Dr.G.C.Sahu -- Dengue

Community Participation In
y p
Aedes Mosquito Control.

DR.G.C.SAHU
Regional Director
g
ROH&FW;GoI;
Ahmedabad.
1 Dr.G.C.Sahu/ROH&FW/GoI/A'bad

Re-emergence of Vector Borne Diseases
Uncontrolled Urbanization

The unrestrained
production and use of
non-
non-biodegradable food
and drink packaging, and
drums and other water
storage vessels that often
become larval habitats;

Non-
Non-existent,
inconsistent, or
fragmented national
f t d ti l
programmes…in
urban areas

2 Sources: Gubler, 1998; PAHO, 1997.
Dr.G.C.Sahu/ROH&FW/GoI/A'bad

Inadequate Environmental Management

Insufficient waste Insufficient and
collection and inadequate water
management. distribution.
Non-biodegradable
N bi d d bl Increased number of
I d b f
containers. water storage containers.
Improper tyre disposal. Inadequate septic
system conditions.

Increase in breeding sites for the vector

Population Movements

p p
More than 750 million people
Migration annually cross international borders.
Increase in rural migration into
urban areas.
1.4 billion international travelers
annualy.
697 million international tourist
International arrivals in 2007 and 715 million in
tourism 2008 (up 3.1%).

Source: OMT data.
Traffic of microorganisms

Effects of Climate change
on A d Mosquito
Aedes M it

Speed up viral incubation in mosquito
Shorten mosquito breeding cycle
Increase mosquito feeding frequency
More efficient t
M ffi i t transmission of dengue virus
i i fd i
from mosquito to human


(WHO)
Countries/areas at risk of dengue transmission, 2007 (DengueNet, WHO)


THE EXTENT OF THE DISEASE AND ITS GLOBAL REACH


DISTRIBUTION OF DF/DHF CASES IN THE
COUNTRY


Aedes Egypti
breeding sites-
sites-
Domestic .


Aedes Egypti
breeding sites-
sites-
Peri-
Peri-Domestic .


Urban:
Both
posh
&
Slums
Areas.


Typical water containers in Urban/Rural that can be potential
breeding place for Aedes mosquitoes.


Typical water containers in Rural/Urban that can be potential
breeding place for Aedes mosquitoes.

The obstacles for Aedes
Mosquito control.


……….obstacles for Aedes Mosquito control.

Present-
Present-day Aedes Mosquito control
programs are not progressing because:
Community participation in dengue
prevention and control is limited to official
demands and never attains community
ownership;



Local health services, now politically and
administratively responsible for the
d i i t ti l ibl f th
prevention and control programs are not
sufficiently established;



Individual and community
behavioral change strategies are
b h i l h t t i
weak and are not incorporated into
the programs;



Water
W t supply and solid waste
l d lid t
management are limited in high-risk areas;
high-



Sustainability and continuity of control
actions are constantly compromised by
other health demands and policies that
compete with them;



Little capacity for intersectoral
coordination…
The VBDCP/Mosquito
problem is not the
sole responsibility of the
p y
Dept of Health.


Operational research on individual or
community-based strategies have
community-y g
not been sufficient.


The Global Strategy for Mosquito/ VBD control

Surveillance for planning
and response

Reduction of Behavioral
disease burden change

This is what you
can do to help…
d t h l


What we should be doing…….

Maintenance of water supply systems

Leakage in water supply pipe line

While augmenting water supply scheme in urban areas, sewage
system with sewage treatment should also be installed
simultaneously in these towns for proper collection,
treatment and waste water generated.
generated.



Establishing proper drainage system

Open sluice-valve chambers with leakage
sluice-
Municipal Corporations shall formulate an integrated approach/ programme for water
supply, sewerage, drainage and solid waste management so as to keep the environment
free from th risks of vector breeding / growth.
f f the i k f t b di th
Storm water drains should invariably be covered and maintain them properly by
way of regular cleaning, de-silting etc. to prevent stagnation of water.
de- etc. water.
Larger storm water drains may be suitably channeled to facilitate adequate velocity for
g y y q y
flow of waste water.
water.


Implementation of bye laws at construction sites can take care of
p y
mosquito breeding.

Construction sites Open overhead tanks

Water stagnation in constructional areas should be prevented.
Overflow of water from the water tanks (i di id l and
O fl f t f th t t k (individual d
community) shall be controlled through proper floating valves.
Proper drainage system should be provided around all Public
Stand Posts to facilitate smooth drain of used water.



Model Civic Byelaws:
Standard design for the lids of
Bad Design Overhead Tanks and Cisterns

X Check nut

Over flow
Pipe protected
with perforation
Not exceed 45nm
MS Plate 50 mmx
Hinge 5mm



Elimination of intra domestic breeding sources very essential
Leaking water tanks, sprinkler systems, coolers etc that cause water
stagnation, should be repaired and reinstalled.
g p



Elimination of intra domestic breeding sources very essential

The vent pipe of septic tanks shall be covered with
pp p
mosquito nets so that the mosquito grown, if any, in the
septic tanks may not be find way to come out.



Prevent mosquito from Breeding!

Remove ALL sources of
R f
stagnant water.
g

Deny the mosquitoes of any chance to
breed.



Easy Steps
Steps..

•Change water in vases/
bowls
b l every other d .
th day
day.

•Add sand granular
insecticide to water.



Easy Steps
Steps…

•Remove water from
flower pot plates every
other d .
th dayday.



Easy Steps
Steps….

•Turn over all storage
containers



Easy Steps…..
E St

•clear blockages and put
Bti insecticide in roof
gutters at least once a
month


If citizens going on a holiday or keep their houses closed for a long time…..

•Seal off all floor and •Cover all toilet bowls
gully traps
Leave your contact number
with your neighbor so that the
corporation authorities c n
c rp r ti n uth riti s can
contact you should there be a
need to inspect your premises
35 urgently. Dr.G.C.Sahu/ROH&FW/GoI/A'bad


Adult vector control in urban areas.

Chemical fogging shall be periodically carried out in the urban areas where
there is a potential risk for the transmission of the diseases..
Proper sanitation including community toilets and drainage facilities
should be provided in the slum areas.
Bio-
Bio-environment control shall be carried out in urban areas to control
mosquito menace.



Promoting the use of larvae eating fishes
for control of mosquito breeding.

Introducing larvae eating fishes Larvae eating fish

Gambusia fish, which eats larva of the mosquito, shall be grown
in all water bodies/ lakes/ ponds / over head tanks



Creating awareness among
school and college going students.

Importance of vector control and vector control measure
shall be inducted in the course curriculum of primary and
secondary level of education for dissemination of
knowledge on vector control among student community (
schools as well as colleges)


ELIMINATION
OF AEDES
EGYPTI
BREEDING
SITES---
SITES---
THE INITIATIVE
MOSTLY LIES
WITH
INDIVIDUALS



Main Types of Adaptive Strategies

• Public education and awareness
• Early-
Early-alert systems: impending weather extremes, heatwaves; infectious
y y p g , ;
disease outbreaks
• Community-
Community-based neighbour-support/care schemes
neighbour-
• Mosquito-
Mosquito-proofed housing design … and ‘cooler’ urban layout
• Disaster preparedness, incl. health-system ‘surge’ capacity
health-
• Enhanced infectious disease control programs
• vaccines, vector control, case detection and treatment
• Improved surveillance:
• Risk indicators (e.g. mosquito numbers, aeroallergen concentration)
• Health outcomes (e.g. inf dis outbreaks, rural suicide rates, seasonal asthma peaks)
• Rural health services, counselling and community strengthening
, g y g g
• Appropriate (esp. health) workforce training, mid-career development
mid-



Strengthening the implementation of the
g g p
social-
social-communication component in the
state/national program.

Promote the behavioral change focus
so that it will be more than just
dissemination of information.



Solid Waste Management.
Management.

All the municipal waste should be collected from dust
bins etc., and transported to the composting/land fill sites
etc. p p g
for treatment and disposal in order to avoid breeding of
flies, mosquito etc.
etc.
The solid waste should be transported in covered
vehicles so as to prevent littering of the waste on streets,
roads etc.
etc.
Likewise, hospital
Lik i h i l waste and bi -medical waste should b
d bio
bio- di l h ld be
separately collected, treated and disposed in order to
prevent breeding of mosquitoes, flies etc.
p g q , etc.


Dead animals, carcasses should be removed
immediately and buried under land fill sites
and properly covered with soil to prevent
breeding of mosquitoes and flies.
flies.
Public
P bli awareness on environmental cleanliness
i t l l li
may be created through IEC and mass media.
media.
Under JNNURM there is provision to
formulate schemes, drainage and solid waste
management simultaneously and incorporate
g y p
the same in the City development Plan (CDP)
(CDP)
to make the environment free from vector
menace.
menace.

Social-
Social-Communication Component

Dissemination of the
behavioral change strategy.
strategy.

Social d
S i l advocacy i fin favor of
f
intra-
intra- and intersectoral actions to
minimize environmental health problems
(water and solid waste management).



Social-
Social-Communication Component

It is not a “magic bullet” that can
g
stop Aedes mosquito breeding.

A person achieves behavioral
changes in steps. There is a need
steps.
to go from one phase to another
sequentially.
sequentially.


What we should be doing
doing…….



Road and Buildings Department

Proper
p
maintenance of
public buildings
and roads f
d d for
prevention of
mosquito
breeding.


g

Industrial Sector

Sensitizing the industrial
work force and to
open centers for
distribution of drugs/
f g
collection of blood
smears and also to
initiate source
reduction activities i
d ti ti iti in
each of the industrial
unit.



Education Department

Propagating
P ti
messages for
community
awareness
through school
children.



Indian Medical Association

Sensitizing the
private
practioners
about drug
policy,
policy case
management and
treatment.
treatment


Water supply Department

Maintenance of
M i t f
water supply
schemes and
prevention of
mosquito breeding
breeding.


Integrated Strategy.

IV.
IV Environmental management and addressing
basic services such as water supply,
disposal of used water, solid waste management and
disposal of used tires.
di l f d ti

V. Patient care within and outside of the health system.

VI. Case reporting (clinical cases, confirmed cases, DHF
and deaths due to DHF, circulating serotypes).



Integrated Strategy

I. Integrated epidemiological and entomological
surveillance.
surveillance.

II. Advocacy and implementation of intersectoral
actions between health, environment and
education as well as other sectors such as
industry and commerce for new materials
materials,
tourism, legislation and judiciary.

III. Effective
III Eff ti community participation.
it participation.
ti i ti

Healthy houses

Environmen
t

Healthy schools

OK That s All
OK, That’s


GOVT
EFFORTS
COUPLED WITH
THE PUBLIC
PARTICIPATION….
PARTICIPATION….
IS THE KEY.

Acknowledgements:
Acknowledgements:
• WHO
• CDC
• NVBDCP
• NICD
• JD(NVBDCP),G.nagar.
• Dy.Director(Epidemic),G.nagar
• MHO, A M C, Ahmedabad
MHO C

56
…….. THANKS
Dr.G.C.Sahu/ROH&FW/GoI/A'bad

Dr.G.C.Sahu -- Dengue

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