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*World Health Day 2014 Vector Borne Ds -  Dr Priya*
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*World Health Day 2014 Vector Borne Ds - Dr Priya*

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This presentation deals with occasion of World Health Day "2014 Theme - Vector Borne Diseases::Small Bite Big Threat" …

This presentation deals with occasion of World Health Day "2014 Theme - Vector Borne Diseases::Small Bite Big Threat"

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Need to celebrate World Health Day, Important Vector Borne Diseases Situation in Punjab India, Dengue, Malaria & JE situation, Prevention & Control of Arthropods, Challanges in public Health are discussed

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  • 1. WORLD HEALTH DAY-2014 THEME - “Vector Borne Diseases” Small Bite , Big Threat
  • 2. World Health Organization (WHO)
  • 3. Dr Priya Bansal Assistant Professor Department of Community Medicine Dayanand Medical College & Hospital, Ludhiana
  • 4. Why this theme was chosen • 17% of all infectious diseases • 1 million deaths annually. • 2.5 billion people in over 100 countries are at risk • Malaria causes more than 6,00,000 deaths every year globally. • Other VBDs diseases such as Chagas disease, leishmaniasis & schistosomiasis
  • 5. Who are affected? • These diseases affect urban, peri-urban & rural communities - Poor living conditions - Safe drinking water - Sanitation. • Malnourished people are especially vulnerable.
  • 6. Economic Effect • Vector-borne diseases play a major role in economic downgrowth • Countries with intensive malaria have income levels of only one third of those that do not have it
  • 7. Definition • Vector-borne disease (VBD) : an illness caused by an infectious microorganism (pathogen) that is transmitted to humans by a vector, usually arthropods 4/19/2014
  • 8. 88 Common Vectors – Mosquitoes (Aedes, Anopheles, Culex, Mansonia) – Fly (Sandfly, Housefly, Tsetse Fly, Black Fly ) – Flea (Rat Flea, Sand Flea ) – Ticks (Hard Tick & Soft Tick) – Lice / Bugs/ Mites/ Cyclops
  • 9. Major Vector Borne Diseases in World • Malaria • Filaria • Kala-azar • Japanese Encephalitis • Dengue / Dengue Hemorrhagic fevers • Chikungunya • Chagas Diseases (American Trypanosomiasis) • Yellow Fever • Leishmaniases • Onchocerciasis (River Blindness) • CCHF (Crimean Congo Haemorrhagic Fever) • Lyme Disease • Tick Borne Encephalitis • Schistosomiasis (Bilharzia)4/19/2014
  • 10. Major Vector Borne Diseases in India 4/19/2014
  • 11. Malaria • Life-threatening disease • Caused by plasmodium species • Transmitted through bite of female anopheles • Plasmodium - four parasite species 4/19/2014
  • 12. Malaria- Burden Globally-2012 • Approx 207 million cases & 6,27,000 deaths • 97 countries- 3.4 billion people at risk
  • 13. Malaria-Burden India-2011 • 1.31 million cases, including 6,50,000 Pf cases & 463 deaths • 27% of population resides in Malaria High Transmission areas • 58% in Low Transmission areas 4/19/2014
  • 14. PUNJAB Year Cases 2011 2660 2012 1689 2013 1764 LUDHIANA Year Cases 2011 381 2012 197 2013 210 Malaria-Burden
  • 15. Malaria Kills More People than AIDS • Malaria kills in one year ,what AIDS kills in 15 years • For every death due to HIV/AIDS, there are about 50 deaths due to malaria
  • 16. WHO are at High Risk? • Young children • Pregnant women • People living with HIV • Natural disasters • Non-immune travellers moving into Endemic areas
  • 17. Malaria • Early diagnosis & treatment is key • If left untreated, disease can lead to severe illness & death • Artemisinin -based combination therapy (ACT)
  • 18. Vaccine • No commercially available vaccine • Vaccine against P. Falciparum is currently under trial. 4/19/2014
  • 19. Dengue fever • Most rapidly spreading viral disease in the world • In past 50 years, incidence has increased 30-fold • Pattern changing from urban to rural settings
  • 20. Dengue • There are four known serotypes of dengue virus (DEN 1 to 4). • Recovery from infection by one provides lifelong immunity
  • 21. Dengue-Burden
  • 22. Globally • Estimated 5,00,000 people with severe dengue require hospitalization each year • About 2.5% of those affected die Dengue-Burden
  • 23. Dengue-Burden India-2011 • Endemic in 31 states/UTs. • About 18059 cases were reported with 109 deaths. • Case Fatality rate was 0.65% • Highest Number of cases were reported from Punjab, followed by TamilNadu, Gujarat, Kerala & Andhra Pradesh. 4/19/2014
  • 24. PUNJAB Year Cases Deaths 2011 3921 33 2012 770 ---- 2013 4117 ----- LUDHIANA Year Cases Deaths 2011 1662 23 2012 269 2 2013 1033 7 Dengue-Burden
  • 25. Dengue • No effective antiviral medications exist • No commercial vaccine available
  • 26. Japanese Encephalitis • Transmitted to humans through infected Culex mosquitoes.
  • 27. Japanese Encephalitis
  • 28. Japanese Encephalitis- Burden Globally • 50,000 cases &10,000 deaths every year • Majority (85%) of cases occur in <15 years of age 4/19/2014
  • 29. Distribution Of Japanese Encephalitis in India // J E Cases And Deaths Reported in 2011 Case Death U P 3490 579 Total 7838 1137 Japanese Encephalitis Endemic areas
  • 30. Japanese Encephalitis • No specific treatment • Vaccine (SA 14-14-2) - most effective preventive measure
  • 31. CHIKUNGUNYA • Occurs in Africa, Asia & Indian subcontinent • In recent decades, there have been outbreaks of the disease in countries
  • 32. Burden-Chikungunya • Earlier reported in 1965 with 3,00,000 cases in Kolkata & Chennai • 2006- Reappeared in 16 states • 17,472 cases were reported by the GOI in 2011 4/19/2014
  • 33. CHIKUNGUNYA • Shares same vectors, symptoms & geographical distribution as dengue, except for the presence of joint pains • No specific treatment 4/19/2014
  • 34. Prevention & Control
  • 35. STRATEGIES • Needs sound knowledge of the  Bionomics  Distribution  Seasonal prevalence  Vectorial capacity  Insecticide susceptibility status  Role of arthropods in disease transmission
  • 36. " Integrated Approach"
  • 37. Integrated Vector Management • " the utilization of all appropriate technological & management techniques to bring about an effective degree of vector suppression in a cost effective manner" • Best approach to strengthen vector control in a way that is compatible with national health systems
  • 38. • Evidence-based decision-making • Monitoring & Evaluation • Advocacy & Social mobilization • Intra & intersectoral Collaboration • Capacity-building • Legislation & Regulation Key Elements of IVM
  • 39. Methods of Control Environmental Control Chemical Control Biological Control Personal Protective measures Genetic control
  • 40. Methods of Control Environment (Source reduction,Waste management) HUMAN (PPM, Repellants) Vector (Chemical Control, Biological Control, Genetic Control)
  • 41. Environmental Control • Eliminate their breeding places • Known as "source reduction" • Results are generally permanent
  • 42.  Filling Levelling & drainage of breeding places Water management (intermittent irrigation) Source Reduction
  • 43. Chemical Control Oiling (diesel oil,fuel oil, kerosene oil) Paris green Synthetic Insecticides (Fenthion, malathion, chlorpyrifos, abate)
  • 44. Indoor residual spraying • Most widely used method • Effective way to reduce sandflies & bugs inside homes • 80% of houses in targeted area need to be sprayed. • Effective for 3–6 months, depending on the insecticide used & type of surface
  • 45. Indoor residual spraying
  • 46. Outdoor spraying • Spraying outer surfaces of - Domestic animal shelters, - Outdoor latrines & - Damp places • Aerial spraying -- control mosquitoes during epidemics of dengue & yellow
  • 47. Biological Control • Introduction of bacterial larvicides & larvivorous fish • Target vector larvae without generating ecological impacts of chemical use • Regular monitoring & restocking is important GAMBUSIA FISHES
  • 48. Genetic Control • "Use of any treatment that reduce the reproductive potential by replacing the hereditary material"  Sterile male technique  Hybrid male technique  Sex distortion  Gene replacement
  • 49. Personal protection • First line of defence • Prevent vectors from biting & feeding on host • Acheived by wearing long sleeved, light-coloured shirts, trousers, socks, shoes & by the use of repellents like Benzyl benzoate, DEET (N,N-diethyl-m- tolumide)
  • 50. Long-lasting Insecticidal Nets • Most efficient & cost- effective method • WHO recommends that everyone at risk of malaria sleeps under a net
  • 51. Waste Management • Empty tins, plastic bottles, unused drums, coconut shells & used car tyres can serve as important breeding sites
  • 52. Housing Modification • Door & window screens • Plaster walls & concrete floors in good condition • Cracks & entry points sealed up
  • 53. 4/19/2014 Challenges in the Control of Vector-Borne Diseases
  • 54. Challenges in the Control of Vector-Borne Diseases Emerging insecticide resistance  Major threat  Widespread use of synthetic insecticides Lack of expertise in vector control  Expertise of entomologists is critical ; an extreme shortage Lack of Surveillance  In many high-burden settings, there is almost no data
  • 55. Entomological Skills • WHO calls for countries to increase their investment in training people with entomological skills, as well as the corresponding infrastructure
  • 56. Sanitation and Access to Safe Drinking Water • Poor sanitation & lack of access to clean drinking water allows many vectors to thrive
  • 57. Environmental Change • Climate change is likely to exacerbate impact
  • 58. Role of Health Education • Active Community participation • Strict enforcement of legislation for wastes disposal • Unless man himself changes his behavior & becomes vector conscious & stops creating breeding places , no one can eliminate
  • 59. Health Education Material on Dengue
  • 60. Health Education Material on Malaria
  • 61. 4/19/2014 Conclusion • VBDs - greatest contributors to human mortality & morbidity in tropical settings & beyond. • Significant progress is being made in combating diseases such as Malaria, Filariasis & Chagas disease • Dengue continue to spread at an alarming pace
  • 62. 4/19/2014 Conclusion • Resistance to insecticides threatens the gains made through vector control & calls for concerted planning & collaboration across sectors • Areas where VBDs overlap, integrated management of insecticide resistance is essential, supported by adequate capacity of trained personnel
  • 63. 4/19/2014 63 Thank You!