Anti Malarial Activities of JALPAIGURI DISTRICT
Malaria is the prime public health hazard of Jalpaiguri District. It contributes a lion share of the malaria problem of the entire West Bengal.
A spontaneous and serious Anti Malarial activity is the cause of declining trend in Malaria in Jalpaiguri in the last 3 years.
Other causes are –
Comparative scenario of Jalpaiguri district
DRUG SCHEDULE FOR TREATMENT OF P vivax MALARIA CASES
(As per NVDBCP Guide Line)
Chloroquine & Primaquine :
Chloroquine & Primaquine
|Age in years||To be given just after collection of B/S||After obtaining B/S report|
|Chloroquine Tab (consecutive 3 days)||Primaquine Tab (1st day single dose)||Pv (Tab Primaquine for 14 days)||Pf|
|1st Day||2nd Day||3rd Day|
|0 -1||½ (75mg)||½ (75mg)||¼ (37.5 mg)||0||Nil||No medicine|
|1+ - 4||1 (150 mg)||1 (150 mg)||½ (75 mg)||1 (7.5 mg)||2.5 mg daily|
|4+ - 8||2 (300 mg)||2 (300 mg)||1 (150 mg)||2 (15 mg)||5 mg daily|
|8+ - 14||3 (450 mg)||3 (450 mg)||1½ (225 mg)||4 ( 30 mg)||10 mg daily|
|14 above||4 (600 mg)||4 (600 mg)||2 (300 mg)||6 (45 mg)||15 mg daily|
NOTE: Tab Primaquine is contraindicated in Pregnancy
For Chloroquine resistant area (2nd line drug)
DRUG SCHEDULE FOR TREATMENT OF P falciperum MALARIA CASES of Jalpaiguri district
Sulphadoxine-Pyrimethamine & Artesunate Combination Therapy :
|Sulphadoxine-Pyrimethamine & Artesunate Combination Therapy|
|Age in Yr.||Artesunate (AS) & SP)||Day-1 (No. of Tab)||Day-2 (No. of Tab)||Day-3 (No. of Tab)||Day-2 (Tab Primaquine)|
|1 to 4Yr||AS||1||1||1||1 (7.5mg)|
|4+ to 8Yr||AS||2||2||2||2(15mg)|
|8+ to 14Yr.||AS||3||3||3||4(30 mg)|
|14 & above||AS||4||4||4||6(45 mg)|
• Jalpaiguri district is a High risk district as a whole.
• 2nd line drug are using for falciparum infection. Sulphadoxine-Pyrimethamine (SP), Artesunate (AS) should always be used in combination. Otherwise resistance to this drug will develop soon.
Now in our district we are using age wise combiblister pack of ACT.
DISTRICT PLAN FOR FOCUSED INTERVENTIONS IN HIGH ENDEMIC AREAS FOR MALARIA OBJECTIVES:
Population (Total) : 3403204 ( 2001 census) Rural:; 2799357 Urban: 603847 Tribal:; 21.03 %
Administrative details : • Geographical area : 6227 sq KM • No. of Sub-Divisions : 3 • No. of Blocks : 13 • No. of Municipalities : 4 • No. of NAC : Added area with Siliguri Municipal Corpn-1, Railway colonies- 2, Army Cantonment area- 2, BSF cantonment area- 5 • No. of Gram Panchayats : 146 • No. of Villages/Hamlets : 742 • No. of Households : 7, 40, 000 (±) • Major Festivals Observed : Swaraswati Puja, Bengali New years day, Siva-ratri, Doljatra, Iid, Durga Puja, Lakshmi Puja, Kali Puja, “Bhai Tika”,Maharam, X-mass day • Public Sector Units : 158 Tea Gardens, No. of credible NGOs : FPAI(Kalchini), • No. of Self Help Groups : (±) 2000 • No. of Kalayani Clubs : Mother’s clubs-112
Physical environment details • Forest : 1790 sq. Km, 28% • Dams : Dam on Teesta & Govt canal – 58.38 thousand hectors • Annual Rainfall : 3200 mm (avg) • Humidity : 82% • Temp : 31’ – 10’C (avg)
Health care delivery infrastructure District Hospital-1, SDH-2, SGH-1, RH-5, BPHC- 8, PHC-38, Malaria Clinics (Microscopy center)-40, Sub-centers-537
SURVEILLANCE AND DIAGNOSIS
Fortnightly Surveillance through regular/contractual staff Activities:
5. During special activities like IRS, ITBN. LLIN-distribution the staff of the concern area be involved for supervision and monitoring etc.
6. After completion of fortnight (Month –as per State direction) the concerned staff will submit his report to their higher tire in specified time.
Establishment of FTDs and Malaria Clinics in Tea Gardens , in Forest villages & in remote villages.
In the 158 tea gardens of the district FTDs established and in few villages FTDs are working under direct supervision of Sub centers(ASHA vols)
Involvement of ASHA, AWW for reporting of fever cases
The following personnel will be deployed for reporting fever cases: ASHA: ( ±) 1707, AWW: ( ±) 6289, OTHERS: Tea garden hospitals, Pvt Hospitals, FTDs
Establishment of Microscopy facility at Sector PHC/CHC by deploying trained Lab Technician (regular/contractual)
Microscopy facilities at PHC/ CHC level established since September 2002 by deploying 38 contractual Lab Technicians in this district It is proposed to provide one malaria Technical lab supervisor (MTLS) in each community block .This may be in lieu of MTS as proposed already.
• Proposal for increase the number of LTs to extend microscopy center up to Gram Panchayet level as the RDT quality always not dependable. Presently the result of the Active blood smears colleted at field level those were not examining within 24 hours due to distance/ Transportation / load. These MCs at GP level may be established if it approved by the State / Higher authority.
Provision of RDT Kits at Sub-Centers
All the 537 sub centers of the district provided with RDK and ACT as this district is a CQ resistance district and it is not possible always to examine the blood smears within 24 hours.
Arrange transportation and storage of RDKs and Micro slides
District store supplied these to the Block Head quarters (CHCs) and block authorities issued these to the PHCs / Sub Center level / Health service providers.
Establishment of Malaria Clinics in Health Posts, Dispensaries, Hospitals Only one malaria clinic in Jalpaiguri town runs by Dy CMOH-II, Jalpaiguri. To be established 4 malaria clinics in the four municipalities within 2012.
Identification of Private Clinics for reporting of fever cases & establishment of Malaria Clinics 158 tea gardens’ clinics already established for service and reporting. Private clinics regularly reporting malaria cases. Army Hospitals, Air Forces Hospital, Para military forces Hospitals, Rail way hospitals are not reporting Fever / malaria cases, these to be established within 2012. Other Private clinics are not reporting Fever / malaria cases, these to be established within 2012.
Sentinel Sites: 1. Dist. Hospital, Jalpaiguri 2. Alipurduar S.D Hospital,Alipurduar 3. Malbazar S.D Hospital,Malbazar 4.Birpara State General Hospital
Annual requirements prepared in January every year and communicate to the state regularly. Making available drugs to FTDs, Malaria Clinics for treatment on the basis of RDK / Microscopy
As 2nd ANM and ASHA volunteers recruited in most of the Sub Center areas, they are equipped with antimalarials e.g. RDK, ACT, Tab CQ, PQ, Glass Slides etc.Supervisors, MPHWs monitoring the stock in a regular interval.
In the urban areas- in the all municipal wards at least one FTD may be opened with the IPP VIII volunteers of municipalities. These volunteers will be trained and equipped with antimalarials. Blood smears of these areas may be examined in the urban malaria clinics (with Dy CMOH-II / ACMOHs / Supdts)
Ensuring availability of anti-malaria drugs for treatment of uncomplicated malaria in PHCs/CHCs/Health care infrastructure in Tea Gardens. Anti malarial drugs for treatment of uncomplicated malaria available at ASHA vols /SCs/PHCs/ BPHCs/RH/ Health care infrastructure in Tea Gardens etc entire rural population of the district covered with the Sub-Centers.
Ensuring availability of anti-malaria drugs, infusion facilities and other supportive drugs for treatment of severe malaria in PHCs/CHCs/Private Clinics/Health care infrastructure in Tea Gardens. Anti malarial drugs infusion facilities and other supportive drugs for treatment of severe malaria available at PHCs/ BPHCs/RH/ SGH /SDH /DH .
Making available necessary logistics at District hospitals for management of multi-organ failure cases- At District hospital for management of multi-organ failure cases (ITU)
Arrange transportation and storage of drugs, etc. Transportation and storage of drugs, etc.available at district, Block PHCs and at PHCs
Training of medical, paramedical personnel and NGOs, particularly in Management of severe Pf malaria. Training of medical, paramedical personnel and NGOs, particularly in Management of severe Pf malaria.
INTEGRATED VECTOR CONTROL – INDOOR RESIDUAL SPRAYING
Preparation of PHC-wise requirement of insecticides and spray equipment All the block head quarter equipped with insecticides (DDT) and spray equipments (e.g.- Stirrup pumps, buckets,nozele tips, nozzle tips with extension cover, lather washer, net for st.pump etc)
Arrange transportation and storage of insecticides and spray equipment Blocks are allotted fund for transportation during operational period.
Recruitment of spray workers for squads Experienced trained old spray workers engaged for DDT spray works. But since 2010 after absorption of DDT spray workers as permanent Gr-D employees it becomes difficult to recruit spray workers in this district as unabsorbed old spray workers remains very few and scattered all over the district which cause very difficult to make gangs.
Training of spray workers, Supervisors on dosage of insecticide, use of spray equipment, preparation of suspension, etc. Before every spray operation supervisors, spray workers trained in doses, preparation of suspension, use of spray equipments, discharge rates etc
Route Map for Spray operations & advance notification to community for IRS and steps to be taken for coverage and quality (1 week prior to due date and on the scheduled date) After planning local panchayets, village leaders initially informed. 2 week prior the schedule date communicated to the supervisor, MPHWs, ASHA vols, to announce to the villagers. Three days before the operation ASHA vols visited house to house for communication and for 100 % acceptance.
Identification of the PHC/District, State, NVBDCP Monitors/Supervisors All the PHCs of the district monitored by different level of officers regularly.
Concurrent and consecutive supervision of spraying and planning of Field visit. All the supervisor tires (District level to SC level) involve in planning. When spray in operation then all the supervisor tires visiting the operation.
Supervision & monitoring of IRS by PHC, District, State as per plan District Level: Dy CMOH-II, Other district level monitoring officers, AMO & DE cell Block Level: BMOH,MI & all other block tire supervisors GP level: GP supervisor, MPHWs SMO:
Compilation of spray completion reports of all PHCs for transmission to state, NVBDCP After completion, reports of all PHCs complied at district and transmitted to State.
Proper stocking of balance DDT and spray equipment for next round of IRS Balance stock of DDT & Spray equipments for next round stored at Block level & district store. But there are no separate specific store rooms for storage of DDT
INTEGRATED VECTOR CONTROL – INSECTICIDE TREATED BED NETS (ITNs) /LONG LASTING INSECTICIDAL NETS (LLINS)
Preparation of Sub centre-wise micro-plan for requirement, distribution of ITNs /LLINs
LLIN/ ITB distribution done in our district irrespective of BPL/APL to cover 100% population of the area.
Assessment of Sub centre-wise community owned bed nets
Before planning implementation SC workers surveyed the area to find out the actual number of community owned bed nets in the area by house to house survey.
In this district Self Help groups were done the insecticide treatment of community owned bed nets.
Sub centre-wise calendar prepared before ITBN for organization of camps for insecticide treatment of bed nets .
Advance notification to community for insecticide treatment camps (1 week prior to due date and on the scheduled date)
Advance notification to the community for ITBN camps noticed to the community at least three times 10days & 3 days before. On the day of operation house to house monitoring done.
INTEGRATED VECTOR CONTROL – USE OF LARVIVOROUS FISH
Mapping of water bodies (mosquito breeding places) for introduction of Control - Use of larvivorous fish
Larvivorous fish culture primarily introduced in our district since 2008 in selected blocks, not in hilly blocks/ where “Flash flood” / “dryness of most of the water bodies take place”
Establishment of hatcheries at PHCs/Networking with Fisheries Dept for stocking larvivorous fish
Seven Hatcheries constructed for LVFC in the different PHCs of this district. Sadar ( CMOH office complex)-1, Rajganj ( RH complex)-1, Maynaguri ( RH complex)-1, Dhupguri ( RH complex)-1, Banarhat (PHC complex)-1, Mangalbari (BPHC complex)-1, Mal (SDH complex)-1
Arrange equipment for transportation of larvivorous fish to identified breeding sites Fishes liberated in the selected water bodies of the high endemic areas of the blocks. Before liberation IEC done in the villages through miking, postering, leaflets-distribution etc)
Training of Health Workers, Personnel of Dept of Fisheries for stocking, transportation, introduction of larvivorous fish
Click the download file given below for details of INTER-SECTORAL CONVERGENCE ,MONITORING AND EVALUATION,Other vector borne diseases apart from Malaria