Practices. Delhi: Kumar Publishing House; 2008. Sunita Pateny. Textbook of Customs Health Nursing. 1st edition. Delhi: Modern Publishers; 2005. • BT Basavanthapa. Community Health Nursing 2nd edition. Jaypee Brothers Medical publishers; 2008.
109. 112 Thank You!Thanks!

MIS – direction data system

These offices are located at unlike state headquarters.

Objective of the partnership is to provide uniformity in diagnosis, treatment and monitoring through a wider base in the country to maximize admission to treatment and better acceptability of appropriate and locally suitable vector control measures.

Lab surveillance from private sector would be enhanced by coordination with private practitioner and individual laboratories

Medical audit to measure effectiveness of programme

with emphasis on malaria diagnosis, handling and prevention and control activities including balance spray and bed-net impregnation, distribution and utilise

Slide positivity charge per unit – no. of blood smears found positive for malaria parasite / no. of claret smears examined 10 100
Annual Blood examination charge per unit – no. of blood smears examined during the year / population covered under surveillance 10 100
API – confirmed cases of malaria during ane year / population covered nether surveillance x 100

Although larvivorous fish have been used successfully in some parts of the country, it is of import that their use is scaled-upwards substantially to achieve demonstrable positive impact. Individuals and communities can reduce mosquito breeding by the following activities:
o Remove discarded containers that might collect water.
o Embrace cisterns (water tanks) with lids or mosquito nets.
o Articulate abroad or remove vegetation and other matter from the banks of streams to
make the flow of h2o smoothen and reduce breeding.
o Eliminate the pools of h2o caused by leaking taps, spillage of h2o effectually
pipes and wells or poor drains by repairing.
o Utilise larvivorous fish in permanent water bodies with potential convenance sites

Malaria is one of the epidemic decumbent diseases, specially in relatively low endemic areas with unstable transmission dynamics.

The integrated training guidelines aim to standardize the training contents for each category of the health care workers as well as non health care functionaries in guild to ameliorate the quality of preparation and to better in delivery of services. For this purpose integrated form curriculum has been developed for all three categories. Besides, training of Private Medical Practitioners and other inter sectoral partners are besides conducted to sensitize. them almost the National Strategies for VBD control. Specialized trainings for entomologists and laboratory technicians are too conducted through some identified Apex Institute having expertise on the concerned field. The capacity building at state, district and PHC level need to exist planned and continued to go on the well trained homo resource available with the program for programme implementation.

June is observed as anti-malaria calendar month, Earth Malaria Day – April 25

Cherry-red zones are free from filaria

Bancrftian filariasis caused by Wucheria Bancrofti is transmitted in man by the bite of infected mosquites – culex and mansonia. This infection causes lymphangitis ,lymphadenitis , elephantiasis of genitals, legs and artillery and causes tropical eosinophilia due to hypersensitivity.
600 million people are at risk and threescore 1000000 are infected in S-Due east Asia.In India 454 million are at chance and 48 million are infected.

NFCP launched in 1955, activities mainly in urban areas. Extended to rural areas since 1994.

Eradicable diseases: Polio, Leprosy, Republic of guinea Worm, Filariasis/Onchocerciasis, Measles and Chagas Disease.
For individual case treatment: Dec 6 mg/kg b.w. orally daily for 12 days. Doxycycline for 14 days too constructive.
MDA: one tab albendazole 400mg &gt; 2 yrs; DEC: 2-five yrs-ane tab, 5-14 yrs- ii tab, &gt;xiv yrs- 3 tab (300mg)
Unmarried dose of ivermectin has been establish to be effective.
National Filaria Day: 15th November

Temphos dose: i ppm

No case of Kala Azar in Gujarat since 2007

Sandfly Phlebotomus argentipus
The active example search will be carried out during one fortnight for which will be decided by each of the owned states. The case search operation is a community based operation, to detect all suspected cases of kala-azar co-ordinate to the case definition of kala-azar and PKDL. Community must therefore be aware of the purpose of house to firm visits past workers and the workers who visit villages should be familiar with case definition, the reporting formats and the treatment schedules, etc. The fever cases detected during the Fortnight are to be treated with the appropriate government of the prescribed drugs, sufficient quantities of which should be available at the PHC and district levels. Agile instance search is to exist carried out in all villages of the owned district where transmission of kala-azar is possible.
Kala-azar case Definition
Persons with fever of more than 15 days duration non responding to anti-malarials and antibiotics with splenomegaly is a suspected example of Kala-azar.
PKDL
Persons with depigmented patches on the body with awareness and with a history of kala-azar in the past is a suspected example of PKDL.

Avoiding sleeping on the flooring, using fine-mesh bed nets, make clean shelters for animals, no cracks crevices, h2o well to be kept airtight, not to sleep naked, application of home-fabricated mustard oil balm
RK 39 rapid diagnostic kit and ELISA are meliorate and fast

2nd line drug: Pentamidine isothionate. Amphotericin B is as well used.

In case of resistance to Dichloro-diphenyl-trichloroethane, BHC is recommended.
From the year 2003-04, 100% aid is provided by the centre.

Fogging by 95% or pure technical malathion (equipment is portable motorized knapsack blowers and cold aerosol generators)
Pyrethrum spray: Indoor; 0.1 – 0.two % @ 30-60 ml / 1000 cu. ft
One liter of ii% pyrethrum excerpt is diluted by kerosene into 20 litres to make 0.1% pyrethrum formulation (equipment: flit pump or mitt operated fogging automobile fitted with microdischarge nozzle)
In SMC, fogging is done by 0.ane% conception (2% extract) pyrethrum and IRS by v % blastoff cypermethrin.
Commercial formulation of 2% pyrethrum extract is diluted with kerosene in the ratio one part of 2% pyrethrum extract with 19 parts of kerosene (volume/volume). Thus, one litre of 2% pyrethrum extract is diluted by kerosene into 20 litres of 0.i% pyrethrum extract
.gear up-to-spray conception.. One litre of .set-to-spray formulation is sufficient to cover 20 households, each household having 100 cubic metres of indoor infinite.

A person exposes his feet while using mechanical aspirator for collecting landing mosquitoes at each drove site. Usually between 6:00 PM to vi:00 AM.

Oviposition traps are traps designed to attract and sample gravid female person mosquitoes, either directly or via eggs deposited within the trap.
Trap pattern varies depending on the mosquito species of interest. (D68) A black jar, containing water and with a hardboard paddle placed inside it, to provide an attractive oviposition site for container breeding mosquitoes. (D70)
The Reiter gravid trap samples female Culex spp. mosquitoes looking to deposit eggs.
It is selective for females which accept taken at least i blood repast. (D68)
Small ovitraps are used for sampling eggs of Aedes spp. mosquitoes.
Larger ovitraps, usually with an attractant or infusion, are used for sampling eggs of Culex spp. mosquitoes.
For sampling of gravid female mosquito population (gravid trap) or eggs to guess gravid population size from number of egg rafts (ovitrap). As only female mosquitoes which have fed at least one time are attracted to these traps the individuals caught are more likely to exist infected. (D70) At that place is a greater take a chance of collecting infected females when using gravid traps which retain the mosquitoes (compared to use of light traps), as only females which have already ingested at least one blood meal should be attracted to the trap. (D68) Gravid trap counts may accept a higher correlation with disease transmission than other traps. (D68, D70) Useful for mosquito species which breed in containers (D70) &quot;More sensitive and economical than larval or developed surveys of Aedes aegypti."
Ovitraps which do not retain the ovipositing females merely sample the eggs; These traps tin can be used to judge the ovipositing adult female mosquito population but not to give data regarding the rate of infection with arboviruses.

Wellness education: special campaigns may be carried out through mass media including newspapers, Television, radio, local cable networks, outdoor like miking.
At household level: utilise of pyrethroid-based aerosols similar 'All OUT' or 'HIT'; keeping room airtight for 15-twenty minutes; during early on morning or belatedly afternoon.
Personal protective measures – total sleeved clothes, ITMN.
Using mosquito repellents similar odomos, called-for neem leaves, coconut shells.
Using tight-fitting screens/wire mesh on doors and windows. Covering all water containers in the firm.
Introducing larvivorous fishes (eg. Gambusia, poecilia – guppy).
At community level: applying temphos (1 ppm) on weekly basis in coordination with health authorities.
At institutional level: weekly checking for aedes larval habitats in overhead tanks, ground water storage, introducing larvivorous fishes, conveying out indoor spraying with 2% pyrethrum, notification of fever cases.

179 districts in 9 states are endemic to JE

No case reported from Gujarat

Flavivirus; Culex Vishnii, Culex tritaeniorhyncus, Culex genidus

Vaccination is however, not recommended equally an outbreak command measure out

No office of IRS

MAC – IgM Antibody Capture ELISA

RDT – rapid diagnostic test

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Source: https://www.slideshare.net/krishnagar90/national-vector-borne-disease-control-programme-nvbdcp-112775871