NATIONAL VECTOR BORNE NATIONAL VECTOR BORNE DISEASE CONTROL PROGRAMMEDISEASE CONTROL PROGRAMME

IntroductionIntroduction Launched in year 2003-04Launched in year 2003-04 Major vector borne diseases-Major vector borne diseases-

• MalariaMalaria

• FilariaFilaria

• Kala-azarKala-azar

• Japanese EncephalitisJapanese Encephalitis

• Dengue / Dengue Hemorrhagic feversDengue / Dengue Hemorrhagic fevers

• ChikungunyaChikungunya

Mission statement Mission statement

Integrated accelerated action towards Integrated accelerated action towards reducing mortality on account of Malaria, Dengue reducing mortality on account of Malaria, Dengue

and JE by halfand JE by half Elimination of Kala-azar by 2010Elimination of Kala-azar by 2010 elimination of lymphatic filariasis by year 2015.elimination of lymphatic filariasis by year 2015.

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India’s contribution to Malaria in SEAR

India contributes to 71% of total malaria cases in the SEAR

Endemic district 250 (in 20 States/UTs)

FILARIA ENDEMIC DISTRICTS Trend Of Average MF rate

Year - 2004 2008

Maharashtra 1.13 0.39

National Average

1.24 0.63

Endemic States - UP, West-Bengal, Jharkhand, Bihar

Distribution Of Japanese Encephalitis in IndiaDistribution Of Japanese Encephalitis in India

J E Cases And Deaths Reported till Nov 2009 C D

U P 2936 530

Total 4102 651

Japanese Encephalitis Endemic areas

Distribution Of Dengue/DHF in IndiaDistribution Of Dengue/DHF in India

Number of cases – Year 2009 (till July)

Total 2900

Maharashtra 385Dengue endemic areas in India

Strategies: Malaria

Early case detection and prompt treatment (EDPT)

Clinically suspected malaria cases are confirmed on microscopy or rapid diagnostic kits(RDK)

Drug Distribution Center (DDC) and Fever Treatment Depots(FTD) have been established in rural areas

In inaccessible areas, Health agencies and volunteers running FTD’s are provided with RDK’s

Strategies: FilariaStrategies: Filaria Mass Drug AdministrationMass Drug Administration--

Single dose mass t/t with DEC every yearSingle dose mass t/t with DEC every year 85% DEC coverage for 5 years.85% DEC coverage for 5 years.

Filaria Control Strategies…Filaria Control Strategies… Morbidity management of cases Morbidity management of cases

Strategies: Kala-azarStrategies: Kala-azar

Enhanced case detection and Complete treatmentEnhanced case detection and Complete treatment

• Every case of fever of more than 15 days duration in Every case of fever of more than 15 days duration in endemic areas , not responding to anti-viral t/t or endemic areas , not responding to anti-viral t/t or antibiotics with spleenomegaly is screened. antibiotics with spleenomegaly is screened.

• Rapid diagnostic kit Rapid diagnostic kit RK39 RK39 has replaced Aldehyde has replaced Aldehyde Test for diagnosis of Kala-azarTest for diagnosis of Kala-azar..

• Introduction of oral drug Introduction of oral drug Miltefosine as the first line Miltefosine as the first line drug since 2008.drug since 2008.

• Directly observed treatment inDirectly observed treatment in

endemic areasendemic areas

RDT

Strategies: Dengue & ChikungunyaStrategies: Dengue & Chikungunya

Early case detection and prompt treatment Early case detection and prompt treatment • Identified 13 Apex Referral Laboratories for advanced Identified 13 Apex Referral Laboratories for advanced

diagnosis and regular surveillance. diagnosis and regular surveillance.

• Identified 137 sentinel surveillance hospitals for proactive Identified 137 sentinel surveillance hospitals for proactive surveillance. surveillance.

• NIV Pune entrusted to supply ELISA test kits to these NIV Pune entrusted to supply ELISA test kits to these institutesinstitutes

Strategies: Japanese EncephalitisStrategies: Japanese Encephalitis

Early case detection and prompt treatmentEarly case detection and prompt treatment--

• Clinical surveillance in endemic areasClinical surveillance in endemic areas

JE Vaccination ProgramJE Vaccination Program- -

• In 2006, 11 endemic districts of 4 states coveredIn 2006, 11 endemic districts of 4 states covered

• Children in 1-15 years age group immunized as an Children in 1-15 years age group immunized as an integral component of Universal Immunizationintegral component of Universal Immunization

• Mouse-brain derived inactivated JE vaccine Mouse-brain derived inactivated JE vaccine manufactured by CRI kasaulimanufactured by CRI kasauli

• 3 doses of 0.5 to 1 ml (day 0, 7, 30) followed by Booster3 doses of 0.5 to 1 ml (day 0, 7, 30) followed by Booster

INTEGRATED VECTOR MANAGEMENTINTEGRATED VECTOR MANAGEMENT• Source reduction, filling, streamlining water bodiesSource reduction, filling, streamlining water bodies• Biological Control-Gambusia Fishes & Biolarvicides (Bacillus Biological Control-Gambusia Fishes & Biolarvicides (Bacillus

sphaericus) sphaericus)

• Impregnated bed netsImpregnated bed nets

• DDT spraying in and around 30 households from a diagnosed DDT spraying in and around 30 households from a diagnosed case of malariacase of malaria

• IEC campaignsIEC campaigns

GAMBUSIA FISHES Abandoned Cement Tank

INTEGRATION UNDER NRHM

At Village LevelAt Village Level Monthly meetings of Village Health & Sanitation Committee Monthly meetings of Village Health & Sanitation Committee

serve as a platform for health education and counseling of serve as a platform for health education and counseling of community.community.

Involvement of ASHA as-Involvement of ASHA as- surveillance worker to inform any increase in fever cases surveillance worker to inform any increase in fever cases

including Dengue/ Chikungunya and J.E.including Dengue/ Chikungunya and J.E. FTD for early detection of suspected malaria cases and treatment FTD for early detection of suspected malaria cases and treatment linkage between ANC services and prevention & treatment of linkage between ANC services and prevention & treatment of

malariamalaria counselor for Filaria cases to practice home based management. counselor for Filaria cases to practice home based management. organizer, motivator and trainer in village level meetings/training organizer, motivator and trainer in village level meetings/training

workshopsworkshops..

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Thank You!Thank You!