(NVBDCP) is implemented in the State/UT’s for prevention and control of vector borne diseases namely Malaria, Filariasis, Kala-azar, Japanese Encephalitis (JE), Dengue and Chikungunya. The Directorate of NVBDCP is the nodal agency for planning, policy making and technical guidance and monitoring and evaluation of programme implementation in respect of prevention and control of these vector borne diseases under the overall umbrella of NRHM.

National Filaria Control Programme

The National Filaria Control Programme (NFCP) has been in operation since 1955. According to recent estimates about 420 million people are exposed to the risk of infection; 19 million manifest the disease, and 25 million have filarial parasites in their blood. 

In June 1978, the operational component of the NFCP was merged with the urban malaria scheme for maximum utilisation of available resources. The training and research components, however, continue to be with the Director, National Institute of Communicable Diseases, Delhi. 

Under the NFCP, the following activities are being undertaken: 

1.  Delimitation of the problem in hitherto unsurveyed areas 

2. Control urban areas through recurrent anti-larval measures and Anti parasitic measures. 

So far 238 out of 300 districts situated in endemic areas have been surveyed, and 175 have been found to be endemic for filariasis. Survey work is in progress in other districts. 

As of 1999 there are 206 filaria control units, 27 survey units, and 199 Filaria clinics functioning in the endemic areas. The population protected so far is hardly 47 million out of 420 million at risk. Since the “vertical” approach to the control of filariasis has had a limited success in terms of coverage of the population at risk, it is now recognised that the horizontal approach making use of the primary health care system is considered essential. In this case, the village Health Guides will have to be trained and involved in anti-filarial activities with local community participation. 

Revised Filaria Control Strategy: 

The strategy follows t he WHO recommendation of Annual Single Dose Mass Drug Therapy with DEC as a supplement to existing NFCP strategy in highly endemic areas to reduce transmission of filaria to a very significant low level. The drug was distributed from door to door in Tamil Nadu and by booth system in other states. The centre provides DEC tablets for the mass therapy campaign and cash assistance for IEC activities to these states. 

Kala-Azar

Kala-azar is now endemic in 31 districts of Bihar, 4 districts of Jharkhand, 11 districts of West Bengal and 6 districts of Uttar Pradesh, besides sporadic cases in few other districts of Uttar Pradesh. A centrally sponsored programme was launched in 1990-91. This has brought down the incidence of the disease from 77,102 cases in 1992 to 13,869 cases in 2013. 

The strategies for Kala-azar elimination are : 

1.  Enhanced case detection and complete treatment including introduction of PK39 rapid diagnostic kits and oral drug Miltefosine for treatment of Kala-azar cases

2. Interruption of transmission through vector control. It has been decided to replace DDT with synthetic pyrethroid for the purpose of fogging to eliminate sandfly, as the insect is becoming resistant to DDT 

3. Communication for behavioural impact and intersectoral convergence 

4. Capacity building

5. Monitoring, supervision and evaluation

6. Research guidelines on prevention and control of Kala-azar have been developed and circulated to the states. 

Japanese Encephalitis

Japanese encephalitis is a disease with high mortality rate and those who survive do so with various degrees of neurological complications. During the last few years it has become a major public health problem. States of Andhra Pradesh, West Bengal, Assam, Tamil Nadu, Karnataka, Bihar, Maharashtra, Manipur, Haryana, Kerala and Uttar Pradesh are reporting maximum number of cases. 

The strategies for prevention and control of Japanese encephalitis include strengthening of the surveillance activities through sentinel sites in tertiary health care institutions, early diagnosis and proper case management, integrated vector control, particularly personal protection and use of larvivorous fishes, capacity building and behaviour change communication. As the JE vectors are outdoor resters, indoor residual spray is not effective. The government of India provides need-based assistance to the states, including support for training programmes and social mobilization. 

As there is no specific cure for this disease, early case management is very important to minimize the risk of complications and death. JE vaccination is recommended for children between 1 to 15 years of age. In addition, health education through different media and interpersonal communication for the community is crucial. Emphasis should be given on keeping pigs away from human dwellings, or in pigsties, particularly during dusk to dawn, which is the biting time of vector mosquitoes. Use of clothes which cover the body fully to avoid mosquito bites are advocated. Use of bed-nets is also very important precaution. Since early reporting of case is important to avoid complications, the community should be given full information about the signs and symptoms of the disease, and the health facilities available at health centres/hospitals. The states are advised to use malathion for outdoor fogging as outbreak control measure in the affected areas.. Epidemiological monitoring of the disease for effective implementation of preventive and control measure and technical support is provided on request by the state health authorities. 

Dengue Fever/ Dengue Haemorrhagic Fever

During 1996, an outbreak of dengue was reported in Delhi. Since then dengue has been reported from other states also. In view of this major outbreak of the disease a “Guideline of Preparation of Contingency Plan in case of outbreak/epidemic of Dengue/Dengue haemorrhagic fever” was prepared and sent to all the states. It includes all the important aspects of control measures like identification of outbreak, demarcation of affected area, containment of outbreak, case management, vector control, IEC activities about Do’s and Don’t’s for prevention of dengue, monitoring and reporting etc. 

Since early reporting of cases is crucial to avoid any complication and mortality, the community is given full information about the signs and symptoms as well as availability of health services at health centres/hospitals. Alerting the hospitals for making adequate arrangements for management of dengue/dengue haemorrhagic fever cases has also been advised. 

Government of India in consultation with states has identified 311 sentinel surveillance hospitals with laboratory support for augmentation of diagnostic facilities in the endemic states. Further, for advanced diagnosis and back-up support 14 Apex Referral Laboratories have been identified and linked with sentinel surveillance hospitals. To make these functional IgM capture ELISA test kits are provided through National Institute of Virology, Pune free of cost. Contingency grant is also provided to meet the operational costs. 

For early diagnosis ELISA based NSI kits have been introduced under the programme which can detect the cases from 1st day of infection. IgM capture ELISA tests can detect the cases after 5th day of infection. 

The main components of midterm plan for prevention and control of dengue are as follows: 

1.  Surveillance: Disease and entomological surveillance 

2. Case management: Laboratory diagnosis and clinical management 

3. Vector management: Environmental management for source reduction, chemical control, personal protection and legislation 

4. Outbreak response: Epidemic preparedness and media management 

5. Capacity building: Training, strengthening human resource and operational research 

6. Behavioural change communication: Social mobilization, and information, education and communication (IEC) 

7. Inter-sectoral coordination: with ministries of urban development, rural development, Panchayati Raj, surface transport and education sector 

8. Monitoring and supervision: Analysis of reports, review, field visit and feed-back 

Chikungunya Fever

Chikungunya fever is a debilitating non-fatal viral illness, re-emerging in the country after a gap of three decades. Govt, of India is continuously monitoring the situation. Guidelines for prevention and control of the disease have been prepared. Since same vector is involved in the transmission of dengue and Chikungunya, strategies for transmission risk reduction by vector control are also the same. Support in the form of logistics and funds are provided to the states. 

For carrying out proactive surveillance and enhancing diagnostic facilities for Chikungunya, the 137 sentinel surveillance hospitals involved in dengue in the affected states also carry out Chikungunya tests. The diagnostic kits are provided through National Institute of Virology, Pune, by the central government.