NATIONAL VECTOR BORNE DISEASE CONTROL

PROGRAMME-MALARIA

REMYA RAJAN

MILESTONESNMCP 1953

SPECTACULAR SUCCESS

NMEP 1958

UMS 1971

RESURGENCE

MPO 1977

MAP 1995

EMCP 1997

NAMP 1999

NVBDCP 2004

IMCP 2005

NATIONAL MALARIA CONTROL PROGRAMME 1953

OBJECTIVES

• TO BRING DOWN MALARIA TRANSMISSION• TO HOLD DOWN MALARIA TRANSMISSION AT LOW LEVEL

STRATEGIES

•INDOOR RESIDUAL SPRAY•TREATMENT OF PATIENTS REPORTING TO HEALTH INSTITUTIONS

ACHIEVEMENTS

•DECLINE IN INCIDENCE FROM 75 MILLION TO ONLY 2 MILLION IN 1958

NATIONAL MALARIA ERADICATION PROGRAMME1958

OBJECTIVES

TO ERADICATE MALARIA FROM INDIA IN 7 TO 9 YEARS

ACTIVITIES

SPRAYING OPERATIONFORTNIGHTLY ACTIVE CASE DETECTIONRADICAL TREATMENTINVESTIGATION OF POSITIVE CASES AND REMEDIAL MEASURES

ACHIEVEMENTS

LOWEST EVER INCIDENCE OF 0.1 MILLION IN 1965NO REPORTED DEATHS DUE TO MALARIA

RESURGENCE OF MALARIA 1967 TO 1976

IN 1965-SUDDEN WITHDRAWAL OF ASSISTANCE ANDSHORTAGE OF INSECTICIDES-STEEP RISE IN MALARIA INCIDENCE

URBAN MALARIA SCHEME 1971☻IN 139 TOWNS IN 19 STATES AND UNION TERRITORIES

OBJECTIVES☻TO CONTROL MALARIA IN URBAN AREAS BY REDUCING VECTORS☻REDUCE MORBIDITY AND MORTALITY BY EARLY DETECTION AND PROMPT TREATMENT

CRITERIA

☻ALL URBAN AREAS WITH GREATER THAN 50,000 POPULATION☻SPR≥5%

PLAN OF ACTION

VECTOR CONTROL BY DRUG TREATMENT ANTI-LARVAL MEASURES

LARVIVOROUS FISHLARVICIDES

RE-CLASSIFICATION OF ENDEMIC AREAS

BASED ON ANNUAL PARASITE INCIDENCE

API LESS THAN 2 API GREATER THAN 2

MODIFIED PLAN OF OPERATION 1977OBJECTIVES

PREVENTION OF DEATH DUE TO MALARIAREDUCTION OF MORBIDITY DUE TO MALARIARETENTION OF ACHIEVEMENTS GAINED SO FAR

AREAS WITH API > 2

SPRAYINGENTOMOLOGICAL ASSESSMENTSURVEILLANCETREATMENT OF CASES

AREAS WITH API < 2

SPRAYING SURVEILLANCETREATMENTFOLLOW UPEPIDEMIOLOGICAL INVESTIGATION

DRUG DISTRIBUTION CENTRE

DISPENSE ANTI MALARIAL DRUGS

FEVER TREATMENT DEPOT

COLLECT BLOOD SLIDES

DISTRIBUTE ANTI MALARIAL DRUGS

RESEARCH

MONITORING TEAMS TO IDENTIFY FALCIPARUM SENSITIVITY TO CHLOROQUINE

TEAM TO TEST ALTERNATE DRUGS FOR CHLOROQUINE RESISTANCE

HEALTH EDUCATION

RE-ORGANISATION FOR IMPLEMENTATION OF PROGRAMME BASED ON GEOGRAPHICAL BOUNDARIES OF DISTRICT

DHO(IMPLEMENTATION OF PROG)

DMO(OPERATION AND EVALUATION)

ASST MALARIA OFFICERS

P.FALCIPARUM CONTAINMENT 1977COMPONENT OF MPO

INTRODUCED WITH THE ASSISTANCE OF SWEDISH INTERNATIONAL DEVELOPMENT AGENCY

TO PREVENT OR CONTROL THE SPREAD OF FALCIPARUM MALARIA

AREAS

SURVEILLANCEAIM•CASE DETECTION THROUGH LAB SERVICES•FACILITIES FOR PROPER TREATMENT

ACTIVE

TYPES

PASSIVE

ACTIVE SURVEILLANCE☻CARRIED OUT BY SURVEILLANCE WORKERS☻SW-10,000☻TERRAIN AREA☻4 SW-HEALTH ASST.☻SW -FUNCTION

PASSIVE SURVEILLANCESEARCH FOR CASES BY LOCAL HEALTH AGENCIES

CASES THOSE ESCAPED ACTIVE SURVEILLANCE ARE SCREENED

PARAMETERS OF SURVEILLANCEAPIABERAFISPRSFR

MALARIA ACTION PROGRAMME 1995

RESURGENCE OF MALARIA

EXPERT COMMITTEE 1994

HIGH RISK AREAS IDENTIFIED

FTD MICROSCOPY FACILITY

1000 POPULATION 30,000 POPULATION

ELEMENTSEARLY DIAGNOSIS AND PROMPT TREATMENTSUSTAINABLE PREVENTIVE MEASURES INCLUDING VECTOR CONTROLPREVENTION OF EPIDEMICSREGULAR ASSESSMENT

HIGH RISK AREAS

HIGH APIHIGH PROPORTION OF PF CASESREPORTED DEATH DUE TO MALARIASPR DOUBLEDSPR >5%

ENHANCED MALARIA CONTROL PROJECT 1997

•WITH WORLD BANK ASSISTANCE•1997-2003, EXTN TO 2005

OBJECTIVES

EFFECTIVE CONTROL OF MALARIABRING DOWN MALARIA MORBIDITYPREVENTION OF DEATH DUE TO MALARIACONSOLIDATION OF GAIN ACHIVED SO FAR

SELECTION OF PHC-CRITERIA

API>2 FOR LAST 3 YRSP.FALCIPARUM>30% OF CASES25% TRBAL POPULATONDEATH DUE TO MALARIA

MAIN COMPONENTS

EARLY CASE DETECTION AND TREATMENTSELECTIVE VECTOR CONTROL AND PERSONAL PROTECTIONHEALTH EDUCATION AND COMMUNITY PARTICIPATION

PLAN OF ACTION

SYNTHETIC PYRETHROIDSBED NETSRAPID DIAGNOSTIC KITSARTEETHER INJECTIONSBLISTER PACKSFUNS FOR TRAINING

NATIONAL ANTI-MALARIA PROGRAMME 1999

NATIONAL VECTOR BORNE DISEASE CONTROL PROGRAMME 2004

OBJECTIVES

REDUCE MALARIA MORBIDITY AND MORTALITY BY 50%

TARGETS AND INDICATORS

ABER>10%MBER OF 0.8% 1.2 – 1.8%API 1.3 OR LESS25% REDUCTION IN MORBIDITY AND MORTALITY BY 201050% REDUCTION IN MORBIDITY AND MORTALITY BY 2012

INTENSIFIED MALARIA CONTROL

PROJECT 2005

MALARIA CONTROL IN TAMILNADU

RURAL URBAN