Malaria- IV
National Programs
Presenter : Dr. Rohit A. Bhat
Chairperson : Dr. Pushpa S. Patil
Bhore committee
• 1946 - 75 million malaria cases
- 0.8 million malaria deaths
• Country wide comprehensive program
• 1951- Planning Commission
National malaria control program
• 1953 - launched
• Objectives: - bring down transmission
- maintain the achievement
• Strategies: - residual insecticide spray
- malaria control team
- anti-malaria drugs
National malaria eradication program
• 8th WHA- 1955
• NMEP- launched 1958
• Nil malaria deaths- 1965
• Resurgence in 1970
Urban malaria scheme
• Launched 1971
• Anti larval
measures
• High number of
cases in 1976
Modified plan of operation
• 1977- 1994
• Objectives:- elimination of malarial deaths
- reduction of malaria morbidity
- maintenance of gains
• Strategies:- API 2 and above
- API less than 2
API 2 and above
API less than 2
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Insecticidal spray
Entomological studies
Malaria surveillance
Treatment of cases
Rural areas [SIDA]
Decentralization of lab
services
• DDCs and FTDs
Focal spray of insecticide
Surveillance and treatment
Radical treatment
Epidemiological
investigation
API 2 and above
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Insecticidal spray
Entomological studies
Malaria surveillance
Treatment of cases
Rural areas [SIDA]
Decentralization of lab
services
• DDCs and FTDs
API 2 and above
API less than 2
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Insecticidal spray
Entomological studies
Malaria surveillance
Treatment of cases
Rural areas [SIDA]
Decentralization of lab
services
• DDCs and FTDs
Focal spray of insecticide
Surveillance and treatment
Radical treatment
Epidemiological
investigation
Malaria action program
Tribes
Epidemic prone areas
Project area
Urban areas
Revised control strategy
• Disease management
Intensified IEC
Case detection
Presumptive treatment
Radical treatment for Plasmodium falciparum
Alternate drug in chloroquine resistance
PROBLEM AREA
ACTION REQUIRED
Tribal Areas
Multipurpose worker
PHC to be equipped
Link worker
Epidemic prone areas
Active Case Detection
Passive Case Detection
Radical treatment for Pf
Project Areas
Mass screening of labors
Incoming populationpresumptive treatment
Urban areas
Surveillance
Slum areas worker- 1 per 20,000
Malaria clinic- 1 per 50,000
Enhanced malaria control project
• 1997
• 6 crore tribal population, 8 states, 100 districts,
19 urban areas
• Strategies:- early detection and treatment
- vector control
- health education and community
participation
• Selection of PHC
Components of EMCP
Early detection and prompt treatment
Selective vector control
Legislative measures
Personal protective measures
Epidemic planning and rapid response and inter sectoral
co- ordination
Institutional and management capacities strengthening
Operation research
Community participation
National anti malaria program
• 1999
• Since 1977- 1045 PHCs
100 districts
19 towns/cities
• 79% districts recorded decline in 2003
• 0.72 million in 1997 -> 0.41 million in 2004
National vector borne disease control
program
• Launched 2004
Malaria
Kala azar
Filaria
Chikungunya
Dengue
Japanese
encephalitis
National rural health mission
Strategies: Rural areas
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Early case detection and prompt treatment
Vector control
Community participation
Environmental management and source
reduction methods
• Monitoring and evaluation of the programs
Strategies: Urban areas
• Norms:- population>50,000
- API>2
- strictly implement laws
• Additional strategy
Passive surveillance in institutions
Recurrent anti larval measures
IEC campaign
Malaria surveillance
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Active case finding
Passive case detection
Rapid fever survey
Mass survey
Annual blood smears examination rate
Slide positivity rate
Intensified malaria control project
• 2005- assistance from global fund
• Objectives:- increase access
- reduce transmission
- enhance awareness
- promote participation
• 4,99,970 DDCs, FTDs, Malaria clinic
National malaria drug policy
Insecticide policy
NVBDC support project (2008-2013)
• Objectives:
1. Reduce malaria morbidity by 25% by 2013
[base year 2007]
2. Reduce malaria mortality by 50% by 2013
[base year 2007]
3. Achieve kala azar elimination by 50% of
sampled blocks during the project period
Project component and sub component
Improving access to
control malaria
• Improving case management
• Strengthening surveillance
• Effective vector control
Improving access to
elimination of kala azar
• Improving case management
• Strengthening surveillance
• Effective vector control
Policy and strategy
development, capacity
building and monitoring
and evaluation
• Policy and strategy development
• Program management and capacity building
• Monitoring and evaluation
Malaria epidemics: Prediction and
Preparedness
• Climatic factors
• Vulnerability
• Parasite factors
• Operational factors
Epidemic response
• Detecting malaria epidemic
• District mobile malaria epidemic control
team[DMECT]
• Emergency vector control measures
Remote sensing and malaria research
Roll back malaria
• Founded in 1998
• Political commitment
• April 2000- Ambuja, Nigeria
Summary
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Comprehensiveness of program
Tribal malaria
Change in program terminology
Environmental sanitation
Political will
Community participation
Malaria diagnosis
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Development of anti malarial resistance
Treatment
Health delivery system
Malaria surveillance
Trained manpower
Social and ethical issues
Use of bed nets
References
• J.Kishore. National Health Programmes of India. 10th
edn
• Oxford Textbook of Public Health Volume 3, 5th edition
• Park’s Textbook of Preventive and Social Medicine 21st
edition
• World Malaria Report 2011 available at
http:// www. who.int
http://www.nvbdcp. gov.in
http://www.malarisite.com
• AH Suryakanta. Textbook of Community Medicine with
Recent Advances 2nd edition
WHO global malaria control strategy
• Technical elements
• Epidemiological indicators
• Core indicators
• Phases of implementation