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
Malaria Situation
2.00
3000
2500
Deaths
2000
1.50
Cases
(in million)
1707
1.00
1500
1311
1144
1055
1000
1018
0.50
753
500
2007
2007
2008
2009
2011
Pf
2010
Cases (in million)
2006
2009
0
2008
0.00
Deaths
2010
2011 (Prov.)
Cases
Death
Cases
Death
Cases
Death
Cases
Death
Cases
Death
1508927
1311
1526210
1055
1563574
1144
1599986
1018
1310656
753
Externally Aided Projects
1. Global Fund Supported Project in North East
2. World Bank Supported Project
Malaria Project States under
GFATM
7 NE States
• 86Districts
• 43 Million Pop.
 7 States
 86 Districts
 43 million Population
Global Fund Supported
Intensified Malaria Control Project-II
• Seven NE states covered
• Project staff - States advised to appoint & train
• Sentinel Surveillance Hospitals for trend of severe
malaria cases and deaths - 14 hospitals identified and
to be made functional
• LLIN – 11.38 million supplied and 10.24 million
processed
• States advised to plan for storage & distribution
• States to ensure availability of RDTs and ACTs
Malaria Project States under World
Bank Project (Phase – I & II)
Expansion of World
Bank Project Districts
Chhattisgarh
Districts : 11 + 5
Jharkhand
Districts : 12 +
10
Madhya Pd.
Districts : 9 + 10
Gujarat
West
Bengal
District : 12
Districts : 7
Maharashtra
District : 5
Orissa
Karnataka
Districts : 7
Andhra Pradesh.
District : 5 + 1
Districts : 13 +
17
•Phase I: 50 Districts in 5 States, Population – 71.04 Million
New States •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
Malaria Surveillance- Annual Blood
Examination Rate (ABER)
State-wise Performance
Status of ABER- 2011
Indicator
(Target > 10% of pop)
States
ABER <5
Bihar, Delhi, Lakshadweep, Manipur,
Sikkim, Uttarakhand , Uttar Pradesh
ABER 5-10
Chandigarh, Himachal Pradesh, Jammu & Kashmir,
Kerala, Tripura, West Bengal
ABER >10
A&N Island, Andhra Pradesh,
Arunachal Pradesh, Assam, Chhattisgarh,
Dadra & Nagar Haveli, Daman & Diu, Goa Gujarat,
Haryana, Jharkhand, Karnataka, M.P,
Maharashtra, Meghalaya, Mizoram, Nagaland, Orissa,
Puducherry Punjab, Rajasthan, Tamil Nadu
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 post 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, and
• Vehicles
to
surveillance
be
provided
for
entomological
Human Resources
State-wise Status
Vacancies
District Malaria Officer
(DMO)
85 Vacancies in 15
States
State-wise Vacancies
Assam – 14, Nagaland – 1, Sikkim – 4,
Andhra Pradesh – 7, Orissa – 6, Gujarat
– 4, Karnataka – 4, Maharashtra – 13,
Himachal Pradesh – 2, Kerala – 3,
Jammu & Kashmir – 1, Punjab – 5, Uttar
Pradesh – 17, Uttarkhand – 2, A&N
Island – 1
Status of Trained ASHAs as on 31.07.2012
In-position
(24 states)
Trained In Malaria
653504
376017
Procurement & Supply of Long
Lasting Insecticidal Nets (LLINs)
(in Lakhs)
S. No
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
State/UTs
Assam
Andhra Pradesh
Arunachal Pradesh
Chhattisgarh
Madhya Pradesh
Manipur
Meghalaya
Mizoram
Nagaland
Tripura
Jharkhand
Orissa
West Bengal
Karnataka
Maharashtra
Gujarat
Total
Approx. Cost (Rs. in Crores)
Total Supplied
(till Dec. 2011)
18.34
10.06
1.20
10.03
7.07
0.55
4.14
2.50
1.00
6.03
6.60
38.02
8.31
0.00
0.00
0.00
113.85
250.00
Under
Procurement
(2012-13)
4.01
8.89
0.50
6.34
14.58
0.50
1.00
0.50
1.50
1.80
20.53
31.39
3.00
2.50
2.40
3.00
102.44
220.00
Malaria- Major Issues
• Surveillance and reporting to be ensured
• RDT, ACT availability to be ensured
• Increase in malaria case to be monitored
• Release of Funds to districts, work performance &
submission of SoE to be monitored and ensured
• Required human resource to be filled up
• Project staff allocated should be filled up on priority
• Timely payment of salary to project staff to be
ensured
Kala-azar Endemic Areas
(52 Districts in 4 States)
6 districts
Pop. – 11.0 mil
31 districts,
Pop. – 62.3 mil
World Bank supported Kala-Azar
Project Areas 46 districts (3 states)
BIHAR
4 districts
Districts : 31
Pop: 6.7 mil
JHARKHAND
Districts : 4
11 districts
Pop. – 50 mil
WEST BENGAL
Districts : 11
States
: 4
Districts
: 52
Population : 130 million
85% of all cases in Bihar.
9 distt in Bihar contribute 65-70% of cases.
Kala-azar – Cases and Deaths
77102
Deaths
72000
1810
61670
62000 57742
1610
1419
1410
52000
606
27049
687
22000
33140
810
29000
24212
610
24479
12000
Cases
Deaths
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1992
1991
1990
2000
410
210
93 105 80
2009
18214
14753
17429
13627
12239
12140
12886
297
255 226
213 168 210
155 157 187 203 151
150
2011
32000
1010
2010
42000
838
1210
44533
39178
33598
32803
10
Kala-Azar: Issues
• The focus on timely and quality Indoor Residual Spray with
DDT to be maintained.
• The vacancy position of Kala-azar Treatment Supervisors
(83 in Bihar and 60 in West Bengal) and other staff to be
filled up.
• 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.
30000
169
157
28292
Cases
25000
110
20000
15000
12317
69
15535
96
12561
80
18860
83
11465
10000
5534
5000
0
2006
2007
2008
2009
2010
2011
Years
Cases
Deaths
2012
(Prov.)
(upto
31st
Aug.)
180
160
140
120
100
80
60
40
20
0
Deaths
Dengue Situation
Diagnostic Facilities at State & District Level
for Dengue & Chikungunya (increased to 347 in 2012)
1
Andhra Pradesh*
32
2
A&N Islands
3
3
Arunachal Pradesh
1
4
Assam*
9
5
Bihar
5
6
Chandigarh*
1
7
Chhattisgarh
2
8
Daman & Diu
1
9
D&N Haveli
1
18 Karnataka*
22
19 Lakshadweep
1
20 Maharashtra*
23
21 Madhya Prd**
17
22 Manipur
2
23 Meghalaya
3
24 Mizoram
1
25 Nagaland
2
26 Orissa
8
27 Pondicherry
4
28 Punjab
15
29 Rajasthan
20
30 Sikkim
2
31 Tamil Nadu*
30
32 Tripura
1
10 Delhi**
33
11 Goa
3
12 Gujarat*
16
13 Haryana
14
14 Himachal Prd
2
15 J & K
7
33 Uttar Pradesh*
22
16 Jharkhand
4
34 Uttarakhand
7
17 Kerala*
20
35 West Bengal*
13
*Locations of 14
Apex Referral Laboratories
Dengue Control Issues
Mid Term Plan approved by CoS emphasizes:
• Disease Surveillance & Entomological Surveillance
• Case management
• Integrated vector control
• Epidemic preparedness and Media management
• Social mobilization
• 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.
9000
8000
7000
6000
5000
4000
3000
2000
1000
0
1400
8249
1169
1200
995
663
684
4110
3855
2871
774
5167
679
4521
765
4483
1000
800
600
400
200
0
2006
2007
2008
2009
2010
Years
Cases
Deaths
2011 2012 (P)
(till 1st
Sept.)
Deaths
Cases
JE/AES Situation
Japanese Encephalitis- Issues
• Improving
coverage
of
JE
vaccination
in
campaign and under UIP.
• Implementing model public health action plan.
• Operationalization of designated sentinel sites.
• 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
Colleges
by
reveals
Medical
compliance
from 40-80% in different states.
•
Mf Rate has declined below 1%
mf rate in 180 districts – First
Endemic districts: 250 (in 20
States/UTs)
Population at risk: 600 million
Population eligible for MDA – 509 Million
step towards elimination
•
Morbidity Management initiated
Thank You