31 Oct 2012 National Vector-Borne Disease Control Programme - - PowerPoint PPT Presentation

State MD NRHM Meeting

• n

31 Oct 2012

National Vector-Borne Disease Control Programme (NVBDCP)

NVBDCP

― Malaria ― Dengue ― Chikungunya ― JE/AES ― Kala-azar ― Lymphatic Filariasis

Morbidity & Mortality of VBDs

Dis Diseas ease

2009 2009 % 2010 2010 % 2011 2011 % 2012 2012 %

Malaria alaria cas case e

1563574 1563574 0.07 1599986 1599986 0.06 1310367 1310367 0.05 715031 715031 0.02

Dea Death th

1144 1144 1018 1018 753 753 176 176

Dengue Dengue cas case e

15535 15535 0.6 28292 28292 0.38 18860 18860 0.8 27392 27392 0.5

Dea Death th

96 96 110 110 169 169 155 155

AE AES/JE JE cas case e

4975 4975 15.6 5167 5167 13.1 8249 8249 14.1 7286 7286 14.6

De Death th

779 779 679 679 1169 1169 1065 1065

Kala ala azar azar cas case e

24212 24212 0.3 29000 29000 0.3 33140 33140 0.2 15705 15705 0.1

De Death th

93 93 105 105 80 80 22 22

Chikunguny Chikunguny a a cas case e

73288 73288 48176 48176 20402 20402 12752 12752

Filaria Filaria Clinical Clinical Cas Cases es

1218077 1218077 1256416 1256416 1252672 1252672

Malaria: 11th Plan Achievement Proposed targets during 12th Plan

• ABER – 8.8%
• API – 1.10%
• Reduction in Morbidity by

28.09% in 2011 against 2006

• Reduction in Mortality by

72.88% in 2011 against 2006

• ABER - over 10%
• API - <1 by 2017
• Achieve pre-elimination status

by 2017 Dengue: 11th Plan Achievement Proposed targets during 12th Plan  Case detection increased from 12317 (2006) to 18860 (2011) but case fatality rate reduced from 1.27 in 2006 to 0.90 in 2011.  Strengthened surveillance by Establishing 311 Sentinel Surveillance Hospitals (SSH) and 14 Apex Referral Laboratories against 110 SSH in 2006.  To sustain Dengue case fatality rate below 1%  To reduce the incidence of Dengue and Chikungunya  To increase SSH in all endemic districts/towns/ cities

11th Plan Achievements & Activities proposed in 12th Plan

JE: 11th Plan Achievement Proposed targets during 12th Plan

• 109 districts covered under JE

vaccination of children 1-15 yrs

• 76 sentinel sites established for

hospital based surveillance

• Increase in the no. of Sentinel Site

Hospitals from 76 to 96.

• Implementation of Effective

Prevention& Control measures against JE/AES under GoM

• Vaccination in 62 additional

districts identified

Filaria: 11th Plan Achievement Proposed targets during 12th Plan

 All eligible population living in reported 250 Filaria endemic districts are covered under Annual Mass Drug Administration.  About 8 Lakhs Lymphoedema (elephantiasis) & 4 Lakhs Hydrocele cases have been listed.  About 90000 hydrocele

• perations have been conducted

 To continue Annual Mass Drug Administration with more than 85% compliance in endemic distt and stop MDA in phased manner in districts achieving elimination criteria.  Start process of certification of elimination.  Intensify Morbidity management

11th Plan Achievements & Activities proposed in 12th Plan

Kala Azar : 11th Plan Achievement Proposed targets during 12th Plan  322 out of 538 endemic blocks have reported less than 1 case per 10000 population in 2011.  Reduction

• f

kala-azar deaths - 57% ( compared to 2006) in 2011  To reduce the annual incidence of Kala-azar to less than one per 10,000 population at the block level by 2015 (total 584 blocks currently endemic).

11th Plan Achievements & Activities proposed in 12th Plan

• Early diagnosis and complete treatment
• (No specific drugs against Dengue, Chikungunya and

J.E.)

• Integrated vector Management (IRS, LLIN, fish,

chemical and bio-larvicide, source reduction)

• Supportive intervention – (Vaccination only against

J.E.)

• Annual MDA (only against LF)
• Behaviour change communication

General Strategy for Prevention and Control of VBDs

General Issues

Programme Priority

• Ownership an commitment by the states
• One nodal officer for all VBDs to be identified at state and district
• level. The district level officers to be renamed as District VBD

Officer.

• Ensuring improved financial performance.

Human Resource

• Filling up of the regular vacant post of District Vector Borne Disease

Control Officers against the sanctioned post and creating new position as per requirement due to creation of more number of districts.

• Filling up of all the contractual post sanctioned under NVBDCP

supported by Gol.

• Capacity building of all level staffs especially the newly recruited and

their proper deployment for optimum utilization towards programme.

Malaria

• Improving surveillance in high endemic areas and

Strengthening microscopy services at PHCs alongwith Quality assurance both for microscopy and Rapid Diagnostic Test (RDT) and complete treatment of malaria cases with timely reporting of malaria cases and deaths. Vector Control

• Quality Indoor Residual Spraying (IRS) as per schedule

under effective supervision and monitoring to achieve minimum 80% coverage.

• To improve the distribution and utilization of LLINs at

community level.

• Strengthening of entomological surveillance.

Administrative

• Enactment of Urban bye-laws for addressing the vector borne

disease problem.

• Ensuring for control of vector borne disease as integral part of all

developmental projects in the state. Dengue, Chikungunya and J.E.

• Establishment of new Sentinel Surveillance Hospitals.
• To evolve multi-sectoral approach for elimination of Aedes Vector

breeding and strengthening vector surveillance.

• Media management and outbreak response communication.
• Ensuring availability of blood component separation facility in major

hospitals for management of severe and complicated dengue cases.

• Adequate IEC activities including sensitization of Community.
• Improvement in Routine Immunization of JE coverage.

Kala Azar

• Strengthening surveillance, diagnostics and treatment

facilities.

• Improving Treatment Compliance.
• Improving quality and coverage of DDT Spray with prior

information and awareness to community. The training of spray workers and other logistics to be ensured. Lymphatic Filariasis

• Ensuring round of MDA with more than 80% drug

compliance

• Intensification of lymphoedema and hydrocele
• perations

State Specific Issues

Human resource

• 1. All states to fill up regular posts
• 2. Ensure contractual engagement provided under

NVBDCP Malaria Timely Reporting

• 1. Arunachal, Chattisgarh,Jharkhand, Orissa and Uttar

Pradesh Malaria surveillance

• 1. Bihar, Jharkhand, Manipur, M.P., Maharashtra, Nagaland,

Orissa, U.P. and West Bengal Dengue/ Chikungunya

• 1. Daily reporting by Andhra, Arunachal, Bihar, Gujarat,

Jharkhand, and MP

• 2. Use of Rapid card which is not recommended by NVBDCP

AES/JE

• 1. Reporting from Bihar
• 2. Functionality of SSH in Kerala
• 3. Funds released to UP for JE/AES Project – Tardy Progress
• 4. Poor Coverage in RI

Kala azar

• 1. Two rounds of Spray with proper supervision
• 2. Case search & treatment compliance

Filaria

• 1. DEC procurement in UP and Bihar
• 2. Reporting by Chattisgarh Andaman and Lakshadeep

S No. Issues States Remarks 1 Release of Ist Instalment except Orissa, MP, Tripura, UP, Uttarkhand and Delhi, all states released Orissa, MP, Tripura, UP (Significant unspent amount i.e. 18.49 , 16.45, 2.67, 8.08 crores). For Uttrakhand and Delhi, SOE for 2011-12 is awaited. Poor release to some states has been due to insufficient state share for matching contribution. 2 Poor Utilisation All states except Chhattisgarh (63%), Kerala (105%), Tamilnadu (40%) Due to delay in decentralised procurement by the states and release to respective districts 3 Audit Report of 2011-12 not received All states except Manipur, Meghayala, Sikkim, Haryana, Himachal Pradesh, Maharashtra, Uttrakhand, Pondicherry, D & N Haveli. Follow up with the respective states is being done on regular basis 4 Status of SOEs SOEs received till August 2012 for the states of J & K, Karnataka, Chattisgarh, , Maharashtra, Daman & Diu. Follow up with the respective states is being done on regular basis

Financial Issues

Timely Release of Funds to State and District Programme Officers is Important for VBDs which are Seasonal Disease

Sl. No. State/ UT Malaria Dengue JE Lymphatic Filariasis Kala-azar Annual Blood Examination Rate (%) Annual Parasite Incidence SSH all functional SSH all functional

• No. of

districts with Mf rate less than 1%

• No. of

blocks with less than 1 case per 10000 population

Target Achv. Target Achv. Target Achv. Target Achv. Target Achv. Target Achv.

1 Andhra Pradesh

13 8.59 0.4 0.25 25 24 6 4 16 out

• f 16

13

Non endemic 2 Arunach al Prd.

14 6.31 <10 3.34 1 1 Non endemic

3 Assam

14 9.87 <1.3 0.79 9 9 9 9 7 out

• f 7

5

4 Bihar

2 0.10 0.01 5 5 3 3 38 out

• f 38

NR

250/ 414 203

5 Chattisg arh

14 7.39 <5 2.23 2 2 9 out

• f 9

NR Non endemic 6 Goa

>20 22.69 <1 0.77 3 3 3 3 2 out

• f 2

2 Progress achieved by states against target set in PIP under NVBDCP during 2012

Sl. No. State/ UT Malaria Dengue JE Lymphatic Filariasis Kala-azar Annual Blood Examination Rate (%) Annual Parasite Incidence SSH functional SSH functional

• No. of distt

with Mf rate <1%

• No. of

blocks < than 1 case per 10000 population

Target Achv. Target Achv. Target Achv. Target Achv. Target Achv. Target Achv.

7 Gujarat

18 13.05 <1.5 0.93 16 9 9 out

• f 9

8 Non endemic

8 Haryana >11 6.24

<1 0.58 12 8 3 2 Non- endemic

9 Himacha l Prad.

10 5.32 <1 0.03 2 Non- endemic

10 J & K

>10 6.88 <0.2 0.12 7 7 Non- endemic

11 Jharkha nd

14 8.36 <2 3.07 4 3 3 3 15/15 not recd. 14/30 1

12 Karnata ka

16 9.13 <0.8 0.16 21 19 5 5 8 out

• f 8

5 Non endemic Progress achieved by states against target set in PIP under NVBDCP during 2012

Sl. No. State/ UT Malaria Dengue JE Lymphatic Filariasis Kala-azar Annual Blood Examination Rate (%) Annual Parasite Incidence SSH functional SSH functional

• No. of distt

with Mf rate <1%

• No. of

blocks < than 1 case per 10000 population

Target Achv. Target Achv. Target Achv. Target Achv. Target Achv. Target Achv.

13 Kerala

>10 3.7 <0.5 0.03 20 19 1 11 out

• f 11

10 Non Endemic

14 Madhya Pradesh

13 8.3 <1.2 0.6 17 17 11 out

• f 11

10

15 Maharas htra

16 9.3 0.1 0.33 23 23 5 2 17 out 17 13

16 Manipur >10

3.4 <1 0.08 2 1 1 Non Endemic

17 Meghala ya

12 8.9 < 5 5.41 3 2

18 Mizoram 17

12.0 5 7.47 5 1 Progress achieved by states against target set in PIP under NVBDCP during 2012

Sl. No. State/ UT Malaria Dengue JE Lymphatic Filariasis Kala-azar Annual Blood Examination Rate (%) Annual Parasite Incidence SSH functional SSH functional

• No. of distt

with Mf rate <1%

• No. of

blocks < than 1 case per 10000 population

Target Achv. Target Achv. Target Achv. Target Achv. Target Achv. Target Achv.

19 Nagalan d

11 8.41 1.3 1.21 2 1 1 Non endemic Non Endemic

20 Orissa

12.5 8.18 <5.5 4.43 7 8 20 out

• f 20

17

21 Punjab

>10 7.81 <0.1 0.05 10 15 Non Endemic

22 Rajasth an

13 7.57 <1 0.38 19 14

23 Sikkim

10 2.77 <1 0.34 2 2

24 Tamil Nadu

<11 7.51 0.3 0.19 30 30 5 5 20 out

• f 20

20

25 Tripura

10 5.79 2.8 2.63 2 Non endemic Progress achieved by states against target set in PIP under NVBDCP during 2012

Sl. No. State/ UT Malaria Dengue JE Lymphatic Filariasis Kala-azar Annual Blood Examination Rate (%) Annual Parasite Incidence SSH functional SSH functional

• No. of distt

with Mf rate <1%

• No. of

blocks < than 1 case per 10000 population

Target Achv. Target Achv. Target Achv. Target Achv. Target Achv. Target Achv.

26 Uttarakh and

>10 1.73 <1 0.1 7 6 Not endemic Not endemic

27 Uttar Pradesh

10 1.40 less than 2 0.16 22 18 17 8 50

• ut of

50 12 13/13 13

28 West Bengal

>10 3.71 1 0.4 13 13 3 3 12

• ut of

12 9 110/ 133 105

29 A&N Islands

>20 15.02 3 2.32 3 3 3 3 Not endemic

30 Chandig arh

>10 7.46 <1 0.2 1 1 Not endemic Progress achieved by states against target set in PIP under NVBDCP during 2012

Sl. No. State/U T Malaria Dengue JE Lymphatic Filariasis Kala-azar Annual Blood Examination Rate (%) Annual Parasite Incidence SSH functional SSH functional

• No. of distt

with Mf rate <1%

• No. of

blocks < than 1 case per 10000 population

Target Achv. Target Achv. Target Achv. Target Achv. Target Achv. Target Achv.

31 D & N

Haveli 20 21.11 <1 10.6 5 1 1 1 1 Non Endemic

32 Daman

& Diu 12 9.83 <1 0.62 1 1 1 1

33

Delhi 10 1.15 <0.0 1 0.01 33 33 11 3 Non endemic

34 Laksha

dweep <5 6.20 1 1 1

35 Pudduc

herry 15 10.93 <0.2 0.06 4 4 1 1 Progress achieved by states against target set in PIP under NVBDCP during 2012

THANK YOU

State Specific Recommendations

State Recommendation Arunachal Pradesh

• 1. Filling up of vacant post in State at earliest.
• 2. Regular Monitoring, Supervision & Proper Programme

Implementation. Assam

• 1. Filling up of vacant post in State at earliest.
• 2. Regular Monitoring, Supervision & Proper Programme

Implementation

• 3. State to follow GOI Guidelines (Dengue)
• 4. Lab. Surveillance to be strengthened at sentinel sites.
• 5. SSHs should be identified.

Manipur

• 1. Filling up of vacant post in State at earliest.
• 2. Regular Monitoring, Supervision & Proper Programme

Implementation

• 3. State to follow GOI Guidelines (Dengue)
• 4. Lab. Surveillance to be strengthened at sentinel sites.
• 5. SSHs to be operationalized.
• 6. JE Vaccination under RI to be given.

State Specific Recommendations

State Recommendation Meghalaya 1. Filling up of vacant post in State at earliest.

• 2. Regular Monitoring, Supervision & Proper Programme

Implementation

• 3. SSHs to be operationalized.
• 4. Referral mechanism to be strengthened in highly affected

districts and critical care services should be ensured at the referral centers to prevent the deaths due to malaria Mizoram

• 1. Training should be completed at the earliest.
• 2. Regular Monitoring, Supervision & Proper Programme

Implementation

• 3. SSHs to be operationalized.

Nagaland

• 1. Proper Surveillance.
• 2. Training of all ASHA & Community Workers should be

completed.

• 3. SSHs to be operationalized.
• 4. Orientation of training programme for laboratory person

and clinicians

State Specific Recommendations

State Recommendation Tripura

• 1. Filling up of vacant post in State at earliest.
• 2. Proper Surveillance.
• 3. Training of all ASHA & Community Workers should

be completed.

• 4. SSHs to be operationalized.

Sikkim 1. Proper Surveillance. 2. SSHs to be operationalized. Andhra Pradesh 1. Filling up of vacant post in State at earliest. 2. Proper Surveillance. 3. Training of all ASHA & Community Workers should be completed. 4. SSHs to be operationalized. 5. Improved coverage of JE vaccination in routine immunization. 6. Increased Monitoring and Supervision.

State Specific Recommendations

State Recommendation Bihar 1. Filling up of vacant post in State at earliest. 2. Proper Surveillance. 3. Training of all ASHA & Community Workers to be completed. 4. SSHs to be operationalized. 5. Improved coverage of JE vaccination in RI. 6. Increased Supervision & Monitoring of IRS. 7. Proper Inventory Management for logistics flow at grass root level 8. Timely submission of reports. 9. Timely observance of MDA for filaria.

• 10. Improved Treatment compliance for Kala-azar.
• 11. Involvement of Medical Colleges, ICMR

Institutions and NCDC Centre for assessment of drug compliance during MDA.

State Specific Recommendations

State Recommendation Chattisgarh 1. Filling up of vacant post in State at earliest. 2. Regular reporting 3. Training of all ASHA & Community Workers should be completed. 4. SSHs to be operationalized. 5. Monitoring of stock position of RDT and Anti malarials 6. To improve IRS coverage. 7. To improve Monitoring, Supervision for all VBDs. Goa 1. JE Vaccination under RI to be given a boost 2. AES/JE Data to be transmitted regularly.

State Specific Recommendations

State Recommendation Gujarat 1. The referral mechanism to be strengthened. 2. Surveillance needs to be improved. 3. To improve timely referral of severe & complicated cases of VBDs. 4. Special focus for prevention and control of Dengue in Ahmedabad and other corporations. Haryana 1. Poor Surveillance 2. Special focus for prevention and control of Dengue in satellite townships of Gurgaon and Faridabad. 3. Strengthening of PHCs/CHCs for early case management of the AES/JE cases. 4. JE Vaccination under RI to be given a boost.

State Specific Recommendations

State Recommendation Himachal Pradesh 1. Poor Surveillance 2. Regular Monitoring, Supervision & Proper Programme Implementation. 3. Timely submission of reports by States. 4. Capacity building of district programme officers. Jammu & Kashmir 1. Filling up of vacant post in State at earliest. 2. Capacity building of district programme officers.

State Specific Recommendations

State Recommendation Jharkhand 1. Filling up of vacant post in State at earliest. 2. Surveillance needs to be improved. 3. Train of all ASHAs and community volunteers 4. Capacity building of district programme officers. 5. Improve Monitoring, Supervision & Proper Programme Implementation. 6. Special focus for prevention and control of Dengue in industrial townships of Jamshedpur 7. Improve IEC/BCC activities. 8. Improve DDT Spray programme & Kala-azar Case search . 9. To improve drug compliance for achieving the goal

• f elimination of Filaria programme

State Specific Recommendations

State Recommendation Karnataka 1. Special attention for prevention of vector mosquito breeding in Bangalore corporation area and other urban areas 2. Data submission to be regular. 3. JE Vaccination under RI to be given a boost. 4. Morbidity management and hydrocele operation to be intensified for filaria programme. Kerala 1. Filling up of vacant post in State at earliest. 2. Special focus for Trivandrum Municipal Corporation and Plantation areas (rubber) for Dengue/Chikungunya. 3. State to ensure use of ELISA based dengue NS1 kits only. 4. Regular Monitoring, Supervision & Proper Programme Implementation

State Specific Recommendations

State Recommendation Madhya Pradesh 1. Filling up of vacant post in State at earliest. 2. The state to improve timely referral of severe & complicated cases. 3. Capacity building of district programme officers 4. To accord priority for morbidity management in filaria elimination Programme. Maharashtra 1. Filling up of vacant post in State at earliest. 2. To improve timely referral of severe & complicated cases. 3. Capacity building of district programme officers 4. To accord priority for morbidity management in filaria elimination Programme.

State Specific Recommendations

State Recommendation Orissa 1. Filling up of vacant post in State at earliest. 2. Proper vigilance and performance of activities as per schedule to be monitored in the Sub-Centres. 3. Special attention needed for mining areas for D&C. 4. Capacity building of doctors of both public and private sectors on national guidelines for dengue case management. 5. To accord priority for morbidity management and hydrocele operation in filaria elimination Programme. Punjab 1. Improve surveillance. 2. Regular Monitoring, Supervision & Proper Programme Implementation 3. Special focus to Ludhiana for Dengue/Chikungunya Rajasthan 1. Filling up of vacant post in State at earliest. 2. Regular Monitoring, Supervision & Proper Programme Implementation. 3. State to follow GOI Guidelines (Dengue) 4. Strengthening of Surveillance activities.

State Specific Recommendations

State Recommendation Tamil Nadu 1. Filling up of vacant post in State at earliest. 2. Improve surveillance. 3. Ensure functioning of all the SSHs and availability

• f both dengue ELISA based NS1 kits and IgM kits

4. JE Vaccination under RI to be given a boost.

State Specific Recommendations

State Recommendation Uttar Pradesh 1. Filling up of vacant post in State at earliest. 2. Regular Monitoring, Supervision & Proper Programme Implementation 3. Improve surveillance. 4. Preparation of district wise Action Plan for effective prevention and control of AES/JE 5. IEC/BCC for identification and immediate referral of cases to nearby health facility. 6. Involve the Medical Colleges, ICMR Institutions and NCDC Centre for Training, Monitoring & assessment of drug compliance during MDA. 7. To improve organized IRS activities. 8. Timely submission of SOE & UC. 9. Line listing of cases through patient coding scheme to be followed.

State Specific Recommendations

State Recommendation Uttarakhand 1. State to follow the GOI guidelines for diagnosis 2. Regular samples of AES cases to be sent to NCDC for JE conformation. 3. Surveillance needs to be improved. 4. Regular Monitoring, Supervision & Proper Programme Implementation.

State Specific Recommendations

State Recommendation West Bengal 1. Filling up of vacant post in State at earliest. 2. State to follow the GOI guidelines for diagnosis 3. Regular samples of AES cases to be sent to NCDC for JE conformation. 4. Improve surveillance.

• 5. Regular Monitoring, Supervision & Proper

Programme Implementation. 6. AES/JE Data to be transmitted regularly. 7. ASHAs honorarium to be paid timely for their reluctance to work for KA programme. 8. To improve IEC/BCC activities. 9. District Collectors need to be involved in regular review of the programme at district level.

State Specific Recommendations

State Recommendation Delhi 1. Surveillance needs to be improved. 2. Enhance inter-sectoral convergence with all the stake holders. 3. Timely reporting Puducherry Andaman & Nicobar Island 1. Malaria needs to be paid focused attention. 2. Vacant post needs to be filled up. 3. Increase Surveillance. 4. Timely submission of SOE/UC Chandigarh 1. Surveillance needs to be improved. 2. Monitoring needs to be improved. Dadra & Nagar Haveli 1. Surveillance needs to be improved. 2. Monitoring needs to be improved. 3. Timely submission of SOE/UC Daman 1. Timely submission of SOE/UC

State Specific Recommendations

State Recommendation Lakshadweep

• 1. Regular Monitoring, Supervision & Proper

Programme Implementation.

• 2. Timely submission of Reports.
• 3. Timely submission of SOE/UC