National Centre for Vector Borne

Diseases Control
(NCVBDC)
Competency: Epidemiology of Communicable and Non-communicable diseases

Environment and Health

Sub-competency:

CM 3.6: Describe the role of vectors in the causation of diseases. Also, discuss
the

National Vector Borne Disease Control Program

CM 8.3: Enumerate and describe disease-specific National Health Programs

including

their prevention and treatment of a case

 At the end of the class, a student of 3rd professional year
should be able to
1. State the objectives of National Vector Borne Disease Control Program
2. Describe the strategies for prevention and control of Malaria under NVBDCP
3. Describe the strategies for prevention and control of Dengue under NVBDCP
4. Describe the strategies for prevention and control of Kala-azar under NVBDCP
5. Describe the strategies for prevention and control of Chikungunya under NVBDCP
6. Describe the strategies for the prevention and control of JE under NVBDCP
7. Describe the strategies for prevention and control of Malaria under NVBDCP
8. Describe the strategies for prevention and control of Filaria under NVBDCP
 UMS (1971), National Anti-Malaria
Modified Plan of Programme (NAMP) NVBDCP became
National Malaria
Operation (MPO) • Lymphatic filariasis part of NHM
Control
Falciparum Control • Kala Azar
Programme
Program (PfCP)
(NMCP)

1953 1958 1977 1995 1998 2003 2005

National Malaria Malaria Action National Vector Borne Disease

Eradication Programme (MAP) Control Programme
Programme (NMEP)
(NAMP + NFCP+ Kala Azar control
programme + prevention and control of
JE and Dengue)
Milestones Japanese Encephalitis
Dengue + Chikunguniya (2006)
 On 8th November 2021

NVBDCP NCVBDC

NATIONAL CENTRE FOR VECTOR-

BORNE DISEASES CONTROL
• NVBDCP is an umbrella programme for the prevention and control of 6 vector-borne diseases -

- malaria, dengue, chikungunya, Japanese encephalitis, kala-azar and lymphatic

filariasis

• Comprehensive program in the country for the prevention and control of VBDs

• Nodal agency – under DGHS , MOHFW and GOI

• Usually, the high-risk areas for VBDs are rural and tribal areas and urban slums.
 -
Early case detection
DISEASE Complete treatment
MANAGEMENT Referral services
Epidemic preparedness
Rapid response

3
INTEGRATED Indoor residual spray
Pronged VECTOR ITN
Larvivorous fish
strategy MANAGEMENT Source reduction

BCC, PPP,
HRD
SUPPORTIVE Operational research
INTERVENTIONS - Monitoring and Evaluation
 Strategies adopted for Malaria under NVBDCP

 NATIONAL FRAMEWORK FOR MALARIA ELIMINATION IN

INDIA (2016 – 2030 )

 NATIONAL STRATEGIC PLAN 2023 – 2027

 URBAN MALARIA SCHEME

NATIONAL FRAMEWORK FOR MALARIA ELIMINATION IN INDIA (2016 – 2030 )

The Framework was developed in close

collaboration with officials from NVBDCP, experts

from the Indian Council of Medical Research,

WHO and representatives from civil society

institutions, professional bodies and partners.

9
CLASSIFICATION OF STATES/UTS BASED ON API AS
PRIMARY CRITERIA
 STRATEGIC APPROACHES
1. Programme phasing
2. District as the unit of planning and implementation
3. Focus on high transmission areas
4. Special strategy for P. vivax elimination

P. vivax malaria is a serious challenge to malaria elimination within the

country due to a multitude of reasons
- 80% of the global P. vivax burden is contributed by 3 countries including
India.
- Parasites can survive in the cooler climate.
- Less responsive to conventional methods of vector control.
- Difficult to detect using conventional diagnostic tools.
 KEY INTERVENTIONS

TEGORY 3 - INTENSIFIED CONTROL PHAS

14
 SPECIFIC OBJECTIVES KEY INTERVENTIONS

Achieve universal coverage

1. Massive scaling up of existing disease
with malaria preventive
and curative services. management and preventive approaches and tools

1. Screening of all fever cases suspected of

Establish an efficient malaria
system to reduce ongoing
2. Classification of areas as per local malaria
transmission of malaria
epidemiology and grading of areas as per risk of
malaria transmission followed by
implementation of a tailored intervention

Reduce malaria specific

Strengthening of intersectoral collaboration.
morbidity and mortality.
 SPECIFIC OBJECTIVES KEY INTERVENTIONS

1. Special interventions for high-risk groups

Contain and prevent possible
outbreaks of malaria, 2. Centres or mobile clinics on fixed days in tribal or
particularly among non-immune conflict-affected areas to provide malaria diagnosis
high-risk mobile and migrant
and treatment
population groups.
3. Increasing community awareness with the
involvement of other sectors

1. Timely referral and treatment of severe malaria

Emphasize reducing malaria 2. Strengthening hospitals in malaria-endemic areas
morbidity and mortality in high 3. Establish a robust supply chain management
transmission pockets such as
system.
tribal, hilly, forested and
conflict-affected areas 4. Maintenance of an optimum level of surveillance
5. Equipping all health institutions
 KEY INTERVENTIONS

ATEGORY 1/2 – PRE-ELIMINATION PHASE

1. Setting up an elimination surveillance system

2. Initiating elimination phase activities in those districts

where the API has been reduced to less than 1 case per 1000

population at risk per year.

3. The planning of elimination measures will be based on

epidemiological investigation and classification of each

 SPECIFIC OBJECTIVE
1. Interrupt transmission of
malaria. KEY INTERVENTIONS

• Efforts to interrupt local transmission

2. Immediately notify each
detected case. in all active foci of malaria

3. Detect any possible continuation • Mandatory notification of each case

of malaria transmission. of malaria
4. Determine the underlying • Adequate case-based surveillance
causes of residual transmission. and complete case management
5. Forecast and prevent any • Early detection and treatment of all
unusual situations, epidemics
cases
and outbreak preparedness
• effective screening, management
6. Prevent re-establishment of local
transmission of malaria. and prevention of malaria among
migrants
7. Ascertain the elimination of
NATIONAL STRATEGIC PLAN 2023 – 2027 (NSP)

The National Strategic Plan (NSP) for Malaria

Elimination (2023-2027) has been developed

based on the National Framework for Malaria

Elimination (NFME) of the National Vector Borne

Disease Control Programme (NVBDCP), Ministry

of Health & Family Welfare (MoHFW),

Government of India and World Health

Organization (WHO) Global Technical Strategy for

 GOAL

 The Vision is of a “Malaria Free India”.

 Mission of the NSP is Malaria elimination in India by 2030 aligned with

the Global Technical Strategy 2016-30 and National Framework for
Malaria Elimination 2016-30.

 Goals are to interrupt local transmission and achieve zero indigenous

case through the country by 2027 and provide an enabling environment
to prevent re-establishment of malaria.
23
 STRATEGIES OF NSP

 Transforming malaria surveillance as a core intervention for malaria

elimination
 Ensuring universal access to malaria diagnosis and treatment by
enhancing and optimizing case management - “testing, treating and
tracking”
 Ensuring universal access to malaria prevention by enhancing and
optimizing vector control
 Accelerating efforts towards elimination and attainment of malaria-
free status
 Promoting research and supporting the generation of strategic
information for malaria elimination and prevention of re-establishment
of malaria transmission
 ACTIONS TO ACHIEVE OBJECTIVES

a) Epidemiological Surveillance and Case Management

b) Strengthening Referral Services

c) Epidemic Preparedness and Rapid Response

d) Integrated Vector management

e) Supportive interventions
PRIORITIZATION
OF
VECTOR
CONTROL
URBAN MALARIA SCHEME(UMS)
EMERGING PROBLEM OF MALARIA IN URBAN AREAS

 Increasing Urban population

 Urban slums with poor housing

 Restricted water supply

 The rapid growth of population in urban towns

 Anti-larval activities are chemical controls

 Towns not under UMS

 Inadequate trained manpower for control

NORMS:

1. The towns should have a minimum

population of 50,000.

2. The API should be 2 or above.

3. The towns should promulgate and

strictly implement the civic by-
laws to prevent/eliminate domestic
and peri-domestic breeding places
Control Strategies under Urban Malaria Scheme:

(i) Parasite control

(ii) Vector control

Vector control comprises of the following components

– Source reduction
– Use of larvicides
– Use of larvivorous fish
– Space spray
– Minor engineering
– Legislative measure
 Source
reduction
DENGUE AND CHIKUNGUNIYA
 OBJECTIVES OF THE MID-TERM PLAN

1. To reduce the incidence of dengue and 2006 – Long term

action plan
Chikungunya to bring down the disease

burden.

2. To reduce the case fatality rate due to 2010 – Mid term

action plan
dengue.
 1. Surveillance
2.Case management

3.Vector management
MAIN COMPONENTS
OF 4.Outbreak response
MID-TERM PLAN
FOR 5.Capacity building
PREVENTION AND
CONTROL
OF 6.Behaviour Change Communication
DENGUE (2011-
2013) 7. Inter-sectoral coordination

8. Monitoring & Supervision

JAPANESE ENCEPHALITIS
 Outbreak of JE

• In June 2019,

• Acute Encephalitis Syndrome (AES)

• Muzaffarpur and districts in Bihar state

of India

• Deaths >150 children(hypoglycemia).

NATIONAL PROGRAMME FOR PREVENTION & CONTROL OF
JE/AES UNDER NVBDCP
GOAL: To reduce morbidity, mortality and disability in children
due to JE/AES
Human Health
resource and
developme family
nt welfare

M/o
Drinking Women
MULTIPRONGED water and child
APPROACH and developme
sanitatio nt
n

Urban Social
developme justice &
nt empower
ment
 ROLES AND RESPONSIBILITIES UNDER NVBDCP (MoHFW)

1. Strengthening and Expanding JE Vaccination

2. Strengthening of Public Health Activities

3. Vector control

4. Disease surveillance

5. Advocacy meeting, Information Education and communication, BCC

6. Case finding and case management

7. Setting Up of Department of Physical Medicine & Rehabilitation at Medical Colleges

8. PICU
 1. STRENGTHENING AND EXPANDING JE VACCINATION

 JE vaccine is an effective preventive measure

 GOI introduced JE vaccination with SA-14-14-2 vaccine in a phased
manner starting from 2006
 2 doses of JE vaccine have been approved to be included in RI .
1st dose at 9 months, 2nd dose at 16-24 months.
 2. VECTOR CONTROL
 ULV (ultra-low volume) fogging is the only recommended method
of vector control and can be used during JE epidemics

 Time of Fogging :
Late evening between (17:00 and 19:00 hrs) No rain, Temperature
Mild

 Personnel Protection Measures:

- Protective clothing, Mats, coils and aerosols, Repellents

- Chemical repellents such as DEET (N, N- Diethyl-m-Toluamide) can provide
protection against JE vector
 3. DISEASE SURVEILLANCE
A continuous monitoring of all factors influencing transmission and
effective control of JE

Types of surveillance

– Epidemiologic

– Clinical

– Laboratory

– Entomological

Case Definition of Suspected Case:

Acute onset of fever, not more than 5-7 days duration. - Change in
mental status with/ without , New onset of seizures
Setting up of Dept of Physical Medicine & Rehabilitation
at medical colleges (Neuro-rehabilitation component)
• 30-40% of children who recover from JE/AES have residual neurological sequelae

• PMR departments were set up to provide high-quality and affordable care to persons with
musculoskeletal & neurological disorders due to JE/AES

• Funds have been provided for the establishment of identified 10 PMR Departments in 10
Medical
Colleges of 5 high burdened States.

• At present, 8 PMR Departments are functional ---- (2 in Assam, 1 in Tamil Nadu, 3 in Uttar
Pradesh and 2
in West Bengal).

• Upgraded PICU in endemic districts

KALA AZAR
 STRATEGIES FOR ELIMINATION
OF KALA AZAR

 Early case detection and complete

Parasite elimination and Treatment
disease management  Strengthening of referral system

 Indoor residual spray

 Environmental management by
Integrated Vector Control maintenance of sanitation and
hygiene

 BCC for social mobilization

 Inter-sectoral convergence
Supportive interventions  Capacity building by training
 Monitoring and Evaluation
LYMPHATIC
FILARIASIS
 LYMPHATIC FILARIASIS

 Lymphatic filariasis, commonly known as

elephantiasis, is a neglected tropical disease
 It impairs the lymphatic system and can lead
to the abnormal enlargement of body parts,
causing pain, severe disability and social
stigma.
 Infection occurs when filarial parasites are
transmitted to humans through mosquitoes.
Infection is usually acquired in childhood
 Wuchereria bancrofti, which is responsible for 90%
of cases
ELIMINATION of LYMPHATIC FILARIASIS

• Annual Mass Drug Administration

TWIN PILLAR STRATEGY

• Morbidity Management and Disability

Prevention (MMDP))
 ANNUAL MASS DRUG
ADMINISTRATION

• Annual MDA  entire at-risk population { 5 years or more }

• Accelerated plan  Global Alliance Elimination of lymphatic filariasis
(GAELF) [WHO]

2018
2004- MDA 2007
Triple Drug Therapy
started [DEC + [Ivermectin+ DEC+
[DEC ] Albendazole] Albendazole]

Bihar, Jharkhand,
Karnataka, UP,
Maharashtra
 MORBIDITY MANAGEMENT AND DISABILITY
PREVENTION (MMDP)

 Home-based management of lymphoedema cases and up-scaling of

hydrocele operations in identified CHCs/ District hospitals /medical
colleges

 The materials required for home-based management are provided in

morbidity management kits

 GOI has revised the financial norms for Morbidity Management

Rs. 150/- Rs. 500/- per kit (February 2021)
 HOME-BASED MANAGEMENT OF LYMPHEDEMA

1. Washing and drying 2. Prevention and cure of entry lesions 3. Elevation of the foot

4. Leg exercise 5.Proper footwear 6. Management of a/c attack

INTERVENTIONAL SURGERIES

Hydrocelectom
y
hydrocele
operations
should be
conducted in
identified CHCs/
District hospitals
Different constituents and steps of LF
elimination programme
 TRANSMISSION ASSESSMENT SURVEY (TAS)

 TAS is a tool designed to know whether the transmission is

interrupted by MDA

 After 5 rounds of MDA + mf survey ---- IU with <1% mf can initiate

TAS

 In TAS school children of 1st and 2nd Standard by 30 cluster sample

methodology to measure circulating antigenemia. [enrolment - >75% for
school survey enrollment]

 In 2020, there were 5 IU/ Districts undergoing TAS 2 and 5 – TAS 3

THANK
YOU