Rota virus vaccine guideline

/fli6«o vf]k sfo{qmd
/f]6f efO/;af6 x'g] kvfnf /f]syfdsf]
nflu /f]6f efO/; vf]k
(Rotavirus Vaccine) z'?jft ug{
tflnd tyf sfo{;~rfng lgb]{lzsf – @)%
g]kfn ;/sf/
:jf:Yo tyf hg;+Vof dGqfno
:jf:Yo ;]jf laefu
afn :jf:Yo dxfzfvf, vf]k zfvf
sf7df8f}+, g]kfn

dGtAo
vf]k cfw'lgs lrlsT;f la1fgsf] Ps dxTjk'0f{ pknlAw xf]  . g]kfn ;/sf/sf] klxnf] k|fyldstfdf
k/]sf], nfut k|efjsf/L / hg :jf:Yosf] ;kmn sfo{qmdsf] ?kdf /x]sf] /fli6«o vf]k sfo{qmd lj=;=
@)#$ ;fndf ljkm/pGdng kZrft z'? eO{ xfn ;Dd cfO{k'Ubf afnaflnsfx¿nfO{ vf]kaf6 arfpg
;lsg] /f]ux¿af6 x'g] la/fdL b/, ckf+utf / lzz' tyf afnd[To'b/ ;d]tdf pNn]Vo ?kdf sdL Nofpg
of] sfo{qmdn] dxTjk0f{ of]ubfg k''¥ofPsf] 5  . ;fy} g]kfndf vf]k P]g cfP ;+u} vf]k Ps sfo{qmddf
dfq l;ldt geO{ x/]s aRrfsf] clwsf/sf] ?kdf :yflkt ePsf] 5  .
/fli6«o vf]k sfo{qmd cGtu{t xfn g]kfndf !% dlxgf ;Ddsf lzz'x¿ / ue{jtL dlxnfx¿sf nflu
lgMz'Ns vf]k ;]jf k|bfg ul/Fb} cfPsf] 5  . /fli6«o vf]k sfo{qmdsf] p2]Zo tyf axjlif{o vf]k sfo{
of]hgf -;g @)! - @)@!_ sf] nIo cg';f/ gofF vf]k tyf k|of]udf cfO{/x]sf cGo vf]kx¿ /fli6«o
vf]k sfo{qmddf qmdzM yk ub}{} hfg] gLlt cg'?k cf=j= @)%÷)^ af6 /f]6f efO{/;n] u/fpg]]
kvfnfaf6 jfnjflnsfnfO{ jrfpg lgoldt vf]k ;]jf dfkm{t /f]6f efO{/; lj?4sf] vf]k z'?jft ug{
nfluPsf] 5  . o;/L ca !% dlxgf dlgsf lzz'x¿nfO{ !@ j6f ;?jf /f]ux¿ la?4 tyf ue{jtL
dlxnfx¿sf nflu 6L=8L=-Td_ vf]k pknAw x'g] 5  .
jfnjflnsfdf emf8fkvfnf u/fpg] k|d'v sf/0f /f]6f efO{/; la?4sf] vf]k k|of]udf cfP ;+u} kvfnf
/ o;sf hl6ntfx¿df pNn]Vo sld cfpg] ck]Iff lnPsf] 5'  . vf]ksf] k|of]u ;+u} kvfnfsf] /f]syfd
/ arfj6sf] nflu ;/;kmfO{ k|a4{g klg plQs} dxTjk'0f{ x'g] s'/fnfO Wofg /fVb} o; lgb]{lzsfn]
;d]6]sf] lgoldt vf]k ;]jfdfkm{t ;/;kmfO{ k|a4{gnfO{ laif]z hf]8 lbb} /f]6f efO/; vf]k ;Fu} ;/;kmfO{
k|j4{gsf ;Gb]zx¿ k|jfx u/fpg :jf:YosdL{ nufPt ;a} ;/f]sf/jfnfx¿nfO cfu|x ub{5'  .
of] lgb]{lzsf g]kfndf vf]k ;]jf k|bfos ;/sf/L, u}x|;/sf/L / lglh :jf:Yo ;+:yfsf ;j}
:jf:YosdL{x¿sf nflu vf]k sfo{qmd ;~rfngdf k|fljlws 1fgsf ;fy} zLk ljsf;sf] nflu dxTjk0f{
;fdfu|L x'g] ljZjf; lnPsf] 5'  . of] k'l:tsf tof/ ug{ cys k|of; ul/ of]ubfg k'¥ofpg] afn :jf:Yo
dxfzfvfsf sd{rf/L, ljZj :jf:Yo ;+u7g – cfO{=kL=l8=, o'lg;]km, /]leg, jf6/P8 / ;+nUg ;j}nfO{
wGojfb lbg rfxG5' .
@)% c;f/
8f= u'0f/fh nf]xgL
dxflgb]{zs
:jf:Yo ;]jf laefu

e'ldsf
/fli6«o vf]k sfo{qmd g]kfn ;/sf/sf] klxnf] k|fyldstf k|fKt sfo{qmd xf]  . o; sfo{qmdsf] dfWodåf/f
afnaflnsfx¿nfO{ vf]kaf6 arfpg ;lsg] /f]ux¿af6 x'g] la/fdL b/df sld NofO{ lzz' tyf afnd[To'b/ ;d]t
36fpg ;+:yfut, afXo Pj+d 3'DtL vf]k s]Gb| dfkm{t b]ze/ vf]k ;]jf ;+rfng ul/Fb} cfPsf] 5  . k|efjsf/L
?kdf vf]k ;]jf ;~rfng u/L u'0f:t/Lo ;]jf k|bfg ug{ :jf:YosdL{x¿nfO{ pgLx¿sf] 1fg / ;Lkdf clej[l4
ug'{ cfaZos 5 .
/fli6«o vf]k sfo{qmdsf] p2]Zo tyf jx'jlif{o vf]k sfo{ of]hgf -;g @)! - @)@!_ sf] nIo cg';f/ gofF
vf]k tyf k|of]udf cfO{/x]sf cGo vf]kx¿ /fli6«o vf]k sfo{qmddf qmdzM yKb} hfg] gLlt cg'?k /f]6f efO/;n]
u/fpg]] kvfnfaf6 jfnjflnsfnfO{ jrfpg cf=j= @)%÷)^ af6 pQm efO/; lj?4sf] vf]k lgoldt vf]k ;]jf
dfkm{t z'?jft ug{ nfluPsf] 5  . lgoldt vf]k ;]jfdf yk ul/Psf] pQm gofF vf]k Jojl:yt Pj+d k|efjsf/L
?kdf ;~rfng ug{sf nflu of] lgb]{lzsf tof/ kfl/Psf] 5  .
/f]6f efO/;n] u/fpg] kvfnf la?4 /f]6f efO/; vf]k z'? ul/Ptfklg kvfnfsf] /f]syfd / arfj6sf] nflu
;/;kmfO k|a4{g plQs} dxTjk'0f{ x'G5  . dfr{ @)!@ df g]kfnsf] /fli6«o vf]k ;Nnfxsf/ ;ldltn] emf8fkvfnf,
6fOkmfO8, /f]6f efO/; / x}hf h:tf /f]ux¿ lj?4 lbOg] vf]knfO{ lgoldt vf]k ;]jfdf ;dfj]z ubf{ vf]ksf
;fy} ;/;kmfO{ k|a4{g PsLs[t ?kdf ;+rfng ug{ ;'emfj lbP cg';f/ afn :jf:Yo dxfzfvfsf] g]t[Tj /
jf6/P8sf] k|fljlws ;xof]udf rf/j6f lhNnfx¿ -DofUbL, gjnk/f;L, alb{of, hfh/sf]6_ df gd'gf kl/of]hgfsf]
?kdf lgoldt vf]k ;]jfdfkm{t ;/;kmfO k|a4{g sfo{qmd ;g @)!^ sf] km]a|'c/L b]lv ;g @)! sf] dfr{;Dd
sfof{Gjog ul/Psf] lyof]  . pQm sfo{qmdaf6 Aoaxf/df kl/jt{g cfO{ emf8fkvfnfdf sdL cfPsf] b]lvPsf]n] /f]6f
efO/; vf]k ;Fu};/;kmfO{ k|j4{gsf ;Gb]zx¿ vf]k ;]jf dfkm{t k|efjsf/L ?kn]k|jfx u/fpg' plrt b]lvG5 .
of] lgb]{lzsf ;/sf/L, u}x|;/sf/L / lglh :jf:Yo ;+:yfsf ;j} :jf:YosdL{x¿sf nflu vf]k sfo{qmd ;~rfngdf
k|fljlws, Jojxfl/s 1fgsf ;fy} zLk ljsf;sf] nflu dxTjk0f{ ;fdfu|L x'g] ljZjf; lnOPsf] 5  . of] k'l:tsf tof/
ug{ cys k|of; ul/ of]ubfg k'¥ofpg] afn :jf:Yo dxfzfvfsf sd{rf/L, ljZj :jf:Yo ;+u7g – cfO{=kL=l8=,
o'lg;]km, /]leg, jf6/P8 / ;+nUg ;j}nfO{ wGojfb lbg rfxG5f}  .
cGTodf, of] k'l:tsfn] tflnd tyf sfo{;~rfngsf] u'0f:t/df clea[l¢ ug{ laz]if of]ubfg k'¥ofpg] 5 eGg]
laZjf; lnPsf]5 .

8f= ljsf; nfld5fg]
lgb]{zs
afn :jf:Yo dxfzfvf
8f= emns zdf{ uf}td
k|d'v, vf]k zfvf
afn :jf:Yo dxfzfvf

efu ! M /fli6«o vf]k sfo{qmd %
k[i7eld %
/fli6«o vf]k sfo{qmdsf] kl/ro %
vf]k sfo{qmdsf] dVo pknlAw ^
ax'jifL{o vf]k of]hgf -;g @)!— @)@!_ ^
/fli]6«o vf]k sfo{qmd tyf ax'jifL{o vf]k of]hgf -@)!–@!_ sf k|d'v p2]Zox¿
/fli6«o :jf:Yo /0fgLlt
/fli6«o vf]k tflnsf *
o; lgb]{lzsfsf] p2]Zo (
k|of]ustf{ (
efu @ M /f]6f efO/;n] u/fpg] kvfnfM ;+lIfKt kl/ro !)
kl/ro !)
ljZjsf] cj:yf !)
g]kfnsf] cj:yf !)
;g]{ tl/sf !!
nIf0f tyf lrGx !!
/f]syfd tyf pkrf/ !@
d'Vo a'Fbfx¿ !#
efu # M /f]6f efO{/; vf]k -Rotavirus Vaccine_ kl/ro !$
kl/ro !$
jgfj6 !$
e08f/0f !%
dfqf / vf]k lbg] pd]/ !%
laifo ;'lr

vf]ksf] x'g ;Sg] c;/ !%
vf]k lbg gx'g] cj:yfx¿ !%
k|of]u lalwsf] ;f/f+z !^
vf]k tof/ / k|of]u ljlw !^
vf]k lbg] dfWod / tl/sf !*
v'jfpg] tl/sf !*
ofb ug'{kg]{ s'/f !(
efu $ M vf]k ;DalGw k/fdz{ @!
efu % M sf]N8r]g, ljt/0f / vf]k Joj:yfkg @#
efu ^ M vf]k kZrft x'g ;Sg] cjfl~5t 36gf @%
efu M /f]6f vf]k sfo{j|md ;+rfng @*
sfo{qmd ;~rfng sfo{gLlt
s= lgoldt vf]k dfkm{t vf]k ;]jf ;+rfng @*
v= sfo{j|mdsf] kl/rofTds uf]i7L tyf tflnd @*
;d]6g'kg]{ ljifoj:t'M @*
u= :jf:Yo lzIff, ;rgf ;~rf/ tyf ;fdflhs kl/rfng @(
!= :jf:Yo lzIff ;fdfu|L @(
@= ;fdflhs kl/rfng @(
#= ;~rf/ @(
3= cg'udg tyf dNof+sg @(
ª= clen]v / tYofÍ ljZn]if0f #)
tYofÍ ljZn]if0f #!
/f]6f efO/; vf]k;“u ;DalGwt ;fwf/0ftof ;f]lwg] k|Zgx¿ ##

/f]6f efO/;af6 x'g] kvfnf /f]syfdsf] nflu
/f]6f efO/; vf]k (Rotavirus Vaccine) z'?jft ug{
5
efu
!
/fli6«o vf]k sfo{qmd
k[i7eld
g]kfndf klxnf]k6s lj=;+= !() - ;g !*%)_ df 8f= cf]nlkmN8n]h+uaxfb'//f0ffsf 5f]/f /zfxL
kl/jf/sf s]6fs]6Lx¿nfO{ lakm/la?4sf]vf]k nufO{lbPsf lyP . lj=;=@)@@ ;fndf lakm/pGd'ng
sfo{qmd z'? eO{ @)#$ ;fndf g]kfnaf6 lakm/pGdng eof] . vf]k sfo{qmd Pp6f zlQmzfnL Pj+
nfut k|efjsf/L (cost effective) hg:jf:y sfo{qmd xf], h;sf]dfWodjf6 ljleGg /f]ux¿ nfUgaf6
;'/Iff k|bfg ub{5 . lj=;+= @)#$ ;fndf lakm/pGdng eP kZrft g]kfndf vf]k sfo{qmd lj:tfl/t
vf]k cfof]hgfsf]?kdf wg'iff, ?kGb]xL /l;Gw'kfNrf]s lhNnfx¿af6 lal;hL /l8lk6L vf]k;]jfaf6
k|f/De u/L qmlds ?kdf cGo lhNnfx¿df lj:tf/ub}{ @)$% ;fn ;Dddf % j6}lhNnfx¿df ^ j6f
/f]ux¿ Ifo/f]u, Eofu't]/f]u, wg'i6+sf/, nx/]vf]sL, kf]lnof] / bfb'/f la?4sf vf]kx¿ ;dfj]z ul/of]  .
o;}ul/@)^) ;fndf x]kf6fOl6; aL, @)^$ ;fnb]lv hfkfgLh OG;]kmnfOl6; hf]lvdk0f{ lhNnfx¿df
/@)# ;fn fj0f ! ut]b]lv % j6}lhNnfx¿df /@)^^ df x]df]lkmN; OGkmNoP~hf aL -lxa_
vf]k z'?jft ul/Psf] lyof]  . To:t} @)) ;fndf ?j]nf vf]knfO{ ;+o'Qm bfb'/f—?a]nf vf]ksf] ?kdf
lgoldt vf]k ;]jfdf ;dfj]z ul/of] . o;}u/L @)@ ;fndf bfb'/f ?j]nfsf]bf]f]dfqf lgodLt
vf]kdf ;dfj]z ul/of] . lj=;+ @)! b]lv lk=;L=eL= (PCV - Pneumococal Conjugate Vaccine)
vf]k lgoldt vf]kdf ;dfj]z ul/Psf] 5  . ;fy} kf]lnof] /f]u pGdng ug{sf] nflu d'vaf6 lbO{g] kf]lnof]
yf]kf -bOPV_ ;~rfngdf /x]sf] / o;sf] ;fy;fy} ;'O{ åf/f lbO{g] kf]lnof] vf]k Pkm=cfO{=lk=le=(fIPV -
Fractional dose of Inactivated Polio Vaccine) vf]k klg cf=j= @)%÷)^ df ;+rfngdf cfPsf]
5 . /fli6«o p2]Zo cg'?k gof+ yk vf]ksf]?kdf /f]6f efO/;åf/f x'g]emf8fkvfnf lj?4 /f]6f efO{/;
vf]k klg cf=a= @)%.^ b]lv lgoldt vf]k ;]jf dfkm{t ;+rfng ug{ nfluPsf]5 .
/fli6«o vf]k sfo{qmdsf] kl/ro
/fli6«o vf]k sfo{qmd cGtu{t xfn g]kfndf !% dlxgf dlgsf jfnjflnsfx¿ /ue{jtL dlxnfx¿sf
nflu lgMz'Ns vf]k ;]jf k|bfg ul/Fb}cfPsf]5 . h;dWo]!% dlxgf dlgsf jfnjflnsfx¿nfO{ !! j6f
;?jf /f]ux¿ -Ifo/f]u (Tuberculosis), Eofu't] /f]u (Diptheria), nx/]vf]sL (Pertusis), wg'i6+sf/
(Tetanus), x]kf6fOl6; la (Hepatitis B), x]df]lkmn; OGkmNoP~hf aL (Haemophilus influenza
type b), kf]lnof] (Polio), bfb'/f (Measles), ?a]nf (Rubella), Godf]sf]s; (Pneumococcus) /
hfkflgh OG;]kmnfOl6; (Japanese Encephalitis)_ la?4 tyf ue{jtL dlxnfx¿sf nflu 6L=8L=-Td_
vf]k pknAw u/fpFb}cfOPsf]5 . ax'jifL{o vf]k of]hgf -;g @)!!— @)!^, @)! — @)@!_ cg';f/
/fli6«o vf]k sfo{qmddf qmdzM gofF vf]kx¿ ;dfj]z ub}{ hfg]of]hgf EfP cg';f//f]6f efO/; vf]k
(Rotavirus vaccine) z'?jft ug{ nfluPsf]]5 . o;/L nlIft jfnjflnsfx¿nfO{ ca !@ j6f ;?jf
/f]ux¿ la?4 tyf ue{jtL dlxnfx¿sf nflu 6L=8L=-Td_ vf]k pknAw x'g]5 .

6
vf]k ;]jf b]ze/sf s/Lj !^))) vf]k s]Gb|x¿, h;df :jf:Yo ;+:yf, afXo vf]k s]Gb| / 3'DtL vf]k
;]jfsf ;fy} lghL tyf u}/;/sf/L :jf:Yo ;+:yfx¿ dfkm{t lgoldt?kdf ;+rfng ul/Fb} cfPsf] 5  .
vf]k sfo{qmdaf6 k|fKt pknlAwsf] cj:yfnfO{ sfod /fVb} sfo{qmdsf] /fli6«o pb]Zo cg'?k vf]kjf6
jrfpg ;lsg] /f]ux¿sf] lgoGq0f, lgjf/0f / pGdng ug{' of] sfo{qmdsf] k|d'v nIo ePsf] / o;sf]
nflu :jf:YosdL{ dxTjk0f{ lhDd]jf/L /xg] 5  .
vf]k sfo{qmdsf] d'Vo pknlAw
• lakm/ /f]usf] pGdng
• jfn d[To'b/df pNn]Vo sld
• ;g @))% b]lv dft[ tyf gjlzz' wg'i6Íf//f]u lgjf/0f
• ;g @)!) b]lv kf]lnof]/f]u zGo cj:yf /pGdngsf]glhs
• bfb'/f ?j]nf tyf l;=cf/=P; -CRS -Congenital Rubella Syndrome_ lgoGq0f / bfb'/f /f]u
lgjf/0f tkm{ pGdv
• hfkflgh O{G;]kmfnfO{l6; /f]u lgoGq0f
• vf]kåf/f jrfpg ;lsg] cGo /f]ux¿df pNn]vgLo sld
• k0f{ vf]k ;'lglZrttf / 3f]if0ff -cf;f9 @)% ;Dd %) lhNnf_
• vf]k P]g @)@ /lgodfjnL @)$ hf/L, cflb
ax'aifL{o vf]k of]hgf -;g @)!–@)@!_
b/ b[li6 (Vision)
g]kfndf vf]kjf6 jrfpg ;lsg] /f]ux¿nfO{ zGo cj:yfdf k'¥ofpg]]  .
Wo]o (Mission)
/fli6«o vf]k sfo{qmd dfk{mt ;j}sf] kx'+rdf x'g]ul/ k|To]s jfnjflnsf / ue{jtL dlxnfnfO{ u'0f:t/Lo,
;'/lIft / ;j{;'ne vf]k ;]jf lg/Gt/ ?kdf k|bfg ug{]  .
vf]k sfo{qmdsf] nIo
afnaflnsfdf vf]kaf6 arfpg ;lsg] la/fldb/, ckfËb/ / d[To'b/nfO{ sd ug'{ g} vf]k sfo{qmdsf]
k|d'v nIo xf]  .

7
/fli]6«o vf]k sfo{qmd tyf ax'jifL{o vf]k of]hgf -@)!–@!_ sf
k|d'v p2]Zox¿
g]kfndf vf]kaf6 /f]syfd ug{ ;lsg] /f]ux¿nfO{ z'Go cj:yfdf k'¥ofpg ax'jifL{o vf]k of]hgfn] lgDGf
på]Zox¿ lnPsf] 5  .
• k|To]s jfnjflnsfn] k0f{ vf]k nufPsf] ;'lglZrt ug]{
• ;+3Lo, k|fb]lzs tyf kflnsf / j8f txdf ;a} vf]kx¿sf] se/]h sDtLdf (% k|ltzt
eGbf dfyL k'¥ofpg] / sfod /fVg]
• vf]kaf6 arfpg ;lsg] /f]ux¿sf] lgoGq0f, lgjf/0f / pGdngnfO{ ltj|tf lbO{ ;f]sf]
lbuf]kg sfod /fVg]
• u'0f:t/Lo vf]k ;]jfsf] nflu cfk'tL{ Joj:yf tyf vf]k Joj:yfkg k|0ffnLnfO{ ;'b[9 ug]{
• vf]k sfo{qmdsf] nflu lbuf] ljlQo Joj:yfkgsf] ;'lglZrt ug]{
• vf]k sfo{qmddf cg';GwfgnfO{ k|a¢{g ug]{, ;fdflhs kl/rfngdf hf]8 ub}{ / gof+
sfo{x¿sf] lj:tf/ ug]{
• gofF tyf sd k|of]u ePsf vf]kx¿nfO{ /fli6«o vf]k sfo{qmddf ;dfj]z u/L vf]kaf6
jrfpg ;lsg] /f]ux¿sf] lgoGq0fnfO{ cem} a9fjf lbg]
• vf]kaf6 arfpg ;lsg] /f]ux¿sf] vf]hk8tfn -;le{n]G;_ sfo{nfO{ ;'b[l9s/0f / lj:tf/
ug]{
• Ps aif{eGbf a9L pd]/ ;dxsf] nflu klg vf]k ;]jf lj:tf/ ub}{ n}hfg]  .
/fli6«o :jf:Yo /0fgLlt / vf]k
/fli6«o :jf:Yo gLlt, @)! sf] /0fgLlt sf] bkmf !=# df klg æ/fHon] k|bfg ub}{ cfPsf] cfwf/et
:jf:Yo ;]jfsf sfo{j|mdnfO{ gful/sx¿sf] :jf:Yo ;DaGwL cfjZostfnfO{ kl/klt{ ug]{ u/L cBfjlws
ub}{ ;a} gful/sn] u'0f:t/Lo :jf:Yo ;]jf k|fKt u/]sf] olsg x'g] u/L /fli6«o lgb]{lzsf / k|f]6f]snx¿
tof/ u/L nfu ul/g]5Æ elg pNn]v ePsf] 5  .
;+;f/sf s]lx b]zx¿n] vf]k P]g agfPsf 5g, h;dWo] g]kfn klg Ps xf]  . vf]k P]g / lgodfanL
cfP ;+u} /fli6«o vf]k sfo{qmd Ps sfo{qmddf dfq l;ldt g/xL x/]s afnaflnsfsf] clwsf/sf]
?kdf :yflkt ePsf] 5  .

8
/fli6«o vf]k tflnsf
vf]ksf] gfd vf]k lbg] pd]/ slt k6s lbg]-k|lt
8f]h eNo'd_
vf]k nufpg] dfWod ;'O{ nufpg] :yfg s'g /f]uaf6 ;'/Iff
u5{
la=l;=hL= hlGdg] lalQs} ! k6s
-k|lt 8f]h )=)% ml_
5fnfleq
(intradermal)
bfofF kfv'/fsf]
dflyNnf] efu
Ifo/f]u
l8=lk=6L=–x]k
aL– lxa
^, !) / !$
xKtfsf] pd]/df
# k6s
-k|lt 8f]h )=% ml_
df;'df
(intramuscular)
afofF lt3|fsf] lar
aflx/L efu
Eofu't] /f]u, nx/]
vf]sL, wg'i6+sf/,
x]kf6fOl6; aL=,
x]dflkmn; aL af6
x'g] d]lgGhfOl6; /
lgdf]lgof
kf]lnof]
-la cf]=lk=le_
^, !) / !$
xKtfsf] pd]/df
# k6s
-k|To]s k6s b'O{ yf]kf_
d'vaf6(Oral) d'vaf6 v'jfOg] kf]lnof]dfO{nfOl6;
Pkm=cfO{=kL=eL= ^ xKtf /
!$ xKtfsf]
pd]/df
@ k6s
-k|lt 8f]h )=! ml_
5fnfleq
(intradermal)
afofF kfv'/fsf]
dflyNnf] efu
kf]lnof]dfO{nfOl6;
/f]6f efO/; ^ xKtf / !)
xKtfsf] pd]/df
@ k6s -k|To]s k6s
6'o'adf ePsf] ;Dk'0f{
vf]k v'afpg]_
d'vaf6(oral) d'vaf6 v'jfOg]
-vf]ksf] 6o'asf]
6'KkfnfO{ ufnfsf]
lelq efu lt/
/fv]/ 6'o'adf
ePsf] ;Dk'0f{ vf]k
v'afpg]_
/f]6f efO/; 4f/f
x'g] ´f8f kfvnf
lk=;L=eL= ^xKtf, !) xKtf
/ ( dlxgfsf]
pd]/df
# k6s-k|lt 8f]h )=%
ml_
df;'df
(intramuscular)
bfofFF lt3|fsf] lar
aflx/L efu
Go'df]sf]s;af6
x'g] d]lgGhfOl6; /
lgdf]lgof
bfb'/f—?a]nf ( dlxgf/ !%
dlxgfsf] pd]/df
@ k6s
-k|lt 8f]h )=% ml_
5fnf / df;' aLr
(subcutaneous)
afofF kfv'/fsf]
dflyNnf] aflx/L
efu
bfb'/f, ?a]nf
h]=O{= !@ dlxgfsf]
pd]/df
! k6s
-k|lt 8f]h )=% ml_
5fnf / df;' aLr
(subcutaneous)
bfofF lt3|fsf]
dflyNnf] aflx/L
efu
hfkflgh
OG;]kmnfOl6;
6L=8L= ue{jtL
dlxnfx¿
k|yd k6s ue{jtL
ePsf] yfxf x'g]ljlQs}
klxnf] dfqf,
To;sf] ! dlxgfsf]
km/sdf bf];|f] dfqf
/ To;kl5sf x/]s
ue{df ! dfqf -k|lt
8f]h )=% ml_
df;'df
(intramuscular )
afofF kfv'/fsf]
dflyNnf] aflx/L
efu
wg'i6+sf/ / Eofu't]
/f]u

9
gf]6M
• k|To]s aRrfnfO{ dfly tf]lsPsf] tflnsf cg';f/ ;a} vf]kx¿ tf]lsPs} ;dodf k'/f u/fpg
k|To]s ;];gdf aRrf lnP/ cfpg cfdf tyf cleefjsnfO{ hfgsf/L lbO{ k|f]T;fxg ug'{kb{5  .
• olb sf/0fj; tf]lsPsf];do tflnsfdf aRrf 5'6 ePdf :jf:YosdL{n]tTsfn}ljleGg
pkfo ckgfO{ aRrfsf]vf]lh u/L vf]k k/f u/fpg' kb{5 .
o; lgb]{lzsfsf] p2]Zo
o; lgb]{lzsfn]vf]k sfo{qmddf ;+nUg x'g];Dk0f{ :jf:YosdL{x¿ tyf sd{rf/Lx¿nfO{ /f]6f
efO/; vf]k lgoldt vf]k;]jf dfkm{t z'?jft ul/k|efjsf/L?kdf sfo{qmd ;~rfng ug{ ;xof]u
k'¥ofpg]5 . o; lgb]{lzsfsf]p2]Zo lgDg cg';f/5g M
• /f]6fefO{/;af6 x'g] kvfnf / /f]6fefO/; vf]k ;DalGw :jf:YosdL{x¿sf] 1fg / l;k
clej[l4 ug]{ .
• /f]6fefO/; vf]k lgoldt vf]k ;]jfdf z'?jft ug{ cfjZos hfgsf/L lbg] .
• vf]k ;];gnfO{ Jojl:yt ?kdf ;~rfng ug{ ;Ifd jgfpg] .
• vf]k;]jf ;+u};/;kmfO k|aw{g ;DalGw cfaZos hfgsf/L u/fpg] .
• u'0f:t/Lo vf]k ;]jf k|bfg ug{ 1fg /l;ksf]ljsf; ug]{ .
k|of]ustf{
of] lgb]{lzsf :jf:Yo rf}sL, k|fylds :jf:Yo s]Gb| ljleGg txsf c:ktfn tyf :jf:Yo ;+:yfdf
sfo{/t :jf:YosdL{x¿ / vf]k sfo{qmd tyf vf]khGo /f]usf] dfxfdf/L lgoGq0fdf ;+nUg
:jf:YosdL{x¿sf nflu tof/ ul/Psf] xf]  .
gf]6M of] lgb]{lzsfdf g;d]l6Psf ljifoj:t'x¿sf] xsdf
/fli6«o vf]k sfo{qmd ;Fu ;DalGwt cGo lgb]{lzsfx¿ h:t}M
:jf:YosdL{x¿sf nflu tflnd tyf sfo{ ;~rfng k'l:tsf,
vf]ksf nflu Jojxfl/s 1fg, vf]k ;+u};/;kmfO k|aw{g
lgb]{lzsf, EoflS;g Joj:yfkg tyf sf]N8r]g dd{t tyf ;Def/,
vf]k kZrft x'g]cjfl~5t 36gf cflbsf]lgb]{lzsf h:tf ;Gbe{
;fdu|Lx¿sf];xof]u lng'kg]{ x'G5 .

10
efu
@
/f]6f efO/;n] u/fpg] kvfnfM
;+lIfKt kl/ro
kl/ro
/f]6f zAb Nofl6g efiffaf6 lnOPsf]xf]h;sf]cy{ rSsf h:tf]uf]nf]x'G5 . of]efO/;sf]sf/0faf6
dflg;df emf8f kvfnf ( gastroenteritis) sf];d:of b]vf kb{5 . of]efO/;sf ;a}k|sf/sf k|hfltx¿n]
(genotype) p:t} k|sf/sf] /f]u nufp5g  . /f]6f efO{/;sf] ;+qmd0f ;a} pd]/sf dflg;x¿df x'g ;S5,
t/ ljz]if u/L of] /f]un] gjhft lzz' ( newborn) / lzz'x¿ (infant) df w]/};+qmd0f u/fpF5 . k|fo
;a}aRrfx¿ # b]lv % aif{sf]pd]/k'Ubf ;Dddf /f]6f efO/; åf/f ;+qmldt x'g k'U5g . ;+;f/df x'g]
s8f hnlaof]hgsf]sf/s dWo]Ps d'Vo sf/s /f]6f efO/; ;+qmd0f klg xf] . of];+qmd0fsf]sf/0f
s8f hnlaof]hg eO{ aRrfx¿sf]d[To' ;d]t x'G5 .
ljZjsf] cj:yf
ljZj :jf:Yo ;+u7gsf]tYof+s cg';f/ljZjdf % jif{d'lgsf aRrfsf]s'n d[To' dWo]clxn]klg
kvfnf k|d'v sf/0f /x]sf]5, s'n d[To' dWo]kvfnfsf]sf/0fn]x'g]d[To' ljZjdf * k|ltzt /x]sf]
5 . kvfnfsf]sf/0faf6 x'g]s'n d[To' dWo]df #@ - #* k|ltzt d[To' /f]6f efO{/;sf]sf/0faf6 x'g]
kvfnfaf6 x'g]cg'dfg ul/Psf]5 . ljZj :jf:Yo ;+u7gsf]tYof+s cg';f/;g @)!# df dfq /f]6f
efO{/; ;+qmd0fsf] sf/0f laZje/ @!%,))) jfnjflnsfsf] d[To' ePsf] lyof]  . To;}ul/ a;]{gL dm08}
@) nfv dflg;x¿ /f]6f efO{/; ;+qmd0fsf]sf/0f c:ktfndf egf{x'g]u/]sf 5g .
g]kfnsf] cj:yf
g]kfnsf] cl3Nnf] jif{x¿sf] HMIS -IMNCI_ sf]tYof+s cg';f/kvfnfsf gofF /f]uL jflif{s ;/b/
$@@ b]lv ^@(÷!))) x'g] u/]sf] b]lvPsf] 5 / pQm /f]uL dWo] )=)@ - )=)÷!))) d[To' x'g] u/]sf]
b]lvG5 . g]kfndf % jif{ d'lgsf]aRrfsf];+Vof sl/j @,()),))) -pGtL; nfv_ /x]sf]5 . pQm
tYof+ssf]cfwf/df sl/j %) k|ltzt cyf{t !$ nfv eGbf w]/}aRrfx¿nfO{ kvfnf nfUg]u/]sf]
b]lvG5 . g]kfndf emf8fkvfnfsf]sf/0faf6 c:ktfn egf{x'g]% jif{ d'lgsf aRrf dWo]@! b]lv #*
k|ltzt aRrfx¿ /f]6f efO{/;sf]sf/0faf6 x'g]kvfnfsf]sf/0f egf{ ePsf]kfO{Psf]5 . (Nepal
Rota Virus Sentinel Surveillance 2010- 2016 Kanti Children Hospital,Public Health Reseach
Laboratory, TUTH, IoM; WHO)

11
g]kfndf % aif{ d'lgsf afnafnLsfdf x'g] kvfnfsf] ca:yf
5 Year
(FY)
Diarrhea in under
5 year
(no.)
Incidence of
diarrhea in 5 year
population
Severe
Dehydration
Case fatality
2010/11 1,735,844 500/1000 0.37% 0.03/1000
2011/12 1,809,205 528/1000 0.26% 0.03/1000
2012/13 1,753,758 578/1000 0.27% 0.07/1000
2013/14 1,766,903 629/1000 0.4% 0.02/1000
2014/15 1,413,111 501/1000 0.3% 0.06/1000
2015/16 1,248,093 422/1000 0.2% 0.07/1000
Data source: HMIS/Annual Reports, Department of Health Services
Community Based Integrated Management of Neonatal and Childhood Illness (CB-IMNCI)
;g]{ tl/sf
of] /f]u clt ;+qmfds x'G5  . of] /f]u d'Vo ?kdf ;+qmldt JolQmsf] lb;faf6 b'lift vfgf / kfgL] (Fecal
Oral Route) sf] dfWodaf6 ;b{5  .
nIf0f tyf lrGx
of] /f]un] ljz]iful/ cfGb|fdf ;+qmd0f u/fp5  . of] clt ;+qmfds (highly contagious) x'G5 . of] /f]u
nfUbf ;'?df ;fdfGo Hj/f] cfpg], kvfnf nfUg], jfGtf x'g], k]6 b'Vg] -Gastroenteritis_ cflb h:tf lrGx,
nIf0fx¿ b]lvG5g  . ;fdfGotof kvfnf s8f lsl;dsf] x'G5 / pQm cj:yf $* 306f ;Dd /xg ;S5,
# b]lv lbgdf cfkm} /f]lsg ;S5  . of]]
;+qmd0faf6 x'g] kvfnfsf] k|d'v ;d:of
hnljof]hg -Dehydration_ g} xf], of]
/f]uaf6 aRrfx¿df x'g] d[To'sf] k|d'v
sf/0f klg s8f hnljof]hg g} xf]  . of]
/f]u h'g;'s} ;dodf nfUg ;S5 t/
ljz]if u/L jfnjflnsfdf hf8f] df};ddf
w]/} b]lvG5  .
lrq g+ ! M kvfnfsf nIf0f lrGxx?

12
/f]syfd tyf pkrf/
/f]6f efO{/;af6 x'g] kvfnfaf6 arfpg] k|d'v pkfo lzz'x¿nfO{ /f]6f efO{/;sf] vf]k lbg'g} xf]  .
/f]6f efO{/;af6 x'g] kvfnfsf] ;fy} cGo sf/0fn] x'g] kvfnfjf6 ;d]t jrfpg ;/;kmfO{ / kf]if0f
-:jR5 vfgf, kfgL, :tgkfg, JolQmut / jftfj/0fLo ;/;kmfO{_ df ljz]if Wofg lbg' clt dxTjk0f{
x'G5 .
vf]k ;]jf k|bfg ug]{ :jf:YosdL{n] vf]k;]jfdf cfPsf cfdf tyf cleefjsnfO{ lgDg
;Gb]zx¿ lbg'kb{5  .
• /f]6f efO{/;sf]kvfnfaf6 jrfpg ;j}jfnaflnsf nfO{ ^ xKtf /!) xKtfsf] pd]/df @
dfqf /f]6fefO/; vf]k v'jfpg' k5{ .
• /f]6f efO{/; nufPt cGo kvfnfjf6 jrfpg aRrfsf]cfdf, a'af /cleefjsx¿nfO{
vf]k;]jfsf] ;fy} kf]if0f / ;/;kmfO{ ;DjlGw lgDg ;+b]zx?sf] af/]df lk/fdz{ ug'{k5{  M
n 3/kl/jf/sf ;a};b:on]lgoldt rlk{sf]k|of]u, jfnjflnsfsf]lb;f klg rlk{df g}
lj;{hg ug]{ /lb;f u/]kl5, vfgf vfg' /v'jfpg'cl3 ;fa'g kfgLn]ldlrldlr clgjfo{
xft w'g]/wf]O{lbg]jf/]k/fdz{ ug'{ kb{5 .
n aRrfnfO v'jfpg] vfgf /fd|f]u/L ksfpg],kfgL pdfn]/ jf z'l4s/0f u/]/ dfq vfg],
v'jfpg];fy}ufO{ e}+;Lsf]bw pdfn]/dfq aRrfnfO{ v'jfpg' kb{5 .
n kvfnfsf]sf/0fjf6 x'g]hnljof]hg tyf l;ls:tkgfaf6 jrfpg aRrfnfO{ k|z:t
dfqfdf cfdfsf]bw r';fpg], emf]lnnf]/kf}li6s vfgf v'jfpg tyf k'gh{nLo emf]]n
v'jfpg]jf/]k/fdz{ ug'{ kb{5 .
n ^ dlxgf ;Dd :tgkfg dfq /^ dlxgf kl5 :tgkfgsf ;fy}yk kf}li6s vfgfsf]
af/]df k|To]s aRrfsf]cleefjsnfO{ k/fdz{ ug'{ kb{5 .
n ^ dlxgf b]lv % jif{ dlgsf jfnjflnsfx¿nfO{ ^ – ^ dlxgfdf g5'6fO{ le6fdLg P
v'jfpg k/fdz{ ug{'sf ;fy}cg'udg ug'{kb{5 .
• kvfnf nfu]sf aRrfx¿nfO{ ;d'bfodf cfwfl/t gjhft lzz' tyf afn /f]usf]Plss[t
Aoa:yfkg -IMNCI) sf]pkrf/tflnsf cg';f/dNof+sg, alu{s/0f, pkrf//cg'udg
ug'k5{ .
• of]/f]u nflu ;s]kl5 afnaflnsfnfO{ hnlaof]hgaf6 arfpg k'gh{lno emf]n /lh+s
rSsL k|of]usf];fy}nIf0f cg';f/sf]Aoa:yfkg ug'kb{5 .

13
d'Vo a'“bfx¿
• Rota Virus af6 x'g]kvfnf /f]u -Diarrhoea_ clt ;+qmfds x'G5 .
• of]/f]u ;a}pd]/sf JolQmx¿df nfUg]ePtfklg ljz]if u/L lzz'x¿ /@ jif{ leqsf aRrffx¿
w]/} k|efljt x'G5g  .
• of]/f]u nfUbf Hj/f]cfpg], kvfnf, jfGtf /k]6 b'Vg]h:tf lrGx, nIf0f b]vf kb{5 .
• of]/f]u ;+qmldt JolQmsf]lb;faf6 k|b'lift vfgf, kfgLaf6 c? JolQmdf ;b{5 .
• of]/f]ujf6 jRg]k|d'v pkfo /f]6f efO{/;sf]vf]k g}xf] . o;sf ;fy}cGo kvfnfaf6 ;d]t
arfpg aRrfx¿sf];/;kmfO{ ;DalGw Aoaxf//kf}li6s vfgfdf klg ljz]if Wofg lbg'kb{5 .
• kvfnf nfu]sf aRrfx¿nfO IMNCI sf]pkrf/tflnsf cg';f/dNof+sg, alu{s/0f, pkrf/
/cg'udg ug'k5{ .
emf8f kvfnfaf6
arfpg] pkfox?
jftfj/l0fo tyf
JolStut ;/;kmfO{
aRrfnfO{ ^ dlxgf
;Dd cfdfsf] b'w
dfq v'jfpg]
:jR5 lkpg] kfgL
v'jfpg]
^–^ dlxgfsf]
km/sdf le6fldg P
v'jfpg]
kg{hlno emf]n, lh+s rSsL
/ ;fljs eGbf j9L emf]nLnf]
/ kf}li6s vfg]s'/f v'jfpg]
^ xKtf / !) xKtfdf
/f]6f vf]k lbg]
/f]6f vf]k
lrq g+ @ M emf8f kvfnfaf6 arfpg] pkfox?

14
efu
#
/f]6f efO{/; vf]k
(Rotavirus Vaccine)
kl/ro
of]vf]k lglZqmo kfl/Psf]lhljt ljiff0f' -Live Attenuated _ af6 tof/ul/Psf];kmf emf]n
-Colorless_ sf]?kdf cfpF5 . of]vf]k Ps aRrfsf]nflu Ps dfqfsf]Knfl:6ssf]6o'jdf cfpF5 .
laZjdf laleGg k|sf/sf /f]6f efO/; la?åsf]vf]k pknAw 5g, h;dWo]g]kfndf xfn Rotarix
gfdsf] RV1-Monovalent Human Rotavirus Vaccine_ k|of]udf NofO{Psf]5 . ;g @))^ b]lv
xfn ;Dd ljZjsf () eGbf al9 b]zx¿df /f]6f efO/; vf]k ;+rfngdf 5 . cGo vf]kem}of]vf]k
klg cToGt ;'/lIft /k|efjsf/L 5 .
jgfj6
of]vf]k tof/L cj:yfdf emf]nsf]?kdf Ps JolQmsf]nflu Ps dfqfsf]Knfl:6s 6o'jdf cfpF5 .
Ps Knfl:6s 6o'jdf !=% Pd=Pn vf]k /x]sf]x'G5 . ;f]6o'jsf];a}dfqf Pp6}aRrfnfO{ d'vaf6
v'jfpg'kb{5 .(1 tube = 1 dose; 1tube = 1.5ml, liquid) .
lrq g+ # M /f]6f efO/; lj?4sf] /f]6fl/S; vf]k

15
e08f/0f
/f]6f efO/; vf]k Freeze Sensitive vf]k xf], of]vf]k nfO{ hDg lbg' x'Gg . of]vf]k hlxn]klg
±@ b]lv ±* l8u|L ;]lN;o;sf]tfkqmddf e08f/0f ug'{kb{5 . . olb of]vf]k hDg uPdf k|of]u ug'{
x'b}g .
dfqf / vf]k lbg] pd]/
of] vf]k ^ xKtf / !) xKtfsf] pd]/df -cf]=kL=eL= tyf k]G6fsf] klxnf] / bf];|f] dfqf ;“u}_ lbO{G5 .
k|To]s aRrfsf] nflu Ps dfqfsf] Knfl:6s 6o'j x'G5 , Tof] 6o'jdf ePsf] ;j} dfqf -sl/j !=%
Pd=Pn _ v'jfpg' kb{5 .
• ^ xKtfdf klxnf]dfqf /!) xKtfdf bf];|f]dfqf lbg] .
• olb aRrf vf]k tflnsf cg';f/gcfO{ kl5 cfPdf k]G6f ! /@ ;+u}/f]6fefO/; vf]k klg
lbg]  .
• o;/L of]vf]k lb+bf b'O dfqfsf]lardf slDtdf rf/xKtfsf]km/s x'g' kb{5 .
• of]vf]k ;'?jft ubf{ k]G6f ! nufO;s]sf]aRrfnfO glbg] .
vf]ksf] x'g ;Sg] c;/
of]vf]k nufPkl5 s]xL aRrfnfO{ ;fdfGo kvfnf tyf k]6sf]u8j8L -Irritability_ x'g ;S5 . of]
vf]k lnPsf]k|lt Ps nfv aRrffx¿ dWo]! jf @ hgf ;Dddf cfGw|f v:g](intussusceptions) x'g]
elgPsf]ePtfklg xfn;fn}clk|msfsf a6f b]zx¿df ul/Psf]o; vf]k (rotarix) sf] cWoogn]
o:tf] hf]lvd gePsf] kfOPsf] 5  .
vf]k lbg gx'g] cj:yfx¿
• klxnf] dfqf /f]6f efO/; vf]k lb+bf Hypersensitivity ePdf bf]f]dfqf glbg]
• aRrfdf of]eGbf cl3 cfGw|f v:g](Intussusceptions) ePsf]yfxf ePdf
• aRrfnfO tf/Gtf/kvfnf jf afGtf eO/x]sf]ca:yf ePdf
• /f]u k|lt/f]wfTds zlQmdf s'g} v/faL ePsf] - ODo'gf]8]km;]G;L_ yfxf ePdf, h:t}M P8;
ePsf] cj:yf

16
k|of]u lalwsf] ;f/f+z
vf]ksf] lsl;d lglZqmo kfl/Psf] hLljt ljiff0f' -Live attenuated_
lbg'kg]{ dfqf b'O{ k6s
dfWod d'vaf6 v'jfpg]yf]kf -ufnfsf]leqL efudf_
;do tflnsf hGd]sf]^ xKtf /!) xKtfdf
k|ltsn c;/ ;fdfGo kvfnf tyf k]6sf] u8j8L
lbg gx'g] cj:yf P8; ePsf lzz'x¿, klxnf]dfqf lb+bf ctL ;Da]bgl;n k|lts[of
-xfOk/;]G;]6Llel6_ ePdf jf cfGw|f v:g] -Intussusceptions_ePsf] yfxf
ePdf
vf]ksf] jgfj6 ! 6o'j Ps dfqf emf]nsf] ?kdf -1 tube -1.5ml, liquid =1 dose)
e08f/ Joj:yf ±@)
b]lv ±*)
;]= tfkqmdsf] lardf e08f/ ug'{ kb{5  .
Wofg lbg' kg]{ s'/f
k|To]s aRrfsf] nflu Ps Knfl:6s 6o'jdf ePsf] ;a} dfqf v'jfpg'kb{5 /
b'a} dfqf k'/f u/fpg'kb{5  . vf]ksf] ;fdfGo c;/sf] jf/]df cleefjsnfO{
k/fdz{ ug'{kb{5  .
vf]k tof/L / k|of]u ljlw
!= /f]6f efO/; vf]k lbg'eGbf klxnf lgDg s'/fx¿ olsg ug'{xf]; .
• vf]ksf]Dofb u'h|g]ldtL olsg ug'{xf]; .
• vf]kdf s'g}v/faL jf cufl8g}v'n]sf]5 ls x]g'{xf]; .
• vf]k ;kmf /+ulalxg / s'g} a:t' (Particles) gePsf]olsg ug'{xf]; .
• vf]kdf s'g}c;fdfGos'/f kfOPdf k|of]u gug'{xf]; .
• of]vf]k tof/L emf]nsf]?kdf pknAw 5 /6o'aaf6 l;w}d'vdf v'jfpg]xf] .
k|of]u ug'{ cl3 lgDg ljlw ckgfO{ 6o'aaf6 vf]k Vjfpg' kb{5 .
lrq g+ $ M /f]6f
efO/; lj?4sf]
/f]6fl/S; vf]k

17
• 6o'asf] lasf]{nfO{ tfGg'xf];  . t/ lasf]{ gkmfNg'xf];  .
• 6o'asf] dflyNnf] efudf /x]sf] emf]nnfO{ lrqdf b]vfPh:t} u/L cf}nfsf] ;xfotfn] tn
emfg'{xf];  .
• lasf]{nfO{ pN6f] kfg''{xf];  .
• 6o'anfO lrqdf b]vfPem};dfpg'xf]; /dflyaf6 lasf]{n]6o'asf]6'Kkf]sf]lar efudf /fvL
3'dfpb}tn lt/k|]; ug'{xf]; .
• 6o'asf]l;n v'n]sf]/Kjfn k/]sf]olsg ug'{xf]; . olb Kjfn gk/]sf]eP k'Mg dflysf]lalw
bf]xf]/ofpg'xf];  .

18
vf]k lbg] dfWod / tl/sf
of] vf]k d'vaf6 v'jfO{G5  . of] vf]k lb+bf kf]nLof] yf]kf v'jfP h:t} tl/sfaf6 lbg'kb{5  . of] vf]k pQm
lbg cGo vf]k tyf ;'O{x¿ klg lbg'kg]{ ePdf klxnf /f]6f / kf]lnof] yf]kf d'vaf6 v'jfO{ ;s]kl5
dfq ;'O{af6 lbg] vf]kx¿ lbg'kb{5  .
v'jfpg] tl/sf
• vf]k lbg' eGbf cl3 aRrfnfO{ cfdfn] sfvdf t];f]{ kf/]/ -Semi reclining
position_ /fVg nufpg'xf];  .
• aRrfsf] ufnfdf xNsf bafP/ aRrfsf] d'v vf]Ng'xf];  .
• aRRffsf] ufnfsf] s''gfaf6 leqL efudf kg]{ u/L 6o'anfO{ 58s] kfl/ d'v
leq /fVg'xf];
• ca lj:tf/} 6o'anfO{ lgrf]b}{ hfg'xf]; / aRrfn] lgn]sf] ;'lglZrt
ug'{xf];  .
• lrpF8f]nfO{ xftn] c8ofpg'xf]; / lgNgdf d2t ug'{xf];  .
of] vf]k kf]lnof] yf]kf eGbf w]/} x'g] ePsf]n] 6ojsf] 6'Kkf] aRrfsf] ufnfsf] s'gfdf /flv lj:tf/} lgrb}{
;j} vf]k em/]sf] / aRrfn] lgn]sf] olsg ug'{ kb{5  .

19
ofb ug'{kg]{ s'/f
of] vf]k ;fdfGo lj/fdL, s'kf]if0f, Pr=cfO{=eL= ePsf] cj:yf / Pre-mature aRrfnfO{ lbg
;lsG5  . k|To]s aRrfnfO{ ^ / !) xKtfsf] pd]/df @ dfqf /f]6f efO/; vf]k g5'6fO{ v'jfpg'
kb{5  . emf8f jfGtf ePsf] cj:yfdf of] vf]k glbg] t/ ;Grf] ePkl5 g5'6fO{ v'jfpg' k5{  .
^ xKtfsf] pd]/df vf]k lb+bf
!) xKtf pd]/df vf]k lb+bf
Step 1
d'vjf6 v'jfpg] vf]kx¿
klxnf /f]6f /To; kl5 OPV
lbg]
Step 2
fIPV klxnf] dfqf afFof
kfv'/fsf] dflyNnf] efu
5fnfleq (ID) lbg]
Step 4
DPT-HepB-Hib klxnf] dfqf
afofF lt3|fsf] lar aflx/L
efu df;'df (IM)
Step 3
PCV klxnf] dfqf bfofF
lt3|fsf] ljr aflx/L efu
df;'df (IM)
Step 1
klxnf lbg] /f]6f efO/; vf]k
/ OPV bf]f] dfqf
Step 2
PCV bf]f] dfqf bfofF
lt3|fsf] ljr aflx/L efu
df;'df (IM)
Step 3
DPT-HepB-Hib
bf]f] dfqf afofF lt3|fsf]
lar aflx/L efu
df;'df(IM)

20
!$ xKtf pd]/df vf]k lb+bf
( dlxgf pd]/df vf]k lb+bf
!@ dlxgf pd]/df vf]k lb+bf !% dlxgf pd]/df vf]k lb+bf
Step 1
klxnf lbg] -OPV t]f] dfqf_
Step 2
fIPV bf]f] dfqf afFof
kfv'/fsf] dflyNnf] efu
5fnfleq (ID) lbg]
Step 3
DPT-HepB-Hib
t]f] dfqf afofF lt3|fsf] lar
aflx/L efu df;'df (IM)
Step 2
MR klxnf] dfqf
afFFof kfv'/fsf] dflyNnf]
efu 5fnf /df;' aLr
(Subcutaneous) lbg]
Step 1
PCV t]f] dfqf
bfFof ltw|fsf]lar aflx/L
efu df;'df (IM)
JE
bfFof lt3|fsf] dflyNnf] aflx/L
efu 5fnf /df;' aLr
(Subcutaneous)
MR bf;|f] dfqf
afFof kfv'/fsf] dflyNnf]
efu 5fnf /df;' lar
(Subcutaneous)

21
efu
$
vf]k ;DalGw k/fdz{
vf]k ;]jf k|lt pTk|]/0ff hufO{ tf]lsPsf vf]kx¿ tflnsf cg';f/ k'/f u/fpg k/fdz{sf] clt dxTj
x'G5  . :jf:YosdL{n] cleefjsnfO{ ;fd'Gg]df /flv ul/g] k/fdz{ / hfgsf/Ln] k0f{ vf]ksf] nflu
dxTjk0f{ ;xof]u ub{5  . o;/L k/fdz{ / hfgsf/L lb+bf :jf:YosdL{n] vf]k ;DalGw eGg} kg]{ tkl;nsf
;rgfx¿ dfkm{t cleefjsx¿nfO{ k/fdz{ ug'{kb{5 .
k/fdz{ ug'{kg]{ ljifoj:t'
• aRrfnfO{ lbg nfu]sf]vf]ksf]-dfqf, k6s, vf]k lbg]dfWod_ /dxTj af/]cleefjsnfO{
atfpg]
• vf]ksf] k|ltc;;/ -;fdfGo c;/_sf] af/]df atfpg] / of] cGo vf]k h:t} ;'/lIft 5 egL
hfgsf/L u/fpg]
• csf]{ vf]ksf]dfqfsf]nflu slxn]/sxfF cfpg' kb{5, s]ePdf t'?Gt}cfpg]eGg]af/]df
;Demfpg]  .
• k0f{vf]k sf8{÷jfn :jf:Yo sf8{sf]dxTj jf/]hfgsf/L lb+b}sf8{ clgafo{ ;'/lIft /fVg /
csf]{ k6s vf]k nufpg cfpFbf of]sf8{ Nofpg ;Demfpg] .
• cleefjsn]vf]k ;DalGw cfˆgf s'g}lh1f;f k|:t't u/]df To;sf];Daf]wg ug]{ .
• of]vf]k pknAw u/fpFbf cleefjsnfO{ cGo vf]k nufpg'kg]{ pd]/, dfqf /k0f{ vf]ksf]
dxTjsf] af/]df hfgsf/L u/fpg' kb{5  .
• fIPV z'?jft ubf{ vf]k ;DjlGw k/fdz{sf] nflu pknAw u/fPsf] k/fdz{ kf]i6/sf] k|of]u ul/
$ j6f d'Vo ;Gb]; clgjfo{ ?kdf eGg 5'6fpg' x'b}g .
• :jf:YosdL{n] vf]k ;]jf k|bfg ubf{ emf8fkvfnf /f]u /f]syfd tyf lgoGq0fsf] nflu eGg} kg]{
;/;kmfO{ k|jw{g /kf]if0f ;DalGw ;Gb]zx¿ clgjfo{ ?kdf vf]k ;];g cl3 jf kl5 lbg'sf
;fy}k|To]s ;];gdf cg''udg ug'{ kb{5 .

22
vf]k tyf ;/;kmfO k|j4{g sfo{qmd ;+rfngsf /0fgLltx¿
• lgoldt vf]k sfo{qmd ;+u};/;kmfO k|j4{g sfo{qmd klg ;+u};+rfng ug]{ .
• ;/;kmfO k|j¢{g ;DaGwL Jojxf/kl/jt{g ;DalGw k/fd;{sf];];g vf]k sfo{stf{n];+rfng
ug]{ . dlxnf :jf:Yo :jo+;]lasfx¿ klg :j}lR5s?kdf ;xof]u ug{ ;Sg]5g .
• vf]k sfo{stfn]dfly pNn]lvt vf]k /;/;kmfO k|j¢{g ;DaGwL Jojxf/dns ;Gb]zx¿
;];g ;+rfng ubf{ k|efasf/L 9+un]k|afx ug{ ;f] ;DjlGw tof/ kfl/Psf] Kofs]h / lalwsf]
k|of]u ug]{  .
• :yfgLo :jf:Yo ;+:yf k|d'v / cGo :jf:YosdL{n] ;];gsf] cg'udg / ;'k/Lj]If0f ug]{  .
• dlxnf :jf:Yo :jo+d ;]ljsfx¿sf] cGo cled'lvs/0f, ;ldIff sfo{qmdx¿sf] cj;/df
;/;kmfO k|j4{g k/fdz{ / ;Gb]zx¿sf] af/]df ;d]t cled'lvs/0f ul/ sfof{Gjog u/fpg]  .
• sfo{qmdsf]clen]v /fVg], k|ltj]bg k7fpg]/;dLIff tyf dNofs+g ug]{ .
• sfo{qmdsf]cg';Gwfg /dNofs+g4f/f sfo{qmdsf]k|efjsfl/tf lgwf{/0f ug]{ .
vf]k tyf ;/;kmfO k|j4{g sfo{qmd ;~rfng k|lqmof
;a}vf]k lSnlgsx¿df vf]k ;]jf k|bfg ubf{ vf]ksf]dxTjk'0f{ k/fd{zsf ;fy};/;kmfO k|j4{g ;];gx¿
;+rfng ug'{ pko'St x'G5 . vf]k ;]jf lng cfpg];a}cfdf jf cleefjsx¿nfO{ vf]k lbg'eGbf
klxnf jf vf]k lbO;s]kl5 vf]k, ;/;kmfO /kf]if0f ;DalGw dxTjk'0f{ ;Gb]zx¿ :jf:YosdL{x¿n]
vf]k lSnlgsx¿df dxTjsf ;fy k|jfx ug'{k5{ .

23
efu
%
sf]N8r]g, ljt/0f / vf]k Joj:yfkg
vf]ksf] e08f/0f
• vf]kx¿nfO{ ±@ l8u|L ;]lG6u|]6 b]lv ±* l8u|L ;]lG6u|]6
tfkqmddf e08f/0f ul/G5  .
• vf]kx¿nfO{ sbflk hDg lbg'x'Fb}g  .
• ;w}+ slG8;lgª u/]sf] cfO;Kofssf] k|of]u u/]/ dfq vf]k
9'jfgL tyf sfo{qmd ;+rfng ug'{ kb{5 .
• vf]ksf] 6oax¿ sf]N8 aS;df /fVbf ;w}+ hLknsdf /fv]/
dfq e08f/0f ug]{  .
vf]k ljt/0f
• ;'Vvf / ;kmf EoflS;g Sofl/o/ -$ j6f cfO; Kofs ePsf] dfq_ k|of]u ug]{  .
• cfO{;Kofs s08L;lgË u/]/ dfq EoflS;g Sofl/o/df /fVg'kb{5  .
• vf]ksf] 6o'ax¿ ;w}+ hLknsdf /fv]/ dfq EoflS;g Sofl/o/df /fVg'kb{5  .
vf]k / 8«k/sf] kl/df0f cg'dfg ug]{
EoflS;gsf] cg'dfg efondf
• /f]6f efO/; vf]ksf] nflu Ö nlIft hg;+Vof jf ljutsf] ;/b/ dfl;s k|ult -h'g w]/} x'G5_
X @ dfqf X !=)% WMF -%Ü v]/b/sf] cfwf/df_ n] u'0fg ug{]  . t/ sfo{qmd z'? ePsf]
dlxgf ! dfqf dfq dfu ug'{ kb{5 eg] bf]f] dlxgf b]lv ljutsf] klxnf] dfqf / dfl;s
cfjZostfsf] cfwf/df b'j} dfqf dfu ug'{ kb{5  .
• la=l;=hL vf]ksf] nflu Ö ! vf]k ;];gsf] nflu slDtdf ! efonsf] cfwf/df ug]{  .
• l8=lk=l6–x]k=lj–lxj, kf]]lnof] vf]ksf] nflu Ö nlIft hg;+VofnfO{ X # dfqf X !=!* WMF
(!%Ü v]/b/sf] cfwf/df_ n] u'0fg ug{] / !) n] efu ug]{  . t/ jf:tljs cfjZostf lgwf{/0f
ug{ slDtdf # jif{sf] k|ultsf] cfwf/df cg'dfg ug'{ pko'Qm x'G5  .

24
• lk= ;L= eL vf]ksf] nflu Ö nlIft hg;+VofnfO{ X # dfqf X !=)% WMF -%Ü v]/b/sf]
cfwf/df_ n] u'0fg ug{] / @ / $ n] efu ug]{  . t/ jf:tljs cfjZostf lgwf{/0f ug{ slDtdf
# jif{sf] k|ultsf] cfwf/df cg'dfg ug'{ pko'Qm x'G5  .
• Pkm=cfO{=lk=le vf]ksf] nflu Ö nlIft hg;+VofnfO{ X @ dfqf X !=)% WMF -%Ü v]/b/sf]
cfwf/df_ n] u'0fg ug{] / % n] efu ug]{  . olb vf]k ;];gsf] nlIft hg;++Vof % hgf eGbf
sd ePdf slDtdf ! efonsf] cfwf/df ug]{  .
• bfb'/f÷?a]nf vf]ksf] nflu Ö nlIft hg;+VofnfO{ X @ dfqf X !=^ WMF -$) Ü v]/hfg]]b/sf]
cfwf/df_ n] u'0fg ug{] / !) n] efu ug]{  . ! vf]k ;];gsf] nflu slDtdf ! efonsf] cfwf/df
dfu ug]{  . olb vf]k ;];gsf] nlIft hg;++Vof klxnf] dfqf / bf];|f] dfqf nufpg] aRrf * hgf
eGbf jl9 ePdf yk efon dfu ug]{ . * hgf eGbf sd ePdf k|lt vf]k s]Gb| ! efPn dfUg] .
• h]=O{= vf]ksf] nflu Ö nlIft hg;+VofnfO{ X ! dfqf X !=^ WMF -$) Ü v]/b/sf] cfwf/df_
n] u'0fg ug{] / % n] efu ug]{ olb vf]k ;];gsf] nlIft hg;++Vof % hgf eGbf sd ePdf
slDtdf ! efonsf] cfwf/df ug]{ / $ hgf eGbf w]/} ePdf yk ul/ dfu ug]{  .
• l6= l8 vf]ksf] nflu Ö nlIft hg;+VofnfO{ X @ dfqf X !=!* WMF (!%Ü v]/b/sf] cfwf/df_
n] u'0fg ug{] / !) n] efu ug]{  . t/ jf:tljs cfjZostf lgwf{/0f ug{ slDtdf # jif{sf]
k|ultsf] cfwf/df cg'dfg ug'{ pko'Qm x'G5  .
gf]6M vf]k ;fdu|L -P=8L=l;l/Gh, 3f]ns l;l/Gh, 8«k/, ;]km6L
aS;_ sf]cg'dfg tyf ljt/0f of]hgf agfpbf ;'Id of]hgf
tof/L ubf{ ePsf]vf]k efPn ÷ 8f]h÷k|ultsf]cfwf/df of]hgf
agfO{ cfklt{ tyf ljt/0f Joj:yf ug'{ p5{ .

25
efu
^
vf]k kZrft x'g ;Sg]
cjfl~5t 36gf(AEFI)
kl/efiff
vf]k nufPkl5 x'g] s'g} klg :jf:Yo ;DalGw cjfl~5t 36gf (AEFI – Adverse Event Following
Immunizaton) h'g vf]k k|of]usf] sf/0faf6 gePsf] klg x'g ;S5  . o:tf cjfl~5t 36gfx¿ vf]k
nufPkl5 ck|Toflzt lrGx, nIf0f, c;fdfGo k|of]uzfnf kl/0ffd jf /f]usf] ?kdf b]vfkb{5g  .
P=O{=Pkm=cfO{= sf k|sf/x¿
k|sf/ kl/efiff
vf]ksf] pTkfbg ;+u
;DalGwt k|ltlqmof
(Vaccine Product-
Related Reaction)
vf]kdf lglxt s]xL tTjx¿sf] sf/0fn] x'g;Sg] k|ltlqmof  . h:t}–
PgfkmfO{n]lS;;  .
An AEFI that is caused or precipitated by a vaccine due to one
or more of the inherent properties of the vaccine product.
vf]ksf] u'0f:t/ ;+u
;Dalwt k|lts[of
(Vaccine quality
defect-related
reaction)
vf]ksf] u'0f:t/Lotfdf x'g] sdLsf sf/0f jf vf]k lbg k|of]u ul/g]
;fdu|Lsf]v/faLsf sf/0f x'g]k|lts[of .
An AEFI that is caused or precipitated by a vaccine that is due
to one or more quality defects of the vaccine product including
its administration device as provided by the manufacturer.
sfo{qmd ;~rfngsf]
qmddf x'g;Sg]q'6L
;+u ;DalGwt k|lts[of
(Immunization
error- related
reaction)
vf]k lbg]qmddf vf]k e08f/0f ubf{, vf]k 3f]Nbf, ;O{ lbFbf x'g;Sg]
q'6Lsf sf/0faf6 x'g;Sg]q'6L .
h:t}– ;'O{ lbPsf]7fFpdf lkk hDg',
An AEFI that is caused by inappropriate vaccine handling, pre-
scribing or administration and thus by its nature is preventable.
Example:Transmission of infection by contaminated multidose
vial.

26
vf]k;+u 8/sf
sf/0f x'g] k|lts[of
(Immunization
Anxiety related
reaction)
vf]k sf]sf/0fn]geO{ vf]k nufpbf ;'O{sf]lrGtfn], 8/n]jf b'vfOsf
sf/0fn] x'g] k|lts[of  .
h:t}– vf]k nufPkl5 a]xf]; x'g]  .
An AEFI arising from anxiety about the immunization.
Example:Vasovagal syncope
;+of]ua; x'g] 36gf
(Co-incidental)
vf]ksf] sf/0fn] geO{ ;+of]ujz x'g] 36gf  . h:t}– ?j]nf–bfb'/f vf]k
nufP kl5 lgdf]lgof x'g' .
An AEFI that is caused by something other than the vaccine
product, immunization error or immunization anxiety.
;fdfGo k|sf/sf cjfl~5t 36gfx¿
(Non-serious or Minor AEFI)
vf]k nufO{;s]kl5 ;fdfGo Hj/f] cfpg], ;'O{ nufPsf] 7fpFdf b'Vg] jf /ftf] x'g] jf ;'lgGg] h:tf ;fdfGo
c;/x¿ x'g ;S5g  . o:tf] vfn] c;/x¿ jf ;fdfGo k|sf/sf cjfl~5t 36gfx¿ ;fdfGotf cfkm}
x/fP/ hfG5g  . j9L Hj/f] cfPdf jf b'v]df Kff/fl;6fdf]n lbg ;lsG5  . ;fdfGo vfn] c;/x¿ klg
:jf:Yo ;+:yfn] dfl;s k|ltj]bg (HMIS 9.3) ug'{kb{5 .
ulDe/ k|sf/sf cjfl~5t 36gfx¿ (Serious AEFI)
;a} k|sf/sf ulDe/ cjfl~5t 36gfx¿ :jf:YosdL{x¿n] clgjfo{ ?kdf l/kf]6{ ug'{kb{5  . ulDe/
k|sf/sf cjfl~5t 36gfx¿ eGgfn]M
!= d[To' x'g'
@= Hofg g} hfg ;Sg] hf]lvd x'g' 
#= c:ktfn egf{ ug'{kg]{ x'g' jf nfdf] ;do;Dd c:ktfndf egf{ eP/ a:g' kg]{ x'g'
$= ckfË x'g' jf czQmtf x'g'
%= hGdhft lj;+ult jf ckfË hGdg' .
oL dfly pNn]v ul/Psf ulDe/ 36gfx¿ cToGt} b'n{e jf cToGt} sd x'G5 / vf]k k|of]usf] sf/0faf6
gePsf] klg x'g ;S5  . o; k|sf/sf 36gfx¿ b]lvPdf t'?Gt -@$ 306fleq_ ;DalGwt lgsfo,
sfof{no tyf afn :jf:Yo dxfzfvfdf k|ltj]bg ug]{ / cfaZos pkrf/ tyf Aoa:yfkgsf nflu
t'?Gt c:ktfn k|]if0f ug]{  .

27
vf]k nufPkl5 x'g;Sg] cjfl~5t 36gfx¿sf] Aoj:yfkg
• :jf:Yo sfo{stf{x¿n] vf]k lbPsf aRrfx¿nfO{ vf]k ;]jfkl5 cfwf 306f hlt cjnf]sgsf]
nflu /fVg'kb{5  . vf]k nufPsf aRrfx¿ 3/df uO{;s]kl5 klg s]xL lbg;Dd aRrfx¿sf]
:jf:Yoaf/] dlxnf :jf:Yo :jo+;]ljsfx¿ dfkm{t hfgsf/L lng]  .
• ;fdfGo k|sf/sf cjfl~5t 36gfx¿, h:t} vf]k lbPsf] 7fpFdf b'Vg], ;'lGgg], Hj/f] cfpg]
ePdf :yfgLo :jf:Yo ;+:yfdf pkrf/ u/fpg ;Nnfx lbg]  .
• uDeL/ k|s[ltsf cjfl~5t 36gfx¿ b]vfk/]df pkrf/sf] nflu d2t ug]{ / t'?Gt glhssf]
:jf:Yo ;+:yf / lhNnf :jf:Yo sfof{nodf k|ltj]bg ug]{  .
• ;fdfGo k|sf/sf 36gfx¿sf] lgoldt dfl;s / ulDe/ k|sf/sf 36gfx¿sf] @$ 306fleq
k|ltj]bg ug]{  .
• k|of]u ePsf] EolS;g efon ;'/lIft /fVg]  .
• P=O{=Pkm=cfO{= cg';Gwfgdf vl6Psf kbflwsf/LnfO{ 36gfsf] cg';Gwfg ug{ / k|ltj]bg tof/
ug{ d2t ug]{  .
efu
efu
efu
• vf]k kZrft x'g] cjfl~5t 36gf ;DalGw
cg';Gwfgsf] glthf gcfpGh]n cleefjs,
;d'bfo tyf ;+rf/sdL{;+u /f]uLsf] jf:tjLs
l:ytL ;do ;dodf tf]lsPsf] JolQm dfkm{t
hfgsf/L u/fpg'kb{5  . o:tf JolQmx¿ lhNnf jf
s]Gb|df tf]lsPsf x'G5g  .
• cg';Gwfgsf]glthf cfPkl5 dfq cjfl~5t
36gfsf] jf:tljs sf/0faf/] hfgsf/L lbg'kb{5  .

28
efu

/f]6f efO/; vf]k sfo{j|md ;+rfng
sfo{qmd ;~rfng sfo{gLlt
s= lgoldt vf]k dfkm{t /f]6f efO/; vf]k ;]jf ;~rfng
v= sfo{j|mdsf] kl/rofTds uf]i7L, tflnd tyf ;dLIff
u= ;~rf/ tyf ;fdflhs kl/rfng
3= cg'udg tyf dNofªsg
ª= clen]v tyf k|ltj]bg
s= lgoldt vf]k dfkm{t vf]k ;]jf ;+rfng
• nlIft ;d'x M !% dlxgf d'lgsf afnjflnsfx¿
• vf]k v'jfpg] pd]/ M ^ xKtf / !) xKtf -@ dfqf _
• vf]k lbg] :yfg M lgoldt vf]k s]Gb|
• vf]k lbg] dfWod M d'vaf6 v'jfpg]
v= sfo{j|mdsf] kl/rofTds uf]i7L tyf tflnd
• ;+3Lo :t/df gLlt lgdf{tf, pRrtxsf kbflwsf/L / ;/f]sf/jfnfx¿ nfO{ sfo{qmd jf/] hfgsf/L
• k||fb]lzs txdf sfo{qmdsf] of]hgf tyf cled'lvs/0f @ lbg
• ;fljs lhNnf txdf M :jf:Yo ;+:yf k|d'v / kflnsf ;+of]hsx¿ ;+u cled'lvs/0f / of]hgf
uf]li7 ! lbg
• :jf:Yo ;+:yf :t/df M ;j} :jf:YosdL{x¿nfO{ cled'lvs/0f ! lbg
;d]6g'kg]{ ljifoj:t'
• /fli6«o vf]k sfo{qmdsf]kl/ro , nIf, p2]Zo /ax'jlif{o vf]k of]hgf af/]hfgsf/L
• sfo{j|mdsf] p2]Zo / cf}lrTo

29
• /f]6f efO{/;af6 x'g]kvfnfsf]cj:yf /vf]ksf]dxTj, sfo{qmd ;+rfng k|s[of
 nlIft hg;ªVofsf]cg'dfg, EoflS;g /vf]k ;fdu|Lsf]cg'dfg, vf]k s]Gb| ;+rfng k|s[of
af/] hfgsf/L
 vf]ksf]kx'Fr k'Ug sl7g ;d'bfo, ;d'x, :yfgsf]klxrfg tyf vf]ksf]kx'Fr k'¥ofpg]sfo{gLlt
 ;/;kmfO, kf]if0f / kvfnfsf] Joj:yfkg af/] hfgsf/L
 ;rgf, lzIff, ;+rf//;d'bfo kl/rfngsf s[ofsnfk /k|s[of
 sfo{j|mdsf] ;'kl/j]If0f tyf cg'udg
 sfo{j|mdsf] clen]v tyf k|ltj]bg
 ;xof]u, ;dGjo /eldsf
gf]6 M of]cj;/df kflnsf ;+of]hs, :jf:Yo ;+:yf k|d'vx¿ /;j}:jf:YosdL{x¿ ;+u 5nkmn
ug]{ cj;/ x'g] ePsfn] lhNnf:t/sf] cled'lvs/0fsf] ;dodf vf]k sf]N8r]gsf] cj:yf, se/]h
ca:yf, vf]k v]/ hfg] b/, 8«k cfp6 b/, k0f{vf]ksf] cj:yf, ;'Idof]hgf tof/L cflb af/] :jf:Yo
;+:yf :t/sf]lja/0f lnO{ cfpg va/ug]{ ;fy};xhstf{x¿n]klg clu|d ;f]ljj/0f tof/
ul/ k|:t'lts/0f u/]/ ;du| vf]ksfo{qmdsf] ;'wf/sf] nflu ;+:yf k|d'v / cGo :jf:YosdL{sf]
eldsf / lhDd]jf/L af/] 5nkmn / k|lta4tf lng'kb{5  . :jf:Yo ;+:yf :t/sf] sfo{qmddf ;f]
af/]df 5nkmn ul/;'wf/ug{ ;d]t hfgsf/L u/fpg'k5{ .
u= :jf:Yo lzIff, ;rgf ;~rf/ tyf ;fdflhs kl/rfng
!= :jf:Yo lzIff ;fdfu|L
• :jf:YosdL{sf] nflu /f]6f efO/; vf]k Fact sheet M of] Fact sheet /f]6f efO/; vf]k
;DalGw :jf:YosdL{sf] hfgsf/Lsf] nflu tof/ ul/Psf] xf]  . ljz]if u/L vf]k sfo{stf{ / cGo
:jf:YosdL{n] ;d]t o;sf] cWoog u/L /f]6f vf]k ;]jf ;~rfngdf o;sf] k|of]u ug'{ kb{5  .
• /f]6f efO/; vf]k ;DalGw kf]:6/ M /f]6f efO/; vf]ksf] jf/]df ;a}sf] hfgsf/Lsf] nflu tof/
kfl/Psf] of] kf]i6/ ;a}n] b]Vg] :yfgdf h:t} :jf:Yo ;+:yf, vf]k ;];g, uf=kf=, g=kf= ejg /
cGo ;fj{hlgs :ynx¿df 6fF:g] Joj:yf ug'{kb{5  .
• a|f];/ -Brochure_ M;d'bfo tyf cleefjsx¿nfO{ of] vf]ksf] jf/]df hfgsf/L u/fO{ vf]k ;]jf
k|lt pTk|]l/t ug{sf] nflu a|f];/ tof/ ul/Psf] 5  . pQm a|f];/ dlxnf :jf:Yo :jo+d;]ljsf,
:jf:YosdL{x¿af6 aRrfsf] cfdf a'jf, cleefjsnfO{ pknAw u/fpg] Joj:yf ug'{kb{5  .

30
@= ;/;kmfO k|a4{g ;];gx¿ ;+rfng
lgoldt vf]k ;]jfdfkm{t ;/;kmfO k|a4{gsf];];g ;+rfngsf]nflu pknAw u/fO{Psf];fdu|Lk|of]u
ug'{kg]{ 5 .
#= ;fdflhs kl/rfng
/f]6f efO/; vf]k z'?jft ePkl5 ;a}jfnjflnsfnfO{ vf]k lbnfpg ;d'bfo kl/rfng /;~rf/sf]
cToGt dxTj x'G5 . of]sfo{qmddf ;d'bfo kl/rfng ;DalGw s[ofsnfk tyf ah]6 Joj:yf 5}g .
t;y{
• :jf:Yo ;+:yfaf6 dlxnf :jf:Yo :jo+d;]ljsfx¿, j8f vf]k ;dGjo ;ldlt nfO{ /f]6fefO/;
vf]k ;~rfng, dfqf, nufpg]pd]/cflbsf]jf/]df kqfrf/ug'{kb{5 .
• ;d'bfo :t/df vf]k af/] ;Gb]z k|jfx ug{ ljBfnox¿af6 ;d]t k|rf/k|;f/ u/fpg kqfrf/
u/]df cem k|efjsf/Lx'G5  .
• cGo sfo{qmdsf] cj;/df ;d]t of] vf]ksf] jf/]df dlxnf :jf:Yo :j+od;]ljsf tyf
;/f]sf/jfnfx¿nfO{ hfgsf/L u/fpg' kb{5  .
of] vf]k z'?jft ubf{ ;d'bfo :t/df cledlvs/0f sfo{qmdsf] Joj:yf gePsf]n] :yfgLo
:t/df ;dGjo u/L jf lgoldt sfo{qmddf dlxnf :jf:Yo :jo+d;]ljsf, j8f vf]k ;dGjo
;ldlt / ;/f]sf/jfnfx¿sf] j}7ssf] Joj:yf ul/ /f]6f vf]k z'?jft tyf cGo vf]kx¿sf]
;d]t ;ldIff / 5nkmn ug{ clt h?/L x'g] ePsf]n] ;f] sf] Joj:yfkg ug{ kxn ug'{kb{5  .
pSt cj;/df ;/;kmfO{ k|aw{g / kf]if0f ;DalGw ;Gb]zx¿ k|jfx ug'{ kb{5  .
$= ;~rf/
of] vf]k z'?jft ;DalGw / vf]ksf] dxTj jf/]df hfgsf/L u/fpg ;+3Lo, k|fb]lzs / kflnsf :t/df
cfd ;~rf/sf dfWodaf6 k|rf/k|;f/ ug'{ pko'Qm x'g]5  . To;} u/L nlIft ;dxnfO{ tof/ kfl/Psf
;~rf/ ;fdfu|Lx¿ h:t} kf]i6/, Fact Sheet cflbsf]dfWodaf6 1fg, l;k, Ifdtf clej[l4 ug{ pQm
;fdfu|Lx¿sf] oyf]lrt ljt/0f / pkof]usf] ;'lglZrt ug'{kb{5  .
3= cg'udg tyf dNof+sg
of]vf]k ;]jf lgoldt vf]k ;]jf ;Fu};~rfng x'g]ePsf]n]dfl;s vf]k ;~rfng kZrft nIo
cg';f/k|ult eP gePsf]tyf klxnf]dfqf /bf]f]dfqf ljrsf]8«k cfp6 cg'udg ul/tTsfn
k|ult xfl;n ug]{ sfo{x¿ ug'{kb{5 . :jf:Yo ;+:yf :t/df vf]k ;~rfng kZrft dfl;s cg'udg,
5nkmn ul/k|ult j9fpg /8«k cfp6 36fpg lgoldt kxn ug'{kb{5 .

31
-ª_ clen]v / tYof° ljZn]if0f
clen]v /fVg]
vf]k nufO{ ;s]kl5 vf]k ;DalGw ;Dk0f{ ljj/0fx¿ HMIS sf sf8{ / /lhi6/df cGo vf]ksf] laa/0f
h:t} clgjfo{ ?kdf eg'{kb{5  . vf]k ;Fu ;DalGwt sf8{ tyf kmf/dx¿sf] ;rL lgDgfg';f/ 5  .
• l8kmN6/÷clgoldttf vf]h k'hf{ (HMIS 1.5)
• v'nf ;dfof]hg km/fd (HMIS 1.6 )
• afn :jf:Yo sf8{ (HMIS 2.1)
• vf]k /lhi6/ (HMIS 2.2)
• vf]k ;]jf ;~rfng ljj/0f (HMIS 2.2.1)
• EoflS;g k|fKt, vr{ tyf v]/ uPsf] ljj/0f– 8f]hdf (HMIS 2.2.2)
• vf]k ;]jf (HMIS 2.2.3)
• l6=l8= vf]k ;]jf (HMIS 2.2.4)
• vf]k cleofg /lhi6/ (HMIS 2.2.5)
• vf]k kZrft x'g] cjfl~5t 36gf (HMIS 2.2.6)
• dlxnf :jf:Yo :jo+;]ljsf /lhi6/– dft[ tyf gjhft lzz' ;DaGwL ljj/0f (HMIS 4.2)
• dlxnf :jf:Yo :jo+;]ljsf sfo{qmdsf] dfl;s k|ltj]bg– qmd ;+Vof -3_, !^, ! / !*
(HMIS 9.1)
• ;d'bfo:t/ :jf:Yo sfo{qmdsf] dfl;s k|ltj]bg – vf]k tyf ufpF3/ lSnlgs sfo{qmd
(HMIS 9.2)
• Dffl;s k|ult k|ltj]bg– Monthly Progress Report (HMIS 9.3)
tYof° ljZn]if0f
vf]k ;]jfsf] k|ult dfl;s, rf}dfl;s tyf aflif{s ?kdf tof/ ul/G5  . o;/L k|ult k|ltj]bg tof/
ug{sf] nflu vf]k sfo{qmddf k|of]u x'g] dVo ;rsx¿ b]xfo adf]lhd 5g  .
!= vf]k se/]h
vf]ksf] se/]h eg]sf] lglZrt calwdf tf]lsPsf] nlIft hg;+Vof dWo] slthgfn] vf]k ;]jf k|fKt
u/] egL lgsfNg] k|ltzt xf]  . pbfx/0fsf] nflu

32
/f]6f efO/; vf]k klxnf] dfqfsf] se/]h =
lglZrt calwdf hDdf /f]6f efO/; vf]k klxnf] dfqf lnPsf] ;+Vof X !))
lglZrt calwdf Ps jif{ d'lgsf]lzz'x¿sf];+Vof
/f]6f efO/; vf]k bf]f] dfqfsf] se/]h =
lglZrt calwdf hDdf /f]6f efO/; vf]k bf]f] dfqf lnPsf] ;+Vof X !))
lglZrt calwdf Ps jif{ d'lgsf]lzz'x¿sf];+Vof
@= 8«k cfp6 b/
8«k cfp6 eg]sf] klxnf] k6s ;]jf lng cfPsf] JolQm ToxL ;]jf jf ;DalGwt ;]jf kl5Nnf] k6s
lng gcfPdf To;nfO{ 8«kcfp6 elgG5  . h:t}M
/f]6f ! vs @ 8«k cfp6 =
-/f]6f ! lnPsf] hDdf ;+Vof - /f]6f @ lnPsf] hDdf ;+Vof _ X !))
/f]6f ! lnPsf]hDdf ;+Vof
o:t} u/L cGo vf]ksf] klg lgsfNg]  .
tYof° ljZn]if0f / k|of]u
nlIft afnjflnsf /ue{jtL dlxnfnfO{ /fli6«o vf]k tflnsf cg';f/sf k|To]s vf]kx¿
;dodf g} k|bfg u/L vf]k hGo /f]ujf6 x'g] /f]ub/, d[To'b/ / ckfËb/ 36fpg' /fli6«o vf]k
sfo{qmd sf] nIf xf]  . To;}n] k|To]s :jf:Yo ;+:yfn] cf–cfˆgf] sfo{ If]qsf] vf]k ;DalGw
tYof+ssf]ljZn]if0f u/L To;sf]cfwf/df ;d:ofsf];dfwfgsf nflu cfjZos lqmofsnfkx¿
;~rfng ug{'kb{5 . vf]k lng 5''6 tyf 8«k cfp6 aRrfx¿ tTsfn klxrfg u/L vf]k k|bfg
ug]{ Joj:yf ug'{ kb{5 .
!=vf]k sfo{qmdsf]lgoldt cg'udg,ljZn]if0f ul/tTsfn 8«kcfp6 /5'6 aRrf nfO{ vf]k
lbnfpg M
 vf]ks]Gb|jfO{h vf]k 6ofnL l;6 tof/u/]/vf]k sfo{ ;lsgf ;fy k|ult 6ofnL u/fpg]
/vf]ks]Gb| :t/df g}5'6 aRrfsf]klxrfg ul/cfjZos sbd rfNg lg/Gt/hfgsf/L
u/fpg],
 6ofnL l;6 tyf HMIS 9.2 af6 :jf:Yo ;+:yfdf dfl;s ;dfof]hg kmf/d tof/
ul/k|ult /8«kcfp6 ljZn]if0f ul/tTsfn 5'6 aRrfnfO{ vf]k k|bfg ug{ cfaZos
sbd rfNg]-:jo+d ;]ljsf nfO{ kqfrf/,cleefas nfO{ kq tyf kmf]g af6 hfgsf/L,
;d'bfo kl/rfng cflb_

33
/f]6f efO/; vf]k;“u ;DalGwt
;fwf/0ftof ;f]lwg] k|Zgx¿ M
-:jf:Yo sdL{x¿sf] nflu_
k|Zg ! M /f]6f efO/; s] xf] 
pQ/ M /f]6f efO/; dfG5] df !(# df la;xk / pgsf ;fyLx¿n] severe gastroenteritis ePsf]
aRrfsf] duodenal mucosa af6 afo]K;L ubf{ kQf nufPsf lyP . of]Reoviridae kl/jf/sf] double-
stranded RNA virus xf]  . /f]6f efO/; Ps cToGt ;+qmfds efO/; xf]  . o;n] aRrfx¿df lg/Gt/
emf8fkvfnf u/fFp5  . h;n] ubf{ aRrfx¿nfO{ c:ktfndf egf{ u/fpg' kg]{ b]lv d[To;Dd x'g ;Sg]
cj:yf l;h{gf u/fFp5  . Rotaviruses most commonly are classified according to group and
serotype. Seven groups of rotavirus have been described (A–G), and are based on genetic
and antigenic differences in the VP6 protein. Only those viruses in groups A, B, and C are
known to cause disease in humans. Group A rotaviruses are the principal cause of human
disease but Group B rotaviruses have been associated with epidemic gastroenteritis in Asia,
and group C rotaviruses have been associated with sporadic mild gastroenteritis.
lrq g+ % M /f]6f efO/;
k|Zg @ M /f]6f efO/;n] ug]{ emf8fkvfnfsf nIf0fx? s:tf x'G5g 
pQ/ M /f]6f efO/; emf8fkvfnf ljleGg k|s[ltsf] x'g] ub{5g  . tf/Gtf/ kftnf] lbzf b]lv ulDe/
k|s[ltsf] emf8f kvfnf ;fy} lg/Gt/ jfGtf x'g] ub{5  . olb ;dod} pkrf/ gkfPdf aRrfx¿df
hnljof]hg, zl//df nj0fsf] dfqfdf c;Gt'ng, emGemgfx6sf ;fy} d[To;Dd x'g] ub{5  .
o;sf] z'?jftL cj:yfdf ulDe/ lsl;dsf] kvfnf ! b]lv # lbg;Dd b]lvg] ub{5 h'g cjwLdf Hj/f]
cfpg], kvfnf nfUg], jfGtf x'g],k]6 b'Vg] cfbL h:tf lrGx tyf nIf0fx¿ b]lvG5g  . # b]lv lbgdf
of] cj:yf cfkm} /f]lsg klg ;S5  .

34
k|Zg # M s] /f]6f efO/; emf8fkvfnf cToGt cToGt ulDe/ x'g ;Sb5 
pQ/ M kfFrjif{d'lgsf aRrfsf]s'n d[To' dWo]clxn]klg emf8fkvfnf k|d'v sf/0f -s'n d[To'sf]*
k|ltzt_ /x]sf]5 . kvfnfsf]sf/0faf6 x'g]s'n d[To' dWo]df #@ b]lv #* k|ltzt d[To' /f]6f efO{/;sf]
sf/0fn] x'g] kvfnfaf6 x'G5  . /f]6f efO{/; ;+qmd0fsf] sf/0f laZje/ aif]{gL emG8} ;f9] rf/nfv
dflg;x¿n]Hofg u'dfpg]u/]sf 5g . ljZj :jf:Yo ;+u7gsf]tYof+s cg';f/;g @)!# df dfq
/f]6f efO{/; ;+qmd0fsf] sf/0f laZje/ @,!%,))) jfnjflnsfsf] d[To' ePsf] lyof]  . To;}ul/ aif]{gL
emG8}@) nfv dflg;x¿ /f]6f efO{/; ;+qmd0fsf]sf/0f c:ktfndf egf{x'g]u/]sf 5g .
g]kfnsf]sfGtL afn c:ktfndf ul/Psf]Ps cWoogn]kvfnfsf]sf/0faf6 c:ktfndf egf{ x'g]%
jif{ d'lgsf aRrf dWo]@! b]lv #* k|ltzt aRrfx¿ /f]6f efO/;sf]sf/0faf6 x'g]kvfnfsf]sf/0f
egf{ ePsf]kfO{Psf]5 .
k|Zg $ M s:tf aRrfx¿ /f]6f efO/; emf8fkvfnfsf] cToGt hf]lvddf
x'g] ub{5g 
pQ/ M /f]6f efO/;sf] ;+qmd0f x'gsf nflu h'g;'s} 7fFp jf :yfg klg pkoQm x'g ;Sb5  . o;af6
x'g] ;+qmd0fsf] cg'kftsf] km/s ljsl;t jf ljsf;zLn b]zx¿df Tolt w]/} 5}g  .
nueu /f]6f efO/; ;Fu ;DalGwt %) k|ltzt d[To hGd]sf] Ps aif{ leq x'g] ub{5 / sl/j %
k|ltzt rfFxL hGd]sf] b'O aif{ leq x'g] u/]sf] 5  .
s'kf]lift aRrfx¿df ulDe/ vfnsf] kvfnfsf] ;fy} hnljof]hgsf] klg pRr hf]lvd x'g] ub{5  . olb
;dod} ;lx pkrf/ u/fOPg eg] aRrfsf] d[To klg x'g] ub{5  .
k|Zg % M /f]6f efO/;af6 s;/L ;+qmd0f x'g] ub{5 
pQ/ M /f]6f efO/; cToGt} ;+qmfds efO/; xf]  . WHO Position Paper -2013_ sf cg';f/
;fwf/0ftof Ps aRrfaf6 csf]{ aRrfdf b'lift kfgL, b'lift vfg]s'/f / kmf]xf]/L xft Ps cfk;df
ldnfPdf of] efO/; ;lhn} ;g{ ;Sb5  . of] efO/; aRrfsf] xftdf 306f} ;Dd lhljt /xg ;Sb5  .
k|Zg ^ M /f]6f efO/; emf8fkvfnf vf;u/L s'g df};ddf al9 x'g] ub{5 
pQ/ M /f]6f efO/; ;+qmd0f / emf8fkvfnf aif{sf] h'g;'s} df};ddf klg x'g ;Sb5  . vf;u/L hf8f]
df};ddf o;sf] ;+qmd0f al9 b]lvg] ub{5  .
k|Zg M /f]6f efO/; emf8fkvfnfsf] kl/If0f s;/L ul/G5 
pQ/ M /f]6f efO/;sf] sf/0fn] x'g] emf8fkvfnf / cGo sf/0fn] x'g] emf8fkvfnfdf vf;} w]/} km/s
x'Fb}g  . To;sf/0f aRrfsf] lbzfnfO{ k|of]uzfnfdf kl/If0f u/]kl5 dfq /f]6f efO/; ;+qmd0f xf] ls
x}g eg]/ yfxf x'g] ub{5  .

35
k|Zg * M /f]6f efO/; emf8fkvfnfsf] pkrf/ s;/L ul/G5 
pQ/ M /f]6f efO/;af6 x'g] emf8fkvfnfsf] s'g} vf; pkrf/ ljwL t 5}g, o;sf] pkrf/ cGo
emf8fkvfnfsf] h:t} x'g] ub{5  . o;sf] pkrf/sf nflu aRrfnfO{ k'gh{lno emf]n -ORS_ / !$
lbg;Dd lh+s rSsL v'jfpg' kb{5  . of] cjwLdf klg emf8fkvfnf /f]lsPg / l:ytL uDeL/ x'Fb} uof]
eg] aRrfnfO{ c:ktfndf egf{ u/fpg cfjZos kb{5  .
k|Zg ( M Ps k6s /f]6f efO/;af6 ;+qmd0f eP kl5 af/Daf/ ;+qmd0f x'g ;S5 
pQ/ M x'g ;S5  . aRrfnfO{ /f]6f efO/;sf] ;+qmd0f k6s k6s x'g] ub{5  . t/ bf]f] k6s x'g]
;+qmd0f ;fdfGotof klxn] h:tf] ulDe/ x'Fb}g  .
k|Zg !) M /f]6f efO/; emf8fkvfnfaf6 s;/L hf]ufpg ;lsG5 
pQ/ M /f]6f efO/; vf]k g} /f]6f efO/; emf8fkvfnf /f]syfdsf] nflu Psdfq pQd / ;/n pkfo
xf]  . /f]6f efO/; vf]k aRrfdf /f]6f efO/; emf8fkvfnfsf] sf/0f c:ktfndf egf{ x'g] / o;af6 x'g]
d[Tob/ 36fpg k|efjsf/L ePsf] 5  .
;fdfGo /f]syfdsf pkfox¿df lgoldt ;/;kmfO, af/Daf/ ;fa'g kfgLn] xft w'g], ;kmf kfgL lkpg]
;fy} tfhf / :j:y vfgf / aRrfnfO{ lgoldt :tgkfg u/fpg' g} x'g  . o;sf cnfjf le6fdLg æPæ
ePsf vfg]s'/f v'jfPdf klg /f]6f efO/; ;+qmd0faf6 arfpg ;lsG5  . t/ of] ljsNk /f]6f efO/;
emf8fkvfnf /f]uaf6 arfpg dfq kof{Kt x'Fb}g  .
k|Zg !! M /f]6f efO/; vf]k ljZjsf c? b]zdf klg pkof]u ul/b} cfPsf] 5 
pQ/ M xf], /f]6f efO/; vf]k ljZjsf c? (% eGbf a9L b]zdf /fli6«o vf]k sfo{qmd cGtu{t lbFb}
cfO/x]sf] 5  . ca g]kfn klg of] vf]k lgoldt vf]k ;]jfdf ;dfj]z ePsf] 5  . g]kfndf of] aif{ b]lv
/f]6f efO/; vf]k ;a} vf]k lSnlgsx¿df lgz'Ns pknAw x'Fb} 5  .
k|Zg !@ M /f]6f efO/; vf]kn] c? k|sf/sf] emf8fkvfnfsf] /f]syfd klg
ug{ ;Sb5 
pQ/ M ;Sb}g, Wofg lbg' kg]{ s'/f rfFxL emf8fkvfnf cGo w]/} k|sf/sf lhjf0f'n] u/fpg ;S5  . /f]6f
efO/; vf]kn] /f]6f efO/;sf sf/0fn] aRrfdf x'g] emf8fkvfnfsf] dfq /f]syfd ug{ ;Sb5  . /f]6f
efO/; vf]k v'jfP kl5 klg cGo sf/0fn] x'g] emf8fkvfnf x'g ;Sg] ;Defjgf x'G5  .
k|Zg !# M /f]6f efO/; vf]k x]bf{ s:tf] b]lvG5 
pQ/ M /f]6f efO/; vf]k ;fdfGotof ;kmf /+uljlxg 3f]nsf] ?kdf kfOG5  . t/ slxn]sfFxL xn'sf kx]Fnf]
/+udf klg kfpg ;lsG5  . t/ km/s /+u ePtf klg o;sf] u'0f:t/ / c;/df s'g} km/s eg] kb}{g  .

36
k|Zg !$ M /f]6f efO/; vf]k slxn] / s;/L lbg] 
pQ/ M /f]6f efO/; vf]k -RVV_, Ps lhljt vf]k xf]  . vf]ksf] Ps dfqf !=% Pd Pn x'G5 / of]
vf]k /fli6«o vf]k sfo{qmdsf] tflnsf cg';f/ aRrf hGd]sf] ^ / !) xKtfdf /fli6«o vf]k sfo{qmd
nfu' ePsf ;j} vf]k lSnlgsdf :jf:YosdL{ åf/f v'jfpg] ul/G5  .
k|Zg !% M s] /f]6f efO/; vf]k sf] yk dfqf klg cfjZos x'G5 
pQ/ M /f]6f efO/; vf]ksf] s'g} yk dfqf -a':6/ 8f]h_ sf] cfjZostf kb}{g  . Tolx ^ / !) xKtfdf
lbOg] vf]ksf] dfqfn] aRrfsf] vf]ksf] dfqf k'/f ug{sf nflu kof{Kt x'G5  .
k|Zg !^ M /f]6f efO/; vf]k lbg' cl3 of kl5 :tgkfg u/fpg ldN5 
pQ/ M ldN5 . vf]k lbg' cl3 of kl5 :tgkfg u/fpg cjZo ldN5 .
k|Zg ! M s:tf] kl/l:yltdf /f]6f efO/; vf]k aRrfnfO{ lbg' x'“b}g 
pQ/ M lgDg lgbfgfTds kl/l:yltdf /f]6fefO{/; vf]k aRrfnfO{ lbg' x'Fb}g M
• olb aRrfnfO{ klxnf s'g} vf]k lbFbf uDeL/ PnhL{ ePsf] eP  .
• olb aRrfdf s'g} cfG›fsf] /f]uaf6 u|l;t ePsf] eP cyjf k]6df ck|];g u/]sf] ePdf cydf
cfG›fdf s'g} v/faL ePsf] eP  .
• /f]u k|lt/f]wfTds zQmLdf s'g} v/faL ePsf] -ODogf]l8lkm;]G;L_ yfxf ePdf  .
k|Zg !* M olb aRrfnfO{ s'g} ;fdfGo lj/fdL 5 eg] o:tf] a]nfdf
/f]6f efO/; vf]k lbg x'G5 ls x'“b}g 
pQ/ M olb aRrfnfO{ s'g} ;fdfGo lj/fdL h:t} M ;fdfGo Hj/f], ;fdfGo vf]sL cfbL s]xL ePsf] eP
o:tf] a]nfdf klg /f]6f efO/; vf]k lbg ;lsG5  . olb aRrfnfO{ vf]k tflnsf cg';f/ cGo vf]k
lbg ldN5 eg] /f]6f efO/; vf]k klg lbg ;lsG5  . aRrf u+eL/ lj/fdL h:t}M pRr Hj/f], uDeL/
emf8fkvfnf cyjf jfGtf eO{ c:ktfndf egf{ ePsf] ca:yf afx]s cGo s'g} klg sf/0fn] vf]k
lbgaf6 aGrLt u/fpg' x'Fb}g  . o:tf] kl/l:yltdf hj ;Dd aRrf k0f{?kn] lgsf] x'Fb}g ta ;Dd of]
vf]ksf] dfqf lbg' x'Fb}g  .
k|Zg !( M Pp6f aRrfnfO{ Ps k6sdf Ps eGbf a9L vf]k lbg' slQsf];'/lIft
x'G5 
pQ/ M lbg x'G5  . /fli6«o vf]k sfo{qmdsf] vf]k tflnsf cg';f/ Ps aRrfnfO{ Ps k6sdf Ps eGbf
a9L vf]k lbg' ;'/lIft 5  . To;}n] /f]6f efO/;sf] klxnf] vf]k lbO{g] lbg klxnf /f]6f, cf] kL eL, Pkm
cfO kL eL, kL ;L eL /k]G6f qmd; lbOG5 .

37
k|Zg @) M /fli6«o vf]k sfo{qmd cGtu{t h'g aRrfnfO{ cf]lkle /
k]+6fEofn]G6sf] klxnf] dfqf lbO;s]sf] x'G5, s] Tof] aRrfnfO{ /f]6f efO/;
vf]ksf] dfqf z'? ug{ ;lsG5 
pQ/ M ;lsFb}g, /f]6f efO/; vf]k sfo{qmd nfu' e};s]kl5sf z'?jftL r/0fdf s]jn lt aRrfnfO{
dfq /f]6f efO/; vf]k lbg ;lsG5 h'g aRrf cf]lkle lkl;eL / k]+6fEofn]G6 vf]ksf] klxnf] dfqfsf]
nflu cfPsf x'g  . lo aRrfnfO{ /f]6f efO/; vf]ksf] bf]f] dfqf vf]k tflnsf cg';f/ cfufdL k6s
:jf:Yo ;+:yf cfFpbf lbg k5{  .
k|Zg @! M olb s'g} aRrfsf] /f]6f efO/;sf] klxnf] dfqf s'g} sf/0faz 5'6]/
kl5 s'g} ;do l9nf] ul/ cfPdf s] ug{' k5{ 
pQ/ M olb s'g} aRrf ^ xKtfsf] pd]/ sl6 ;s]kl5 klg vf]k tflnsf cg';f/ klxnf] dfqf vf]k lng
cfPdf p;nfO{ cf]lkle, lkl;eL / k]+6fEofn]G6sf] klxnf] dfqf / bf];|f] dfqfsf] ;fy ;fy} /f]6f efO/;
vf]ksf] klg lbg' k5{ .
k|Zg @@ M olb s'g} aRrfn] /f]6f efO/;sf] klxnf] dfqf kfPsf] t/ bf]f] dfqf
gkfPsf] eP s] ug]{ 
pQ/ M olb bf]f] dfqf 5'6]sf] eP k]+6fEofn]G6 bf];|f] ;+u lbg' kb{5  .
k|Zg @# M olb vf]k cjwLdf aRrfnfO{ cf]lkle vf]k eGbf klxnf /f]6f efO/;
vf]k lbOPsf] /}5 eg] s] ug]{ 
pQ/ M lrGtf lng' kb}{g  . cf]lkle eGbf kl5 klg /f]6fefO{/; vf]k lbg ;lsG5  .
k|Zg @$ M ;do gk'uL hGd]sf aRrfnfO{ /f]6f efO/; lbgsf nflu a]Un} vf]k
tflnsf cfjZos k5{ 
pQ/ M kb}{g  . /f]6f efO/; vf]ksf] dfqf aRrfsf] ue{sf] pd]/ cg';f ge} aRrf hGd]s} pd]/sf]
cfwf/df lbg' k5{  .
k|Zg @% M s'g s'g :jf:Yo ;+:yfdf /f]6f efO/; vf]k pknAw x'G5 
pQ/ M /fli6«o vf]k sfo{qmd nfu' ePsf ;j} vf]k lSnlgsdf /f]6f efO/; vf]k pknAw x'G5  . of]
vf]k kf]lnof] yf]kf h:tf] 3/ 3/ df uP/ v'jfpg ldNb}g  .

38
k|Zg @^ M olb vf]k cjwLdf /f]6f efO/; vf]k pnkAw gePdf s] ug]{ 
pQ/ M aRrf h'g vf]ksf nflu of]Uo 5 lt vf]kx¿ lbg' k5{  . / afFsL /x]sf] /f]6f efO/; vf]k
cfufdL vf]k ;qdf lbg' k5{ .
k|Zg @ M /f]6f efO/; vf]ksf] b'ik|efjx¿ klg x'G5g 
pQ/ M of]vf]k nufPkl5 s]xL jRrfnfO{ ;fdfGo kvfnf tyf k]6sf]u8j8L -Irritability_ x'g ;S5 .
of]vf]k lnPsf]k|lt Ps nfv jRRffx¿ dWo]! jf @ hgf ;Dddf cfGw|f v:g](intussusceptions)
x'g]elgPsf]ePtfklg xfn;fn}clk|msfsf a6f b]zx¿df ul/Psf]o; vf]k (rotatix) sf] cWoogn]
o:tf] hf]lvd gePsf] kfOPsf] 5  .
oxfF yfxf kfpg' kg]{ dVo s'/f rfFxL olb aRrfnfO{ /f]6f efO/; vf]k lbOPsf] /}g5 eg] klg dfly
pNn]lvt cj:yf cfpg ;Sg] ;Defjgf /xG5  .aRrfnfO{ ;dodf g} /f]6f efO/; vf]k lbOPsf] 5
eg] /f]6f efO/; kvfnf / cGo k|lts'n ;d:of x'g lbFb}g  . o;}n] aRrfnfO{ /f]6f efO/; kvfnfaf6
arfpg /f]6f efO/; vf]k lbg cfjZos 5  .
k|Zg @* M /f]6f efO/; vf]ksf] 6o'adf EofS;Lg efon dlg6/ -VVM_ n]lvPsf]
x'G5 
pQ/ M pQ/M x'G5 . /f]6f efO/; vf]ksf] 6o'adf cGo vf]ksf] hMt} lelePd x'G5 . ha lelePdsf]
/Ë kl/jt{g eP/ # jf $ ePdf k|of]u ug{ x'b}g . To:t} ha ldtL ;lsG5 ta of] k|of]u ug{' x'Fb}g .
hj;Dd leqL auf{sf/sf] /+u aflx/sf] uf]nfsf/sf] /+u eGbf xNsf x'G5 ta ;Dd k|of]u ug{'k5{  .
olb leqL auf{sf/sf] /+u aflx/L uf]nfsf/sf] /+us} a/fa/ cyjf Tof] eGbf uf9f ePdf vf]ksf] k|of]u
ug{' x'Fb}g  .
k|Zg @( M Pp6f 6o'adfdf /f]6f efO/; vf]ksf] slt dfqf x'G5 
pQ/ M /f]6fefO{/;sf] Ps 6o'adf Ps dfqf pknAw u/fOPsf] x'G5  . :jf:YosdL{n] of] vf]k k|of]u
ug{' eGbf klxnf vf]k;Fu ;DaGwLt ;Dk0f{ ljj/0f cWoog ug{' k5{ .

39
k|Zg #) M /f]6f efO/; vf]knfO{ slt tfkqmddf e08f/0f ug{' k5{ 
pQ/ M :jf:Yo ;]jf k|bfos ;+:yf tyf vf]k nufpg] :yfgdf /f]6fefO{/; vf]knfO{ ‌@ l8u|L ;]lN;o;
b]lv +* l8u|L ;]lN;o; ;Ddsf] tfkqmddf /fVg' kb{5  . /f]6fefO{/; vf]knfO{ tfkaf6 hf]ufpg cfOPncf/
-ILR_ df ljl;hL vf]k;Fu} cyjf To;sf] dfyL /flvG5  .
k|Zg #! M /f]6f efO/; vf]knfO{ Ps 7f“paf6 csf]{ 7f“pdf s;/L lnP/ hfg' k5{ 
pQ/ M/f]6fefO{/; vf]knfO{ cGoq n}hfFbf cfO; Kofs /flvPsf] jftfg's'nLt vf]kjfxg aS;fdf /fv]/
n}hfg' kb{5  .
k|Zg #@ M olb aRrfnfO{ v'jfOPsf] /f]6f efO/; vf]k aRrfn] d'vaf6 lgsfn]df
cyjf v'jfpg] ljlQs} jfGtf u/]df s] ug]{ 
pQ/ M olb aRrfn] d'vaf6 lgsfn] jf tTsfn jfGtf u/] km]/L bf]xf]of{P/ v'jfpg' k5{  .

! hGdg]
ljlQs} la=l;=hL= •bf”of kfv'/fsf] dflyNnf] efu
5fnfleq (Intra-dermal)
•Ifo/f]u
@ ^
xKtfdf
/f]6f -klxnf] dfqf_
kf]lnof] -klxnf] dfqf_
Pkm=cfO{=lk=eL=
-klxnf] dfqf_
lk=l;=eL -klxnf] dfqf_
l8=lk=6L=, x]k aL-lxa
-klxnf] dfqf_
•d'vdf-ufnfsf] leqL efudf_
•d'vdf b'O{ yf]kf
•af”of kfv'/fsf] dflyNnf] efu
5fnfleq (ID)
•bf”of ltw|fsf] lar aflx/L efu
df;'df (IM)
•af”of lt3|fsf] lar aflx/L efu df;'df
(IM)
•/f]6f efO/;af6 x'g] emf8fkvfnf
•kf]lnof]
•kf]lnof]
•lgdf]lgof -Godf]sf]sn /f]ux?_
• Eofu't] /f]u, nx/] vf]sL, wg'i6”sf/,
x]kf6fO6l6;-aL, x]df]lkmn; OG n'PGhf-aL,
#
$
%
^

!)
xKtfdf
!$
xKtfdf
(
dlxgfdf
!@
dlxgfdf
!%
dlxgfdf
/f]6f -bf]f] dfqf_
kf]lnof] -bf]f] dfqf_
lk=l;=eL -bf]f] dfqf
l8=lk=6L=, x]k aL-lxa -bf]f] dfqf_
kf]lnof] -t]f] dfqf_
Pkm=cfO{=lk=eL=
-bf]f] dfqf_
l8=lk=6L=, x]k aL-lxa -t]f] dfqf_
lk=l;=eL
-t]f] dfqf_
bfb'/f-?a]nf
-klxnf] dfqf_
•bfb'/f / ?a]nf
hfkflgh
OG;]kmnfOl6;
•bf”of lt3|fsf] dflyNnf] aflx/L
efu 5fnf / df;' aLr
(Subcutaneous)
•hfkflgh OG;]kmnfOl6;
bfb'/f-?a]nf
-bf]f] dfqf_
5fnf / df;' lar
(Subcutaneous)
/f]6fefO/; vf]ksf] xsdf vf]k pknAw eO;s]kl5 dfq tflnsf cg';f/ vf]k ;+rfng x'g]5 .
k6s/
e]6
s'g pd]/df s'g vf]k ;'O{ nufpg] :yfg / dfWod s'g /f]uaf6 arfp”5
•d'vdf -ufnfsf] leqL efudf_
•d'vdf b'O{ yf]kf
df;'df (IM)
•af”of lt3|fsf] lar aflx/L efu
df;'df (IM)
•kf]lnof]
•d'vdf b'O{ yf]kf
5fnfleq (ID)
df;'df (IM)
•kf]lnof]
•kf]lnof]
df;'df (IM)
5fnf / df;' aLr (Subcutaneous)
k)f{ vf]k, ;'lglZrt eljio
/fli6«o vf]k-tflnsf
•bfb'/f / ?a]nf
;Demg'xf];M ue{jtL dlxnfn] klxnf] ue{df slDtdf Ps dlxgfsf] cGt/df @ k6s l6=8L= vf]k nufpg} k5{ .
! hGdg]
ljlQs} la=l;=hL= •bf”of kfv'/fsf] dflyNnf] efu
5fnfleq (Intra-dermal)
•Ifo/f]u
@ ^
xKtfdf
/f]6f -klxnf] dfqf_
kf]lnof] -klxnf] dfqf_
Pkm=cfO{=lk=eL=
-klxnf] dfqf_
lk=l;=eL -klxnf] dfqf_
l8=lk=6L=, x]k aL-lxa
-klxnf] dfqf_
•d'vdf-ufnfsf] leqL efudf_
•d'vdf b'O{ yf]kf
5fnfleq (ID)
df;'df (IM)
•af”of lt3|fsf] lar aflx/L efu df;'df
(IM)
•kf]lnof]
•kf]lnof]
#
$
%
^

!)
xKtfdf
!$
xKtfdf
(
dlxgfdf
!@
dlxgfdf
!%
dlxgfdf
/f]6f -bf]f] dfqf_
kf]lnof] -bf]f] dfqf_
lk=l;=eL -bf]f] dfqf
l8=lk=6L=, x]k aL-lxa -bf]f] dfqf_
kf]lnof] -t]f] dfqf_
Pkm=cfO{=lk=eL=
-bf]f] dfqf_
l8=lk=6L=, x]k aL-lxa -t]f] dfqf_
lk=l;=eL
-t]f] dfqf_
bfb'/f-?a]nf
-klxnf] dfqf_
•bfb'/f / ?a]nf
hfkflgh
OG;]kmnfOl6;
•bf”of lt3|fsf] dflyNnf] aflx/L
efu 5fnf / df;' aLr
(Subcutaneous)
•hfkflgh OG;]kmnfOl6;
bfb'/f-?a]nf
-bf]f] dfqf_
5fnf / df;' lar
(Subcutaneous)
/f]6fefO/; vf]ksf] xsdf vf]k pknAw eO;s]kl5 dfq tflnsf cg';f/ vf]k ;+rfng x'g]5 .
k6s/
e]6
s'g pd]/df s'g vf]k ;'O{ nufpg] :yfg / dfWod s'g /f]uaf6 arfp”5
•d'vdf -ufnfsf] leqL efudf_
•d'vdf b'O{ yf]kf
df;'df (IM)
df;'df (IM)
•kf]lnof]
•d'vdf b'O{ yf]kf
5fnfleq (ID)
df;'df (IM)
•kf]lnof]
•kf]lnof]
df;'df (IM)
5fnf / df;' aLr (Subcutaneous)
k)f{ vf]k, ;'lglZrt eljio
/fli6«o vf]k-tflnsf
•bfb'/f / ?a]nf
;Demg'xf];M ue{jtL dlxnfn] klxnf] ue{df slDtdf Ps dlxgfsf] cGt/df @ k6s l6=8L= vf]k nufpg} k5{ .
g]kfn ;/sf/
:jf:Yo tyf hg;+Vof dGqfno
:jf:Yo ;]jf ljefu
Printed in Partnership with the RAVIN Project in Nepal

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