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Learn about the history and strategies of the National Malaria Control Program in India, including insecticide spray, treatment, surveillance, and community participation.
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Malaria- IVNational Programs Presenter : Dr. Rohit A. Bhat Chairperson : Dr. Pushpa S. Patil
Bhore committee • 1946 - 75 million malaria cases - 0.8 million malaria deaths • Country wide comprehensive program • 1951- Planning Commission
National malaria control program • 1953 - launched • Objectives: - bring down transmission - maintain the achievement • Strategies: - residual insecticide spray - malaria control team - anti-malaria drugs
National malaria eradication program • 8th WHA- 1955 • NMEP- launched 1958 • Nil malaria deaths- 1965 • Resurgence in 1970
Urban malaria scheme • Launched 1971 • Anti larval measures • High number of cases in 1976
Modified plan of operation • 1977- 1994 • Objectives:- elimination of malarial deaths - reduction of malaria morbidity - maintenance of gains • Strategies:- API 2 and above - API less than 2
API 2 and above API less than 2 Focal spray of insecticide Surveillance and treatment Radical treatment Epidemiological investigation • Insecticidal spray • Entomological studies • Malaria surveillance • Treatment of cases • Rural areas [SIDA] • Decentralization of lab services • DDCs and FTDs
API 2 and above • Insecticidal spray • Entomological studies • Malaria surveillance • Treatment of cases • Rural areas [SIDA] • Decentralization of lab services • DDCs and FTDs
API 2 and above API less than 2 Focal spray of insecticide Surveillance and treatment Radical treatment Epidemiological investigation • Insecticidal spray • Entomological studies • Malaria surveillance • Treatment of cases • Rural areas [SIDA] • Decentralization of lab services • DDCs and FTDs
Tribes Epidemic prone areas Project area Urban areas
Revised control strategy • Disease management • Intensified IEC • Case detection • Presumptive treatment • Radical treatment for Plasmodium falciparum • Alternate drug in chloroquine resistance
Enhanced malaria control project • 1997 • 6 crore tribal population, 8 states, 100 districts, 19 urban areas • Strategies:- early detection and treatment - vector control - health education and community participation • Selection of PHC
National anti malaria program • 1999 • Since 1977- 1045 PHCs 100 districts 19 towns/cities • 79% districts recorded decline in 2003 • 0.72 million in 1997 -> 0.41 million in 2004
National vector borne disease control program • Launched 2004 • Kala azar • Chikungunya • Japanese encephalitis • Malaria • Filaria • Dengue
Strategies: Rural areas • Early case detection and prompt treatment • Vector control • Community participation • Environmental management and source reduction methods • Monitoring and evaluation of the programs
Strategies: Urban areas • Norms:- population>50,000 - API>2 - strictly implement laws • Additional strategy • Passive surveillance in institutions • Recurrent anti larval measures • IEC campaign
Malaria surveillance • Active case finding • Passive case detection • Rapid fever survey • Mass survey • Annual blood smears examination rate • Slide positivity rate
Intensified malaria control project • 2005- assistance from global fund • Objectives:- increase access - reduce transmission - enhance awareness - promote participation • 4,99,970 DDCs, FTDs, Malaria clinic
NVBDC support project (2008-2013) • Objectives: • Reduce malaria morbidity by 25% by 2013 [base year 2007] • Reduce malaria mortality by 50% by 2013 [base year 2007] • Achieve kalaazarelimination by 50% of sampled blocks during the project period
Malaria epidemics: Prediction and Preparedness • Climatic factors • Vulnerability • Parasite factors • Operational factors
Epidemic response • Detecting malaria epidemic • District mobile malaria epidemic control team[DMECT] • Emergency vector control measures
Roll back malaria • Founded in 1998 • Political commitment • April 2000- Ambuja, Nigeria
Summary • Comprehensiveness of program • Tribal malaria • Change in program terminology • Environmental sanitation • Political will • Community participation • Malaria diagnosis
Development of anti malarial resistance • Treatment • Health delivery system • Malaria surveillance • Trained manpower • Social and ethical issues • Use of bed nets
References • J.Kishore. National Health Programmes of India. 10thedn • Oxford Textbook of Public Health Volume 3, 5th edition • Park’s Textbook of Preventive and Social Medicine 21st edition • World Malaria Report 2011 available at http:// www. who.int http://www.nvbdcp. gov.in http://www.malarisite.com • AH Suryakanta. Textbook of Community Medicine with Recent Advances 2nd edition
WHO global malaria control strategy • Technical elements • Epidemiological indicators • Core indicators