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Main components of prevention and control of dengue, Kala Azar and Lymphatic filriasis under NVBDCP

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National Vector Borne Disease Control Programme (NVBDCP) - Prevention & Control Components

Dengue, Kala-azar, and Lymphatic Filariasis are three of the six vector-borne diseases (along with Malaria, Japanese Encephalitis, and Chikungunya) covered under NVBDCP, which operates on a common three-pronged strategy: (i) disease management (early case detection + complete treatment, referral, epidemic preparedness/rapid response), (ii) Integrated Vector Management (IRS, ITNs, larvivorous fish, anti-larval measures, source reduction, minor environmental engineering), and (iii) supportive interventions (BCC, public-private partnership, intersectoral convergence, capacity building, operational research, M&E, web-based MIS) - Park's Textbook of Preventive and Social Medicine, p. 468.

1. Dengue / Dengue Haemorrhagic Fever

  • Contingency planning: A standing "Guideline for Preparation of Contingency Plan in case of outbreak/epidemic of Dengue/DHF" covers outbreak identification, demarcation of the affected area, containment, case management, vector control, IEC activities, and monitoring/reporting.
  • Early reporting and case management: Community sensitization on signs/symptoms; hospitals alerted in advance to ensure preparedness for managing dengue/DHF cases.
  • Surveillance and diagnostic network: 521 sentinel surveillance hospitals with laboratory support in endemic states, backed by 14 Apex Referral Laboratories. IgM capture ELISA kits are supplied free of cost through the National Institute of Virology (NIV), Pune, and contingency grants cover operational costs.
  • Early diagnosis: Introduction of NS1-antigen ELISA kits, which can detect infection from day 1, complementing IgM capture ELISA (used from day 5 onward).
  • Vector control and IEC: Anti-larval/source reduction measures against Aedes breeding sites, and "Do's and Don'ts" behaviour change communication for household-level prevention.
(Park's Textbook of Preventive and Social Medicine, p. 476-477)

2. Kala-azar (Visceral Leishmaniasis)

The Kala-azar elimination strategy (revised launch: 2 September 2014) rests on six pillars:
  1. Enhanced case detection and complete treatment - rK39 rapid diagnostic kits for field-level diagnosis; oral Miltefosine for treatment; newer single-dose Liposomal Amphotericin B (10 mg/kg IV), supplied free by WHO, to rapidly clear the human reservoir of infection.
  2. Interruption of transmission through vector control - indoor residual spraying against sandflies, with DDT being replaced by synthetic pyrethroids because of emerging DDT resistance.
  3. Behaviour change communication and intersectoral convergence.
  4. Capacity building of health staff and field workers.
  5. Monitoring, supervision and evaluation.
  6. Operational research, with national guidelines on prevention/control circulated to states.
Active case search: Frequency increased from annual to quarterly, conducted during a dedicated "Kala-azar Fortnight" - door-to-door search by peripheral health workers/ASHAs/volunteers, referring suspected kala-azar and Post-Kala-azar Dermal Leishmaniasis (PKDL) cases to treatment centres.
Financial incentives: Rs. 300 to ASHA per case identified; Rs. 100/200 for one/two rounds of insecticide spray facilitated; Rs. 500 wage-loss compensation to the patient during hospital treatment; Rs. 2,000 for PKDL cases.
(Park's Textbook of Preventive and Social Medicine, p. 476)

3. Lymphatic Filariasis

  • Mass Drug Administration (MDA): Ongoing since 2004; changed in 2007 from DEC alone to DEC + Albendazole given as a single annual dose, distributed on "National Filaria Day" through ASHAs/trained drug distributors. Target coverage ≥65-80% sustained for 5-6 years to bring community microfilaria prevalence below 1% and interrupt transmission.
  • Surveillance: Night blood survey (NBS) conducted at sentinel and random sites (4 each, 500 slides/site = 4,000 slides per implementation unit) before each MDA round to track microfilaria rates.
  • Morbidity management and disability prevention (MMDP): Identification of lymphoedema/elephantiasis and hydrocele cases with referral to PHC/CHC; training patients in home-based foot/limb hygiene care to reduce acute attacks; surgical management (e.g., hydrocelectomy) where indicated.
  • Vector control: Anti-larval and environmental measures against Culex quinquefasciatus, which breeds in polluted water/poor drainage (source reduction, minor engineering, larvivorous fish).
  • Health education: IEC on the disease, MDA compliance, and morbidity self-care.
(Park's Textbook of Preventive and Social Medicine, p. 314-316; Health Worker Male programme duties, p. 552-553)

Common thread across all three

Each disease-specific programme under NVBDCP follows the same overarching template - case detection and treatment, vector control (IRS/anti-larval/source reduction), and supportive interventions (BCC, capacity building, surveillance, M&E) - adapted to the specific vector (mosquito for dengue/filariasis vs. sandfly for kala-azar) and disease biology (acute epidemic-prone for dengue, chronic disabling for filariasis, elimination-targeted for kala-azar).
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