National Vector Borne Disease Control Research Articles

Epidemiology of Post-Kala-azar Dermal Leishmaniasis.

Post-kala-azar dermal leishmaniasis (PKDL) is a cutaneous sequel of visceral leishmaniasis (VL) or kala-azar and has become an entity of epidemiological significance by virtue of its ability to maintain the disease in circulation during inter-epidemic periods. PKDL has been identified as one of the epidemiological marker of “kala-azar elimination programme.” Data obtained in 2018 showed PKDL distribution primarily concentrated in 6 countries, which includes India, Sudan, south Sudan, Bangladesh, Ethiopia, and Nepal in decreasing order of case-burden. In India, PKDL cases are mainly found in 54 districts, of which 33 are in Bihar, 11 in West Bengal, 4 in Jharkhand, and 6 in Uttar Pradesh. In West Bengal the districts reporting cases of PKDL cases include Darjeeling, Uttar Dinajpur, Dakshin Dinajpur, Malda, and Murshidabad. The vulnerability on the young age is documented in various studies. The studies also highlights a male predominance of the disease but recent active surveillance suggested that macular form of PKDL shows female-predominance. It is recommended that along with passive case detection, active survey helps in early identification of cases, thus reducing disease transmission in the community. The Accelerated plan for Kala-azar elimination in 2017 introduced by Government of India with the goal to eliminate Kala-azar as a public health problem, targets to reduceing annual incidence <1/10,000. Leishmania donovani is the established causative agent, but others like L. tropica or L. infantum may occasionally lead to the disease, especially with HIV-co-infection. Dermal tropism of the parasite has been attributed to overexpression of parasite surface receptors (like gp 63, gp46). Various host factors are also identified to contribute to the development of the disease, including high pretreatment IL 10 and parasite level, inadequate dose and duration of treatment, malnutrition, immuno-suppression, decreased interferon-gamma receptor 1 gene, etc. PKDL is mostly concentrated in the plains below an altitude of 600 mts which is attributed to the environment conducive for the vector sand fly (Phlebotumus). Risk factors are also linked to the habitat of the sand fly. Keeping these things in mind “Integrated vector control” is adopted under National vector borne disease control programme as one of the strategies to bring down the disease burden.

National Vector Borne Disease Control Programme: Current Updates

Vector-borne diseases are a group of communicable diseases transmitted by mosquitoes and other vectors. National Vector Borne Disease Control Programme is the programme for prevention &amp; control of these diseases. Many new initiatives have been undertaken in the programme which includes National Programme for Prevention &amp; Control of JE/AES, Strategic Plan for Malaria control in India (2012-2017), National Drug Policy on Malaria-2013, Environmental Codes of Practice, etc. in order to make India free from vector borne diseases with equitable access to quality health care.

El Ni\xf1o Southern Oscillation as an early warning tool for dengue outbreak in India

BackgroundDengue is rapidly expanding climate-sensitive mosquito-borne disease worldwide. Outbreaks of dengue occur in various parts of India as well but there is no tool to provide early warning. The current study was, therefore, undertaken to find out the link between El Niño, precipitation, and dengue cases, which could help in early preparedness for control of dengue.MethodsData on Oceanic Niño Index (ONI) was extracted from CPC-IRI (USA) while the data on monthly rainfall was procured from India Meteorological Department. Data on annual dengue cases was taken from the website of National Vector Borne Disease Control Programme (NVBDCP). Correlation analysis was used to analyse the relationship between seasonal positive ONI, rainfall index and dengue case index based on past 20 years’ state-level data. The dengue case index representing ‘relative deviation from mean’ was correlated to the 3 months average ONI. The computed r values of dengue case index and positive ONI were further interpreted using generated spatial correlation map. The short-term prediction of dengue probability map has been prepared based on phase-wise (El Niño, La Niña, and Neutral) 20 years averaged ONI.ResultsA high correlation between positive ONI and dengue incidence was found, particularly in the states of Arunachal Pradesh, Chhattisgarh, Haryana, Uttarakhand, Andaman and Nicobar Islands, Delhi, Daman and Diu. The states like Assam, Himachal Pradesh, Meghalaya, Manipur, Mizoram, Jammu & Kashmir, Uttar Pradesh, Orissa, and Andhra Pradesh shown negative correlation between summer El Niño and dengue incidence. Two - three month lag was found between monthly ‘rainfall index’ and dengue cases at local-scale analysis.ConclusionThe generated map signifies the spatial correlation between positive ONI and dengue case index, indicating positive correlation in the central part, while negative correlation in some coastal, northern, and north-eastern part of India. The findings offer a tool for early preparedness for undertaking intervention measures against dengue by the national programme at state level. For further improvement of results, study at micro-scale district level for finding month-wise association with Indian Ocean Dipole and local weather variables is desired for better explanation of dengue outbreaks in the states with ‘no association’.

Assessment of effectiveness of DAMaN: A malaria intervention program initiated by Government of Odisha, India.

India, a persistently significant contributor to the global malaria burden, rolled out several anti-malaria interventions at the national and state level to control and recently, to eliminate the disease. Odisha, the eastern Indian state with the highest malaria burden experienced substantial gains shown by various anti-malaria initiatives implemented under the National Vector-borne Disease Control Programme (NVBDCP). However, recalcitrant high-transmission "pockets" of malaria persist in hard-to-reach stretches of the state, characterised by limited access to routine malaria surveillance and the forested hilly topography favouring unbridled vector breeding. The prevalence of asymptomatic malaria in such pockets serves as perpetual malaria reservoir, thus hindering its elimination. Therefore, a project with the acronym DAMaN was initiated since 2017 by state NVBDCP, targeting locally identified high endemic 'pockets' in 23 districts. DAMaN comprised biennial mass screening and treatment, provisioning of long-lasting insecticidal net (LLIN) and behavioural change communication. Subsequently, to inform policy, assessment of DAMaN was conceived that aims to estimate the coverage of the various components of the project; the prevalence of malaria, even at sub-patent level especially among pregnant/lactating women and children; and its impact on malaria incidence. A survey of DAMaN beneficiaries will measure coverage; and knowledge and practices related to LLIN; along with collection of blood specimens from a probability sample. A multi-stage stratified clustered sample of 2228 households (~33% having pregnant/lactating women) will be selected from 6 DAMaN districts. Routine DAMaN project data (2017-2018) and NVBDCP data (2013-2018) will be extracted. Rapid Diagnostic Test, Polymerase Chain Reaction and blood smear microscopy will be conducted to detect malarial parasitemia. In addition to measuring DAMaN's coverage and malarial prevalence in DAMaN pockets, its impact will be estimated using pre-post differences and Interrupted Time Series analysis using 2017 as the "inflection" point. The assessment may help to validate the unique strategies employed by DAMaN.

Evaluation of bio-efficacy and durability of long-lasting insecticidal nets distributed by malaria elimination programme in Eastern India

BackgroundLong-lasting insecticidal nets (LLINs) are the most favoured vector control tools worldwide. Timely monitoring and evaluation of LLINs is important to sustain the impact of this promising vector control method and for replacement of worn-out and those rendered ineffective. During the mid-2017, LLINs were distributed by the National Vector Borne Disease Control Programme (NVBDCP) in high malaria endemic districts of the eastern coastal state of Odisha. The study was carried out to assess the field performance of the LLINs post 30 months of distribution in Koraput district of Odisha state.MethodsA total of 130 households were randomly selected from three villages of Laxmipur CHC in Koraput district, Odisha, India; one each from hilltop, foothill and plain terrain. The net users were interviewed to elicit information on usage, washing practices, physical integrity, bio-efficacy and survivorship of LLINs to confirm the claimed three-year life of the LLINs.Results74.8% of the LLINs were physically present after 30 months of distribution. The numbers (%) of LLINs used previous night varied from 30 to 61% between study villages. 74% respondents were using the LLINs throughout the year and 26% only seasonally. Of the total, 85% of the nets were reported to be washed and 95% nets were dried under shade as recommended. Altogether, 58% of the surveyed nets were found torn with holes. Of these, 74 (57%) nets were in good condition, 10 (8%) nets were in serviceable and 45 (35%) nets were badly torn and needed replacement. A total of 45 (93.75%), 68 (80%) and 71 (63.8%) LLINs were physically present in hilltop, foothill and plain villages, respectively. The LLINs did meet the efficacy criteria, given the 100% mortality to the exposed Anopheles jeyporiensis mosquitoes post 30 months distribution.ConclusionsThe findings of this study were communicated to the programme officials of the state and LLINs were replenished soon after 31st month post-distribution of LLINs.

Pattern of time utilization by multipurpose health workers male in district Sonipat, Haryana

Background: A multipurpose health worker is the key functionary in a sub centre. They associate with the community at grass-root levels. This study explores time utilization pattern of multipurpose health workers in the multifarious domains of their activities.Methods: A time motion study conducted among health workers (HWs) male of all subcentres of district Sonipat, Haryana. Participants self‑reported their daily activities on a time measurement workbook for one month. Data were entered in Excel and analyzed using statistical package for social studies software.Results: Time utilization patterns revealed that HWs spent nearly one third (31.5%) of their time on national vector born disease control programme. Documentation constituted nearly 16.3% of their time. Others activities include maternal and child health (7.4%), service for minor ailment (6.7%), revised national tuberculosis control programme (6.7%) and meetings (4.5%). They spent 13.9% of their time on non-productive activities. The proportion of time spent on field-based activities was 63.2% and on sub center based activities was 22.9% of the total working time. A negative correlation of field-based activities was found with age, job experience and residing in joint family.Conclusions: The study reflects the time spent by HWs male in various domains of activities in relations to their job responsibilities and the multipurpose nature of their works. Some of the health programmes were ignored by HWs and were also found to be spending significant time on non-productive works.

A study on “clinical epidemiology of filarial lymphedema patients attending filariasis clinic in Pondicherry”

Introductionlymphatic filariasis (LF) is a vector-borne disease of the tropical and sub-tropical countries due to infection by filarial worms, which invade the lymphatics of humans initiating pathological changes leading to various clinical sequela, one major sequel of infection is lymphoedema of the limbs. MethodsThe study was carried out among the filarial lymphoedema patients attending Vector Control Research Centre & National vector Borne Disease Control Programme (NVBDCP) Clinic at Pondicherry. ResultsThe study showed that. Unilateral LE was predominant and more than 40% of the patients are from 60+ age group. LE grade was clinically assessed based on the four stage WHO criteria 1982. Over all, prevalence of LE Grade of lower extremities was Grade I 14.5%, Grade II 37.5%, Grade III 22.5% and Grade IV 25.15% and 52.1% and 76.2% were obese among male and female LE patients respectively. Frequency of more than 3 ADLA episodes was higher among grade III lymphoedema patients requiring antibiotic prophylaxis. ConclusionPrevalence of Intertrigo and frequent ADLA episodes were higher in grade III LE patients. In total 9/143 (6.29%) of LE patients had more than 3 ADLA Episodes in 1 year and these patients require antibiotic (penicillin/doxycycline prophylaxis).

Frequency and trend of dengue fever in a tertiary care hospital in Kancheepuram, Tamilnadu: three-year retrospective study

Background: Dengue is a mosquito borne viral disease which is endemic in the tropical and subtropical regions. In the recent years it has become a significant public health problem and its incidence is increasing in India. In 2016 1.1 lakh new dengue cases were reported in India. The objectives of the study was to describe the frequency and distribution of dengue infection and to determine the association between dengue infection and selected variables.Methods: The study is a hospital based retrospective study conducted in a tertiary care hospital in a rural area of Kancheepuram district. Three-year data (January 2015 to December 2017) was collected from the medical records department of the hospital. Dengue cases were diagnosed by ELISA test.Results: Among 340 dengue patients admitted in the hospital 240 (74.5%) were male and 100 (25.5%) were female. In this study, 306 (90%) patients were of the classical dengue type and 34 (10%) patients belong to dengue haemorrhagic fever type. There is a spike in the case load after the monsoons. There was a positive statistical significant association (p&lt;0.0001) between dengue infection and male sex, low socioeconomic status and platelet count at the time of admission.Conclusions: Results of the study indicate that there should be proper education of the public through various available Medias and awareness campaigns. All dengue patients must be appropriately treated in order to prevent complications. The national vector borne disease control program must extend its coverage to combat dengue infection.

Trend Analysis of Three Major Mosquito Borne Diseases in Punjab, India

Background & Objectives: Understanding the distribution and prevalence of three major mosquito borne diseases in an area is critical for the development of effective vector control strategies and public health interventions. The present study is therefore aimed to explore the epidemiological trend of malaria, dengue and chikungunya from 2012 to 2018 in Punjab. Methods: Quantitatively retrospective data was collected from Department of Health and Family Welfare, the National Vector Borne Disease Control Programme (NVBDCP), Punjab from 2012 to March 2018. The collected data was statistically analysed. Results: In case of malaria highest prevalent districts in Punjab are Mansa and Bathinda, for dengue Patiala, Ludhiana and S.A.S. Nagar and Patiala for chikungunya. Malaria was reported mainly from rural areas while dengue and chikungunya were found more in urban areas. For all three mosquito borne diseases, males were infected more as compared to females. Malaria cases were reported in months of August and September while dengue cases increased from July to November whereas chikungunya cases were highest in months of August to October. Conclusions: These findings help in concluding the trend analysis which in turn helps us to increase our focus on disease endemic districts along with boosting the vector control strategies in respective districts. Further the control of these mosquito borne diseases can be solved by employing adequate human resources, by increasing awareness in the community by conducting health camps and strengthening the entomological surveillance for timely reduction in the breeding of the vectors, especially before the repeated rise in cases during the period from July to November each year.

Malaria case detection in Chhattisgarh, 2015–2019: Comparison of cases reported by the National Vector Borne Disease Control Programme and community health workers

Malaria case detection in Chhattisgarh, 2015–2019: Comparison of cases reported by the National Vector Borne Disease Control Programme and community health workers

Japanese encephalitis in Uttar Pradesh, India: A situational analysis.

Introduction:Japanese encephalitis (JE) is a vector-borne, viral illness caused by the Japanese Encephalitis Virus. Permanent neurologic or psychiatric sequelae can occur in 30%–50% of those with encephalitis; hence, JE is a cause of major public health concern. For the ease of diagnosis and facilitation of surveillance, National Vector Borne Disease Control Programme uses the term Acute Encephalitis Syndrome (AES). In this study, an attempt has been made to ascertain the status and trends of AES and JE in Uttar Pradesh, India.Methodology:This is a record-based retrospective study. The data were obtained from the Directorate of Medical and Health Services of Uttar Pradesh and analyzed using software SPSS version 24.0.Results:In Uttar Pradesh, there were 47,509 reported cases of AES from 2005 to 2018,. With yearly fluctuations, the average Case Fatality Rate of AES was 17.49% with highest in 2005 (24.76%) and lowest in 2018 (8%). Among the patients with AES, 9.98% were found positive for JE. The most commonly affected age group is 1-5 years for both AES and JE, closely followed by the age group of 5-10 years. Peak occurrence of both AES and JE was recorded in month of September. Among the AES-affected patients 53.8% were males and 46.2% were females.Conclusion:The most commonly affected age group was 1-5 years with peak occurrence in the month of September. Though there was a downward trend in CFR, awareness activities like “Dastak” campaign and intersectoral preventive activities, needs to be strengthened.

Forecasting of Malaria in India Using Time Series Analysis

Background: Although there has been marked reduction in the number of malaria cases in India under National Vector Borne Disease Control Programme (NVBDCP), malaria still is the leading cause of infectious diseases with the development of drug resistant Plasmodium species and insecticide resistant mosquitoes. Keeping this in view, the present study attempts to forecast the malaria cases in India. Methods: We adopted an Auto Regressive Integrated Moving Average (ARIMA) models on the data collected on the number of malaria cases from 1990 to 2017 .The same has been used to predict the number of cases till 2025 without any additional intervention. Results: The results also showed a decreasing trend in the actual and forecasted numbers of malaria cases. The appropriate ARIMA (10, 1, 9) model was selected based on Bayesian Information Criteria (BIC) values. Conclusions: Hence, to achieve the target of Sustainable Developmental Goal by 2030, additional interventions with an increase in the intensity of existing interventions and support of the international community along with WHO is essential.

Malaria risk map for India based on climate, ecology and geographical modelling.

Mapping the malaria risk at various geographical levels is often undertaken considering climate suitability, infection rate and/or malaria vector distribution, while the ecological factors related to topography and vegetation cover are generally neglected. The present study abides a holistic approach to risk mapping by including topographic, climatic and vegetation components into the framework of malaria risk modelling. This work attempts to delineate the areas of Plasmodium falciparum and Plasmodium vivax malaria transmission risk in India using seven geo-ecological indicators: temperature, relative humidity, rainfall, forest cover, soil, slope, altitude and the normalized difference vegetation index using multi-criteria decision analysis based on geographical information system (GIS). The weight of the risk indicators was assigned by an analytical hierarchical process with the climate suitability (temperature and humidity) data generated using fuzzy logic. Model validation was done through both primary and secondary datasets. The spatio-ecological model was based on GIS to classify the country into five zones characterized by various levels of malaria transmission risk (very high; high; moderate; low; and very low. The study found that about 13% of the country is under very high malaria risk, which includes the malaria- endemic districts of the states of Chhattisgarh, Odisha, Jharkhand, Tripura, Assam, Meghalaya and Manipur. The study also showed that the transmission risk suitability for P. vivax is higher than that for P. falciparum in the Himalayan region. The field study corroborates the identified malaria risk zones and highlights that the low to moderate risk zones are outbreak-prone. It is expected that this information will help the National Vector Borne Disease Control Programme in India to undertake improved surveillance and conduct target based interventions.

1785. Dengue Outbreaks and Predominant Circulating Virus Serotypes and Genotypes over More Than Two Decades in a Hyper-endemic Region

BackgroundDengue is the most widespread arboviral disease globally. Serotyping of dengue viruses and their genotyping is important in tracing the epidemiology of the disease, monitoring trends and anticipating the possibility of outbreaks in a community.MethodsThis study is a retrospective analysis, based on data from a tertiary care center from Delhi, India and their correlation with reported literature on circulation and outbreaks of dengue in this region of north India since 1996, when the first virus isolation confirmed outbreak of dengue was reported by our virology laboratory (an Apex Laboratory of the National Vector Borne Disease Control Program, Government of India).Circulating serotypes of DENV were detected and identified from serum samples of suspected dengue patients with fever of 5 days duration or less, by virus isolation in cell culture and/or by real-time or conventional reverse transcription polymerase chain reaction (PCR). Representative serum samples of patients with suspected dengue with duration of fever <5 days were inoculated onto the C6/36 clone of Aedes albopictus cells, and the isolates were identified by indirect immunofluorescence using serotype-specific monoclonal antibodies. Sequencing was done for representative strains as required.ResultsThe predominant serotypes identified were DENV 2 (1996), followed temporally by DENV 1 (1997–2002), DENV 3 (2003–2007), DENV 1 (2008–2012), DENV 2 (2013–2015), and DENV 3 (2016–2018). In 2003, Delhi became hyper-endemic for dengue, with all dengue serotypes co-circulating. Predominant serotypes continued to circulate for 3–6 years. Outbreaks occurred either in the year a serotype was re-introduced after a gap of a few years to become the predominant serotype, or in the following year; except in 2015, when there was a genotypic lineage change in a DENV 2 serotype which had been predominant since 2 years prior to the outbreak year.ConclusionRe-introduction of a dengue serotype which was out of circulation for a few years can precipitate an outbreak. Analysis of temporal patterns and close monitoring of circulating virus strains, particularly at either end of the transmission season, may help in early prediction of the trend for a given year, providing an opportunity to put in place control measures well in time.Disclosures All authors: No reported disclosures.

Field effectiveness of new visceral leishmaniasis regimens after 1 year following treatment within public health facilities in Bihar, India

BackgroundAn earlier open label, prospective, non-randomized, non-comparative, multi-centric study conducted within public health facilities in Bihar, India (CTRI/2012/08/002891) measured the field effectiveness of three new treatment regimens for visceral leishmaniasis (VL): single dose AmBisome (SDA), and combination therapies of AmBisome and miltefosine (AmB+Milt) and miltefosine and paromomycin (Milt+PM) up to 6 months follow-up. The National Vector Borne Disease Control Program (NVBDCP) recommended an extended follow up at 12 months post-treatment of the original study cohort to quantify late relapses.MethodsThe 1,761 patients enrolled in the original study with the three new regimens were contacted and traced between 10 and 36 months following completion of treatment to determine their health status and any occurrence of VL relapse.ResultsOf 1,761 patients enrolled in the original study, 1,368 were traced at the extended follow-up visit: 711 (80.5%), 295 (83.2%) and 362 (71.5%) patients treated with SDA, AmB+Milt and Milt+PM respectively. Of those traced, a total of 75 patients were reported to have relapsed by the extended follow-up; 45 (6.3%) in the SDA, 25 (8.5%) in the AmB+Milt and 5 (1.4%) in the Milt+PM arms. Of the 75 relapse cases, 55 had already been identified in the 6-months follow-up and 20 were identified as new cases of relapse at extended follow-up; 7 in the SDA, 10 in the AmB+Milt and 3 in the Milt+PM arms.ConclusionExtending follow-up beyond the standard 6 months identified additional relapses, suggesting that 12-month sentinel follow-up may be useful as a programmatic tool to better identify and quantify relapses. With limited drug options, there remains an urgent need to develop effective new chemical entities (NCEs) for VL.

Estimating the dengue burden in India

Estimating the dengue burden in India

Cardiac Manifestations in Dengue Patients in a Rural Tertiary Care Centre in Coastal Kerala

Background: Dengue epidemic is a major health problem in India. Kerala has reported the highest number of dengue related deaths in the country in 2017 as per the reports of the directorate of National Vector Borne Disease Control Programme (NVBDCP). The aim of the present study is to find out the cardiac manifestations of patients admitted with dengue fever during the epidemic in 2017 in a rural tertiary care centre in coastal Kerala. Method: 341 patients who were admitted in the medicine department of a rural tertiary care Centre in Kerala with Dengue were included in the study. W.H.O case definitions were used for the diagnosis. Complete blood counts, RBS, serum creatinine and liver function tests and E.C.G were carried out in all patients. Echocardiogram and cardiac biomarkers were done when indicated. Results: Males predominated. 317 were diagnosed as dengue fever, 12 as dengue hemorrhagic fever and 12 had dengue shock syndrome. Only four patients succumbed to death. Head ache and myalgia were the common symptoms at the time of presentation. 72 patients had abnormal ECG, but all had normal ECG at the time of discharge, indicating a transient change during the episode. Conclusion: This retrospective observational study included 341 patients admitted in a rural tertiary care Centre in Kerala. Patients were diagnosed as per W.H.O. case definition for dengue. 317 were diagnosed as dengue fever, 12 as dengue hemorrhagic fever and 12 had dengue shock syndrome. Study population was predominantly males. 72 patients had abnormal ECG, but all had normal ECG at the time of discharge, indicating a transient change during the episode.

Rational use of blood components in children with dengue by using WHO and NVBDC guidelines

Background: Dengue fever has become a major public health concern. The disease is now endemic in more than 100 countries with very high case fatality rate and children are the most affected age group worldwide. During explosive outbreaks, there is sudden surge in demands of blood components. Hence the aim of present research was to study the rational use of blood components in children with dengue by using WHO 2012 and NVBDCP 2015 (GOI) guidelines.Methods: Total 219 children of age ˂12 years, who has been diagnosed to have dengue and received blood component therapy during 12 months of study period, were included in the study. The transfusions of blood components [packed red cells (PRC), platelets and fresh frozen plasma (FFP)] were being given to the cases accordance to the WHO and NVBDCP guidelines. The patients’ demographic data, diagnosis, details of blood component therapy used the reason for transfusion was recorded.Results: Out of 219 children, 12(5.4%) children received platelet transfusion, 4(1.8%) children received PRC transfusion and 5(2.2%) children received FFP transfusion. One transfusion (4.7%) out of 12 platelet transfusion was inappropriate and all PRC and FFP transfusions were appropriate according to WHO and National Vector Born Disease Control Programme (GOI) guidelines.Conclusions: The need for platelet transfusion is often overemphasized and the fact is that the platelet count alone is not a predictor of bleeding. Unnecessary and empirical use of platelets should be completely avoided.

The Organization, Implementation, and Functioning of Dengue Surveillance in India-A Systematic Scoping Review.

Dengue´s re-emerging epidemiology poses a major global health threat. In India, dengue contributes significantly to the global communicable disease burden, and has been declared highly endemic. This study aims to identify and critically appraise India’s dengue surveillance system. We conducted a systematic literature review, searching Medline, Web of Sciences, Global Health, and Indian Journals. We conducted a narrative synthesis and thematic analysis. Eighteen studies fulfilled eligibility. Organizationally, most studies referred to the National Vector Borne Disease Control Programme, primarily responsible for overall vector and disease control, as well as the Integrated Disease Surveillance Programme, responsible for reporting, outbreak identification, and integration. Surveillance implementation was mostly framed as passive, sentinel, and hospital-based. Reporting varies from weekly to monthly, flowing from primary healthcare centres to district and national authorities. Dengue confirmation is only recognized if conducted with government-distributed MAC-ELISA tests. The surveillance system predominantly relies on public reporting units. In terms of functioning, current surveillance seems to have improved dengue reporting as well the system’s detection capacities. Emergency and outbreak responses are often described as timely; however, they are challenged by underreporting, weak data reliability, lack of private reporting, and system fragmentation. Concluding, India’s dengue surveillance structure remains weak. Efforts to create an infrastructure of communication, cooperation, and integration are evident, however, not achieved yet.

Assessment of national vector borne disease control programme in state of Karnataka

ABSTRACTBackground:National vector borne disease control programme(NVBDCP) was launched to control the prevalence of vector borne diseases like malaria, filaria, Japanese encephalitis (JE), Dengue/DHF, chikungunya, lymphatic filariasis and Kala Azar. The present study was done to assess the activities of NVBDCP in state of Karnatakaand to analyze selective qualitative and quantitative indicators related to the activities.Methods:Quantitatively retrospective data was collected from Directorate office Department of Health and Family Welfare, NVBDCP section from April 2016 to March 2017. Qualitatively questionnaire based protocol was made and interviews were conducted with District programme officer, PHC medical officer and grass root level health workers like ANM, ASHA with reference to one each of selected least performing districts and good performing districts in the state. The collected data was analysed by using Microsoft Excel 2010 version.Results:The highest prevalent districts in Karnataka areDakshina Kannada for malaria, Udupi for dengue, Tumakurufor chikungunya andBidar for lymphatic filariasis. Major factors related to poor outcome in some districts were rigid attitude of the community, poor support of local panchayats and less human resources.Conclusion:The result of this investigation revealed that Dakshina Kannada has got highest number of cases with greater proposition and high prevalence rate of vector borne diseases due to lack of sufficient human resources and geographical factors. Strengthening the surveillance activities along with integrated vector control programmes will improves the outcome of the programme.