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DEPARTMENT OF HEALTH & FAMILY WELFARE
NAGALAND : KOHIMA

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 National Vector Borne Disease Control Programme    (NVBDCP)

 

    The National Vector Borne Disease Control Program (NVBDCP) covers 6 vector borne diseases namely 

      1.      Malaria
     2.
      Japanese Encephalitis
     3.
      Dengue
     4.
      Kala Azar
     5.
      Chikungunya
     6.
      Filariasis

      It has four main objectives (a) Early case detection & Prompt Treatment (b) Vector control measures (c) Capacity Building & (d) IEC/BCC activities

 Vector Borne Diseases like Malaria, JE, & Dengue are found in Nagaland. Malaria is endemic in all the 11 districts whereas JE cases are detected in 9 districts (Dimapur, Kohima, Longleng, Mokokchung, Mon, Peren, Tuensang, Wokha & Zunheboto) & Dengue only from one District i.e Dimapur.   Through the implementation of NVBDCP program activities in our State, it has shown its achievement by decreasing in Malarial cases and decline in no of deaths due to Vector Borne cases. 
 

National Framework for Malaria Elimination in India (2016–2030):

        National Framework for Malaria Elimination in India (NFME) 2016- 2030 was launched by Hon’ble Health & Family Welfare Minister, Govt of India in February, 2016.

Vision

 Goals

 Achievements:-

Key indicators, achievements, 12th Plan targets

Indicator

National Target

 

Target for 2014

Target for

2015

Target for

2016

12th Plan target (2012-2017)

 

Annual Blood Examination Rate

(ABER)

 

 

>10%

 

11%

 

11%

 

15%

 

To sustain the National Target of>10% at both State  & District level     

Achievement

11.63%

11.68%

-

Annual Parasite Incidence

 (API)

 

<1

(by 2017)

 

<1

 

0.76

 

<1

 

<1

  

Sl. No

Activities

2014

2015

2016

1

Total Blood Slide Collection & Examined

2,34,653

2,35,651

2,52,232

2

Total Malaria Positive

1,936

1,527

828

3

Total P.F

647

532

316

4

Total Malaria Death

2

3

0

5

Distribution of Larvivorous fish seeds

4,91,900

4,01,500

6,13,500

6

IRS was carried out in two Rounds in 2016. In the first round   61% of the target households was covered & in the second round   51 %  of the targeted households was covered.

7

 IEC activities were carried out at various levels Block, PHCs & Sub- Centres upto village level during the transmission season

8

Sufficient Anti-Malarial drugs & supportive medicines were issued to all the districts for distribution to Health Units.

9

Diagnostic facility for JE/Dengue is presently available in Dimapur.

                  Number of Malaria, JE & Dengue cases & Deaths from 2014- 2016

                   Malaria:

 

District

 

2014

2015

2016

Cases

Deaths

Cases

Deaths

Cases

Deaths

DIMAPUR

98

0

77

0

32

0

KIPHIRE

38

0

69

0

25

0

KOHIMA

157

1

132

1

96

0

LONGLENG

188

0

157

0

59

0

MOKOKCHUNG

562

0

375

0

212

0

MON

48

0

32

0

28

0

PEREN

70

0

54

1

12

0

PHEK

82

0

21

0

32

0

TUENSANG

106

0

83

0

48

0

WOKHA

205

1

191

0

70

0

ZUNHEBOTO

149

0

76

0

39

0

UMS DIMAPUR

233

0

260

1

175

0

Total

1936

2

1527

3

828

0

             Japanese Encephalitis:

       Presently, in Nagaland we have  one  JE Sentinel Site Hospital attached to Dimapur Civil Hospital where confirmatory test for suspected JE /AES is been done .  The number of cases & deaths reported under this SSH is shown below.

 

Sl. No

Year

District

No. of cases

Deaths

1

 

2014

Dimapur

18

1

Mokokchung

1

0

Tuensang

1

0

Total

 

20

1

2

 

2015

Dimapur

9

1

Wokha

1

0

Total

 

10

1

3

2016

Nil

Nil

Nil

Grand Total

30

2

         Dengue:

 

Sl. No

Year

No. of cases

Deaths

1

2011

3

0

2

2012

0

0

3

2013

0

0

4

2014

0

0

5

2015

21

1

6

2016 

138

0

 Bivalent RDT & ACT-AL:

            Rapid Test Kit which can be tested both for Plasmodium Vivax & Plasmodium Falciparum has been made available through Central Supply in 2013. These Tests kits are used in high endemic areas,  and where there is no  facility for Peripheral Blood Slide Examination.

            There have been instances of resistance to ACT-SP regimen used for treatment of Falciparum malaria, Therefore instead of Sulfadoxine-Pyrimethamine combination. The Standard treatment for Falciparum malaria has been changed to Artesunate Lumefanthrine ( ACT-AL).

            Other routine activities like monitoring & Supervision, training of manpower, integrated vector management activities, Review Meetings, IEC/BCC Activities are being carried out. 

 Entomology under NVBDCP:

Among Vector Borne Diseases, Malaria continues to figure prominently owing to its wider prevalence and distribution in the Country. In addition to Malaria, the steady spread of Japanese Encephalitis, as wells the re-occurrence of dengue/DHF in Urban areas made the task of controlling these diseases a difficult one.

            Keeping in view the urgent need to remain in full preparedness for combating these diseases, it was necessary to prepare operational Guidelines as on Entomological aspects of the diseases. These guidelines provide full Chronology of the Entomological measures that are required to be carried out in the fields for generating precise data which will provide a definite pointer towards the disease trends & will help concern authorities  to be vigilant for any combat operation that may be required to suppress any outbreak of Vector Borne Diseases. These will also help the State to generate the information on various ecological aspects of the Vectors including Susceptibility Status as well as impact of different insecticides been used .

            There are fluctuations in incidence from year to year and during different season of the same year. However, when there is a break down in the Control measures focal outbreaks of VBD may occur. The lack of Entomological Monitoring & consequent lack of information on the exact Transmission potential over a number of years may led to focal outbreaks. Entomological information with regard to vector Density, Vector Longevity, Susceptibility to insecticide, Sporozoite rate and Man – Mosquito Contact co-related with Epidemiological parameters is essential to get a complete picture of a VBD in an area.  Entomological Investigation in the Persistent transmission foci and during Outbreak areas can play a vital role in planning Control Strategy for the disease. For instance by Entomological Investigation It can be Established whether anti- adult measures are effective or not to interrupt the transmission and type of appropriate intervention can be applied to achieve results within a specific time frame.  Data on change in feeding & Resting Behavior , incrimination of suspected vectors & Vector Resistance to insecticides are the  main Entomological Inputs for deciding control Strategy. 

            Different Activities are undertaken for effective use of Insecticide Treated Bednet ( ITBN) or Long Lasting Insecticide Treated Bed Nets ( LLIN). The success of ITBN/ LLIN Strategy required Comprehensive Information on the following Aspects of Mosquito Bionomics which are also undertaken by Entomologists:

(a)    Feeding & resting Behavior

(b)   Biting Time

(c)    Transmission Dynamics

(d)   Length of Transmission Season

(e)    Socio-Cultural Factors &

(f)    Socio- Economics  

     Larval Control Measures are  undertaken by Urban Vector Borne Disease Control with  Chemical & Biological Controls. Routine Checking of Water Bodies are carried out and  if found positive for breeding of Mosquitoes, anti Larval measures are taken up in those breeding Places. Larvivorous fish Hatchery is also maintaining & Distribution to different Bodies in the States from time to time is also maintaining as a measure of Biological Control .

            The monthly Technical ( Entomological ) Reports are submitting in 11 Performa ( EF 1-11) every month to NVBDCP  Delhi . The map of the zones showing the District & health unit, Index villages indicating the Status of Different Vectors are Recorded & send along with the Annual Report.

     LLIN (Long Lasting Insecticidal Nets):-

         To reduce mosquito population for controlling malaria, a number of methods are available like larvicidal fish, Indoor Residual Spray with insecticides, elimination of breeding sites by methods like filling up of small pits and ditches, channelization of canal, sanitation activities through Village Health and Sanitation Committee, covering of open water containers etc. Long Lasting Insecticidal Nets (LLINs) is a newer & effective intervention to prevent human-mosquito contact by acting as a barrier and it also kills the mosquitoes coming in contact with net. The Directorate of National Vector Borne Disease Control Programme (NVBDCP), Ministry of Health and Family Welfare (MoH&FW), Govt. of India has supplied about 9,15,067 LLINs for needy people of high risk areas of Nagaland for free of cost distribution.

 District wise Distribution of LLIN Bales:

Sl.No

District

Size (Bales)

Small

Medium

Large

1

Wokha

82

394

446

2

Mokokchung

613

983

1017

3

Phek

677

662

423

4

Kohima

799

369

294

5

Peren

242

419

215

6

Tuensang

632

772

651

7

UVBDCS

361

3100

442

8

Kiphire

274

305

248

9

Zunheboto

220

269

275

10

Longleng

401

209

299

11

Dimapur

325

3010

340

12

Mon

Nil

2067

100

13

State

83

1164

60

                 Total

4709

13723

4810

 

Vision Statement                                                                                                               Citizen Charter

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