National Vector Borne Disease Control Research Articles

Effectiveness of Eupatorium Perfoliatum 30C in Preventing Dengue Fever-A Prospective, Community-Based, Open Label, Parallel Cohort Study in Delhi, India.

The study was undertaken to evaluate the protective effect of Eupatorium perfoliatum (EP) 30C on the incidence of dengue fever. This study was designed as a prospective, open label, parallel cohort study. Participants were enrolled in two medicine cohort (MC) communities and one control cohort (CC) community. Participants in MC who were more than 5 years of age received four medicated globules and those aged between 1 and 5 years received two medicated globules of EP 30C once a week for 10 weeks. Participants in CC received no medical intervention. Both cohorts received information and educational material regarding dengue. The primary outcome was incidence of dengue cases based on laboratory confirmation or the clinical definition of dengue as per the case definition notified by the National Vector-Borne Disease Control Program, Government of India, during the 14 weeks of intervention and observation. The analysis included 20,607 participants residing in three slums of Delhi, of which MC and CC included 15,298 and 5,309 participants respectively. The overall protective effect of EP 30C in MC against probable/laboratory-confirmed dengue was 59.59% (95% confidence interval [CI], 50.74 to 66.85, p = 0.0001). The overall protective effect of EP 30C against laboratory-confirmed dengue was 72.78% (95% CI, 54.45 to 83.74, p = 0.0001): 26 cases per 15,298 (0.13 per 1,000 person-weeks) in MC versus 33 cases per 5,309 (0.46 per 1,000 person-weeks) in CC. The use of EP 30C was associated with some protection against probable and laboratory-confirmed dengue.

Unveiling spatio-temporal mysteries: A quest to decode India's Dengue and Malaria trend (2003-2022)

Dengue and malaria are two mosquito-borne diseases that are dangerous globally, especially in tropical and subtropical regions. In India, these two diseases pose severe health issues as they account for 74.37 % of the total vector-borne disease burden in the country. The present study examined the spatio-temporal patterns of prevalence of dengue and malaria across all states in India. Data related to epidemiological statistics were obtained from the Central Bureau of Health Intelligence (CBHI) and the National Vector Borne Disease Control Program (NVBDCP) for 2003–2017 and 2018–2022, respectively. In this study, we have utilized the Mann-Kendall test, Modified Mann-Kendall test, Sens's slope, Innovative trend analysis, and Percent Bias for trend analysis. Furthermore, a hotspot analysis was conducted to compare and examine the evolving patterns of these diseases over space and time. The Mann-Kendall test showed a significant increase in dengue cases throughout India, with Sen's slope showing the fastest growth in Punjab. West Bengal exhibited the most significant ITA slope increase. The PBIAS slope showed a gradual rise from the southern to the northern and north-eastern states. Mann-Kendall results indicated a statistically significant decline in malaria cases, dropping mostly in Odisha, followed by the northern, southern, and north-eastern states. Only Mizoram displayed an insignificant upward trend in malaria cases. Hotspot analysis revealed that dengue fever hotspots expanded in India's central, western, and northern regions, affecting 66.72 % of the country, whereas significant coldspots remain unchanged. Malaria hotspots covered 47.46 % of north-eastern, eastern coastal, and northern areas, while coldspots almost remained unchanged. This study provides valuable insights for health authorities to prioritize and identify the regions that need immediate intervention regarding these two mosquito-borne diseases.

Dengue Seroprevalence in Different Geographic Zones of India: A Systematic Review and Meta-Analysis of Cross-Sectional Studies

Dengue is a highly prevalent mosquito-borne disease that is endemic in over 100 countries. It has a wider impact in terms of severity of illness and mortality risk in the absence of an effective vaccine as yet. The purpose of this study was to use meta-analysis to find out how common the dengue virus (DENV) is in India based on public data and to figure out how much of a problem. We searched, read, and reviewed about DENV in India that were available online. Forty-four cross-sectional studies were selected from the 178 records. There were reports of dengue cases in 14 out of the 28 states. Out of the patients presenting with symptoms of Dengue 27% of people were confirmed to have DENV infection with 82.29% (95% CI. 81-84%), having dengue IgM, 41.67% (95% CI: 40.16-43.43), having dengue IgG, and 23.97% (95% C.I. 14-43%), having both IgG and IgM from positive sample n=27156. Hospital-based cross-sectional studies on suspected Dengue-like illness (DLI) found that 99.48% of people had confirmed dengue out of the patients with features of DLI, and community-based studies found that 0.52% of DLI cases had dengue. The seroprevalence rates for East, South, North, and Western regions were 35.38% (95% C.I.14-31%), 11.57% (95% C.I. 2-69%), 38.10% (95% C.I. 9-61%), and 14.87% (95% C.I. 6-38%) correspondingly. DENV is interestingly spreading across the whole country, and the disease’s frequency varies a lot from place to place and from 2010-2023. However this review does not find appropriate published literature from 50% of the Indian states. The identification of IgG-class antibodies to dengue virus is indicative of prior exposure to this pathogen. Almost all immunocompetent individuals should have developed IgG antibodies against the dengue virus within three weeks of exposure. The presence of dengue virus IgM-class antibodies is indicative of an acute phase of infection. National Vector borne Disease Control Programme (NVBDCP) has some surveillance information, appropriate designed research into prevalence and risk factors for DENV infection would be required to provide adequate information for public health intervention.

Spatiotemporal Epidemiology of Malaria in India from 2007 to 2022.

India is a major contributor to the global burden of malaria, especially Plasmodium vivax infection. Understanding the spatiotemporal trends of malaria across India over the last two decades may assist in targeted intervention. The population-normalized spatiotemporal trends of malaria epidemiology in India from 2007 to 2022 were analyzed using a geographic information system with the publicly available "malaria situation" report of the National Vector Borne Disease Control Program (NVBDCP). The NVBDCP data showed malaria cases to have steeply declined from 1.17 million in 2015 to 0.18 million cases in 2022; this is 10.1 and 18.7 fold lower than the WHO's estimate of 11.93 million and 3.38 million cases in 2015 and 2022, respectively. From 2007 to 2022, Mizoram, Meghalaya, Tripura, Odisha, Chhattisgarh, and Jharkhand consistently reported high caseloads of Plasmodium falciparum. In the same period, the P. vivax caseload was high in Arunachal Pradesh, Mizoram, Nagaland, Jharkhand, Odisha, Chhattisgarh, Goa, Daman and Diu, Dadra and Nagar Haveli, and Andaman and Nicobar Islands. The distribution of forest cover, annual rainfall, and proportion of the Scheduled Tribe population (the most underprivileged in Indian society) spatially correlated with malaria cases and deaths. Mizoram is the only state where cases were higher in 2022 than in 2007. Overall, India has made tremendous progress in controlling malaria and malaria-related deaths in the last decade. The decline could be attributed to the effective vector and parasite control strategies implemented across the country.

Long-Lasting Insecticidal Net Coverage and Utilization in Burla Town of Sambalpur District: A Cross-Sectional Study.

Background Vector-borne diseases continue to significantly contribute to mortality and morbidity, especially in developing nations. Vector management is a key pillar in combating these diseases, and long-lasting insecticidal nets (LLINs) are cost-effective tools. The Government of India, under the National Vector Borne Disease Control Programme (NVBDCP), has distributed LLINs for free to increase coverage and utilization. This study aims to estimate the coverage and utilization of LLINs in Burla town. Method This cross-sectional study was conducted from October to December 2022 in Burla town of Sambalpur in Odisha, India. The estimated sample size was 510 households, assuming 50% coverage. Multi-stage cluster sampling was adopted to select the Anganwadi centers and households. A pretested questionnaire was utilized for data collection by trained personnel through Epicollect5 (Centre for Genomic Pathogen Surveillance, Oxford, UK). Logistic regression was used to identify predictors for LLIN usage. Results The survey covered 516 households with 2,541 individuals and 1,165 nets. Household-level coverage was 94.2%, and regular utilization was 45.74%. Skin reactions (35.7%) were the most common reason for non-usage, followed by low mosquito density (12%). Logistic regression showed that the number of rooms (adjusted odds ratio (AOR) = 0.663, p = 0.012), number of bed nets (AOR = 2.757, p < 0.001), knowledge of malaria (AOR = 2.92, p = 0.04), adopting other measures for mosquito control (AOR = 0.295, p < 0.001), and washing the net (AOR =1.92, p = 0.028) significantly predicted sleeping under mosquito net. Conclusion Our study has depicted high coverage of LLINs in Burla town, but utilization needs further improvement. Counseling regarding proper use can decrease the skin reactions responsible for non-usage. Regular health education programs are required to emphasize the benefits of LLIN use, along with regular monitoring and supervision.

Outcome Assessment of the implementation of Mass Drug Administration against Lymphatic Filariasis, in Kalaburagi (Gulbarga) District of Karnataka state: A Cross Sectional Survey.

Mass Drug Administration of Di-Ethyl Carbamazine and Albendazole is an effective strategy recommended by World Health Organization (WHO) to prevent transmission and eliminate Lymphatic Filariasis. Under the National Vector Borne Disease Control Programme in India, Mass Drug Administration (MDA) is carried out as a yearly activity in endemic areas to accelerate the progress towards elimination of lymphatic Filariasis. The study was carried with the objective to determine the coverage of Mass Drug Administration against Lymphatic Filariasis among the eligible population in Kalaburagi district and delineate the common reasons for non acceptance of MDA. Field based cross sectional survey was carried out in Kalaburagi. Cluster sampling of 4 clusters (3 rural and 1 urban) from four different taluks (one cluster from each taluk) of the district reporting high, medium and low coverage of MDA (as reported by District Malaria Office) Members from selected Households in all clusters were interviewed regarding MDA administration, Directly Observed treatment, side effects and any co morbidities which ruled out MDA administration. Responses documented as tally marks in assessment sheets shared by National Vector Borne Disease Control Programme office. Proportions, frequencies, and mean were calculated and inferential statistics were used. A total of 1263 individuals were assessed for Mass Drug administration from a total of 240 households (60 households in each cluster). The coverage of MDA varied from 90.33% in Heerapur in Kalaburagi Urban to 97.87% in Mogala thanda (Chittapur Taluk). MDA Coverage against Lymphatic Filariasis has improved when compared to previous reported studies carried out and it has also exceeded the coverage threshold as determined by programme for elimination of Lymphatic Filariasis.

Clinico-demographic Profile of Childhood Encephalitis: A Hospital based Study

Introduction: Childhood encephalitis have numerous etiologies, varied presentations and wide outcome ranges, varying from complete recovery to devastating neurological sequele and death. During 2016 nationwide, 11,651 case and 1301 deaths were reported to the National Vector Borne Diseases Control Programme (NVBDCP), with a case fatality rate (CFR) of around 11%. It is a major health problem in the state of Uttar Pradesh, several districts have been experiencing recurrent episodes of encephalitis with different magnitudes. Under this backdrop, the present study was undertaken to know the clinical profile of children admitted with encephalitis. Materials and Methods: The present study was conducted in the Department of Pediatrics , Shri Ram Murti Smarak Institute of Medical Sciences over a period of 13 months (from January 2021 to February 2022). Total 74 cases of AES were included in this study. This was a prospective, observational, hospital based study. We collected relevant data of the encephalitis cases, analyzed and interpreted accordingly. Results: In the present study, total 74 cases of AES were admitted in pediatrics department during the study period. Out of 84 AES patients, majority 45.9% were between one month to five years of age. Male were 59.5% and female cases were 40.5%. The common presenting clinical manifestations were fever with altered sensorium (100%) and seizures in 100% cases. Most common nerve involved was optic nerve in 81% of the cases. Signs of raised ICP was seen in 35.1% of the cases. Laboratory report, CSF analysis revealed 45.9% patients had normal CSF cell count, 51.3% of the patients had normal protein levels. 62.2% had clinical features for 3 to 7 days prior to presentation. 43.2% patients had altered mental status between 0 to 24 hours prior to admission. About 67.6% patients had GCS &lt;8 and required intubation. CT scan head was performed in 13.5% cases and was abnormal in 40% cases. MRI Brain was done in 29.7% cases and most common area involved was thalamus in 36.4% cases. Conclusion: The common clinical features in childhood encephalitis are fever, altered sensorium and seizures, that was seen in 100% of the cases. CSF cell count was found to be normal and abnormal in almost equal number of cases.

Role of homoeopathy of Ayush in dengue fever

In 21st century, dengue came to the limelight. Earlier, it was taught that this is one of the eruptive fevers in human beings where in dengue, the eruption appears typically on the 6th day of the fever. Knowledge and approaches to dengue took a paradigm shift in 21st century. It came to be clubbed under the National Vector Borne Disease Control Program. A mosquito borne single stranded RNA virus is the leading cause of arthropod borne viral diseases like dengue globally. All the types of dengue virus are capable of inducing severe diseases like dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). No one wants to be in DHF or DSS stage as these are mortal stages while other stages are morbid. A vector borne disease (VBD) transmitted by mosquito has no specific cure in modern medicine. To add to that, the issue of platelet transfusion that is made universal because of the inherent panic does more harm than good. It is here that homoeopathy has a role to play therapeutically. The article discusses the disease and the related physiology as well as pathology that goes inside the body during an episode of dengue fever. Along with the diagnosis and management approaches, the article elicits the role of homoeopathy through a suggested treatment protocol. Through the inherent properties of homoeopathy such as cost effectiveness, clinical effectiveness and zero side effects, the article proposes large scale application of homoeopathy at all levels.

Strength in struggle: unravelling the journey of national vector borne disease control programme India: a comprehensive SWOT analysis

India, like many other regions, faces the substantial burden of vector-borne diseases. Initially confined to tropical and sub-tropical regions, vector-borne diseases are now spreading to new geographies due to increasing unplanned urbanization, changes in land use, growing international travel, and the impact of climate and environmental dynamics. To address these challenges, India implemented the National Vector Borne Disease Control Program (NVBDCP) in 2003-04, which targets the prevention and control of the six vector-borne diseases. Over the years, numerous initiatives have been undertaken to combat the challenges posed by vector-borne diseases in India. The successes, such as streamlined resource utilization and the introduction of effective tools, have led to substantial reductions in disease burden. Nevertheless, issues like manpower shortages, logistical hurdles, and a lack of research resources remain as challenges. Moreover, the program must confront emerging threats posed by urbanization, climate change, and resistance to treatments. NVBDCP's roadmap for the future includes embracing opportunities like vaccine development, and research, as well as fostering collaborations with partners. By addressing its weaknesses and effectively managing the threats at hand, the program can continue its vital mission of combatting vector-borne diseases in India. The implementation of these strategies is essential to ensure the sustained success of disease control and prevention efforts in the country.

Coverage evaluation of mass drug administration with triple drug regimen in an evaluation unit in Nagpur district of Maharashtra, India.

Triple drug regimen (IDA; Ivermectin, Diethylcarbamazine, Albendazole) recommended for accelerating elimination of lymphatic filariasis was launched in India in December 2018. Nagpur district in Maharashtra was one of the first five districts where this strategy was introduced. The National Vector Borne Disease Control Programme (NVBDCP) at the district reported ~85.0% treatment coverage in the first round of mass drug administration (MDA) with IDA implemented in EU-2 in Nagpur district in January 2019. As per the national guideline, a coverage evaluation survey was carried out and both quantitative and qualitative data were collected to assess the treatment coverage, the level of community preparation and identify the gaps, if any, for improvement. A Coverage Evaluation Survey (CES) following the WHO recommended protocol was conducted in one of the two evaluation units (EU-2) in Nagpur district in March 2019. Coverage Sample Builder (CSB) V2.9 tool was used to calculate the sample size, select sites and estimate drug coverage. The CSB tool followed a two-stage cluster sampling procedure to select 30 primary sampling units (ward/village as a cluster) and a list of random numbers for selecting households (HHs) in each cluster. The results were analyzed for operational indicators. Stata ver. 14.0 software was used to construct the 95% confidence limits accounting for clustering. A total of 1601 individuals aged 5-85 years of both gender from 328 HHs were surveyed from the 30 randomly selected clusters in EU-2. The mean age was 33.8±17.6 years. Among the surveyed population, 78.0% received the drugs (programme reach) and 66.1% consumed the drugs (survey coverage). Survey coverage was significantly higher in rural (82.6%) than in urban (59.4%) and peri-urban (58.6%) areas (P<0.001). Directly observed treatment (DOT) among the surveyed population was 51.6%. Adverse events were reported among 6.9% respondents who reported to have consumed the drugs. The IDA based MDA strategy could achieve just the required level of treatment coverage (~65%) in EU-2, Nagpur district, which had previously undergone several rounds of DA-MDAs (Diethylcarbamazine, Albendazole). Having achieved an effective treatment coverage of >80% in rural areas, the coverage in urban and peri-urban areas need to be improved in order to attain the impact of IDA-MDA. It is imperative to strengthen drug delivery and community preparation activities along with improved DOT especially in urban and peri-urban areas to achieve the required level of treatment coverage. Addition of ivermectin did not have any additional perceived adverse events.

Baseline characterization of entomological drivers of malaria transmission in Namibia: a targeted operational entomological surveillance strategy

BackgroundNamibia’s focus on the elimination of malaria requires an evidence-based strategy directed at understanding and targeting the entomological drivers of malaria transmission. In 2018 and 2019, the Namibia National Vector-borne Diseases Control Program (NVDCP) implemented baseline entomological surveillance based on a question-based approach outlined in the Entomological Surveillance Planning Tool (ESPT). In the present study, we report on the findings of the ESPT-based NVDCP on baseline vector species composition and bionomic traits in malaria endemic regions in northern Namibia, which has the aim of generating an evidence base for programmatic decision-making.MethodsNine representative sentinel sites were included in the 2018 entomological surveillance program (Kunene, Omusati, Oshana, Ohangwena, Oshikoto, Otjozondjupa, Kavango West, Kavango East and Zambezi); the number was reduced to four sites in 2019 due to limited funding (Ohangwena, Kavango West, Kavango East, and Zambezi). In the 2018 baseline collections, multiple sampling methods (human landing catches, pyrethroid spray catches, U.S. Centers for Disease Control and Prevention light traps [CDC-LTs], resting boxes [RBs] and larval sampling) were utilized to evaluate indoor/outdoor human biting rates, resting behaviors and insecticide resistance (IR). CDC-LTs and RBs were not used in 2019 due to low and non-representative sampling efficacies.ResultsOverall, molecular evidence demonstrated the presence of three primary mosquito vectors, namely Anopheles arabiensis, rediscovered Anopheles gambiae sensu stricto and Anopheles funestus sensu stricto, alongside Anopheles squamosus and members of the Anopheles coustani complex. Vectors were found to bite throughout the night (1800 hours 0600 hours) both indoors and outdoors, with An. arabiensis having the highest biting rates outdoors. Low numbers of indoor resting Anopheles point to possible low indoor residual spraying (IRS) efficacy—with An. arabiensis found to be the major vector species resting indoors. The IR tests demonstrated varying country-wide resistance levels to the insecticide deltamethrin, with the resistance levels confirmed to have increased in 2019, evidence that impacts national programmatic decision-making. Vectors demonstrated susceptibility to the insecticides dichlorodiphenyltrichloroethane, bendiocarb and Actellic 300CS in 2018, with mosquitoes from only one site (Kavango West) demonstrating possible resistance to DDT. Targeted and question-based entomological surveillance enabled a rapid and focused evidence base to be built, showing where and when humans were being bitten and providing entomological data on long-lasting insecticidal nets, IRS efficacy and insecticide resistance, which the Ministry of Health and Social Services-Namibia can use to further build a monitoring and evaluation framework for understanding the drivers of transmission.ConclusionIdentification and characterization of species-specific bionomic traits allows for an understanding of where and when vector human contact may occur as well as the potential impact of interventions. Low indoor resting rates as well as the presence of insecticide resistance (and the increase in its frequency) point to the need for mosquito-behavior-directed and appropriate interventions as well as the requirement for a resistance mitigation strategy. The ESPT-based question- and minimal essential indicator-based operational research strategy provides programs with directed and focused data for facilitating decision-making while requiring limited funding and capacity.Graphical

Semantic web-based diagnosis and treatment of vector-borne diseases using SWRL rules

Vector-borne diseases (VBDs) are a kind of infection caused through the transmission of vectors generated by the bites of infected parasites, bacteria, and viruses, such as ticks, mosquitoes, triatomine bugs, blackflies, and sandflies. If these diseases are not properly treated within a reasonable time frame, the mortality rate may rise. In this work, we propose a set of ontologies that will help in the diagnosis and treatment of vector-borne diseases. For developing VBD’s ontology, electronic health records taken from the Indian Health Records website, text data generated from Indian government medical mobile applications, and doctors’ prescribed handwritten notes of patients are used as input. This data is then converted into correct text using Optical Character Recognition (OCR) and a spelling checker after pre-processing. Natural Language Processing (NLP) is applied for entity extraction from text data for making Resource Description Framework (RDF) medical data with the help of the Patient Clinical Data (PCD) ontology. Afterwards, Basic Formal Ontology (BFO), National Vector Borne Disease Control Program (NVBDCP) guidelines, and RDF medical data are used to develop ontologies for VBDs, and Semantic Web Rule Language (SWRL) rules are applied for diagnosis and treatment. The developed ontology helps in the construction of decision support systems (DSS) for the NVBDCP to control these diseases.

Management of Insect Borne Human Diseases – A Case Study on Novel Bio-Larvicide for Mosquito Borne Diseases Including Dengue

In India National Vector Borne Diseases Control programme is an umbrella organization for management and control of six out of eight insect-borne human diseases, viz., Malaria, Lymphatic Filariasis (LF), Kala-azar, Dengue/ Chikungunya, and Japanese Encephalitis. Of these, India is committed for elimination of the first three diseases from the country. 8.6% of India’s total population belongs to tribal community yet contribute 21% of Plasmodium falciparum infection and 29% of malaria-related deaths. There is an urgent need to implement novel strategies to overcome insecticide resistance in Anopheles culicifacies that transmit 60-70% of malaria cases in India. One such strategy is to use Chilodonella uncinata, an indigenous, maternally transmitted, facultative protozoan bio-larvicide with many biological control properties against mosquito vectors. In view of the above, if India really aims to achieve malaria elimination by 2030, there is an urgent need that tribal regions are given more attention.

Coverage of mass drug administration (MDA) and operational issues in elimination of lymphatic filariasis in selected districts of Jharkhand, India.

Despite annual rounds of mass drug administration (MDA) being carried out every year since 2004 to break the transmission of lymphatic filariasis, India has not achieved elimination status in many areas of country. This study was conducted to determine the operational issues in the implementation of MDA for elimination of lymphatic filariasis in selected districts of Jharkhand. Two districts of Jharkhand state were selected for present cross-sectional study. Multi-staged cluster sampling was adopted to select study participants. Data were collected with use of prescribed questionnaire of National Vector Borne Disease Control Programme (NVBDCP) from the study participants. Data related to socio-demographic details, coverage and compliance of MDA and operational issues were collected. Findings of independent assessment show that percentage of MDA coverage and compliance for Hazaribag district was 96.02% and 88.90%, respectively. On the other hand, percentage of MDA coverage and compliance was found to be only 67.06% and 48.44% in Chatra district. Overall drug consumption was significantly associated with age group (p-value = 0.045), educational status (p-value = <0.0001) and socio-economic status (p-value <0.0001) of eligible population. Most common reason for not swallowing the drugs was found to be absence of family members at the time of MDA rounds followed by no visit of house by drug distributors. Coverage and compliance of MDA was better in Hazaribag district as compared to Chatra district. In order to increase compliance, socio-demographic factors must also be addressed apart from other operational issues.

A study to assess knowledge of primary health workers on malaria epidemiology, diagnosis, and treatment in Patiala district, India

Background: India accounts for (4%) of all malaria cases worldwide. The World malaria report 2017 showed that, by 2016, global progress against malaria had stalled and was off track to meet the Global Technical Strategy milestones for 2020. Aims and Objectives: The aim of the study is to assess knowledge of rural medical officers (RMO) and health workers on malaria epidemiology, diagnosis, and treatment as per National Vector Borne Disease Control Program of India guidelines. Materials and methods: A descriptive, observational, and cross-sectional study was done among government health personnel’s using a semi-structured questionnaire. Results: In the present study, 258 health personnel’s participated comprising multipurpose health workers female (MPHW-F), multipurpose health worker male (MPHW-M), and RMO. The standardized score on knowledge of vector biology and epidemiology was 72% and 54% for RMO and (MPHW-M), respectively. On malaria diagnosis, MPHW-M has got median score (53%) as compared to RMO (46%). On national malaria drug policy, there is a marginal difference between median score of RMO (42%) and MPHW-M (40%). Overall, there is incomplete and poor knowledge of treatment of malaria among all health personnel’s with lack of concept about presumptive treatment. Training showed some positive impact on the knowledge of MPHW-F but no impact on MPHW-M. Graduates and experienced workers have got better knowledge than undergraduates and MPHW-M have more knowledge than MPHW-F. There is poor knowledge of reporting formats, and usage of rapid diagnostic kits among all the health personnels. There was no significant impact of education qualification, in service training and work experience on the knowledge of Male health workers. Conclusion: Training needs to be suitably tailored as there is a lot of scope of improvement in the knowledge regarding malaria diagnosis and treatment among health workers.

Insecticide resistance status of malaria vectors in the malaria endemic states of India: implications and way forward for malaria elimination

BackgroundIn 2012, the World Health Organization (WHO) released the Global Plan for Insecticide Resistance Management in malaria vectors to stress the need to address insecticide resistance. In a prospective multi-centric study commissioned by the Indian Council of Medical Research (ICMR), we assessed the insecticide susceptibility status of the primary malaria vectors in India from 2017 through 2019. MethodsThe insecticide susceptibility status of the prevalent primary malaria vectors – An. culicifacies, An. fluviatilis, An. stephensi, An. minimus and An. baimaii and secondary malaria vectors - An. aconitus, An. annularis and An. philippinensis/nivepes from 328 villages in 79 districts of 15 states of India were assessed following the WHO method mainly to insecticides used in vector control, organochlorine (DDT), organophosphate (malathion), and other pyrethroids (alpha-cypermethrin, cyfluthrin, lambda-cyhalothrin and permethrin). The study sites were selected as suggested by the National Vector Borne Disease Control Programme. ResultsThe primary malaria vector An. culicifacies showed resistance to DDT (50/50 districts including two districts of Northeastern India), malathion (27/44 districts), and deltamethrin (17/44 districts). This species was resistant to DDT alone in 19 districts, double resistant to DDT-malathion in 16 districts, double resistant to DDT-deltamethrin in 6 districts, and triple resistant to DDT-malathion-deltamethrin in 9 districts. An. minimus and An. baimaii were susceptible in Northeastern India while An. fluviatilis and the secondary malaria vector An. annularis was resistant to DDT in Jharkhand. ConclusionIn this study we report that among the primary vectors An. culicifacies is predominantly resistant to multiple insecticides. Our data suggest that periodic monitoring of insecticide susceptibility is vital. The national malaria program can take proactive steps for insecticide resistance management to continue its push toward malaria elimination in India.

Prevention and Elimination of Malaria in India

India, just like many other countries in the world, has been combating malaria for a long time. Its geographical location along with its climate and general economic situation, have been causing the country to be a common habitat for malaria, which is a vector-borne disease carried by mosquitoes, as they mainly thrive in swamps or undrained ponds that are prevalent in India throughout the year. Witnessing the rise of the spread of malaria in India, the government does not just sit back and practice non-intervention, rather, over the past decades, the government, though not often entirely successful, have been developing various strategies and programs in countering the disease. Some of the most crucial ones include the National Malaria Control Programme in 1953 and agencies established include the National Vector Borne Disease Control Programme that has been developing plans for total eradication of malaria by 2030. Some of the strategies include traditional use of pesticides, while others are about distributing medications and improving surveillance programs in tracking the disease.

Implementation and acceptance of government-sponsored malaria control interventions in Meghalaya, India

BackgroundIndia has made considerable progress in malaria reduction over the past two decades, with government-sponsored indoor residual spraying (IRS) and insecticide-treated bed net (ITN) or long-lasting insecticidal nets (LLIN) distribution being the main vector-related prevention efforts. Few investigations have used non-participant observational methods to assess malaria control measures while they were being implemented, nor documented people’s perceptions and acceptance of IRS or LLINs in India, and none have done so in the northeast region. This study evaluated household (HH)-level operation of IRS and distribution of LLINs by India’s National Vector Borne Disease Control Programme (NVBDCP) in 50 villages of Meghalaya state, and documented their acceptance and use.MethodsStudy field teams accompanied the government health system teams during August-October, 2019 and 2020 to observe deployment of LLINs, and record HH-level data on LLIN numbers and use. In addition, NVBDCP spray teams were followed during 2019–2021 to observe IRS preparation and administration. HH members were interviewed to better understand reasons for acceptance or refusal of spraying.ResultsA total of 8386 LLINs were distributed to 2727 HHs in 24 villages from five Primary Health Centres, representing 99.5% of planned coverage. Interviews with 80 HH residents indicated that they appreciated the LLIN dissemination programme, and generally made regular and appropriate use of LLINs, except during overnight travel or when working in agricultural fields. However, HH-level IRS application, which was observed at 632 HHs, did not always follow standard insecticide preparation and safety protocols. Of 1,079 occupied HHs visited by the spray team, 632 (58.6%) refused to allow any spraying. Only 198 (18.4%) HHs agreed to be sprayed, comprising 152 (14.1%) that were only partly sprayed, and 46 (4.3%) that were fully sprayed. Reasons for refusal included: inadequate time to rearrange HH items, young children were present, annoying smell, staining of walls, and threat to bee-keeping or Eri silk moth cultivation.ConclusionsThese findings are among the first in India that independently evaluate people's perceptions and acceptance of ongoing government-sponsored IRS and LLIN programmes for malaria prevention. They represent important insights for achieving India's goal of malaria elimination by 2030.

Pattern of clinical presentation, lab findings and mortality risk among patients of dengue fever admitted in pediatric intensive care unit in a tertiary care centre in South-east Rajasthan

Background: India is one of the 7 identified countries in south-east Asia region regularly reporting dengue fever outbreaks. Dengue can present with varying degrees of severity of illness in Indian children, present study is aimed at studying the clinical presentation lab findings and mortality risk among patients of dengue fever admitted in PICU in a tertiary care centre in South-east Rajasthan. Methods: It is a retrospective observational study. All dengue seropositive patients admitted in PICU from August 2021 to October 2021 were included in the study. Patients were classified based on National Vector Borne Disease Control Program (NVBDCP). Clinical presentation laboratory findings and mortality risk among patient were studied. esults: Out of 61 patients with dengue, 28(46%) were males and 33(54%) were females. Fever was present in 100% cases followed by GI symptoms vomiting(54.1%), pain abdomen(52.5%) and bleeding manifestations(26.2%) were common presenting complaints. On examination common findings were conjunctival congestion (57%) , hepatomegaly (44%) and flushing (26%). Among complications hypotension/shock (51%) was the commonest followed by hemorrhage (31%), pleural effusion and hepatitis each 21%. Most common bleeding manifestation was melena (19%). Most common affected age group was between10-15 years (42.6%).

Radiological features of dengue fever in cases and control

Background: Dengue (pronounced DENgee) fever is a painful, debilitating mosquito-borne disease caused by any one of four closely related dengue viruses. Aim of the study was to study radiological features of dengue fever in cases and control.Methods: Randomized, double blind, placebo controlled, parallel group study conducted among 100 seropositive dengue patients,18-60 years of age (fulfilling inclusion and exclusion criteria) at Lala Lajpat Rai hospital, Kanpur for December 2019 October 2021. Selected patients were subjected to history, examination, necessary investigations and then were managed according to national vector borne disease control programme (NVBDCP) guidelines. A total of 100 serology proven dengue patients were included and followed up. Two groups (fifty in each) were allocated by simple first and then systematic random sampling. Case group was given doxycycline and control group was given placebo.Results: USG findings commonly seen in both the cases and control group were hepatomegaly, splenomegaly, ascites right pleural effusion, thickened GB wall and edema. In both the groups, pleural effusion was the most common complication.Conclusions: Ultrasound examinations detected plasma leakage in multiple body compartments around time of defervescence. Presence of plasma leakage in form of ascites and pleural effusion was more in control group as compared to case group seems doxycycline decrease the plasma leakage. Pleural effusion is most common finding of plasma leakage.