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Review Meeting with State Health Secretaries on 11 th & 12 th September, 2012. National Vector-Borne Disease Control Programme (NVBDCP). NVBDCP. Malaria Kala-azar Dengue Chikungunya JE/AES Lymphatic Filariasis. General Strategy for Prevention and Control of VBDs.
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Review Meeting with State Health Secretaries on 11th & 12th September, 2012.National Vector-Borne Disease Control Programme (NVBDCP)
NVBDCP • Malaria • Kala-azar • Dengue • Chikungunya • JE/AES • Lymphatic Filariasis
General Strategy for Prevention and Control of VBDs • Early diagnosis and complete treatment • (No specific drugs against Dengue, Chikungunya and J.E.) • Integrated vector Management (IRS, LLIN, fish, chemical and bio-larvicide, source reduction) • Supportive intervention – (Vaccination only against J.E.) • Annual MDA (only against LF) • Behaviour change communication
Externally Aided Projects Global Fund Supported Project in North East World Bank Supported Project
Malaria Project States under GFATM • 7 NE States • 86Districts • 43 Million Pop. • 7 States • 86 Districts • 43 million Population
Malaria Project States under World Bank Project (Phase – I & II) Chhattisgarh Districts : 11 + 5 Expansion of World Bank Project Districts Jharkhand Districts : 12 + 10 Madhya Pd. Districts : 9 + 10 Gujarat District : 12 West Bengal Districts : 7 Maharashtra District : 5 Orissa Districts : 13 + 17 Andhra Pradesh. District : 5 + 1 Karnataka Districts : 7 • Phase I: 50 Districts in 5 States, Population – 71.04 Million • Phase II: 74 Districts in 9 States (5 of P-I + 4 New), Population – 170.77 Million • Total in Phase I & II – 124 Districts in 9 States, Population – 241.81 Million New States
Malaria Surveillance- Annual Blood Examination Rate (ABER) in 2011
Entomological Surveillance • Entomological surveillance to be strengthened at state and zonal level to monitor prevalence of vectors and their susceptibility to insecticides • Current Status • Of 35 states/UTs, 31 have sanctioned posts of State Entomologist . • Only 11 are in position. • Total 72 zones in country (1 added in Nagaland). • 36 zones have entomologists. • 37 are to be filled up • Mobility and logistic supports to be provided for entomological surveillance
Human Resources State-wise Status Status of Trained ASHAs as on 31.07.2012
Procurement & Supply of Long Lasting Insecticidal Nets (LLINs)
Malaria - Action Points Surveillance and reporting of cases and deaths to be monitored Required human resource to be provided Project staff allocated should be filled up on priority Rapid Diagnosis Tests (RDTs) and Anti-malarial Drugs including Artemisinin based Combination Therapy (ACT) to be ensured Release of Funds to districts & submission of SoEs to be monitored Timely payment of salary to project staff to be ensured
Kala-azar Endemic Areas (52 Districts in 4 States) JHARKHAND Districts : 4 WEST BENGAL Districts : 11 6 districts Pop. – 11.0 mil 31 districts, Pop. – 62.3 mil • World Bank supported Kala-Azar Project Areas 46 districts (3 states) BIHAR Districts : 31 4 districts Pop: 6.7 mil 11 districts Pop. – 50 mil States : 4 Districts : 52 Population : 130 million 85% of all cases in Bihar. 9 distt in Bihar contribute 65-70% of cases.
Kala-Azar Elimination – Action Points • The focus on timely and quality Indoor Residual Spray with DDT to be maintained. • Vacant positions of Kala-azar Treatment Supervisors (83 in Bihar and 60 in West Bengal). • Standard treatment guidelines to be followed. • Regular monitoring and supervision to be strengthened at the district level (preferably under the Chairmanship of District Magistrate) • In Bihar, a dedicated State Programme Officer should be appointed.
Diagnostic Facilitiesat State & District Levelfor Dengue & Chikungunya (increased to 347in 2012) *Locations of 14 Apex Referral Laboratories
Dengue Control – Action Points • Mid Term Plan approved by Committee of Secretaries and disseminated to states emphasizes: • Entomological surveillance & disease surveillance • Case management • Integrated vector control • Epidemic preparedness and Media management • Inter-sectoral coordination • Initiatives • NS1 : ELISA based test Introduced for early detection – availability at all diagnostic facilities to be ensured • Numbers of Diagnostic facilities increased – Functional status to be ensured.
Japanese Encephalitis (JE)/ Acute Encephalitis Syndrome (AES) Situation
JE/AES – Action Points(Specially in 60 Districts of UP, Bihar, Assam, TN, WB) • Operationalization of designated sentinel sites. • Implementing model public health action plan. • Improving coverage of JE vaccination in campaign mode & under UIP. • Strengthening district hospitals for improving medical attention to admitted children. • Medical rehabilitation of disabled cases.
Elimination of Lymphatic Filariasis – (1) Elimination of Lymphatic Filariasis in India by 2015. The twin pillars of LF elimination strategy include: Transmission control by Annual MDA for 5-7 years or more with DEC + Albendazole Disability Prevention and Management by Home based management of lymphoedema cases and up-scaling of hydrocele operations
Elimination of Lymphatic Filariasis – (2) Population at Risk of LF • MDA launched in 2004 has been expanded to 250 endemic districts. • MDA coverage has increased from 72% in 2004 to 88% in 2011. • Assessment by Medical Colleges reveals compliance from 40-80% in different states. • Mf Rate has declined below 1% mf rate in 180 districts – First step towards elimination • Morbidity Management initiated Endemic districts: 250 (in 20 States/UTs) Population at risk: 600 million Population eligible for MDA – 509 Million
World Bank Phase – I Malaria Project States Jharkhand Districts : 12 Madhya Pradesh Districts : 9 Orissa Districts:13 Chhattisgarh Districts : 11 Andhra Pradesh Districts : 5 States -5, Districts -50, Population -79.10 Million
World Bank Phase – II Malaria Project States Expansion of World Bank Project Districts Chhattisgarh Districts : 5 Jharkhand Districts : 10 Madhya Pd. Districts : 10 Gujarat District : 12 West Bengal Districts : 7 Maharashtra District : 5 Orissa Districts : 17 Andhra Pradesh. District :1 Karnataka Districts : 7 74 Districts in 9 States (5 of P-I + 4 New), Population - 111 Million New States
Inclusion of 74 Additional Districts under World Bank Phase II Project – (1)
Inclusion of 74 Additional Districts under World Bank Phase II Project – (2) Phase I - 50 Districts , Phase II – 74 Districts, Total – (50+74) = 124 Districts
AES/JE Situation In India Number of endemic districts: 135; Population: 330 million
