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Vector Borne Diseases State Conclave Igatpuri 23- 24 May 2014

Vector Borne Diseases State Conclave Igatpuri 23- 24 May 2014. Joint Director of Health Services. Dengue in Maharashtra. Health Circle Wise Dengue Deaths 2013. 2. 2. 4. 8. 2. 2. 2. 1. 8. 10. 2. 3. 7. 8. 3. 3. 4. 10. 4. 1. 7. 2. 1. Dengue Deaths from

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Vector Borne Diseases State Conclave Igatpuri 23- 24 May 2014

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  1. Vector Borne DiseasesState ConclaveIgatpuri23- 24 May 2014 Joint Director of Health Services

  2. WORLD HEALTH DAY 2014

  3. Dengue in Maharashtra

  4. Health Circle Wise Dengue Deaths 2013

  5. 2 2 4 8 2 2 2 1 8 10 2 3 7 8 3 3 4 10 4 1 7 2 1 Dengue Deaths from Rural Maharashtra 2013 2

  6. INITIATIVES TO CONTAIN DENGUE

  7. ‘VBD Free Village’ Schemeकिटकजन्यआजारमुक्तगाव

  8. ROLE OF VHNSC • 15% of VHNSC untied funds can be utilized for source reduction of VBD vectors • Activities to be carried out by utilizing this fund • Minor engineering • Application of temephos in water containers • Human Resource required for source reduction & cleaning • IEC • Construction of Guppy fish hatchery

  9. VBD Free Health Institutions PHC ShevgaonAhmadnagar PHC ChincholiChandrapur • Study by Dr Kharat ADHS & Dr. Kambale DD Thane is an eye opener. • 5 doctors among deceased in 2013 Dengue Mortality List.

  10. Coordination With Urban Counterpart Urban verses Rural Role of DD & CS Review of urban areas in every monthly meeting. Special focus on Surveillance Vector management Lab facilities Implementation of civic bye laws Technical inputs wherever needed.

  11. Dengue Active Search

  12. Dengue – Active Case Search • Develop SURVEILLANCE NETWORK for Dengue. • Block level workshop for Private Medical Practitioners for reporting Suspected/ Confirmed Dengue cases to Public Health authority. • Disseminating Suspected Case definition • Displaying request for Dengue reporting with contact numbers of DHO & DMO in every clinic, hospital & labs. • Weekly visit to Private Medical Practitioners by MPW/ HA/HS & all other officers during field visits.

  13. संशयित/ निश्चितडेंग्यूरुग्णकळवा आपल्यागावातूनडेंग्यूआजारपळवा….! • डेंग्यूचीसंशयितरोगीकसाओळखावा ? • सातदिवसापेक्षाकमीकालावधीचातीव्रताप • तीव्रडोकेदुखी • अंगदुखी/ स्नायूदुखी • बुबळामागेवेदना • अंगावरलालसरपुरळ/ रॅश • रुग्णाचेनाव, पत्ताआणिफोननंबरखालीलफोनवरलगेचकळवा. • जिल्हाआरोग्यअधिकारी- नावमोबाईल - कार्यालय • जिल्हाहिवतापअधिकारी – नाव - मोबाईल - कार्यालय

  14. Actions after Dengue case get reported • Visit to suspected case & serum sample collection. • Entomological surveillance of work place & home of suspected case along with adjacent 100 houses. • Rapid Fever Survey of adjacent 100 houses. • If required collection of 5-10% sample collection. • Emptying positive container, use of antilarval. • Necessary vector management actions with people’s support – Cleanliness Drive, Dry day,Fogging etc • Appropriate treatment to affected • IEC

  15. Sentinel Surveillance Hospitals Dengue, CHK & JE • Monthly visit to these centers by District level officers. • Review inventory & address other issues, if any. • Representatives of SSH should attend monthly review meetings at district & divisional level.

  16. Dengue Case Management • Role of CS – • Plan on job training for all clinicians working at public hospitals. • Guidance from DMER faculties. • One half day workshop per 2-3 blocks • Use of clinical management booklet available on NVBDCP website. www.nvbdcp.gov.in

  17. Elimination of lymphatic filaria 2015

  18. Neglected Tropical Diseases • 66 th World Health Assembly last year declared 17 diseases as NEGLECTED TROPICAL DISEASES. • FILARIA is one of them….!

  19. FILARIA ENDEMIC DISTRICTS OF MAHARASHTRA

  20. High Endemic district for Filaria

  21. National Health Policy (2002) • Goal : To eliminate lymphatic filariasis from India by the year 2015. • Objectives: • To reduce and eliminate transmission of LF by Mass Drug Administration of Diethycarbamazine Citrate (DEC). • To reduce and prevent morbidity in affected persons, and • To strengthen the existing health care services.

  22. National filaria control programme • Launched in 1955. • Elimination of LF means LF ceases to be public health problem when mf rate is less than 1 % & the children borne after initiation of ELF are free from ciculating antigenemia. • WHA 50.29 in 1997 – ELF by 2020. • National Health Policy (2002) – ELF by 2015.

  23. Twin pillars of elf

  24. Mass Drug Administration -2004 • Interruption of transmission of filariasis by Annual MDA for 5 years or more to the population except: - children below 2 years- pregnant women- seriously ill persons • DEC + Albendazole in selected districts • 17 districts. • 27.5 million population

  25. Morbidity Management • Home based management of lymphoedema cases and • Up-scaling of hydrocele operations in the identified CHCs / District hospitals/ medical colleges.

  26. Filaria Control strategies

  27. INFRASTRUCTURE UNDER NATIONAL FILARIA CONTROL PROGRAMME FILARIA SURVEY UNIT FILARIA CONTROL UNIT • Aurangabad, • Thane, • Nasik, • Pune, • Akola, • Nagpur • Vasai, • Palghar • Akkalkot • Nanded • A’vati • Rajura • Chandrapur • Gadchiroli • Dhanora • Bhandara • Pawani • Nagpur(R) • Umred • Nagpur corp • Wardha, • Thane corp

  28. Activities under NFCP I National Filaria Control units : 16 • Night blood surveillance in jurisdiction – 10% Popln • B.S. Coll by F.I.– 600 B.S. / F.I. • Examination of blood slides by L.T. • Treatment • Weekly Anti larval measures • Morbidity management • Hydrocelctomy

  29. Activities under NFCP II • Survey Units : 6 • Regional night blood surveillance – 10% popln • Entomological surveillance • B.S. coll by F.I. – 3000 B.S. /Mnth by 2 F.I. • Examination of blood slides by L.T. • Treatment • Night Clinics : 34 • Night blood surveillance in jurisdiction – 100% popln in 2-3 years • B.S. coll by F.I.- 1500 B.S. / F.I./Mnth • Examination of blood slides by L.T. • Treatment • Morbidity management

  30. Towards elimination of Filaria Mf% trend

  31. Base Line Data Districts with > 1 mf rate

  32. Transmission Assessment Survey (TAS) – Validation of Elimination Status • Criteria to go for TAS – • 5 MDA rounds with 65 % consumption rate. • Mf rate < 1% in last 3 years at every spot in Base line survey. • Such districts will undergo ADDITIONAL MF SURVEY…! If mf < 1 at all 10 spots of survey…. • TAS – Survey of school children of 1 & 2 Standard. If TAS succeeds – ELF validated. • In 2013-14 – Districts selected – Thane, Akola, Jalgaon & Sindhudurg. Thane failed in ADD SURVEY • Jalgaon & Sindhudurg completed TAS in April. Akola will do it in JUNE.

  33. Role of DHO in Filaria Control • Coordination with NFCU,NFSU & Night clinics in their jurisdiction. • Monthly review of Filaria units. • Field visits by DHO, ADHO, THO & MO to different Filaria Units • Planning & Monitoring – Filaria Surveillance activity from 16-31 August 13. • Active role in MDA planning & implementation. • Validation of elephantiasis & hydrocele cases from MO PHC. • Line listing of cases from SC to district level.(New/Old) • Morbidity management Clinics at SC, PHC & RH/SDH. • Planning of Hydrocelectomy Camps at RH/SDH/DH as per line list of cases

  34. Weekly Morbidity Management Clinic at every SC/PHC/RH

  35. Role of CS in VBD Control • Focus on Passive surveillance of Hospitals – Review of hospitals with poor passive surveillance. • Establish Sentinel Hospitals for Malaria to reduce malaria mortality. • Assure functional SSH for Dengue, CHK, JE. • On job case management trainings for all clinicians. • Planning of Hydrocelectomy Camps at RH/SDH/DH as per line list of cases. • Regular IDSP reporting.

  36. MALARIA

  37. MALARIA TREND IN STATE

  38. API range MAP of the State API less than 1 API 1 -5 API more than 5

  39. Active Surveillance NIL Collection MPWs ( Average) NIL Collection Villages ( Average)

  40. Passive Surveillance –Districts with > 30 % PHCs with < 15 % BS Collection

  41. Passive Surveillance –Districts with > 30 % Hospitals with < 15 % BS Collection

  42. MPW – Backbone of vbd control activity • Ask every MPW to prepare his ATP ( Fortnightly Surveillance Programme) based on SF 1 Register. • Ensure his field visits by cross checking ATP with his daily diary. • Stenciling will help to cross check his visits in field. • Check time lag between BS Collection & Transportation to lab. • Check line list of Breeding sites & action taken by MPW. • Vacant area should be given to adjacent MPW. • New & untrained MPWs need mentoring & on job training.

  43. MPWs Surveillance CalenderPHC MurumgaonGadchiroli

  44. 11 Things MPW should do during his field visits . • H-t-H survey of 100 houses daily for fever cases. • Entomological survey of 10 % houses daily. • Necessary action & reporting of villages with > than normal entomological indices. • Visit to migrated population/ labours on development project. • Enumeration & visit to breeding sites & guppy fish hatcheries. • Introduction of Guppy fishes in appropriate breeding sites • Visit to ASHA – RDK use, RT verification of pts treated by ASHA. • School visit – especially ASHRAM SHALA – Surveillance & IEC. • Water Quality related work – storage facility of TCL , Regularity of water purification • Visit to Private doctors & labs for malaria, Dengue cases information • Meeting with VHNSC members & seek necessary help in vector control.

  45. Laboratory Issues • Quality of BS. • Hospital based LTs are not regular in submitting their positive & negative slides for cross checking. • Time lag • Need of integration & combined meetings of all LTs working under different schemes. • Functional Malaria Clinics

  46. TIME LAG BSC & EXAMINE- Dist: Buldhana – Antrikhedekar PHC 1 MONTH, 21 DAYS, 19 DAYS,18 DAYS,17 DAYS, 10 DAYS,

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