NATIONAL VECTOR

BORNE DISEASE
CONTROL PROGRAMME

HISTORY
National malaria control programme 1953
National filaria control programme 1955
Kala azar control programme 1990

NATIONAL VECTOR BORNE DISEASE CONTROL

PROGRAMME 2003 - 2004
Umbrella programme for prevention and control of
Malaria and other Vector Borne diseases like Dengue,
Filaria, Kala Azar, Japanese Encephalitis and
Chikungunya

OUTCOME OF THE PROGRAMME

Annual Malaria Incidence to be <1/1000

Kala-azar elimination by 2015, <1 case per 10000

population in all blocks

Less than 1 per cent microfilaria prevalence in all

districts

Dengue mortality reduction rate: 50% by 2010 and

sustaining at that level until 2012.

Japanese Encephalitis mortality reduction rate:

50% by 2010 and sustaining at that level until

2012.

MDG GOAL 6
Combat HIV/AIDS, Malaria and other diseases

Target 8: Halt by 2015 and begin to reverse the

incidence of malaria and other major diseases
Incidence and death rates associated with malaria
Proportion of children under 5 sleeping under
insecticide-treated bednets
Proportion of children under 5 with fever who are
treated with appropriate anti-malarial drugs

PROBLEM STATEMENT
MALARIA
About 95% population in the country resides in
malaria endemic areas
80% of malaria reported in the country is confined to

areas consisting 20% of population residing in tribal,

hilly, difficult and inaccessible areas

MALARIA SITUATION IN SEAR

TREND OF MALARIA (2001-2013)

The country SPR has declined from 2.31 to 0.98 and SFR has declined from 1.11 in
2001 to 0.49 in 2012. This indicates declining overall endemicity of malaria in the
country.

NATIONAL ANTI MALARIA PROGRAMME :

1999
National malaria control programme 1953 58

Indoor residual spraying with DDT 80%

reduction in incidence of malaria
National malaria eradication programme 1958
Incidence of malaria in 1961 50,000 to 6.4 million

cases (1976)

MODIFIED PLAN OF OPERATION :

APRIL 1977
Objectives :
Prevent mortality and reduce morbidity
Intensive antimalarial measures insecticidal
spraying, antilarval measures, early diagnosis and
prompt treatment(EDPT), surveillance

ROLL BACK MALARIA

International goal - To halve the malaria associated

mortality by 2010 and again by 2015

National goal To maintain the ABER of over 10%

by active and passive surveillance and bring down

the API to 1.3% or less

RBMs overall strategy

To reduce malaria morbidity and mortality by

reaching universal coverage and strengthening

health systems.
Global Malaria Action Plan defines two stages of
malaria control:
(1) scaling-up for impact (SUFI) of preventive and
therapeutic interventions, and
(2) sustaining control over time.

RBM's vision: A world free from the burden of malaria

By 2015, the malaria-specific MDG s achieved, and malaria

is no longer a major cause of mortality and no longer a

barrier to social and economic development and growth
anywhere in the world.
Beyond 2015, all countries and partners sustain their
political and financial commitment to malaria control
efforts. The burden of malaria never rises above the 2015
level, ensuring that malaria does not re-emerge as a global
threat.
In the long term, global malaria eradication is achieved.
There is no malaria infection in any country. Malaria control
efforts can be stopped.

STRATEGIES
SURVEILLANCE AND CASE MANAGEMENT
Case detection (active and passive)
Early diagnosis and complete treatment
Sentinel surveillance

Active case detection by fortnightly visits and

passive case detection at subcentres and PHC

Blood smears and RDK
Treatment according to national drug policy

Integrated vector management

Indoor residual spraying
Insecticide treated bed nets (ITN)/long lasting

insecticide treated nets (LLIN)

Antilarval measures including source reduction

Two rounds of DDT/synthetic pyrethroids or 3

rounds of malathion according to insecticide policy

in the area
Spray operations in all areas with API > 2 or above

Priority of spray in areas with API or SPR > 5

Spray timings mid Feb to mid May
ITN/LLIN priority in areas API>5
Reduction of breeding sites source reduction and

use of larvivorous fish

Epidemic preparedness and response

Epidemiological & entomological parameters
Climate factors
Operational factors
Linkage with IDSP
Supportive interventions
Capacity building and training Integrated training program at all levels
Standardization of training guidelines
Rapid response team

Training of private medical practitioners and other

intersectoral partners, entomologist, lab technicians
BCC empowers people to take rational and

informed decisions

Intersectoral collaboration enhanced level of

campaigning before peak transmission season

(partnership with private sector, NGO, CBO, local self
government)
Linkage with NHM RDK, ACT, human resources
Monitoring and evaluation - monitoring of drug and

insecticide resistance
Operational research and applied field research

external assistance by GFATM, World Bank

URBAN MALARIA SCHEME

UMS - Approved during 1971
push (for earning livelihood) and urban pull (for

availing both Medicare/ educational opportunities)

phenomenon
Societal changes, unplanned urbanization, completion

of projects, Intermittent water supply led to increased

water storage practices which resulted in extensive
breeding of An.stephensi, vector of urban malaria.

About 10% of the total cases of malaria are reported

from urban areas.

Protecting 130.1 million population from malaria as

well as from other mosquito borne diseases in 131

towns in 19 States and Union Territory.

Objectives:
a) To control malaria by reducing the vector
population in the urban areas
b) Reduce morbidity and mortality through EDPT
NORMS :
a) Minimum population of 50,000
b) API >2 or above
c) Promulgate and strictly implement the civic bylaws to prevent/eliminate domestic and peridomestic breeding places

STRATEGY
(i) Parasite control & (ii) Vector control
Parasite control:
Early case detection & prompt treatment (EDPT) to patients
through passive surveillance institutions such as hospitals,
dispensaries and malaria clinics
Vector control:
Source reduction
Minor engineering methods like filling ditches, areas, pits, low
lying areas, streamlining, channelising, deweeding, trimming of
drains, water disposal and sanitation, empty water container
once in a week, etc.

Anti-larval methods

Chemical: Recurrent anti-larval measures

through conventional larvicides in towns
temephos and fenthion
Biological Control
Larvivorous fish at appropriate breeding sites

Aerosol Space Spray

Space spraying of Pyrethrum extract(2%) in 50

houses in and around every malaria positive case to
kill the infective mosquitoes.
IEC campaigns for community awareness and

their involvement.
Legislative measures

Filaria Problem statement

Indigenous cases have been reported from about 250

districts in 20 states/Union Territories.

North-Western States/UTs namely Jammu & Kashmir,

Himachal Pradesh, Punjab, Haryana, Chandigarh,

Rajasthan, Delhi and Uttaranchal and North-Eastern
States namely Sikkim, Arunachal Pradesh, Nagaland,
Meghalaya, Mizoram, Manipur and Tripura are known to
be free from indigenously acquired filarial infection.

FILARIA ENDEMIC DISRICTS

History:
1949 to 1954 - pilot project in Orissa
1955 - National Filaria Control Programme (NFCP)
was launched
Elimination of filariasis by 2015
National health policy (2002) Eliminate lymphatic
filariasis by 2015

Strategy
Interruption of transmission of filariasis by

Annual MDA for 5 years or more to the

population : Single day mass therapy of DEC at a
dose of 6 mg/kg body wt. annually
Morbidity Management: Home based

management of lymphoedema cases and

up-scaling of hydrocele operations in the identified
CHCs / District hospitals/ medical colleges.
Vector control measures

Progress
MDA coverage of > 87% to interrupt transmission
> 87% coverage achieved in 16 states
Line listing of lymphoedema and hydrocele cases
Microfilaria survey decrease in the microfilaria

rate to < .33% (2012)

KALA AZAR

Endemic in eastern States of India namely Bihar, Jharkhand,

Uttar Pradesh and West Bengal

48 districts endemic; sporadic cases reported from a few other

districts

Estimated165.4 million population at risk in 4 states

Mostly poor socio-economic groups of population primarily

living in rural areas are affected

KALA AZAR

Cases 8728 Deaths 13 (Till July 2013)

KALA AZAR
Kala Azar control program 1990-91
National health policy elimination of Kala Azar by
2015
Strategies:
Vector control through IRS with DDT up to 6 feet
height from the ground twice annually
Early Diagnosis and Complete treatment
Information Education Communication
Capacity Building

JAPANESE ENCEPHALITIS
JE viral activity has been widespread in India. The

first evidence of presence of JE virus dates back to

1952.
First case was reported in 1955
Outbreaks have been reported from different parts of
the country.
During recent past (1998-2004), 17 states and Union
Territories have reported JE incidence
Annual incidence ranged between 1714 and 6594 and
deaths between 367 and 1665

JE AFFECTED DISTRICTS

Cases 569 Deaths 126 (August 2013)

JAPANESE ENCEPHALITIS
Japanese Encephalitis mortality reduction rate: 50%
by 2010 and sustaining at that level until 2012
Strategies:
Reducing the vector density and taking personal
protection against mosquito bites using insecticide
treated mosquito nets.
Early diagnosis and case management
Vaccination of children between 1-15 years of age
Supportive interventions Outbreak preparedness

Dengue - Problem statement

Disease is prevalent throughout India in most of the

metropolitan cities and towns

Outbreaks have also been reported from rural areas of

Haryana, Maharashtra & Karnataka

Endemic in 23 states/UT
Risk of dengue increased and outbreaks continue
Spread from urban to rural areas

DENGUE ENDEMIC DISTRICTS

Dengue mortality reduction rate: 50% by 2010 and

sustaining at that level until 2012.

Cases 22092 Deaths 74 (August 2013)

CHIKUNGUNYA
The states affected by chikungunya are Andhra Pradesh,

Karnataka, Maharasthra, Madhya Pradesh, Tamil Nadu,

Gujarat & Kerala.
Major epidemic of Chikungunya fever :

1963 (Kolkata), 1965 ( Pondicherry and Chennai in

Tamil Nadu, Rajahmundry , Vishakapatnam and
Kakinada in Andhra Pradesh; Sagar in Madhya Pradesh;
and Nagpur in Maharashtra) and 1973, (Barsi in
Maharashtra ).

Sporadic cases also continued to be recorded

especially in Maharasthtra state during 1983 and

2000
Chikungunya suspected fever cases in 2013 9546

(August 2013)

DENGUE FEVER/DENGUE HAEMORRHAGIC

FEVER AND CHIKUNGUNYA

Strategies
Early case reporting and management
Integrated vector management
Supportive interventions

VECTOR CONTROL MEASURES

1. PERSONAL PROPHALATIC MEASURES

Use of mosquito repellent creams, liquids, coils, mats
etc.
Wearing of full sleeve shirts and full pants with socks
Use of bednets for sleeping infants and young
children during day time to prevent mosquito bite
2. BIOLOGICAL CONTROL
Use of larvivorous fishes in ornamental tanks,
fountains, etc.

3. CHEMICAL CONTROL
Use of chemical larvicides like abate in big breeding
containers
Aerosol space spray during day time
4. ENVIRONMENTAL MANAGEMENT & SOURCE
REDUCTION METHODS
Detection & elimination of mosquito breeding sources
Management of roof tops, porticos and sunshades
Proper covering of stored water
Reliable water supply

.
5. HEALTH EDUCATION
Impart knowledge to common people regarding the
disease and vector through various media sources like
T.V, Radio, Cinema slides, etc.
6. COMMUNITY PARTICIPATION
Sensitizing and involving the community for detection
of Aedes breeding places and their elimination

Endemicity Classification : (WHO)

Degree of endemicity as per WHO criteria based on

spleen rate in children ( 2-9 years)
Hypoendemic Malaria : not exceeding 10%
Mesoendemic Malaria : between 11 to 50%
Hyperendemic Malaria : constantly over 50% ,
spleen rate in adults also high ( over 25%)
Holoendemic Malaria : constantly over 75% , spleen
rate in adults low

OVERALL STRATEGIES :

DISEASE
VECTOR
INVOLVEMENT OF COMMUNITY

1. Disease management :
Early Diagnosis and Prompt Treatment
Strengthening of Referral Services
2. Quality Assurance on Laboratory Diagnosis
3. Insecticide Treated Nets
4. Environment management

5. Improve efficiency and quality of services at all

levels
6. Involvement of NGOs/Private
Sector/Community/Local self govt.
7. Legislative measures
8. BCC for social mobilization
9. Monitoring and evaluation
10. Research