8 Anti Malarial Measures

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8 Anti Malarial Measures

  1. 1. NATIONAL VECTOR BORNE DISEASE CONTROL PROGRAMME-MALARIA REMYA RAJAN
  2. 2. MILESTONES NMCP 1953 SPECTACULAR SUCCESS NMEP 1958 UMS 1971 RESURGENCE MPO 1977 MAP 1995
  3. 3. EMCP 1997 NAMP 1999 NVBDCP 2004 IMCP 2005
  4. 4. NATIONAL MALARIA CONTROL PROGRAMME 1953 <ul><li>OBJECTIVES </li></ul><ul><li>TO BRING DOWN MALARIA TRANSMISSION </li></ul><ul><li>TO HOLD DOWN MALARIA TRANSMISSION AT LOW LEVEL </li></ul><ul><li>STRATEGIES </li></ul><ul><li>INDOOR RESIDUAL SPRAY </li></ul><ul><li>TREATMENT OF PATIENTS REPORTING TO HEALTH INSTITUTIONS </li></ul><ul><li>ACHIEVEMENTS </li></ul><ul><li>DECLINE IN INCIDENCE FROM 75 MILLION TO ONLY 2 MILLION IN 1958 </li></ul>
  5. 5. <ul><li>NATIONAL MALARIA ERADICATION PROGRAMME 1958 </li></ul><ul><li>OBJECTIVES </li></ul><ul><li>TO ERADICATE MALARIA FROM INDIA IN 7 TO 9 YEARS </li></ul><ul><li>ACTIVITIES </li></ul><ul><li>SPRAYING OPERATION </li></ul><ul><li>FORTNIGHTLY ACTIVE CASE DETECTION </li></ul><ul><li>RADICAL TREATMENT </li></ul><ul><li>INVESTIGATION OF POSITIVE CASES AND REMEDIAL MEASURES </li></ul><ul><li>ACHIEVEMENTS </li></ul><ul><li>LOWEST EVER INCIDENCE OF 0.1 MILLION IN 1965 </li></ul><ul><li>NO REPORTED DEATHS DUE TO MALARIA </li></ul>
  6. 6. RESURGENCE OF MALARIA 1967 TO 1976 IN 1965- SUDDEN WITHDRAWAL OF ASSISTANCE AND SHORTAGE OF INSECTICIDES- STEEP RISE IN MALARIA INCIDENCE
  7. 7. <ul><li>URBAN MALARIA SCHEME 1971 </li></ul><ul><li>IN 139 TOWNS IN 19 STATES AND UNION TERRITORIES </li></ul><ul><li>OBJECTIVES </li></ul><ul><li>TO CONTROL MALARIA IN URBAN AREAS BY REDUCING VECTORS </li></ul><ul><li>REDUCE MORBIDITY AND MORTALITY BY EARLY DETECTION AND PROMPT TREATMENT </li></ul><ul><li>CRITERIA </li></ul><ul><li>ALL URBAN AREAS WITH GREATER THAN </li></ul><ul><li>50,000 POPULATION </li></ul><ul><li>SPR ≥5% </li></ul>
  8. 8. PLAN OF ACTION VECTOR CONTROL BY DRUG TREATMENT ANTI-LARVAL MEASURES <ul><li>LARVIVOROUS FISH </li></ul><ul><li>LARVICIDES </li></ul>
  9. 9. <ul><li>RE-CLASSIFICATION OF ENDEMIC AREAS </li></ul><ul><li>BASED ON ANNUAL PARASITE INCIDENCE </li></ul><ul><li>API LESS THAN 2 API GREATER THAN 2 </li></ul><ul><li>MODIFIED PLAN OF OPERATION 1977 </li></ul><ul><li>OBJECTIVES </li></ul><ul><li>PREVENTION OF DEATH DUE TO MALARIA </li></ul><ul><li>REDUCTION OF MORBIDITY DUE TO MALARIA </li></ul><ul><li>RETENTION OF ACHIEVEMENTS GAINED SO FAR </li></ul>
  10. 10. <ul><li>AREAS WITH API > 2 </li></ul><ul><li>SPRAYING </li></ul><ul><li>ENTOMOLOGICAL ASSESSMENT </li></ul><ul><li>SURVEILLANCE </li></ul><ul><li>TREATMENT OF CASES </li></ul><ul><li>AREAS WITH API < 2 </li></ul><ul><li>SPRAYING </li></ul><ul><li>SURVEILLANCE </li></ul><ul><li>TREATMENT </li></ul><ul><li>FOLLOW UP </li></ul><ul><li>EPIDEMIOLOGICAL INVESTIGATION </li></ul>
  11. 11. <ul><li>DRUG DISTRIBUTION CENTRE </li></ul><ul><li>DISPENSE ANTI MALARIAL DRUGS </li></ul><ul><li>FEVER TREATMENT DEPOT </li></ul><ul><li>COLLECT BLOOD SLIDES </li></ul><ul><li>DISTRIBUTE ANTI MALARIAL DRUGS </li></ul>
  12. 12. <ul><li>RESEARCH </li></ul><ul><li>MONITORING TEAMS TO IDENTIFY FALCIPARUM SENSITIVITY TO CHLOROQUINE </li></ul><ul><li>TEAM TO TEST ALTERNATE DRUGS FOR CHLOROQUINE RESISTANCE </li></ul><ul><li>HEALTH EDUCATION </li></ul>
  13. 13. <ul><li>RE-ORGANISATION </li></ul><ul><li>FOR IMPLEMENTATION OF PROGRAMME </li></ul><ul><li>BASED ON GEOGRAPHICAL BOUNDARIES OF DISTRICT </li></ul><ul><li>DHO(IMPLEMENTATION OF PROG) </li></ul><ul><li>DMO(OPERATION AND EVALUATION) </li></ul><ul><li>ASST MALARIA OFFICERS </li></ul>
  14. 14. <ul><li>P.FALCIPARUM CONTAINMENT 1977 </li></ul><ul><li>COMPONENT OF MPO </li></ul><ul><li>INTRODUCED WITH THE ASSISTANCE OF SWEDISH </li></ul><ul><li>INTERNATIONAL DEVELOPMENT AGENCY </li></ul><ul><li>TO PREVENT OR CONTROL THE SPREAD OF FALCIPARUM MALARIA </li></ul><ul><li>AREAS </li></ul>
  15. 15. <ul><li>SURVEILLANCE </li></ul><ul><li>AIM </li></ul><ul><li>CASE DETECTION THROUGH LAB SERVICES </li></ul><ul><li>FACILITIES FOR PROPER TREATMENT </li></ul><ul><li>ACTIVE </li></ul><ul><li>TYPES </li></ul><ul><li>PASSIVE </li></ul><ul><li>ACTIVE SURVEILLANCE </li></ul><ul><li>CARRIED OUT BY SURVEILLANCE WORKERS </li></ul><ul><li>SW-10,000 </li></ul><ul><li>TERRAIN AREA </li></ul><ul><li>4 SW-HEALTH ASST. </li></ul><ul><li>SW -FUNCTION </li></ul>
  16. 16. <ul><li>PASSIVE SURVEILLANCE </li></ul><ul><li>SEARCH FOR CASES BY LOCAL HEALTH AGENCIES </li></ul><ul><li>CASES THOSE ESCAPED ACTIVE SURVEILLANCE ARE SCREENED </li></ul><ul><li>PARAMETERS OF SURVEILLANCE </li></ul><ul><li>API </li></ul><ul><li>ABER </li></ul><ul><li>AFI </li></ul><ul><li>SPR </li></ul><ul><li>SFR </li></ul>
  17. 17. MALARIA ACTION PROGRAMME 1995 RESURGENCE OF MALARIA EXPERT COMMITTEE 1994 HIGH RISK AREAS IDENTIFIED FTD MICROSCOPY FACILITY 1000 POPULATION 30,000 POPULATION
  18. 18. <ul><li>ELEMENTS </li></ul><ul><li>EARLY DIAGNOSIS AND PROMPT TREATMENT </li></ul><ul><li>SUSTAINABLE PREVENTIVE MEASURES INCLUDING VECTOR CONTROL </li></ul><ul><li>PREVENTION OF EPIDEMICS </li></ul><ul><li>REGULAR ASSESSMENT </li></ul><ul><li>HIGH RISK AREAS </li></ul><ul><li>HIGH API </li></ul><ul><li>HIGH PROPORTION OF PF CASES </li></ul><ul><li>REPORTED DEATH DUE TO MALARIA </li></ul><ul><li>SPR DOUBLED </li></ul><ul><li>SPR >5% </li></ul>
  19. 19. <ul><li>ENHANCED MALARIA CONTROL PROJECT 1997 </li></ul><ul><li>WITH WORLD BANK ASSISTANCE </li></ul><ul><li>1997-2003, EXTN TO 2005 </li></ul><ul><li>OBJECTIVES </li></ul><ul><li>EFFECTIVE CONTRO L OF MALARIA </li></ul><ul><li>BRING DOWN MALARIA MORBIDITY </li></ul><ul><li>PREVENTION OF DEATH DUE TO MALARIA </li></ul><ul><li>CONSOLIDATION OF GAIN ACHIVED SO FAR </li></ul><ul><li>SELECTION OF PHC-CRITERIA </li></ul><ul><li>API>2 FOR LAST 3 YRS </li></ul><ul><li>P .FALCIPARUM>30% OF CASES </li></ul><ul><li>25% TR BAL POPULAT ON </li></ul><ul><li>DEATH DUE TO MALARIA </li></ul>
  20. 20. <ul><li>MAIN COMPONENTS </li></ul><ul><li>EARLY CASE DETECTION AND TREATMENT </li></ul><ul><li>SELECTIVE VECTOR CONTROL AND PERSONAL PROTECTION </li></ul><ul><li>HEALTH EDUCATION AND COMMUNITY PARTICIPATION </li></ul><ul><li>PLAN OF ACTION </li></ul><ul><li>SYNTHETIC PYRETHROIDS </li></ul><ul><li>BED NETS </li></ul><ul><li>RAPID DIAGNOSTIC KITS </li></ul><ul><li>ARTEETHER INJECTIONS </li></ul><ul><li>BLISTER PACKS </li></ul><ul><li>FUNS FOR TRAINING </li></ul>
  21. 21. <ul><li>NATIONAL ANTI-MALARIA PROGRAMME 1999 </li></ul><ul><li>NATIONAL VECTOR BORNE DISEASE CONTROL PROGRAMME 2004 </li></ul><ul><li>OBJECTIVES </li></ul><ul><li>REDUCE MALARIA MORBIDITY AND MORTALITY BY 50 % </li></ul><ul><li>TARGETS AND INDICATORS </li></ul><ul><li>ABER>10% </li></ul><ul><li>MBER OF 0.8 % </li></ul><ul><li>1.2 – 1.8% </li></ul><ul><li>API 1.3 OR LESS </li></ul><ul><li>25% REDUCTION IN MORBIDITY AND MORTALITY BY 2010 </li></ul><ul><li>50% REDUCTION IN MORBIDITY AND MORTALITY BY 2012 </li></ul>
  22. 22. INTENSIFIED MALARIA CONTROL PROJECT 2005
  23. 23. MALARIA CONTROL IN TAMILNADU RURAL URBAN

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