NVBDCP according to k park
Reading File
Finding Sources
Finding Sources
Reading File
Finding Sources
Finding Sources
Reading File
Reading File
Reading File
Reading File
Reading File
Reading File
Reading File
Reading File
Reading File
Reading File
Reading File
I now have comprehensive content from K Park's textbook on NVBDCP. Let me compile a thorough answer.
National Vector Borne Disease Control Programme (NVBDCP)
Park's Textbook of Preventive and Social Medicine
Overview
The NVBDCP is implemented across all States/UTs for prevention and control of six vector-borne diseases:
- Malaria
- Filariasis (Lymphatic)
- Kala-azar (Visceral Leishmaniasis)
- Japanese Encephalitis (JE)
- Dengue
- Chikungunya
The Directorate of NVBDCP is the nodal agency for planning, policy-making, technical guidance, monitoring, and evaluation. States are responsible for planning, implementation, and supervision. It functions under the overall umbrella of NRHM.
Of the six diseases, malaria, filariasis, JE, dengue, and chikungunya are transmitted by mosquitoes, while kala-azar is transmitted by sand flies.
Three-Pronged Strategy
Under NVBDCP, prevention and control follows three broad strategies:
-
Disease Management - early case detection, complete treatment, strengthening referral services, epidemic preparedness, and rapid response
-
Integrated Vector Management (IVM) - indoor residual spraying (IRS) in selected high-risk areas, insecticide-treated bed-nets (ITNs/LLINs), larvivorous fish, anti-larval measures in urban areas, source reduction, minor environmental engineering
-
Supportive Interventions - behaviour change communication (BCC), public-private partnership, inter-sectoral convergence, human resource development, operational research (drug resistance, insecticide susceptibility), monitoring and evaluation, web-based MIS, JE vaccination, annual mass drug administration against lymphatic filariasis
(A) Malaria - Historical Milestones
| Year | Milestone |
|---|---|
| Pre-1953 | ~75 million cases; 0.8 million deaths |
| 1953 | National Malaria Control Programme (NMCP) launched |
| 1958 | Changed to National Malaria Eradication Programme |
| 1965 | Cases reduced to 0.1 million |
| Early 1970s | Resurgence of malaria |
| 1976 | Cases peaked at 6.46 million |
| 1977 | Modified Plan of Operations implemented |
| 1997 | World Bank-assisted Enhanced Malaria Control Project (EMCP) |
| 1999 | Renamed to National Anti Malaria Programme (NAMP) |
| 2002 | Renamed to NVBDCP |
| 2005 | NVBDCP integrated into NRHM; Introduction of RDT |
| 2006 | ACT introduced in chloroquine-resistant falciparum areas |
| 2008 | ACT extended to ~95% Pf cases; World Bank supported NMCP launched |
| 2009 | Introduction of LLINs |
| 2010 | New Drug Policy 2010 |
| 2012 | Bivalent RDT introduced (detects both P. vivax and P. falciparum) |
| 2013 | New Drug Policy 2013 |
| 2016 | National Framework for Malaria Elimination launched |
| 2017 | National Strategic Plan for Malaria Elimination 2017-2022 launched |
Main Programme Activities
- Formulating policies and guidelines
- Technical guidance
- Planning
- Logistics
- Monitoring and evaluation
- Coordination with States/UTs, NCDC, NIMR
- Collaboration with WHO, World Bank, GFATM, donor agencies
- Training
- Facilitating research through NCDC, NIMR, Regional Medical Research Centres
- Coordinating activities in inter-state and inter-country border areas
Organization
- Central level: 19 Regional Offices for Health & Family Welfare under DGHS, Ministry of Health & FW (in 19 states), with malaria-trained staff
- State level: Vector Borne Disease Control Division under Dept. of Health & FW, headed by State Programme Officer (SPO); each state has a State VBDC Society (now merged with State Health & FW Society under NRHM)
- Divisional level: Zonal officers with technical and administrative responsibilities under Senior Divisional Officers (SDOs)
- District level: Chief Medical Officer (CMO)/District Health Officer (DHO) has overall responsibility; District Malaria Offices (DMOs) headed by DVBDC Officer; assisted by Assistant Malaria Officer (AMO) and Malaria Inspectors (MIs)
- PHC level: Medical Officer PHC has overall responsibility for surveillance, laboratory services, and spray supervision; MPWs + ASHAs carry out case detection and community outreach
Drug Distribution Centres (DDC) and Fever Treatment Depots (FTD)
- DDCs: Dispense anti-malarial tablets only (as per NMEP schedule); manned by voluntary community workers
- FTDs: Collect blood slides AND distribute anti-malarial tablets; manned by voluntary community workers
- These were established due to the increasing demand for anti-malarial drugs and the inadequacy of supply through surveillance workers and medical institutions alone
Urban Malaria Scheme
- Launched in 1971
- Methodology: vector control by intensive anti-larval measures + drug treatment
- ~7.4% of total malaria cases and ~10.9% of malaria deaths are from urban areas
- Major cities affected: Chennai, Vadodara, Visakhapatnam, Ahmedabad, Kolkata, Navi Mumbai, Vijayawada
- Urban vector breeds in man-made containers (overhead tanks, water coolers, cisterns, flower vases, old tyres, etc.)
- Control: civil bye-laws, larvivorous fish, larvicides for unsuitable water bodies
Malaria Elimination Goals (National Framework 2016)
| Target Year | Goal |
|---|---|
| 2022 | Transmission interrupted in all 26 States/UTs (Categories 1 & 2 in 2014); zero indigenous cases |
| 2024 | API < 1 per 1000 population in ALL States and UTs |
| 2027 | Indigenous transmission interrupted throughout entire India |
| 2030 | Malaria eliminated from entire country; initiate WHO certification process |
Programme Phasing - Classification of States/UTs (2014)
| Category | Definition |
|---|---|
| Category 0 | Prevention of re-establishment - zero indigenous cases (no state currently) |
| Category 1 | Elimination phase - API < 1, all districts API < 1 (15 states/UTs) |
| Category 2 | Pre-elimination phase - API < 1, but some districts API ≥ 1 (11 states) |
| Category 3 | Intensified control phase - API ≥ 1 (10 states/UTs) |
- Category 1 states: HP, Punjab, J&K, Kerala, Manipur, Puducherry, Chandigarh, Uttarakhand, Haryana, Sikkim, Rajasthan, Daman & Diu, Goa, Delhi, Lakshadweep
- Category 2 states: Bihar, Tamil Nadu, Telangana, UP, Karnataka, WB, AP, Assam, Maharashtra, Gujarat, Nagaland
- Category 3 states: Andaman & Nicobar, MP, Dadra & NH, Jharkhand, Arunachal Pradesh, Chhattisgarh, Odisha, Meghalaya, Tripura, Mizoram
Surveillance
- Active Case Detection (ACD): Blood smears collected by MPWs/ANMs during fortnightly house visits in rural areas
- Passive Case Detection (PCD): Fever cases reporting to ASHAs, sub-centres, malaria clinics, CHCs, secondary and tertiary hospitals
- RDT: Introduced in 2003; bivalent RDT (P. vivax + P. falciparum) introduced in 2012
Surveillance Parameters
| Parameter | Full Form |
|---|---|
| API | Annual Parasite Incidence |
| ABER | Annual Blood Examination Rate (target ~10%) |
| AFI | Annual Falciparum Incidence |
| SPR | Slide Positivity Rate |
| SFR | Slide Falciparum Rate |
Sentinel surveillance: Established in high-endemic districts; 1-3 sentinel sites per district in large hospitals to record all OPD/IPD malaria cases and malaria-related deaths.
Integrated Vector Management (IVM)
- IRS (Indoor Residual Spray): Primary method in rural settings; ~80 million population covered
- DDT is the insecticide of choice
- Where DDT resistance exists: malathion or synthetic pyrethroids
- DDT: 2 rounds of spraying; malathion: 3 rounds
- Anti-larval measures: Chemical, biological (larvivorous fish - Gambusia, Lebistes), and environmental - used primarily in urban areas
- ITNs/LLINs: Being scaled up to replace IRS in suitable areas
- LLINs: for areas with API ≥ 5
- Conventional ITNs + IRS: for API ≥ 2
- IRS preferred in very hot areas or where ITNs are not acceptable
- Coverage target: >80% in high-risk areas
Health Worker Male (HWM) Duties under NVBDCP
Malaria:
- Collect thick & thin blood smears on one glass slide from fever cases
- Contact ASHAs and FTDs during fortnightly village visits; collect blood smears, replenish drugs, slides, and RDKs
- Dispatch blood smears with MF-2 to PHC Lab twice weekly
- Administer radical treatment to positive cases as per drug schedule
- Inform spray dates to ASHA/FTD; assist in motivating community for spray operations
Kala-azar (endemic areas): Enquire about fever >15 days duration in each family; refer suspected cases to PHC/CHC; health education
Japanese Encephalitis (endemic areas): Identify fever cases with encephalitis symptoms; refer to PHC/CHC; maintain records for follow-up
Filaria (endemic areas): Identify lymphoedema/elephantiasis/hydrocele cases; refer for management; train patients on home-based care; identify/train drug distributors (ASHAs) for mass drug distribution of DEC + albendazole on National Filaria Day
Source: Park's Textbook of Preventive and Social Medicine, Chapter on National Health Programmes - NVBDCP section
In short
NVBDCP - Quick Summary (K Park)
What is it?
- Controls 6 vector-borne diseases: Malaria, Filariasis, Kala-azar, Japanese Encephalitis, Dengue, Chikungunya
- Nodal agency: Directorate of NVBDCP (under NRHM)
- Renamed from NAMP to NVBDCP in 2002
3-Pronged Strategy
- Disease Management - early diagnosis + complete treatment
- Integrated Vector Management (IVM) - IRS, ITNs/LLINs, anti-larval measures
- Supportive Interventions - BCC, training, research, JE vaccination, MDA for filariasis
Malaria Key Milestones
- 1953 - NMCP launched
- 1958 - Changed to Eradication Programme
- 1976 - Peak resurgence (6.46 million cases)
- 2002 - Renamed NVBDCP
- 2016 - National Framework for Malaria Elimination (goal: eliminate by 2030)
Elimination Categories (API-based)
| Category | Criteria |
|---|---|
| Cat 0 | Zero indigenous cases |
| Cat 1 | API < 1 (all districts) |
| Cat 2 | API < 1 (state), some districts ≥ 1 |
| Cat 3 | API ≥ 1 |
Surveillance Parameters
API, ABER (target ~10%), AFI, SPR, SFR
- ACD: MPWs do fortnightly house visits
- PCD: Fever cases reporting to ASHAs/facilities
- RDT introduced 2003; bivalent RDT in 2012
Vector Control
- Rural: IRS (DDT first choice; malathion/pyrethroids if resistance)
- Urban: Anti-larval measures (Gambusia fish, larvicides)
- LLINs: For API ≥ 5 areas
- ITNs + IRS: For API ≥ 2 areas
Special Schemes
- Urban Malaria Scheme: Since 1971; anti-larval measures + drug treatment
- DDC: Dispenses drugs only
- FTD: Collects slides + dispenses drugs; both run by community volunteers
This is a shared conversation. Sign in to Orris to start your own chat.