The National Vector Borne Disease Control Programme (NVBDCP) is an umbrella programme under the National Health Mission that aims to control and prevent six vector-borne diseases: malaria, kala-azar, filariasis, dengue, Japanese encephalitis, and chikungunya. The programme focuses on disease management, integrated vector management, and supportive interventions like indoor residual spraying and larvivorous fish. Its goals are to reduce mortality from certain diseases and eliminate kala-azar and filariasis by targeted years. The programme is coordinated by the Directorate of NVBDCP and implemented at national, state, district, and local levels.
National Vector Borne Disease Control Programme (NVBDCP)Vivek Varat
The National Vector Borne Disease Control Programme (NVBDCP) is an umbrella programme for prevention and control of malaria and other vector borne diseases. Under the programme, it is ensured that the disadvantaged and marginalised sections benefit from the delivery of services so that the desired National Health Policy and Rural Health Mission goals are achieved. The Directorate of NVBDCP under the Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India, is the nodal agency responsible for planning, coordination, implementation, monitoring and evaluation of NVBDCP programme at all levels.
National Vector Borne Disease Control Programme (NVBDCP)Vivek Varat
The National Vector Borne Disease Control Programme (NVBDCP) is an umbrella programme for prevention and control of malaria and other vector borne diseases. Under the programme, it is ensured that the disadvantaged and marginalised sections benefit from the delivery of services so that the desired National Health Policy and Rural Health Mission goals are achieved. The Directorate of NVBDCP under the Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India, is the nodal agency responsible for planning, coordination, implementation, monitoring and evaluation of NVBDCP programme at all levels.
National framework for malaria elimination in indiaAparna Chaudhary
outlines India’s strategy for elimination of the disease by 2030. The framework has been developed with a vision to eliminate malaria from the country and contribute to improved health and quality of life and alleviation of poverty.
National Program for Prevention and Control of Cancer, Diabetes, CVD and Stro...Vivek Varat
Government of India initiated a National Programme for Prevention and Control of Cancers, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) during 2010-11 after integrating the National Cancer Control Programme (NCCP) with (NPDCS).
National framework for malaria elimination in indiaAparna Chaudhary
outlines India’s strategy for elimination of the disease by 2030. The framework has been developed with a vision to eliminate malaria from the country and contribute to improved health and quality of life and alleviation of poverty.
National Program for Prevention and Control of Cancer, Diabetes, CVD and Stro...Vivek Varat
Government of India initiated a National Programme for Prevention and Control of Cancers, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) during 2010-11 after integrating the National Cancer Control Programme (NCCP) with (NPDCS).
Implemented in India among all ST/UT s for the control of SIX
vector borne diseases
Started in 2002-2003
1. Malaria
2. Dengue
3. Filariasis
4. Kala azar
5. JE
6. Chikungunya
The Main activities of the programme
1) Formulating policies and guidelines
2) Technical guidance
3) Planning
4) Logistics
5) Monitoring and evaluation
6) Coordination of activities through state/UTs and in consultation with National Centre
for disease control (NCDC),National Institute of Malarial Research (NIMR)
7) Collabaoration with intl agencies
8) Training
9) Facilitating research through NCDC, NIMR, Regional medical research centers
10) Coordinating control activities in the inter-state and inter country border areas.
Epidemiology of Malaria & Dengue_Sagar Parajuli.pptxSagarParajuli9
This presentation is prepared as part of the Course assignment of “Epidemiology of Diseases and Health Problems” for the Master's Degree of Public Health (MPH), Pokhara University and can be used as reference materials. The content and facts included in the presentation are as of information available till December 2022 and no conflict of interest is associated with the presentation. The presentation is prepared by Sagar Parajuli.
Epidemiological Perspective of Malaria_Sagar Parajuli.pptxSagarParajuli9
This presentation is prepared as part of the Course assignment of “Epidemiology of Diseases and Health Problems” for the Master's Degree of Public Health (MPH), Pokhara University and can be used as reference materials. The content and facts included in the presentation are as of information available till December 2022 and no conflict of interest is associated with the presentation. The presentation is prepared by Sagar Parajuli.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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NVBDCP
1. NATIONAL VECTOR- BORNE
DISEASE CONTROL
PROGRAMME
Presented by: Dr. Paripurna Baruah, PGT,
Deptt. Of Microbiology
Moderator: Dr. Monjuri Kotoky, Associate
professor, Deptt of Microbiology
2. INTRODUCTION
NVBDCP is an umbrella programme under NHM dedicated to the
control and prevention of 6 vector- borne diseases:
MALARIA
KALA- AZAR
FILARIA (LYMPHATIC FILARIASIS)
DENGUE/ DHF
JAPANESE ENCEPHALITIS
CHIKUNGUNYA
3. INTRODUCTION
• Under the programme, it is ensured that the disadvantaged and marginalized
sections of the society benefit from the delivery of services so that the
desired National Health Policy and Rural Health Mission Goals are
achieved.
• The Directorate of NVBDCP under the Directorate General of Health
Services, Ministry of Health and Family Welfare, Government of India, is
the nodal agency responsible for planning, coordination, implementation,
monitoring and evaluation of NVBDCP at all levels.
4. 1953: Launching of national
malaria control programme
(NMCP)
1958: NMCP was changed to national malaria
eradication programme (NMEP)
1977: modified plan of operations
implemented
1999: directorate of NMEP
was renamed as directorate
of National anti malaria
programme (NAMP)
2003: National vector borne
disease control programme
(NVBDCP)
National filaria control
programme (NFCP)
Kala- azar control
programme
Dengue/ dengue
hemorrhagic fever
Japanese encephalitis
HISTORICAL PERSPECTIVE
2006: Chikungunya brought
under the purview
5. ORGANISATION OF
THE PROGRAMME
Directorate General
Of Health Services,
MOHFW
Planning and
monitoring of the
programme
Spray operations
Management of funds
and planning,
monitoring of
programme activities
National level
nodal office
Directorate of
NVBDCP
State Vector
Borne Disease
Control Division
State Vector
Borne Disease
Control Society
Zonal offices
Technical and
administrative
responsibilities
District Vector
Borne Disease
Control Society
District Malaria
Office
6. MAIN ACTIVITIES OF THE DIRECTORATE OF NVBDCP
1. Formulating policies and guidelines
2. Providing technical guidance to the states
3. Planning
4. Logistics
5. Monitoring and evaluation
6. Coordination of activities through states and UTs
7. Collaboration with international organizations
8. Training
9. Facilitating research through NCDC, RMRC, NIMR etc.
10. Coordinating control activities in inter- state and inter- country border
areas
7. THREE PRONGED STRATEGY
Prevention
and
control of
VBDs
Disease
management
Integrated
vector
management
Supportive
interventions
• Indoor residual spray
• ITNs/ LLINs
• Larvivorous fish
• Source reduction
• BCC
• PPP
• ISC
• HRD
• OR
• M&E
• Early case detection
• Complete treatment
• Referral services
• Epidemic
preparedness
• Rapid response
8. MISSION STATEMENT
• INTEGRATED ACCELERATED ACTION TOWARDS
• Reducing mortality on account of MALARIA, DENGUE and JE by half
• Elimination of KALA- AZAR by 2010
• Elimination of LYMPHATIC FILARIASIS by 2015
10. PARAMETERS OF MALARIA SURVEILLANCE
• API: Annual Parasite Incidence
• API= confirmed cases during 1yr/ population under surveillance x 1000
• ABER: Annual Blood Examination Rate
• ABER= number of slides examined/ population X 100
• AFI: Annual Falciparum Incidence
• SPR: Slide Positivity Rate
• SFR: Slide Falciparum Rate
11. MILESTONES OF
MALARIA CONTROL
ACTIVITIES IN INDIA
YEAR
Prior to
1953:
Estimated malaria cases: 75 million
Deaths due to malaria: 0.8 million
1953 National malaria control programme launched
1958 national malaria eradication programme launched
1965 Cases reduced to 0.1 million
1976 Resurgence of malaria, 6.46 million cases
1977 modified plan of operations implemented
World bank assisted EMCP launched
1999 renaming of programme to NAMP
2002 renaming of NAMP to NVBDCP
2005 introduction of RDT
2006 ACT introduced in areas showing chloroquine resistance in falciparum malaria
2008 ACT extended to high Pf predominant districts covering 95% of Pf cases
World bank supported NMCP launched
2009 LLINs introduced
2010 new drug policy 2010
2012 bivalent RDT introduced
2013 new drug policy 2013
2016 national framework of malaria elimination in India launched
12. NATIONAL FRAMEWORK OF MALARIA ELIMINATION IN
INDIA (2016- 2030)
• Launched in February 2016
• GOALS
• Eliminate malaria (zero indigenous cases) throughout the entire country by 2030.
• Maintain malaria free status in areas where malaria transmission has been interrupted and prevent re- introduction of
malaria.
• OBJECTIVES
• By 2022: transmission of malaria interrupted and zero indigenous cases to be attained in all 26 states/ UTs that were under
categories 1 and 2 in 2014
• By 2024: incidence of malaria to be reduced to less than 1 case/ 1000 population in all states and UTs and their districts
• By 2027: indigenous transmission of malaria to be interrupted in all states and UTs of India
• By 2030: malaria to be eliminated throughout the entire country and re- establishment of transmission prevented.
13. PROGRAMME PHASING
CLASSIFICATION OF STATES AND UTs FOR MALARIA
ELIMINATION IN INDIA
CATEGORY DEFINITION
CATEGORY 0
Prevention of
re-
establishment
phase
States/ UTs with zero indigenous
cases of malaria (currently no
states)
CATEGORY 1
Elimination
phase
States/ UTs and all their districts
reporting API < 1 (15 states/ UTs)
CATEGORY 2
Pre-elimination
phase
States/ UTs with API < 1 but some
of their districts reporting API > 1
(11 states)
CATEGORY 3
Intensified
control phase
States/ UTs with API > 1 (10 states/
UTs)
• CATEGORY 1:
• HP, Punjab, J&K, Kerala, Manipur,
Puducherry, Chandigarh, Uttarakhand,
Haryana, Sikkim, Rajasthan, Daman&
Diu, Goa, Delhi, Lakshadweep
• CATEGORY 2:
• Bihar, TN, Telangana, UP, Karnataka,
WB, Andhra Pradesh, Assam,
Maharashtra, Gujarat, Nagaland
• CATEGORY 3:
• Andaman& Nicobar, MP, Dadar&
Nagar Haveli, Jharkhand, AP,
Chhattisgarh, Odisha, Meghalaya,
Tripura, Mizoram
14. • Malaria-attributable morbidity
and mortality in India during
2001–2017.
• Malaria positive cases denote
confirmed diagnosis by presence
of malarial parasite in finger-
prick blood-smears;
• Pf cases denote positivity for
Plasmodium falciparum;
• Death cases are attributed to
confirmed falciparum malarial
infection.
15. • Distribution of malaria-attributed deaths
in different geo-epidemiological regions
of India for data based on 2014–2017.
• NE refers to group of seven sister States
of northeast India including Arunachal
Pradesh, Assam, Meghalaya, Manipur,
Mizoram, Nagaland and Tripura;
• Central States include Madhya Pradesh
and Chhattisgarh; Eastern States include
Bihar, Jharkhand, Odisha (formerly
Orissa) and West Bengal;
• Western States include Maharashtra, Goa,
Gujarat and Rajasthan.
• In the remaining Indian States and Union
Territories, death cases were few and far
(not shown).
16. MILESTONES AND TARGETS
• By 2020,
• All category 1 states (2014) to have completely interrupted malaria
transmission and achieved zero indigenous cases and deaths due to malaria
• All category 2 states (2014) to enter category 1
• 5 category 3 states (2014) to enter category 2
• 5 category 3 states to reduce disease burden
• Estimated malaria burden at national level to reduce by 15- 20% as compared
to 2014
17. • By 2022
• All states/UTs under category 1 and 2 to interrupt malaria transmission
and achieve zero indigenous cases and deaths due to malaria
• 5 category 3 states to enter category 2 and the other 5 to enter category
1
• Estimated malaria burden at national level to reduce by 30- 35% as
compared to 2014
18. • By 2024,
• All states/ UTs and their districts to reduce API to < 1 per 1000
population at risk, sustain zero deaths due to malaria and establish
fully functional malaria surveillance to track, investigate and respond
to each case
• 31 states/ UTs to interrupt transmission of malaria and zero indigenous
cases/ deaths due to malaria
• 5 states in category 3 in 2014 to enter elimination phase
19. • By 2027,
• Indigenous transmission
interrupted
• The entire country to have no
indigenous cases and no deaths
due to malaria
• By 2030,
• The entire country to sustain
status of zero indigenous cases
and deaths due to malaria for 3
consecutive years
• India to initiate the processes for
certification of malaria
elimination status
20. KEY INTERVENTIONS RECOMMENDED FOR EACH
CATEGORY
• CATEGORY 3 (INTENSIFIED CONTROL PHASE)
• Massive scaling up of the existing disease management and preventive approaches
• Screening of all fever cases suspected for malaria
• Tailored interventions for areas as per malaria epidemiology and risk of transmission
• Special interventions for high risk areas: tribal, conflict affected, hard- to- reach
• Mobile clinics on fixed days in these areas
• Timely referral and treatment of severe malaria cases
• Robust supply chain management system
• Optimum level of surveillance
• Equipping all health institutions with microscopy, RDTs and injectable artemisinin
derivatives for treatment of severe malaria
21. • CATEGORY 2 (PRE- ELIMINATION PHASE)
• Particular focus is laid on setting up an elimination surveillance
system
• Elimination phase activities are set up districts with API < 1 case/
1000 population/ year
22. • CATEGORY 1 (ELIMINATION PHASE)
• Interruption of local transmission in all active foci of malaria
• Mandatory notification of each case of malaria
• Adequate case base surveillance and complete case management to handle
each case of malaria
• Investigation and classification of each malaria foci
• Active vector control measures in each foci
• Early detection and treatment of all cases by ACD/ PCD
• State and national level malaria database
23. • Effective screening, management and prevention of malaria among mobile and migrant
population
• Effective epidemic forecasting and response system
• Rigorous quality assurance of medicines and diagnostics
• National level reference laboratories
• All positive and a fixed percentage of negative slides will be referred to this laboratory for
confirmation and cross- checking
• After elimination has been achieved in each state/ UT, 100% cases to be notified to this laboratory
so that a national database can be maintained
• Training of master trainers and accreditation/ certification of microscopists as per Indian Public
Health Standards
• During investigation of foci, all suspected cases of malaria are to be screened for malaria
• Surveillance of migrant population and population residing in the vicinity of industrial
areas
24. • CATEGORY 0 (PREVENTION OF RE- ESTABLISHMENT PHASE)
• Detection of any re- introduced case of malaria
• Prompt notification of all detected cases
• Determination of underlying cause of resumed transmission
• Rapid curative and preventive measures
• Prevent re- introduction and re- establishment of transmission
• Maintenance of malaria- free status
25.
26. INTERACTION OF MALARIA CONTROL WITH OTHER HEALTH PROGRAMMES
IDSP
Reproductive & child
health:
IMNCI
JSY
Antenatal care services
Other vector borne
disease:
Dengue & malaria
Malaria & Kala- azar
Malaria & Filariasis
Malaria
control
27. MAJOR EXTERNALLY SUPPORTED PROJECTS
Intensified Malaria Control Project (IMCP) II
• Supported by Global Fund Round 9
• Since October 2010 for 5 years in the NE states
• Covered population of 46 million in 86 districts
• Early diagnosis, complete treatment, integrated vector control
Malaria control and kala- azar elimination
• Supported by World Bank
• 5 years: 2009 to 31 December 2013
28. LYMPHATIC FILARIASIS
• Filariasis is endemic in 250
districts in 16 states and 5 UTs
• About 360 million people are
exposed to risk of infection
29. NATIONAL FILARIA CONTROL PROGRAMME
• Started in 1955
• In June 1978, the operational component of NFCP was merged with
the urban malaria scheme for maximum utilization of available
resources.
• In 2003- 04 it was merged with NVBDCP
• It is being Implemented through
206 filaria control
units
199 filaria clinics 27 survey units
30. REVISED FILARIA CONTROL STRATEGY
• The national health policy 2002 aims at elimination of lymphatic
filariasis by 2015
• The elimination is defined as “ lymphatic filariasis ceases to be a
public health problem when the number of microfilaria carriers is <
1% and the children born after initiation of ELF are free from
circulating antigenaemia (presence of adult filarial worm in human
body)
31. GUIDELINES UNDER NVBDCP
ELF
2015
Annual mass drug
administration of
antifilarial drug for 5 yrs
or more to the eligible
population to interrupt
transmission
Home based
management of
lymphoedema cases and
upscaling of hydrocele
operations in identified
CHCs/ district hospitals/
medical colleges
2004
• Annual MDA
with single dose
DEC
• November
• 202 districts
• 72.4% coverage
2007
• DEC +
Albendazole
• 250 districts
2014
86.8% coverage
2004
• Door- to-
door survey
to encourage
home based
foot care
• Upscaling of
hydrocele
operations
2014
• 8 lacs
lymphoedem
a cases
• 4 lacs
hydrocele
cases
32. ACCELERATED
PLAN FOR
ELIMINATION
OF LYMPHATIC
FILARIASIS
(APELF) 2021
Launched by GoI in
October 2018
Triple drug therapy
with ivermectin+ DEC +
Albendazole in a
phased manner
The programme to
commence in
November 2019 across
high burden states Triple drug therapy
approach will be rolled
out across 16 districts
of Bihar, Gujarat,
Karnataka,
Maharashtra and UP
By February 2019 IDA was
rolled out across 4 endemic
districts
Arwal (Bihar)
Simdega (Jharkhand)
Nagpur (Maha)
Varanasi (UP)
33. KALA AZAR
• Kala azar is endemic in 33
districts of Bihar, 4 districts of
Jharkhand, 11 districts of West
Bengal, 6 districts of Uttar
Pradesh
• The centrally sponsored
programme for control of kala
azar was launched in 1990- 91
• Brought down the number of
cases from 77,102 in 1992 to
7,277 in 2015
34. GUIDELINES UNDER NVBDCP
Kala azar Technical
Supervisor along
with designated
ASHA worker
ensure detection,
treatment and
follow-up of cases
Active case
search: kala
azar
fortnight
Vector
control
IEC and inter
sectoral
convergence
Diagnosis
Treatment
research
guidelines
Quarterly door-to-door search for cases of kala
azar and PKDL
2 rounds of annual DDT spraying in endemic area
under direct supervision of NHM institution
Encourage environmental
sanitation and personal
protection from sandfly bite
rK39 rapid diagnostic
kits
• SSG
• Miltefosine
• Paramomycin
35. REVISED
STRATEGY FOR
TOTAL
ERADICATION OF
KALA AZAR
2015
Launched on 2
September 2014
Rapid diagnostic kits
developed by ICMR
Single dose Liposomal
Amphotericin B (10mg/
kg bw)
Free supply of the drug
by WHO
synthetic Pyrethroid,
directed specifically at
the sand fly, supplied for
spraying on the walls of
homes in the endemic
regions.
36. PATIENT CODING
SCHEME
• The patient and his relatives are
counselled properly at the time of
registration at the health
institution (CHC/PHC/district
hospital) about the importance of
full treatment
• The coding would be arranged in
the order of Country Code cum
State Code- District Code- PHC
Code, Sub-Centre / NGO Code-
Patient Code.
37. DENGUE/ DHF
CHIKUNGUNYA
Figure 3 Average dengue incidence rates (per million population) by state in
India from 1998 to 2014. The map was generated with ArcGIS-10.2.1
software (http://www.esri.in) from dengue case data.
38. GUIDELINES UNDER NVDCP
• Early case detection and management
• IVM
• Entomological surveys
• Larval surveys: containers in houses are examined for larvae and pupae
• House Index = no. of houses infected/ no. of houses inspected x 100
• Breteau Index = no of positive containers/ no of houses inspected x 100
An HI > 5% and/or a BI > 20% for a locality is an indication that the locality is dengue sensitive
and therefore adequate preventive measures to be taken
39. GUIDELINES UNDER NVDCP
• Container Index = no of positive containers/ no of containers inspected x 100
• Pupae Index = no pf pupae/ no of houses inspected x 100
• Adult surveys: expressed in terms of landing/ biting counts per man hour
• Source reduction
• Personal protection
40. Strategic
action
plan
521 sentinel
surveillance
hospitals and 14
apex referral
laboratories
Diagnostic kits
supplied by NIV,
Pune 2007
Regular
monitoring of
larval densities in
rural and urban
areas
Collabration with
rogi Kalyn samiti
for referral and
transport of
emergency cases
VHSC for
sanitation and
reduction of
breeding sites
Legislative
measures
1. Model civic by-
laws
2. Building
construction
regulation act
3. Environmental
health act
4. Health impact
assessment
41. Case definition of Chikungunya
• Probable or suspected case: a patient meeting the clinical criteria only
• Confirmed (definitive) case: a patient meeting both the clinical and laboratory criteria
• Clinical criteria: Acute onset of fever and severe arthralgia / arthritis with or without skin rash and
residing or having left an epidemic area 15 days prior to onset of symptoms
Laboratory criteria: At least one of the following tests done in the acute phase of illness
Direct evidence
• Virus isolation / Presence of viral RNA by RT-PCR
Indirect evidence
• Presence of virus specific IgM antibodies in single serum sample collected in acute or
convalescent stage.
• Four-fold increase in IgG values in samples collected at least three weeks apart.
42. NVBDCP Laboratory Network
• Directorate of National Vector Borne Disease
Control Programme, GOI has identified a network
of laboratories (Sentinel Surveillance Hospitals and
Apex Referral Laboratories) for surveillance of
chikungunya fever cases across the country since
2007.
• All SSHs are connected to 15 apex referral
laboratories (ARLs)
• Chikungunya IgM ELISA Test kits (1 Kit= 96 tests)
are provided to the identified laboratories through
National Institute of Virology (NIV), Pune since
2007. Cost is borne by GOI. Buffer stock is also
maintained at NIV, Pune to meet any emergency in
case of outbreak in new areas and to avoid stock
out.
NUMBER OF SSH YEAR
110 2007
137 2008
170 2009
182 2010
311 2011
347 2012
394 2013
439 2014
521 2015
542 2016
43. Laboratory confirmation in case of
Chikungunya outbreak
• Outbreak criteria: One or more cases in an area where no case was reported before.
• For the Public Health action, it is not necessary to confirm the diagnosis of each and every
suspected Chikungunya case.
• However, Laboratory confirmation of the suspected cases would be required to validate the clinical
diagnosis of the suspected cases.
• Confirmation of few cases would be enough to identify the cause of fever outbreak.
• Out of the reported suspected Chikungunya fever cases, 5-10% blood samples should be randomly
collected for Laboratory test.
In case, any blood sample is found positive serologically for Chikungunya IgM antibody the respective
area (sub-centre/ Ward ) should be declared as having confirmed outbreak of Chikungunya.
There is no need for taking additional blood samples for laboratory diagnosis of Chikungunya from that
sub-centre area/Ward and clinically suspected cases should be treated as Chikungunya.
44. JAPANESE
ENCEPHALITIS
• First case of JE reported in 1955
• During the recent past (1998- 2004)
15 states and UTs have reported JE
incidence
NVBDCP. Annual report 2014-15, Govt. of India. DGHS, MoHFW, N-Delhi.
45. GUIDELINES UNDER NVBDCP
• Children between 1- 15 yrs
• Initiation in 2006 with
single dose live attenuated
SA-14-14-2 vaccine in a
phased manner
• Outdoor fogging with
malathion during
outbreaks
• Anti larval measures
• Personal protection
• Biological control
• Strengthening of referral
services
• Symptomatic case
management
• Management of
sequelae
• Epidemic preparedness
and rapid response
• Training and capacity
building
• BCC
• Periodic reviews/
reports and field
visits for monitoring
of JE Supportive
interventions
Early
diagnosis and
case
management
vaccinationIVM
46. National Programme for Prevention and Control of
Japanese Encephalitis/ Acute Encephalitis Syndrome
2014
GOAL : To reduce morbidity, mortality and disability in children due to JE/AES.
OBJECTIVES :
• to strengthen and expand JE vaccination in affected districts;
• to strengthen surveillance, vector control, case management and timely referral of serious and
complicated cases;
• to increase access to safe drinking water and proper sanitation facilities to the target population in
affected rural and urban areas;
• to estimate disability burden due to JE/AES, and to provide for adequate facilities for physical, medical,
neurological and social rehabilitation;
• to improve nutritional status of children at risk of JE/AES;
• to carry out intensified IEC/BCC activities regarding JE/AES.
47. This strategy can be implemented only with the active
engagement of the Ministries/ Departments of
(i) Health and Family Welfare
(ii) Drinking Water and Sanitation
(iii) Social Justice and Empowerment
(iv) Women and Child Development
(v) Urban Development (Housing and Urban Poverty Alleviation) and
(vi) Human Resource Development (Department of School Education
and Literacy)
48. JE/ AES SURVEILLANCE
This surveillance will be carried out through sentinel sites and other
health institutions:
• Sentinel Surveillance Sites with laboratories (SSSL) facilities
• Sentinel Surveillance Sites without laboratories facilities
• Other Informer Units
49. JE surveillance activities at the district level
• The District Vector Borne Disease Officer (DVBDO) or the identified
health officer will study all reports received from all SSSL, SSSs
without Laboratory and Informer Units and also reconcile data with
existing surveillance systems such as IDSP to identify if there are any
outbreaks.
• In the office of DVBDO, compilation of all information/reports will be
undertaken for interpretation and action. Report will be submitted to
SPO in form AESF-2, AESF-2A, AESF-3.
50. Surveillance activities at state level
• The District will report to the state on daily/weekly/monthly basis as per requirement depending on the
disease situation.
• Data from the districts will be compiled and analysed at the state level to understand the disease situation to
provide feedback to the districts and to initiate appropriate prevention and control measures.
• To strengthen the JE/AES surveillance the state may coordinate with existing ICMR designated Viral
Diagnostic Laboratories (VDL).
• Final compiled date from the state will be sent to the national level on daily/weekly/monthly basis as desired
by the disease situation.
• Presently 85 sentinel sites and diagnostic centres exist in different States.
• Considering growing number of JE reporting districts, it has been decided to add 20 more such centres with
provision of manpower, equipment, kits, capacity building etc.
51.
52. Periodicity of reports
• Daily report should be generated and transmitted in an outbreak
situation
• Weekly report in transmission period and monthly report in inter-
epidemic period.
• In outbreak situation action taken report should be sent along with
daily report.
• Note : The decision on the periodicity of the reports will be made at
the state level by the State Programme Officer based on the local JE
transmission pattern.
53. Eco-Entomological Surveillance
Objectives of Entomological Surveillance
1. To identify the JE vector mosquitoes in an area
2. To monitor JE vector abundance in JE endemic areas
3. To detect JE virus in vector mosquitoes
4. To suggest appropriate vector control measures
54. Choice of index villages
At least 3 villages in which JE has occurred in the recent past (past five
years)
At least 2 villages which remained unaffected till date would be monitored
in each affected block
Sampling would be carried out on fortnightly basis
Surveillance would be carried out round the year to known the JE vector
density, their resting behavior, feeding behavior and detection/isolation of JE
virus from vector mosquitoes.
56. Thermal fogging (ULV)
• Thermal fogging with portable fogging is done in outdoor situations (outside human habitation),
where large number of JE cases are reported.
• Fogging should be carried out in downwind to upwind direction.
• During outdoor fogging it is important to direct the fog to all possible adult mosquito resting sites
like bushes, tree-shaded areas and other outdoor resting in peri-domestic habitats.
• The most effective type of thermal fog for mosquito control is medium / dry fog i.e. it should just
moisten the hand when the hand is passed quickly through the fog at a distance of about 2.5 to 3.0
meters in front of the fog tube.
• The technical specification recommended for fogging machined should be of BIS standard no.
14855 (Part 1): 2000 for Vector Control.
• Under NVBDCP, presently Malathion and Pyrethrum formulations are use for fogging
applications.
• For thermal fogging: 5 per cent Malathion (Technical) in kerosene/diesel (1 litre of technical
Malathion in 19 litres of diluents).
57. During outbreak situations, fogging applications have to be
carried out at 7-10 days interval till a significant reduction in
vector densities is achieved.
59. Veterinary Based Surveillance
• By identifying the prevalence & density of pigs, ducks, and ardeid birds and detecting viral activity
in susceptible hosts, veterinary surveillance helps to track the rate of Haemagglutination Inhibition
(HI) antibody carriers and the appearance of antibody from fresh infection as an index of the
spread of JE virus in animal host.
• Veterinary-based surveillance is conducted with the help of animal husbandry department.
• Sera sample from these animals is randomly collected for serology to ascertain transmission of JE
virus.
The objectives of Veterinary based surveillance are:
Prevalence of Pigs/Ducks, Ardeid Birds in an area
To detect viral activity in susceptible hosts
60. Institutes for screening for antibody carriers
and other virology studies
i) National Institute of Virology (NIV), Pune.
ii) Centre for Research in Medical Entomology (CRME), Madurai.
iii) VBRI (Veterinary Biological Research Institute), Shanthinagar, Hyderabad, Andhra Pradesh.
iv) Kyasanoor Forest Disease Laboratory, Shimoga, Karnataka.
v) Institute of Vector control and Zoonosis Hosur, Tamil NAdu.
vi) Indian Veterinary Research Institute (IVRI), Izatnagar, Bareilly, U.P.
vii) Diagnostic Research Laboratories, RWITC. Ltd. (Approved By Govt. of India
61.
62.
63.
64.
65.
66. REFERENCES
• Park’s textbook of preventive and social medicine, 24th edition.
• www.nvbdcp.gov.in
• National Framework for Malaria Elimination in India 2016-2030. Directorate of National Vector Borne
Disease Control Programme (NVBDCP). Ministry of Health & Family Welfare, Government of India. p. 43.
Available from: http://www.nvbdcp.gov.in/malaria [Accessed: 20 February 2018]
• National Vector Borne Disease Control Programme, Directorate General of Health Services, Ministry of
Health & Family Welfare. Government of India. Malaria. Available from: http://www.nvbdcp.gov.in/malaria
[Accessed: February 20, 2018]
• Sabesan, Shanmugavelu & Raju, Hari Kishan & Swaminathan, Subramanian & Srivastava, Pradeep &
Jambulingam, Purushothaman. (2013). Lymphatic Filariasis Transmission Risk Map of India, Based on a
Geo-Environmental Risk Model. Vector borne and zoonotic diseases (Larchmont, N.Y.). 13.
10.1089/vbz.2012.1238.