Malaria Control In India

Malaria Control Programs NMCP 53 MAP 95 NMEP 58 EMCP 97 UMS 71 NAMP 99 MPO 77

RBM 98

Malaria Trend across the centuries, in India

MALARIA INCIDENCE IN RURAL AND URBAN AREAS OF TAMILNADU Year

State Cases

Rural Cases

Chennai Cases

Chennai %

Other UMS Cases

Other UMS %

1990

120029

48478

51272

42.7

20279

16.9

1991

144762

57403

67013

46.3

20346

14.1

1992

151633

52298

72314

47.7

27021

17.8

1993

148057

42908

76749

51.8

28400

19.2

1994

104964

39736

48352

46.1

16876

16.1

1995

92375

40739

41822

45.3

9814

10.6

1996

80586

27249

45930

57.0

7407

9.2

1997

72426

23429

41735

57.6

7262

10.0

1998

63915

16023

40475

63.3

7417

11.6

1999

56366

12141

38165

67.7

6060

10.8

2000

43053

7574

31861

74.0

3618

8.4

2001

31551

5121

23652

75.0

2778

8.8

2002

34523

5490

27205

78.8

1828

5.3

2002 (Jan to Nov)

31385

5017

24725

78.8

1643

5.2

2003(Jan to Nov)

39423

11105

26429

67.0

1889

4.8

Malaria Situation in Coimbatore district ( 1998 – 2002 )

Year

Total Population

Blood smears examined

Total +ve

pf

ABER

SPR

SFR

API

Death

Radical Rx given

1998

24,92,219

2,42,036

21

5

10.7

0.08

0.002

0.01

-

21

1999

25,14,963

2,42,984

125

54

9.51

0.05

0.02

0.05

-

91

2000

25,20,557

2,48,424

7

1

9.4

0.003

0.004

0.002

-

7

2001

25,44,766

2,43,099

10

-

9.6

0.004

-

0.003

-

10

2002

25,94,943

2,66,647

12

-

10.1

0.004

-

0.005

-

12

Source : District Malaria Officer, Coimbatore

Approaches to Malaria Control A). The management of Malaria cases in the community 1). Case Detection

Active

Passive

2). Treatment

Presumptive

Radical

3). Mass Drug Administration & Chemoprophylaxis

B). Active intervention to control / interrupt malaria transmission 1). Stratify

API <2

API >2

2). Vector Control Strategies a). Anti-adult measures

b) Anti-larval measures

i) Space Spray application

i) Larvicides

ii) Residual Spraying

ii) Source Reduction

Chemical Biological

iii) Individual Protection

Integrated Control

N A M P Control Strategies API >2

API<2 Focal Spraying

Spraying Entomological assessment Surveillance ( active & passive ) Treatment

Active surv once in 15 days

Surveillance ( active & passive ) Treatment Follow up Epidemiological Investigation

Treatment Presumptive Tab. Chloroquine 600 mg ( 10 mg/kg ) + Tab. Primaquine 15 mg ( 0.25 mg/kg ) Vivax

Radical

Tab. Chloroquine 600 mg ( 10 mg/kg ) + Tab. Primaquine 15 mg ( 0.25 mg/kg ) on day 1 Tab. Primaquine 15 mg on day 2 & 3 Falciparum Tab. Chloroquine 600 mg ( 10 mg/kg ) + Tab. Primaquine 45 mg ( 0.25 mg/kg )

Parameters of Malaria Surveillance API

ABER

=

=

Confirmed cases during the Yr Population under surveillance # of slides examined Population under surveillance

Annual Falciparum Incidence

X 100

Index of Operational Efficiency

pf proportion Spleen Rate

Slide Positivity Rate Slide Falciparum Rate

X 1000

Measure of Endemicity of Malaria

Vector Indices : 1. Human Blood Index

2. Sporozoite Rate

3. Mosq density ( # of mosq/man-hour-catch )

4. Inoculation Rates

5. Man biting Rate ( biting density – bites/day/person )