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OUTLINE OF PRESENTATION

Evolving malaria control strategies in India.

NVBDCP.


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MILESTONES OF MALARIA

CONTROL ACTIVITIES IN INDIANational Malaria Control Program (NMCP) - 1953

spectacular success

National Malaria Eradication Program (NMEP) -1958

Urban Malaria Scheme (UMS) - 1971

resurgence

Modified Plan of Operations (MPO) - 1977


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National Anti Malaria Program (NAMP) - 1999

NVBDCP

Intensified Malaria Control Project (IMCP) -2005

New Drug Policy -2010

Enhanced Malaria Control Program (EMCP) -1997


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NATIONAL MALARIA

CONTROL PROGRAMME

1953OBJECTIVES:To hold down malaria transmission at low level

STRATEGIES:Indoor residual spray (IRS)

Malaria control teams to survey and monitor incidence.

ACHIEVEMENTS:Decline in incidence from 75 million to only 2 million in 1958


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NATIONAL MALARIA

ERADICATIONPROGRAMME1958

OBJECTIVES:To eradicate malaria from India in 7 to 9 years

ACTIVITIES:Spraying operation

Fortnightly active case detection

Radical treatmentInvestigation of positive cases and remedial measures

ACHIEVEMENTS :Lowest ever incidence of 0.1 million in 1965

No reported deaths due to malaria


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RESURGENCE OF MALARIA -

1965

Sudden withdrawal of assistance and insecticides led to steep rise in

malaria incidence.


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-1971

Involved 139 towns in 19 states and Union Territories.

OBJECTIVES:a) To prevent deaths due to malaria.

B) Reduction in transmission and morbidity.

NORMS:The towns should have a minimum population of 50,000.

The API should be 2 or above.

METHODOLOGY:It Comprises vector Control by intensive antilarval measures and drug

treatment.


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RE-CLASSIFICATION OF ENDEMIC AREAS

It is based on annual parasite incidence (API)

API less than 2 API greater than 2

MODIFIED PLAN OF

OPERATION 1977

OBJECTIVES:

Prevention of death due to malariaReduction of morbidity due to malaria

Retention of achievements gained so far.


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Control in AREAS WITH API > 2:

Spraying insecticides

Entomological assessment

Surveillance

Treatment of cases

Decentralisation of laboratory services at- PHC

Establishment of drug distribution centres (DDC)and fever treatment depots (FTDs)

Control in AREAS WITH API < 2:

Focal spraying of insecticidesSurveillance and treatment

Follow up

Epidemiological investigation


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DRUG DISTRIBUTION CENTRE

Dispense anti malarial drugs

FEVER TREATMENT

DEPOT

Collect blood slides

Distribute anti malarial drugs

MALARIA CONTROL STRATEGIES


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MALARIA CONTROL STRATEGIES

under NVBDCP1.SURVEILLANCE AND CASE MANAGEMENT:

Case detection(passive and active)

Early diagnosis and complete treatment

Sentinal surveillance

2.INTEGRATED VECTOR MANAGEMENT

Indoor residual sprays(IRS)

Insecticide treated bed nets(ITBN) / Long lasting insecticidalnets(LLINs))

Anti larval measures including source reduction

3.EPIDEMIC PREPAREDNESS AND EARLY RESPONSE

4.SUPPORTIVE INTERVENTION

Capacity building

Behaviour change communication(bcc)

Intersectoral collaboration

Monitoring and evaluation

Operational research and applied field research


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SURVEILLANCE

AIM:Case detection through lab services

To provide facilities for proper treatment

Active

Types

Passive

ACTIVE SURVEILLANCE

Carried out by surveillance workers

PASSIVE SURVEILLANCE

Search for cases by local health agencies

Cases those escaped active surveillance are screened


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INTEGRATED VECTOR

MANAGEMENT

The IVM includes safe use of insecticides

and monitoring of insecticide resistance. Themeasures of vector control and protection

include:


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ANTI-LARVAL MEASURESoSource reduction

ochemical controloBiological control

ANTI -ADULT MEASURESoResidual sprays

oSpace sprays

GENETIC CONTROL

PROTECTION AGAINST MOSQUITO

BITESoMosquito net

oScreening

oRepellents


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Behaviour change

communication (BCC)

BCC is a systematic process that motivates

individuals, families and communities to change theirinappropriate or unhealthy behaviour.

BCC is directed at:Early recognition of signs and symptoms of malaria.

Early treatment seeking from appropriate provider.

Adherence to treatment regimens.Ensuring protection of children and pregnant ladies.

Use of insecticide treated bed nets (ITNs).

Acceptance of indoor residual sprays (IRS), etc.


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INTENSIFIED MALARIA

CONTROL PROJECT

Launched in july 2005 with assistance of global fund for

AIDS,TB and malaria in NE states,Odisha,jharkhand and

WB

OBJECTIVES:1-Increase access rapid diagnosis and treatment through community

participation

2-Reduce transmission by use of insecticide treated bed nets and

larvivorous fishes.

3-Enhance awareness about malaria control

4-To promote community, NGO and private sector participation


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Th k Y U


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Thank You


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Making the smears


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Thin and Thick smear


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Appearance of Thick and Thin

Smears


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chemoprophylaxis

Chemoprophylaxis is recommended travellers, migrantlabourers and military personnel exposed to malaria in highly endemic

areas. Use of personal protection measures like insecticide-treated

bednets should be encouraged for pregnant women and other

vulnerable populations.


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PROGRAM EVALUATION

Internal assessments are conducted by central teams as well asby LQAS, periodically.

External assessments are done through large sample surveys

every 2-3 years and are conducted by NVBDCP / NIMR.


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The study in 10 randomly sampled high burden blockswith API > 2 can be spread out over 80

villages to include 1600 households / fever cases.

Such samples are adequate to detect differences of

more than 10% across two surveys. The survey datawill be examined along with other sources of

information, including MIS and LQAS and planning

data.


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THANK YOU

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