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
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) in 2011
(Target: at least 10% of population at risk)
ABER
<5
States
Bihar,
Delhi,
Lakshadweep,
Uttarakhand , Uttar Pradesh
Manipur,
Sikkim,
5-10
Chandigarh, Himachal Pradesh, Jammu & Kashmir,
Kerala, Tripura, West Bengal
>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 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
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 - 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)
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 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.
Dengue Situation
169
157
180
28292
160
25000
140
110
Cases
20000
15000
12317
69
15535
96
12561
80
18860
120
83
11465
10000
100
80
60
5534
40
5000
20
0
0
2006
2007
2008
2009
2010
2011
Years
Cases
Deaths
2012
(Prov.)
(upto
31st
Aug.)
Deaths
30000
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 – 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.
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
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
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
Status of ASHAs – (1)
S. No
States/UTs
No. of ASHA Inposition
No . of ASHA
Trained In Malaria
1
Assam
28387
22150
2
Arunachal Pradesh.
3862
2592
3
Meghalaya
6255
5307
4
Manipur
3878
3120
5
Mizoram
1786
1786
6
Nagaland
1541
1195
7
Tripura
7367
7367
8
Jharkhand
39125
36659
9
Orissa
41207
30037
10
West Bengal
30114
1500
11
Andhra Pradesh
67379
8020
12
Chattisgarh
59489
18240
Status of ASHAs – (2)
S. No
States/UTs
No. of ASHA Inposition
No . of ASHA Trained
In Malaria
13
Madhya Pradesh
50113
32033
14
Maharashtra
58022
53012
15
Gujarat
29675
24248
16
Bihar
78350
53000
17
Karnataka
32743
9044
18
Kerala
31252
24000
19
Sikkim
637
150
20
Uttrakhand
11086
0
21
Punjab
16590
15893
22
D & N Haveli
150
150
23
Rajasthan
42496
25714
24
Haryana
12000
800
653504
376017
Total
Status of Project Staff – (1)
State
consultant
States/UTs
District VBD
consultant
MTS
KTS
LTs
Allo
cati
on
In
positi
on
Allocat
ion
In
positi
on
Alloca
tion
In
positio
n
Allocat
ion
In
positi
on
Allocat
ion
In
positio
n
Arunachal Pd
5
5
15
15
46
41
0
0
11
11
Assam
5
3
27
0
100
28
0
0
0
0
Manipur
5
3
9
0
16
14
0
0
12
12
Meghalaya
5
5
7
7
34
33
0
0
10
10
Mizoram
5
5
9
9
16
13
0
0
8
8
Nagaland
5
3
15
11
21
21
0
0
11
11
Tripura
5
0
4
0
25
2
0
0
10
2
Andhra Pd
6
3
6
5
36
26
0
0
18
15
Chhattisgarh
6
4
16
8
96
34
0
0
48
14
10
6
26
8
132
48
24
16
66
23
Jharkhand
Status of Project Staff – (2)
States/UTs
State
consult
ant
District VBD
consultan
t
MTS
KTS
LTs
Allo
cati
on
In
posit
ion
Alloc
atio
n
In
positi
on
Alloca
tion
In
positi
on
Alloca
tion
In
positio
n
Alloc
ation
In
positi
on
Madhya Pd
6
3
19
7
114
42
0
0
57
18
Maharashtra
6
5
5
1
30
0
0
0
15
0
Orissa
7
7
30
27
180
127
0
0
90
62
Gujarat
6
4
12
2
72
64
0
0
36
18
10
3
18
8
42
0
66
31
21
0
Karnataka
6
5
7
7
42
32
0
0
21
18
Bihar
6
2
31
31
0
0
186
146
0
0
Total
104
66
256
146
1002
525
276
193
434
222
West Bengal
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
West Bengal
District : 12
Districts : 7
Maharashtra
District : 5
Karnataka
Districts : 7
New
States
Orissa
Andhra Pradesh.
Districts : 17
District :1
74 Districts in 9 States (5 of P-I + 4 New),
Population - 111 Million
Inclusion of 74 Additional Districts
under World Bank Phase II Project – (1)
S.
No
States
1.
Andhra Pradesh
(1)
2
Chhattisgarh
(5)
3
Jharkhand
(10)
4
Madhya Pradesh
(10)
5
Orissa
(17)
Additional Districts- Phase II
Adilabad
Janjgir (Champa), Mahasamund, Durg,
Rajnandgaon
and Kawardha
Jamtara, Garhwa, Dhanbad, Bokaro, Chatra,
Deoghar, Giridih, Hazaribagh, Kodarma and
Palamu
Dhar, Ratlam, Rajgarh, Shivpuri, Sheopur,
Satna, Sagar, Panna, Jabalpur and Seoni
Angul, Balasore, Bargarh, Bhadrak, Bolangir,
Boudh, Cuttack, Deogarh, Dhenkanal,
Ganjam, Jagatsinghpur, Jaipur, Khurda,
Kendrapada, Nayagarh, Sonepur and Puri
Inclusion of 74 Additional Districts
under World Bank Phase II Project – (2)
S.
No
States
Additional Districts- Phase II
6
Gujarat
(12)
7
Karnataka
(7)
8
Maharashtra
(5)
Raigarh, Gr. Mumbai, Chandrapur, Gadchiroll and
Thane
9.
West Bengal
(7)
Bankura, Birbhum, Coochbihar, Jalpaiguri,
Midnapur (E), Midnapur (W) and Purulia
Surendranagar, Patan, Vadodara, Godhra, Dahod,
Surat, Rajkot, Kutchh (Bhuj), Junagarh, Valsad ,
Surat Mun. Corp and Ahmedabad Corp.
Kolar, Tumkur, Chitradurga, Belgaum, Raichur,
Koppal and Dakahina Kannada
Phase I - 50 Districts ,
Total
Phase II – 74 Districts,
– (50+74) = 124 Districts
Entomological Infrastructure – (1)
State Entomologist (HQ)
Sr. No
States
Zonal Entomological Units
Sanctioned In position Vacant Sanctioned In Position Vacant
Vehicle
1
Andhra Pradesh
2
0
2
6
5
1
0
2
Arunachal Pradesh
1
0
1
2
1
1
0
3
Assam
1
1
0
3
3
0
0
4
5
6
Bihar
Chattishgarh
Goa
1
1
1
0
0
1
1
1
0
4
2
0
0
0
0
4
2
0
0
0
0
7
Gujarat
1
1
0
6
4
2
0
8
Haryana
1
0
1
2
0
2
0
9
Himachal Pradesh
1
0
1
1
0
1
0
10
J&K
1
0
1
0
0
0
0
11
Jharkhand
1
0
1
2
0
2
0
12
Karnataka
1
0
1
4
3
1
3
13
Kerala
1
1
0
1
1
0
1
14
Madhya Pradesh
1
1
0
5
2
3
0
15
Maharashtra
1
0
1
4
2
2
0
16
Manipur
1
1
0
0
0
0
0
17
Meghalaya
1
1
0
0
0
0
0
18
Mizoram
1
0
1
0
0
0
0
Entomological Infrastructure – (2)
State Entomologist (HQ)
Sr. No States
Zonal Entomological Units
Sanctioned In position Vacant
Sanctioned In Position Vacant
Vehicle
19
Nagaland
1
1
0
1
1
0
0
20
Orissa
1
1
0
3
0
3
0
21
Punjab
1
0
1
3
0
3
2
22
Rajasthan
1
0
1
7
4
3
0
23
Sikkim
1
0
1
0
0
0
0
24
Tamil Nadu
2
2
0
9
9
0
7
25
Tripura
1
0
1
0
0
0
0
26
Uttarakhand
1
0
1
2
0
2
0
27
Uttar Pradesh
1
0
1
9
6
3
0
28
West Bengal
1
0
1
3
0
3
0
29
30
31
32
33
34
35
A & N Island
Chandigarh
D & N Haveli
Daman & Diu
Delhi
Lakshadweep
Puducherry
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
28
11
17
79
41
38
13
Total
0
0
0
0
0
AES/JE Situation In India
Sl.
No.
States/UTs
1 Andhra
Pradesh
Number of endemic districts:
135; Population: 330 million
2 Assam
3 Bihar
4 Chandigarh
5 Delhi
6 Goa
7 Haryana
8 Karnataka
9 Kerala
10 Maharashtra
11 Manipur
12 Punjab
13 Tamil Nadu
14 Uttar Pradesh
15 West Bengal
16 Nagaland
17 Uttarakhand
18 Jharkhand
Grand Total
2009
2010
2011
C
49
D
0
C
139
D
7
C
73
D
1
462
325
0
0
66
12
246
3
5
6
0
265
3073
454
9
0
92
95
0
0
3
10
8
0
0
0
0
8
556
5
2
0
4975
779
469
50
0
0
80
1
143
19
34
118
2
466
3540
70
11
7
18
5167
117
7
0
0
0
1
1
5
17
15
0
7
494
0
6
0
2
679
1319
821
0
9
91
90
397
88
35
11
0
762
3492
714
44
0
303
8249
250
197
0
0
1
14
0
6
9
0
0
29
579
58
6
0
19
1169
State specific
Recommendations for VBDs
State Specific Recommendations
State
Recommendation
Arunachal
Pradesh
1. Filling up of vacant post in State at earliest.
2. Regular Monitoring, Supervision & Proper Programme
Implementation.
Assam
1. Filling up of vacant post in State at earliest.
2. Regular Monitoring, Supervision & Proper Programme
Implementation
3. State to follow GOI Guidelines (Dengue)
4. Lab. Surveillance to be strengthened at sentinel sites.
5. SSHs should be identified.
Manipur
1. Filling up of vacant post in State at earliest.
2. Regular Monitoring, Supervision & Proper Programme
Implementation
3. State to follow GOI Guidelines (Dengue)
4. Lab. Surveillance to be strengthened at sentinel sites.
5. SSHs to be operationalized.
6. JE Vaccination under RI to be given.
State Specific Recommendations
State
Recommendation
Meghalaya
1. Filling up of vacant post in State at earliest.
2. Regular Monitoring, Supervision & Proper Programme
Implementation
3. SSHs to be operationalized.
4. Referral mechanism to be strengthened in highly affected
districts and critical care services should be ensured at
the referral centers to prevent the deaths due to malaria
Mizoram
1. Training should be completed at the earliest.
2. Regular Monitoring, Supervision & Proper Programme
Implementation
3. SSHs to be operationalized.
Nagaland
1. Proper Surveillance.
2. Training of all ASHA & Community Workers should be
completed.
3. SSHs to be operationalized.
4. Orientation of training programme for laboratory person
and clinicians
State Specific Recommendations
State
Recommendation
Tripura
1. Filling up of vacant post in State at earliest.
2. Proper Surveillance.
3. Training of all ASHA & Community Workers should
be completed.
4. SSHs to be operationalized.
Sikkim
1. Proper Surveillance.
2. SSHs to be operationalized.
Andhra Pradesh
1. Filling up of vacant post in State at earliest.
2. Proper Surveillance.
3. Training of all ASHA & Community Workers
should be completed.
4. SSHs to be operationalized.
5. Improved coverage of JE vaccination in routine
immunization.
6. Increased Monitoring and Supervision.
State Specific Recommendations
State
Recommendation
Bihar
1. Filling up of vacant post in State at earliest.
2. Proper Surveillance.
3. Training of all ASHA & Community Workers to be
completed.
4. SSHs to be operationalized.
5. Improved coverage of JE vaccination in RI.
6. Increased Supervision & Monitoring of IRS.
7. Proper Inventory Management for logistics flow
at grass root level
8. Timely submission of reports.
9. Timely observance of MDA for filaria.
10. Improved Treatment compliance for Kala-azar.
11. Involvement of Medical Colleges, ICMR
Institutions and NCDC Centre for assessment of
drug compliance during MDA.
State Specific Recommendations
State
Recommendation
Chattisgarh
1. Filling up of vacant post in State at earliest.
2. Regular reporting
3. Training of all ASHA & Community Workers
should be completed.
4. SSHs to be operationalized.
5. Monitoring of stock position of RDT and Anti
malarials
6. To improve IRS coverage.
7. To improve Monitoring, Supervision for all VBDs.
Goa
1. JE Vaccination under RI to be given a boost
2. AES/JE Data to be transmitted regularly.
State Specific Recommendations
State
Recommendation
Gujarat
1. The referral mechanism to be strengthened.
2. Surveillance needs to be improved.
3. To improve timely referral of severe &
complicated cases of VBDs.
4. Special focus for prevention and control of
Dengue in Ahmedabad and other corporations.
Haryana
1. Poor Surveillance
2. Special focus for prevention and control of
Dengue in satellite townships of Gurgaon and
Faridabad.
3. Strengthening of PHCs/CHCs for early case
management of the AES/JE cases.
4. JE Vaccination under RI to be given a boost.
State Specific Recommendations
State
Recommendation
Himachal Pradesh 1. Poor Surveillance
2. Regular Monitoring, Supervision & Proper
Programme Implementation.
3. Timely submission of reports by States.
4. Capacity building of district programme officers.
Jammu & Kashmir 1. Filling up of vacant post in State at earliest.
2. Capacity building of district programme officers.
State Specific Recommendations
State
Recommendation
Jharkhand
1.
2.
3.
4.
5.
6.
7.
8.
9.
Filling up of vacant post in State at earliest.
Surveillance needs to be improved.
Train of all ASHAs and community volunteers
Capacity building of district programme officers.
Improve Monitoring, Supervision & Proper
Programme Implementation.
Special focus for prevention and control of Dengue
in industrial townships of Jamshedpur
Improve IEC/BCC activities.
Improve DDT Spray programme & Kala-azar Case
search .
To improve drug compliance for achieving the goal
of elimination of Filaria programme
State Specific Recommendations
State
Recommendation
Karnataka
1. Special attention for prevention of vector mosquito
breeding in Bangalore corporation area and other
urban areas
2. Data submission to be regular.
3. JE Vaccination under RI to be given a boost.
4. Morbidity management and hydrocele operation to
be intensified for filaria programme.
Kerala
1. Filling up of vacant post in State at earliest.
2. Special focus for Trivandrum Municipal Corporation
and Plantation areas (rubber) for
Dengue/Chikungunya.
3. State to ensure use of ELISA based dengue NS1
kits only.
4. Regular Monitoring, Supervision & Proper
Programme Implementation
State Specific Recommendations
State
Recommendation
Madhya Pradesh
1. Filling up of vacant post in State at earliest.
2. The state to improve timely referral of severe &
complicated cases.
3. Capacity building of district programme officers
4. To accord priority for morbidity management in
filaria elimination Programme.
Maharashtra
1. Filling up of vacant post in State at earliest.
2. To improve timely referral of severe & complicated
cases.
3. Capacity building of district programme officers
4. To accord priority for morbidity management in
filaria elimination Programme.
State Specific Recommendations
State
Recommendation
Orissa
1. Filling up of vacant post in State at earliest.
2. Proper vigilance and performance of activities as
per schedule to be monitored in the Sub-Centres.
3. Special attention needed for mining areas for D&C.
4. Capacity building of doctors of both public and
private sectors on national guidelines for dengue
case management.
5. To accord priority for morbidity management and
hydrocele operation in filaria elimination
Programme.
Punjab
1. Improve surveillance.
2. Regular Monitoring, Supervision & Proper
Programme Implementation
3. Special focus to Ludhiana for Dengue/Chikungunya
Rajasthan
1. Filling up of vacant post in State at earliest.
2. Regular Monitoring, Supervision & Proper
Programme Implementation.
3. State to follow GOI Guidelines (Dengue)
State Specific Recommendations
State
Recommendation
Tamil Nadu
1. Filling up of vacant post in State at earliest.
2. Improve surveillance.
3. Ensure functioning of all the SSHs and availability
of both dengue ELISA based NS1 kits and IgM kits
4. JE Vaccination under RI to be given a boost.
State Specific Recommendations
State
Recommendation
Uttar Pradesh
1. Filling up of vacant post in State at earliest.
2. Regular Monitoring, Supervision & Proper
Programme Implementation
3. Improve surveillance.
4. Preparation of district wise Action Plan for effective
prevention and control of AES/JE
5. IEC/BCC for identification and immediate referral of
cases to nearby health facility.
6. Involve the Medical Colleges, ICMR Institutions and
NCDC Centre for Training, Monitoring &
assessment of drug compliance during MDA.
7. To improve organized IRS activities.
8. Timely submission of SOE & UC.
9. Line listing of cases through patient coding scheme
to be followed.
State Specific Recommendations
State
Recommendation
Uttarakhand
1. State to follow the GOI guidelines for diagnosis
2. Regular samples of AES cases to be sent to NCDC
for JE conformation.
3. Surveillance needs to be improved.
4. Regular Monitoring, Supervision & Proper
Programme Implementation.
State Specific Recommendations
State
Recommendation
West Bengal
1. Filling up of vacant post in State at earliest.
2. State to follow the GOI guidelines for diagnosis
3. Regular samples of AES cases to be sent to NCDC
for JE conformation.
4. Improve surveillance.
5. Regular Monitoring, Supervision & Proper
Programme Implementation.
6. AES/JE Data to be transmitted regularly.
7. ASHAs honorarium to be paid timely for their
reluctance to work for KA programme.
8. To improve IEC/BCC activities.
9. District Collectors need to be involved in regular
review of the programme at district level.
State Specific Recommendations
State
Recommendation
Delhi
1. Surveillance needs to be improved.
2. Enhance inter-sectoral convergence with all the
stake holders.
3. Timely reporting
Puducherry
Andaman &
Nicobar Island
1.
2.
3.
4.
Malaria needs to be paid focused attention.
Vacant post needs to be filled up.
Increase Surveillance.
Timely submission of SOE/UC
Chandigarh
1. Surveillance needs to be improved.
2. Monitoring needs to be improved.
Dadra & Nagar
Haveli
1. Surveillance needs to be improved.
2. Monitoring needs to be improved.
3. Timely submission of SOE/UC
Daman
1. Timely submission of SOE/UC
State Specific Recommendations
State
Recommendation
Lakshadweep
1. Regular Monitoring, Supervision & Proper
Programme Implementation.
2. Timely submission of Reports.
3. Timely submission of SOE/UC
Kala-azar Issues in Bihar – (1)
• Dedicated State Programme Manager.
• KTS to be filled ( 83 KTS of 276 vacant).
• Timely salaries to VBD consultants to be ensured.
• Capacity building in the districts by filling keys posts
of DMOs, Malaria Inspectors, MPHWs, Technicians
etc.
• Standard treatment guidelines.
Kala-azar Issues in Bihar – (2)
• Payment of loss of wages to the patients @ Rs 50 per day.
• Payment of incentive to ASHA/Health Volunteer
• Quality and coverage of Indoor Residual Spray with DDT
50%.
• Monitoring and supervision need strengthening- Monthly
Review at the level of District Collector at least once.
Kala-azar Issues in Jharkhand
• Poor treatment Compliance.
• No follow up mechanism.
• IRS not well planed and organized.
• Lack of monitoring and supervision.
• Proper treatment guidelines
• Case search activities not carried out during
2010 & 2011.
Kala-azar Issues in West Bengal
• 60 posts of KTS and 5 posts of VBD Consultants
have not been filled up.
• IRS activities delayed and not done with proper
planning.
• Inadequate supervision and monitoring.
• Proper treatment guidelines to be followed.
Financial Issues
State
Issues
Madaya Pradesh,
Huge unspent balance and
Tripura,
contribution of state’s share
Uttarakhand &
Lakshadeep
Orissa
Huge unspent balance
Delhi
Audit report 2009-10 & 2010-11
and SOE 2011-12 is awaited
Lymphatic Filariasis: Major Issues
S. No
Issues
States
1
Poor Compliance
Assam, Bihar, Chattisgarh, Jharkhand,
Kerala, Orissa, Uttar Pradesh, West Bengal
2
Lymphodema
Bihar, Chattisgarh, Jharkhand, Karnataka,
Management to be Kerala, Orissa, Uttar Pradesh, West Bengal
geared up
3
Hydrocele
Operations to be
geared up
Bihar, Chattisgarh, Orissa, Uttar Pradesh
and West Bengal
4
Mf Rate ( Night
Survey)
Crucial Parameter and needs proper
supervision.
Districts with less than 1% Mf rate needs
validation
5
MDA-2011 round
Bihar – Not done,
Jharkhand – scheduled on 24th Sept. 2012
U.P. – Could do only in 14 districts as DEC
was not procured
Dengue Morbidity Trend and Case
Fatality Rate
30000
3.50
28292
3.30
3.06
25000
3.00
2.55
18860
20000
16517
1.80
15000
Cases
1.08
10000
5000
3306
1177 707 944 650
2.00
15535
1.71
12754
1.60
1.69
12561
1198512317
1.271.25
1.08 1.31
0.64
0.62
5534
4153
1926
2.50
1.50 CFR
0.90 1.00
0.50
0.39
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
0.00
1996
0
Year
Cases
CFR
States Reported Increase in 2011:
Andhra Pradesh, Chhattisgarh, Manipur, Odisha, Uttarakhand, Dadra &
Nagar Haveli and Puducherry (7)
Chikungunya Situation in India
Year
No. of States Suspected
Affected
Cases
Samples
Tested
Confirmed
Cases (% )
2006
16
1390322
15961
2001 (12.5)
2007
14
59535
7850
1826 (23.3)
2008
13
95091
7886
2461( 31.2)
2009
13
73288
17552
6811( 38.8)
2010
18
48176
14588
5602 (38.4)
2011
21
20402
12035
3642 (30.3)
2006-2011 total 21 states affected
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
• Long Lasting Insecticidal Nets (LLINs) – 11.38 million
supplied and 10.24 million processed
• States advised to plan for storage & distribution
• States to ensure availability of RDTs and ACTs