State MD NRHM Meeting on 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 cas case e 73288 73288 48176 48176 20402 20402 12752 12752 a a Filaria Filaria Clinical Clinical 1218077 1218077 1256416 1256416 1252672 1252672 Cas Cases es
11 th Plan Achievements & Activities proposed in 12 th Plan Proposed targets during 12 th Plan Malaria: 11 th Plan Achievement • ABER – 8.8% • ABER - over 10% • API - <1 by 2017 • API – 1.10% • • Achieve pre-elimination status Reduction in Morbidity by by 2017 28.09% in 2011 against 2006 • Reduction in Mortality by 72.88% in 2011 against 2006 Proposed targets during 12 th Plan Dengue: 11 th Plan Achievement To sustain Dengue case fatality Case detection increased from 12317 rate below 1% (2006) to 18860 (2011) but case To reduce the incidence of fatality rate reduced from 1.27 in 2006 Dengue and Chikungunya to 0.90 in 2011. To increase SSH in all endemic Strengthened surveillance by districts/towns/ cities Establishing 311 Sentinel Surveillance Hospitals (SSH) and 14 Apex Referral Laboratories against 110 SSH in 2006.
11 th Plan Achievements & Activities proposed in 12 th Plan JE: 11 th Plan Achievement Proposed targets during 12 th Plan • 109 districts covered under JE • Increase in the no. of Sentinel Site Hospitals from 76 to 96. vaccination of children 1-15 yrs • Implementation of Effective • 76 sentinel sites established for hospital based surveillance Prevention& Control measures against JE/AES under GoM • Vaccination in 62 additional districts identified Proposed targets during 12 th Plan Filaria: 11 th Plan Achievement To continue Annual Mass Drug All eligible population living in Administration with more than 85% reported 250 Filaria endemic compliance in endemic distt and districts are covered under stop MDA in phased manner in Annual Mass Drug Administration. districts achieving elimination About 8 Lakhs Lymphoedema criteria. Start process of certification of (elephantiasis) & 4 Lakhs elimination. Hydrocele cases have been Intensify Morbidity management listed. About 90000 hydrocele operations have been conducted
11 th Plan Achievements & Activities proposed in 12 th Plan Proposed targets during 12th Kala Azar : 11th Plan Achievement Plan To 322 out of 538 endemic reduce the annual incidence of Kala-azar to blocks have reported less less than one per 10,000 than 1 case per 10000 population in 2011. population at the block Reduction level by 2015 (total 584 of kala-azar blocks currently endemic). deaths - 57% ( compared to 2006) in 2011
General Strategy for Prevention and Control of VBDs 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 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 operations
State Specific Issues Human 1. All states to fill up regular posts resource 2. Ensure contractual engagement provided under NVBDCP Malaria Timely 1. Arunachal, Chattisgarh,Jharkhand, Orissa and Uttar Reporting Pradesh Malaria 1. Bihar, Jharkhand, Manipur, M.P., Maharashtra, Nagaland, surveillance Orissa, U.P. and West Bengal Dengue/ 1. Daily reporting by Andhra, Arunachal, Bihar, Gujarat, Chikungunya 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
Financial Issues Timely Release of Funds to State and District Programme Officers is Important for VBDs which are Seasonal Disease S No. Issues States Remarks 1 Release of Ist except Orissa, MP, Tripura, Orissa, MP, Tripura, UP (Significant Instalment UP, Uttarkhand and Delhi, unspent amount i.e. 18.49 , 16.45, 2.67, all states released 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 Due to delay in decentralised Chhattisgarh (63%), Kerala procurement by the states and release (105%), Tamilnadu (40%) to respective districts 3 Audit Report of All states except Manipur, Follow up with the respective states is 2011-12 not Meghayala, Sikkim, being done on regular basis received Haryana, Himachal Pradesh, Maharashtra, Uttrakhand, Pondicherry, D & N Haveli. 4 Status of SOEs SOEs received till August Follow up with the respective states is 2012 for the states of J & K, being done on regular basis Karnataka, Chattisgarh, , Maharashtra, Daman & Diu.
Progress achieved by states against target set in PIP under NVBDCP during 2012 Malaria Dengue JE Lymphatic Kala-azar Filariasis Annual Annual SSH all SSH all No. of No. of Blood Parasite functional functional districts with blocks with Sl. State/ Examination Incidence Mf rate less less than 1 No. UT Rate (%) than 1% case per 10000 population Target Achv. Target Achv. Target Achv. Target Achv. Target Achv. Target Achv. 1 Andhra 13 8.59 0.4 0.25 25 24 6 4 16 out 13 Pradesh of 16 Non endemic 2 Arunach 14 6.31 <10 3.34 1 1 Non al Prd. endemic 3 Assam 14 9.87 <1.3 0.79 9 9 9 9 7 out 5 of 7 4 Bihar NR 2 0.10 0 0.01 5 5 3 3 38 out 250/ 203 of 38 414 5 Chattisg NR 14 7.39 <5 2.23 2 2 9 out arh Non of 9 endemic 6 Goa >20 22.69 <1 0.77 3 3 3 3 2 out 2 of 2
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