- 1. National Vector Borne Diseases Control
Programme-GujaratPresentation ofStatus Report DR.G.C.SAHU
ROH&FW GOVT OF INDIA AHMEDABAD
2. MOSQUITOS OF PUBLIC HEALTH IMPORTANCE AEDES-- DENGUE
ANOPHELES-MALARIA CULEX--FILERIA .AND THE TYPE OF EGGS THEY LAY .
ANO. AED. CUL. 3.
- Reduction in Annual Parasitic Incidence by 30%.
- Preventing deaths due to malaria.
- Reduction in morbidity due to Dengue and Chikungunya by
50%.
- Reducing Micro Filaria Rate by 50%.
Overall Goals1. To reduce malaria morbidity and mortality by 50
% in 5 years. 2. To bring down LF transmission by achieving more
than 90 % reduction in Mf rate in five years. 3. To reduce
incidence of Dengue as well as Chikungunya by more than 50%.
- Objectively verifiable indicators
- Annual parasitic Incidence to be reduced by 50% at the end of
the project period.
- Reduction in micro filaria rate to less than 1.
- Reduction in mortality due to malaria and dengue.
- Reduction in sero positivity rate for Dengue and
Chikungunya.
4. Organizational chart of NVBDCP in Gujarat. BHO Department of
Health & Family Welfare Honorable Health Minister Additional
Chief Secretary Health & FW Commissioner Health, Medical
Services &Medical education Additional Director Health Services
5. LIFE CYCLE OF MALARIA PARASITE AS IT PROCEEDS IN HUMAN &
VECTOR MOSQUITO LIFECYCLEOF MAL.PARASITEP.VIVAX LIFECYCLEOF
MAL.PARASITE PF. 6. Malaria paradigms in Gujarat The peculiar
geo-ecological conditions in Gujarat Statewhich consists of diverse
topographic features, climatic conditionsand other favorable
factors such as rapid industrialization and urbanization have
facilitated the formation of different malaria paradigms Valsad,
Navsari, Bharuch,Jamnagar and Junagadh Coastal malaria Surat,
Valsad, Bharuch,Kutch, Jamnagar. Industrial malaria
Surat,Vadoadara, Ahmedabad, Bharuch. Urban malaria Surat city,
other urban areas. Migration malaria Central Gujarat :Kheda, Anand,
Panchamahal, Vadodara Irrigation malaria 4 districts in the Kutch
and North Gujarat region Epidemic prone semi arid and arid area 11
districts of South, Central and North Gujarat. Tribal malaria
Areas/districts covered Malaria paradigm 7. Malaria situation in
India 8. Endemic areas for malaria(based on API 2 as baseline) 9.
Malaria situation in Gujarat 1967 to 2006 10. 11. Significant
increase in Malaria from 32 nd to 37 thweek 12. Rise in falciparum
incidence From 32 nd week to 37 thweek 13. Drug resistant blocks
identified in Gujarat Matar, mahudha,Mehmdabad Nadiad Kheda Olpad,
Choryasi,Kamrej Suart city Surat Harij, Radhanpur, Patadi, Rapar
Sami Patan Limkheda, Dhanpur Devgadhbaria Dahod Anand Umreth Anand
Nakhatrana, Mundra, Mandvi, Anjar Bhuj Kutch Santrampur, Lunawada,
Khanpur Kadana Panchmahal Adjoining blocks Block in which drug
resistance detected District 14. Dr.G.C.Sahu/ROH&FW/GoI/A'bad
Khavada-Gorewali/ Kachchh-bhuj Kadana/ Panch mahals PHCs where
alternatrive drugpolicyisinplace.GUJARAT Pansora/Anand
Degawada/Dahod Lolada/Patan Surat city(CHQ&ACT)
Khanvel-D&NH 15. Dengue Control..need for an..Integrated
Strategy 16. 17. 18. 50 %Contribution by the Corporations 19. AMC
reported more cases in 2010 20. 21. 22. Surat, Valsad and Navsari
reported more cases 23. Jamnagar corporation Reported significant
riseIn cases 24. Bhavanagar district and corporation Reported more
cases. 25. During 2009 a total of 68confirmed Chikungunya caseshave
been reported fromA,bad (6), Kheda(15), Anand (4), SK (2), Vadodara
(10), PM (2),Bharuch (2), Narmda (6), Rajkot (3) Junagadh (5),
Porbandar (1), VMC (1), SMC (11) 26. 27. AS Fauci GLOBAL EXAMPLES
OF EMERGING AND RE-EMERGING INFECTIOUS DISEASES 28.
Social Communication Epidemiological Surveillance Entomology
Patient Care Laboratory IntegratedStrategy Components 29. 30. 31.
Filaria situation of Gujarat State: 2006-2009 Year BSE MF cases MF
rate 2006 73379 142 0.20 2007 80664 112 0.14 2008 71224 81 0.11
2009 64531 45 0.10 32. District wise Lymphoedema and hydrocele
cases reported in Gujarat State Sr. No Name of District/Corporation
No. of Patients Total Lymphoedema Hydorcele 1 Surat 1422 879 2301 2
SMC 470 157 627 3 Tapi 247 266 513 4 Valsad 65 37 102 5 Navsari 449
457 906 6 Rajkot 45 3 48 7 RMC 28 0 28 8 Jamnagar 169 0 169 9 JMC
250 3 253 10 Junagadh 59 0 59 11 Jun-Cor. 59 4 63 12 Porbandar 55 3
58 13 Amreli 64 3 67 14 Vadodara 11 148 159 Total 3393 1960 5353
33. 85.05 28427530 11587201 13624583 TOTAL 91.35 131985 52381 57339
Vadodara 8 86.66 1174632 503067 580500 Porbandar 7 85.43 4880904
2006956 2349131 Rajkot 6 84.23 3041789 1292624 1534570 Amreli 5
84.29 7061983 2681194 3181020 Surat City 4 85.78 6348576 2580704
3008681 Surat3 85.05 2581470 1113545 1309288 Navsari 2 84.58
3206191 1356730 1604054 Valsad 1 % Cov. Consumption of DEC tablets
Population covered Total Pop. District Sr. No MDA coverage - 2006
34. 35. Coverage under MDA during 2009 Sr. No. District/Corporation
Total Population Eligible population Pop. Covered No. of tablets
administered % pop. Covered DEC Alb 1 Surat 1658762 1490395 1394526
3738824 1394526 84.07 2 Surat Muni.Corp. 4530348 4077313 3992472
10877376 3992472 88.13 3 Tapi 835279 751749 689250 1880495 697819
82.52 4 Valsad 1661890 1488650 1489881 3665965 1418742 89.65 5
Navsari 1380170 1200153 1144648 2872825 1144648 82.94 6 Rajkot
2461984 2142686 2150124 5368556 2150124 87.33 7 Rajkot Muni.Corp.
1504606 1361830 1163527 3146086 1163527 77.33 8 Jamnagar 1705501
1557330 1519045 3776086 1519045 89.07 9 Jamnagar Muni.Corp. 588013
470410 445308 1168659 445308 75.73 10 Junagah 2768982 2428643
2373654 5940261 2373654 85.72 11 Junagadh Muni.Corp. 262600 223210
192760 515870 192760 73.40 12 Amreli 1431227 1428000 1295827
3356178 1332259 90.54 13 Porbandar 590717 502109 534121 1298614
534121 90.42 14 Vadodara(Dabhoi) 58332 57447 56587 147032 56587
97.01 TOTAL 21438411 19179925 18441730 47752827 18415592 86.02
36.
- Integrated Vector Management:
- Introduction of larvivorous fish in identified water
bodies
-
- Insecticide treated bed nets
-
- Early case detection and prompt, complete treatment
-
- Quality Assurance of laboratory diagnosis of malaria
-
- Strengthening of referral services
- Cross-cutting interventions :
-
- Capacity Building through integrated training approach
-
- Communication for Behavior Impact
-
- Inter-sectoral collaboration
- Close monitoring and supervision with periodic
reviews/evaluations
STRATEGIES UNDER NVBDCP:MALARIA CONTROL 37. STRATEGIES UNDER
NVBDCP:DENGUE/CHIKUNGUNYA CONTROL
- Integrated Vector Management:
- Anti larval measures/source reduction
- Introduction of larvivorous fish in identified water
bodies.
- Indoor space Spraying/fogging
- Case management and surveillance
- Early diagnosis for confirmation and to facilitate preventive
steps
- Strengthening of referral services for case management
- Cross-cutting interventions:
- Capacity Building through integrated training approach
- Communication for Behaviour Impact
- Inter-sectoral collaboration
- Close monitoring and supervision with periodic
reviews/evaluations
38. Indicators monitored on a regular basis
- Fever rate in the OPD/community.
- Sero Positivity rate for Dengue and Chikungunya
- Larval indices viz. HI, BI and CI
- Time lag between BSC and complete treatment.
- Case fatality rate for Dengue and falciparum cases.
39.
- EARLY DETECTION OF WRANING SIGNALS THROUGH REGULAR WEEKLY AND
MONTHLY MONITORING..FOR PREVENTING OUTBREAKS. A CONTINUOUS
PROCESS
40. Monitoring of comparative malaria situation is useful to
identify vulnerable spots. 41. 42. 43. 44. 45. 46. 47. Year 2006.
GIS mapping of village wise malaria situation helped to identify
high risk villages and to plan containment measures accordingly.
48. Facilities/institutions available for training in the State
- Regional Office for H&F.W, Ahmedabad.
- Health & F.W Training center- State level (1)
- Divisional Training center (4)
- District Training Team (17)
- National Institute of Malaria Research- field station,
Nadiad
Technical experts working in the above institutions are
capableof imparting training for the batches proposed in the
training. 49. Training modules available
- Case management protocol for Dengue and malaria
50. Prevention and controlof Vector Borne Diseases (Preparedness
activities)
- Series of review meetings are organized at the State level
which are chaired by Honorable Chief Minister, Health Minister,
Additional Chief Secretary Health and Commissioner Health during
the pre transmission period.
51. Surveillance and Case Management.
- All the 18000 villages were screened for fever cases during the
months of March, April, May and June 2006 by campaign mode.
- Additional manpower ( 2772 Malaria Link Volunteers and419
Vector Control Teams of 6 members) was deployed.
- Surveillance was also intensified through the volunteers
ofFever Treatment Depots, Drug Distribution Centers and ICDS
workers.
52.
- 3000 Arogya Melas were organized in all the districts of the
state.
- More than 10.0 lakh people took the benefit out of these
camps.
- 8 Government Medical Colleges and 2 Private Medical Colleges
were involved and the services of the Specialists from the
Departments of Medicine, Pediatrics and Gynecology was utilized for
treating the patients in the Arogya Melas..
Surveillance and Case Management. 53.
- AlternateSystems of Medicine were actively involved in the
campaign against Chikungunay and 25 lakh people were provided with
Ayurvedic Preparation as a prophylactic measure.
- Suspected Chikungunya patients were provided with treatment at
their doorsteps through surveillance teams .
54.
- Management of severely ill patients was ensured in all the
major hospitals of the state by providing them with free treatment.
These patients were subsequently followed up.
- The Hospitals and Dispensaries functioning under ESIS were also
opened to the General Public, more than 30,000 peoples
benefited.
Surveillance and Case Management. 55.
- Larvae eating fishes were introduced in 67956 permanent water
bodiesout of 150267 ( 45.22%). This activity which was initiated
from February 2006.
- Biolarvicide ( 9000 Kg) was made available to each Corporation,
Districts and Nagarpalikas for anti larval measures.
Vector Control - Biological 56. Demonstration of Guppyfishesto
school children 57. Vector Control - Chemical (Insecticides used:
Malathion 25 % WDP , Deltamethrine 2.5 % WP &
Alphacypermethrine 5 % WP).
- Indoor Residual Spray commenced in 63.58 lakh population in May
2006 to protect the high risk population.
- 13.50 lakh population covered under Malathion 25% and 50.08
lakh population covered under Synthetic Pyrethroid.
- Room coverage achieved-89.78%
58. Fogging operations.
- Indoor fogging operation was undertaken in 40 lakh houses for
adult vector control.
- Outdoor fogging was undertaken in Surat and Ahmedabad cities in
closed mills and other public places tominimize vector density
.
- Fogging machines (100 no.s) provided by UNICEF have been put in
to operation in the worst affected areas of the State.
59. Vector Control- Insecticide Treated Mosquito Nets
- 403508 community owned bed nets were treated with insecticide
in addition to the 138448 insecticide treatedbed nets distributed
under various projects.
- Insecticide Treated Bed nets were provided in Hospitals to
prevent the transmission of vector borne diseases.
60. Vector Control Source reduction.
- 419 Vector Control Teams ( each team comprising 6 members) were
deployed on daily wages basis to intensify vector control
measures.
- Elimination of breeding places mainly intra domestic wastaken
up on a large scale in the worst affected areas.
- 1.49 Lakhs breeding places were eliminated during the house to
house drive that was undertaken
61.
Biological Control INTEGRATED VECTOR MANAGEMENT An
Evidence-based decision making process, rationalizing the use of
vector control methods and emphasizing the engagement of
communities JUDICIOUS USE & SELECTION OF VECTOR CONTROL OPTIONS
62.
- Health Minister wrote letters to all the Sarpanches of the
Village Panchayats and other elected representatives of the
District Panchayat, Nagarpalikas and Municipal Corporations.
- Health Minister addressed the people of Gujarat through
Doordarshan during anti Malaria Month .
63.
- Messages through Doordarshan, EtV and Zee TV was relayed for
generating community awareness.
- Messages through All India Radio and Radio Mirchi were also
relayed.
- Exhibition/ road shows were organized.
64. TABLO ORGANISED DURING REPUBLIC DAY PARADE ON 26 THJANUARY
2006 AT GANDHINAGAR 65. GATE ON MAIN TRAFFIC CIRCLES OF GANDHINAGAR
TOWN. NO ENTRY MALARIA,DENGUE, CHIKUNGUNYA 66.
- School children and NCC cadets were involved in source
reduction activities.
- Hoardings and posters were displayed.
- 10 lakhs of handbills were printed and distributed.
- Social mobilization through NGOs, and other sectors was also
ensured.
- Community was educated during Krushi Mahotsav and Anti Malaria
Month.
67. Highlights of the innovative steps undertaken. 68.
- Areas reporting increase in fever incidence as per IDSP reports
and also the weekly reports from the districts are being monitored
on a day to day basis by deploying surveillance teams.
- Intensive surveillance in high risk areas and follow of malaria
cases detected during 2005 and 2006 was being carried out as a pre
transmission drive in all the districts.
- Biological control and other source reduction activities were
intensified by deploying additional vector control teams on daily
wages basis.
Innovative steps undertakenby the State. 69.
- Treating community owned mosquito nets and making available
more mosquito nets out of various sources was taken up as a
priority.
- Additional vector control teams deployed in Dengue prone areas
like Gandhinagar and Ahmedabad for Dengue prevention and control
activities.
- Timely commencement of Indoor Residual Spray.
- Awareness generation activities implemented as a part of Krushi
Mahotsava and Anti Malaria Month.
- Permission given to all districts to outsource the work of
laboratory Technicians by paying Rs. 3/ slide considering the
vacancies.
- To overcome the problem of entomological staff, the work will
also be outsourced through Indian Red Cross.
70. This completes the current presentation.
Dr.G.C.Sahu/ROH&FW/GoI/A'bad 71. THANK YOU
Dr.G.C.Sahu/ROH&FW/GoI/A'bad