NATIONAL VECTOR BORNE DISEASE CONTROL PROGRAMME (NVBDCP)

The National Vector Borne Disease Control Programme (NVBDCP) is an umbrella programme for prevention and control of Vector borne diseases. Prior to 2004, the various Vector Borne Diseases were managed under separate National Health Programmes. At present 6 Vector Borne Diseases are managed under NVBDCP. 

1.    Malaria

2.    Dengue

3.    Chikungunya

4.    Japanese Encephalitis

5.    Lymphatic Filariasis

6.    Kala Azar

 MALARIA: Malaria is a very ancient vector borne disease. It is caused by the bite of an infected Anopheles mosquito. The Anopheles sits at an angle on walls and on hard surface and thus can be recognized with naked eye. The Anopheles prefers clean water collections like puddles, ponds, wells, small canals, water tanks etc. for breeding. Anopheles mosquitoes bite at night. Some bite shortly after sunset while others bite later, around midnight or the early morning. Only the female Anopheles mosquito bites as she requires blood meal (protein) for laying eggs in her life time, while the male mosquito sips plant sap for survival.

No death has been reported in Punjab due to Malaria in 2009.

Signs and Symptoms of Malaria

Typical: Sudden onset of high fever with rigors and sensation of extreme cold followed by feeling of burning, leading to profuse sweating. The febrile paroxysms may occur every alternate day. Headache, body ache, nausea, etc. may be the associated features.

Atypical: In atypical cases, classical presentation as mentioned above may not manifest. Hence, any fever case without any other obvious cause in the endemic areas during transmission season may be considered as malaria.  However, none of the symptoms exclude malaria with certainty therefore a trained clinician has to judge and ensure whether they constitute any other obvious cause.

 Activities being undertaken:

1.                  Surveillance:       Active and Passive

2.                  Early Diagnosis & Prompt Treatment (EDPT)

3.                  Indoor Residual Spray

4.                  Urban Malaria Scheme(UMS) 

1. Surveillance:

Malaria surveillance connotes the maintenance of an on-going watch/ vigil over the status of malaria in a group or community. The main purpose of surveillance is to detect changes in trends or distribution in malaria and other vector borne diseases in order to initiate investigative or control measures.  The ultimate objective of malaria surveillance is prevention and control of malaria in the community.

Surveillance is of two types under NVBDCP:

a)            Active Surveillance: Under this, the fortnightly domiciliary visits are made by MPHW (M) for active search of all fever cases and blood slides are prepared and sent to the laboratory for confirmation of the cases. If found positive for Malaria, MPHW (M) provides full radical treatment.

b)           Passive Surveillance:Under Passive Surveillance, blood slide of a fever case is made when he/ she attends the OPD of a health centre, for confirmation of Malaria.

Malaria surveillance includes laboratory confirmation of presumptive diagnosis, finding out the source/ site of infection and identification of all cases and susceptible contacts and still others who are at risk in order to prevent further spread of the disease. 

Parameters of Surveillance: 

i)             ABER (Annual Blood Slide Examination Rate):

 ABER       =          No. of blood smears collected during the year   x 100

                              Population covered under surveillance

 ABER is an index of operational efficacy of the programme. ABER should be > 10% in one year in an area.

State of Punjab achieved the target of ABER > 10%.

ii)     API (Annual Parasite Incidence): 

API = No. of Positive Malaria Cases in one year    X 1000

                  Population of the area 

API indicates load of Malaria cases in an area in one year and helps in making decision regarding Indoor Residual Spray to be carried out.      

State of Punjab achieved the target of API < 1.3.

1. Early Diagnosis & Prompt Treatment (EDPT): EDPT is the main strategy of malaria control - radical treatment is necessary for all the cases of malaria to prevent transmission of malaria. Chloroquine is the main anti-malaria drug for uncomplicated malaria. Fever Treatment Depots (FTDs) have been established in the rural areas for providing easy access to anti-malarial drugs to the community. Treatment of Malaria is as per the Malaria Drug Policy 2010 issued by GOI. (Annexure I) 

2.  Indoor Residual Spray:    As per GOI guidelines, the subcentres where the API (Annual Parasite Incidence) is more than 2. IRS is continued for 3 years or till the API of the area decreases below 2. As per GOI policy DDT (50%) and Malathion are used for Indoor Residual Spray. 42 subcentres in 8 districts will undergo Indoor Residual Spray (IRS) in 2011. Village wise microplan of IRS is at Annexure II. 

3.  Urban Malaria Scheme:   Urban Malaria Scheme (UMS) was launched in 1971 by GOI under Modified Plan of Operation (MPO) which was designed to tackle the malaria load in both urban and rural areas in the country simultaneously. Under MPO, it was decided to initiate antilarval and antiparasitic measures to abate the malaria transmission in urban areas. The activities undertaken to control malaria in towns was named as Urban Malaria Scheme which was approved during 1971. UMS was started in the State of Punjab in 1977-78 in 5 towns namely Amritsar, Ludhiana, Ferozepur, Jalandhar and Patiala. Three more towns i.e. Malerkotla, Bathinda & Kapurthala were added in the scheme in 1980-81. In 1987-88, five more towns i.e. Rajpura, Nabha, Jagraon, Hoshiarpur and Gurdaspur were included in UMS. In the year 2008, 8 new towns namely Sangrur, Barnala, SAS Nagar, Phagwara, Khanna, Faridkot, Malout and Tarn Taran were included in Urban Malaria Scheme after getting approval from GOI. Under this scheme the GOI supplies the material in kind i.e. Larvicides for eliminating mosquito larvae. Now, Urban Malaria Scheme is operational in 21 towns of Punjab.

Norms of Urban malaria Scheme - Annexure III 

4.            IEC activities: These are done to generate awareness among the general public regarding prevention, control and management of Malaria. IEC activities were undertaken throughout the State in 2010. Advocacy Workshops will be undertaken at District, Sub divisional, Block and Subcentre levels in the 4 weeks of June 2011 which will be celebrated as Anti Malaria Month.

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