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Dr. Amandeep Kaur
Assistant Professor
Department of Community Medicine
Govt. Medical College, Haldwani
 Launched in year 2003-04
 Vector borne disease includes:
1. Malaria
2. Filariasis
3. Kala-azar
4. Dengue
5. Chikungunya and
6. Japanese Encephalitis (JE)
1. Disease management
2. Integrated Vector Management (IVM)
3. Supportive interventions
 Maintenance of ongoing watch over VBD status
 Detect changes in trends/distribution
 Measuring the effectiveness of the programme
 Prevention & Control of VBDs – ULTIMATE OBJECTIVE
 Active Surveillance
 Passive Surveillance
 Sentinel Surveillance
 Entomological Surveillance
 Adult Vector Surveillance
 Larval Surveillance
Disease
surveillance
Vector
surveillance
 Annual Blood Examination Rate
 Annual Parasite Index
 Slide Positivity Rate
Continuous
data
collection
Pool of data
available for
analysis
Analysis
Outbreak or
case
suspected or
confirmed
Decisions
Response
actions
Collection of additional data
 The early warning signals communicated to MO PHCs
 Weekly fever trends made available by the IDSP reports
 Outbreak confirmed if :
Doubling in slide positivity rate
Increasing trend of malaria incidence
Increasing vector density
 Once a strong degree of suspicion of outbreak is present, the
following steps taken - (should be completed in 7-10 days
period)
Rapid fever survey / Mass survey
Estimation of population involved
Measures for Liquidation of Foci
Follow up action – two consecutive follow up surveys
(after 21 days)
 Measures to control adult mosquitoes:
Indoor Residual Spray ( IRS )
 Anti-larval measures:
chemical,
biological and
environmental
 Personal protection:
Bed nets, including insecticide treated nets
Effectiveness depends on -
 Timing
 adherence to the specified criteria of the insecticide
 application procedure,
 public acceptance of spraying,
 use of well maintained equipment,
 adequately trained personnel,
 good coverage and
 effective supervision.
S.No Name of Insecticide Preparation
of
suspension
in water
Dosage per
sq. metre of
active
ingredient
Residual
effect in
weeks
Area to be
covered by 10
lit. of
suspension
1. DDT 50% wp 1 kg/10 Lit 1 gm 10-12 500 sq.m
2. Malathion 25% wp 2 kg/10 Lit 2 gm 6-8 250 sq.m
3. Deltamethrin 2.5% wp 400 gm/10 Lit 20 mg 10-12 500 sq.m
4. Cyfluthrin 10%wp 125 gm/10 Lit 25 mg 10-12 500 sq.m
5. Lambdacyhalothrin
10% wp
125 gm/10 Lit 25 mg 10-12 500 sq.m
6 Alphacypermethrin
5%wp
250gm/10 Lit. 25 mg 10-12 500 sq.m
 Environmental control : filling
ditches, areas, pits, low lying
areas, etc.
 Chemical control : larvicides like
Temephos & Pirimiphos methyl
 Biological control : larvivorous fish
– Gambusia affinis & Poecilia
reticulata
Bacillus thuringiensis var
israelensis (Bti)
Bacillus sphaericus
 An insecticide-treated net is a
mosquito net that repels, disables
and/or kills mosquitoes coming
into contact with insecticide on the
netting material.
 Avert around 50% of malaria
cases, compared to untreated
nets
Two categories of ITNs:
▪ Conventionally Treated Nets
▪ Long-lasting Insecticidal Nets
(LLINs)
It has been shown that around 60% coverage of all adults and
children can achieve equitable community-wide benefits
 When full coverage is achieved, ITNs reduce all-cause
child mortality by an average 18% (14–29%) in sub-
Saharan Africa
 5.5 lives could be saved per year for every 1000
children under 5 years of age protected
 ITNs reduce clinical episodes of
malaria caused by P. falciparum
and P. vivax infections by 50%
(39–62%)
 For areas with API <1
▪ Vector control by minor engineering processes
▪ Involvement of PRIs & Municipal bodies
 For areas with API between 1 – 2
▪ Source reduction & Biological control
 For areas having API between 2 – 5
▪ Vector control by LLIN distribution – 2 per 5
household members
▪ Quality IRS under supervision based on earlier
epidemiological impact
For areas having API >5
 For areas having Perennial Transmission (>5 months /
year)
▪ 2 rounds of IRS with DDT or 3 rounds with
Malathion
▪ Priority distribution of LLINs
▪ Vector bionomic studies for future change of
strategy
 For areas having Seasonal Transmission (<5 months /
year)
▪ 1 round of DDT before start of transmission
 Behavior change communication
 Capacity building
 Inter-sectoral collaboration
 Public Private Partnership
 Legislations
 Monitoring and evaluation
 Operational research and applied
field research.
 Live attenuated SA 14-14-2 vaccine
 0.5 ml, subcutaneous, single dose
 In 2006, GoI initiated a pilot project of immunizing
children in hyperendemic districts of 4 states - UP,
Assam, West Bengal, Karnataka
FOR TRAVELLERS:
 Aged >1 yr, visiting endemic areas for at least 2 wks-
▪ 3 primary doses – 0, 7 and 28 days
▪ 2 primary doses - 4 wks apart
 RTS,S/AS02 (commercial name: Mosquirix) –
recombinant protein vaccine
 Designed for children resident in malaria-endemic areas
 Developed by PATH and GlaxoSmithKline (GSK) with
support from the Bill and Melinda Gates Foundation
 In October 2011 the group reported first findings from the
Phase III trial of RTS,S indicating that 46% of 15,460
inoculated infants and children were protected for 15
months
Prev & control nvbdcp final

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Prev & control nvbdcp final

  • 1. Dr. Amandeep Kaur Assistant Professor Department of Community Medicine Govt. Medical College, Haldwani
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  • 4.  Launched in year 2003-04  Vector borne disease includes: 1. Malaria 2. Filariasis 3. Kala-azar 4. Dengue 5. Chikungunya and 6. Japanese Encephalitis (JE)
  • 5. 1. Disease management 2. Integrated Vector Management (IVM) 3. Supportive interventions
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  • 7.  Maintenance of ongoing watch over VBD status  Detect changes in trends/distribution  Measuring the effectiveness of the programme  Prevention & Control of VBDs – ULTIMATE OBJECTIVE
  • 8.  Active Surveillance  Passive Surveillance  Sentinel Surveillance  Entomological Surveillance  Adult Vector Surveillance  Larval Surveillance Disease surveillance Vector surveillance
  • 9.  Annual Blood Examination Rate  Annual Parasite Index  Slide Positivity Rate
  • 10. Continuous data collection Pool of data available for analysis Analysis Outbreak or case suspected or confirmed Decisions Response actions Collection of additional data
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  • 12.  The early warning signals communicated to MO PHCs  Weekly fever trends made available by the IDSP reports  Outbreak confirmed if : Doubling in slide positivity rate Increasing trend of malaria incidence Increasing vector density
  • 13.  Once a strong degree of suspicion of outbreak is present, the following steps taken - (should be completed in 7-10 days period) Rapid fever survey / Mass survey Estimation of population involved Measures for Liquidation of Foci Follow up action – two consecutive follow up surveys (after 21 days)
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  • 16.  Measures to control adult mosquitoes: Indoor Residual Spray ( IRS )  Anti-larval measures: chemical, biological and environmental  Personal protection: Bed nets, including insecticide treated nets
  • 17. Effectiveness depends on -  Timing  adherence to the specified criteria of the insecticide  application procedure,  public acceptance of spraying,  use of well maintained equipment,  adequately trained personnel,  good coverage and  effective supervision.
  • 18. S.No Name of Insecticide Preparation of suspension in water Dosage per sq. metre of active ingredient Residual effect in weeks Area to be covered by 10 lit. of suspension 1. DDT 50% wp 1 kg/10 Lit 1 gm 10-12 500 sq.m 2. Malathion 25% wp 2 kg/10 Lit 2 gm 6-8 250 sq.m 3. Deltamethrin 2.5% wp 400 gm/10 Lit 20 mg 10-12 500 sq.m 4. Cyfluthrin 10%wp 125 gm/10 Lit 25 mg 10-12 500 sq.m 5. Lambdacyhalothrin 10% wp 125 gm/10 Lit 25 mg 10-12 500 sq.m 6 Alphacypermethrin 5%wp 250gm/10 Lit. 25 mg 10-12 500 sq.m
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  • 21.  Environmental control : filling ditches, areas, pits, low lying areas, etc.  Chemical control : larvicides like Temephos & Pirimiphos methyl  Biological control : larvivorous fish – Gambusia affinis & Poecilia reticulata Bacillus thuringiensis var israelensis (Bti) Bacillus sphaericus
  • 22.  An insecticide-treated net is a mosquito net that repels, disables and/or kills mosquitoes coming into contact with insecticide on the netting material.  Avert around 50% of malaria cases, compared to untreated nets Two categories of ITNs: ▪ Conventionally Treated Nets ▪ Long-lasting Insecticidal Nets (LLINs) It has been shown that around 60% coverage of all adults and children can achieve equitable community-wide benefits
  • 23.  When full coverage is achieved, ITNs reduce all-cause child mortality by an average 18% (14–29%) in sub- Saharan Africa  5.5 lives could be saved per year for every 1000 children under 5 years of age protected  ITNs reduce clinical episodes of malaria caused by P. falciparum and P. vivax infections by 50% (39–62%)
  • 24.  For areas with API <1 ▪ Vector control by minor engineering processes ▪ Involvement of PRIs & Municipal bodies  For areas with API between 1 – 2 ▪ Source reduction & Biological control  For areas having API between 2 – 5 ▪ Vector control by LLIN distribution – 2 per 5 household members ▪ Quality IRS under supervision based on earlier epidemiological impact
  • 25. For areas having API >5  For areas having Perennial Transmission (>5 months / year) ▪ 2 rounds of IRS with DDT or 3 rounds with Malathion ▪ Priority distribution of LLINs ▪ Vector bionomic studies for future change of strategy  For areas having Seasonal Transmission (<5 months / year) ▪ 1 round of DDT before start of transmission
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  • 27.  Behavior change communication  Capacity building  Inter-sectoral collaboration  Public Private Partnership  Legislations  Monitoring and evaluation  Operational research and applied field research.
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  • 30.  Live attenuated SA 14-14-2 vaccine  0.5 ml, subcutaneous, single dose  In 2006, GoI initiated a pilot project of immunizing children in hyperendemic districts of 4 states - UP, Assam, West Bengal, Karnataka FOR TRAVELLERS:  Aged >1 yr, visiting endemic areas for at least 2 wks- ▪ 3 primary doses – 0, 7 and 28 days ▪ 2 primary doses - 4 wks apart
  • 31.  RTS,S/AS02 (commercial name: Mosquirix) – recombinant protein vaccine  Designed for children resident in malaria-endemic areas  Developed by PATH and GlaxoSmithKline (GSK) with support from the Bill and Melinda Gates Foundation  In October 2011 the group reported first findings from the Phase III trial of RTS,S indicating that 46% of 15,460 inoculated infants and children were protected for 15 months

Editor's Notes

  1. API depends upon the adequacy of ABER; in areas with low ABER, the significance of API is lost.  If ABER is satisfactory, API becomes the most important criterion to assess the malaria prevalence in the community.  API is also used under the MPO for decision on spray operations.
  2. Identical vector control methods are used to control malaria and leishmaniasis in rural areas, and malaria and dengue in urban areas, to achieve cost-effectiveness and synergy. Currently - IRS as the primary method of vector control in rural setting, and anti-larval measures in the urban areas.
  3. To ensure its continued insecticidal (USUALLY PYRETHROID) effect, the net should be re-treated after three washes, or at least once a year. A long-lasting insecticidal net is a factory-treated mosquito net made with netting material that has insecticide incorporated within or bound around the fibres. The net must retain its effective biological activity without re-treatment for at least 20 WHO standard washes under laboratory conditions and THREE-FOUR years of recommended use under field conditions.
  4. Available for JE, tick borne encephalitis, tularaemia, plague…….. But not widely used. With the exception of malaria, few other VBDs have funding.