Mosquito Breeding Habitats in SSP in Gujarat. Year 1965 28.99 99,667 29,576 29.67 73,504 29.24...
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Transcript of Mosquito Breeding Habitats in SSP in Gujarat. Year 1965 28.99 99,667 29,576 29.67 73,504 29.24...
Year
1965 28.99 99,667 29,576 29.67 73,504 29.24 26,163 30.891970 50.35 694,017 199,743 28.78 593,902 26.08 100,115 44.981975 50.01 5,166,142 1,843,681 35.68 4,436,891 29.70 729,251 72.091980 49.82 2,898,140 1,055,750 36.42 2,310,129 26.47 588,011 75.511985 49.86 1,864,380 940,788 50.46 1,319,375 39.11 545,005 77.941990 50.15 2,018,783 804,148 39.83 1,266,665 27.40 752,118 60.751995 48.47 2,296,008 1,465,078 50.06 1,503,877 37.25 792,131 70.24
2000 52.59 2,019,065 1,404,737 69.57 971,149 49.28 1,047,916 88.37
% NAMP population in BPL states
at risk of malaria
Relationship of Poverty with Malaria in the Indian States Below Poverty Line in 1999-2000
Total malaria cases
in India
Total malaria cases in BPL states
% Malaria cases in BPL states
Total P. vivax cases in India
% P. vivax cases in BPL states
Total P. falci-parum cases in India
% P.falci-parumcases
in BPL states
Malaria and Poverty
• Malaria-wheels within wheels
• Malaria- a development issue
• Malaria control should rely on poverty alleviation for human development, social security & sustainable environment
MALNAD REGION, INDIA
Dense Forests were replaced by coffee plantations. An. fluviatilis transmitted malaria disappeared. Malnad is healthy.
50,000 Sq Km Area
Malnad
Malaria epidemic in Punjab in 1908 caused 300,000 deaths in 20 million populations over a period of three years.
Malaria in Punjab flares up after July-August rains. The malaria mortality figures of Punjab from 1867-1943 revealed that in 77-years majority of malaria peaks were followed by 8-year cycle.
The relationship of rainfall with malaria was investigated and epidemic forecasting methods were developed in Punjab.
Irrigation changed the malaria epidemiology and the region was converted to endemic malaria.
MALARIA IN PUNJAB
Rice Cultivation and Malaria in Punjab
0
500000
1000000
1500000
2000000
2500000
1970
1974
1978
1982
1986
1990
1994
1998
2002
Rice in HectareMalaria cases
% Share of Cropped Area1970-73 7.6%1996-98 28.4%
Bioenvironmental Malaria control at the Indian Oils Ltd. Mathura, U.P.
1388
1004
320 313163
62 28
523
62 51 54 13 3 30
200
400
600
800
1000
1200
1400
1600
1800
2000
1996 1997 1998 1999 2000 2001 2002
Malaria casesPf cases
Bioenvironmental Malaria Control in BHEL and IDPL, Hardwar, Uttranchal
0
500
1000
1500
2000
2500
3000
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
Malaria cases in BHEL
Malaria cases in IDPL
Malaria Outbreak in Bargi Dam area in Narayanganj PHC, M.P.
-5000
500100015002000250030003500400045005000
Malaria casesPf cases
Dam
Dam completed
Dam impounded
Malaria Control in Karnataka in Partnership with PHC System
• Major silk producing region. Farmers unwilling to allow the use of DDT
• High malaria incidence and deaths
• Major Breeding habitats of An. culicifacies– Wells: Species A (Vector Species)– Streams: Species B (Non-Vector Species)– All wells mapped and fishes released– Malaria cases declined sharply
Impact of Fishes on Malaria
0
200
400
600
800
1000
1200
1400
1600
1993 1994 1995 1996 1997 1998 1999 2000 2001 2002
Gambusia (PHC Kamasamudram)
Population 38000 in 93 villages
Malaria cases
Malaria cases
Rise of malaria in DDT sprayed villages. In 1998 fishes were released in problem villages.
0
1000
2000
3000
4000
5000
6000
7000
8000
9000
10000
1993 1994 1995 1996 1997 1998 1999 2000 2001 2002
DDT (PHC Gudibanda)
Population 52554 38 problem villages
Fishes released
Malaria Cases
Impact of SP spraying (1996-98) on Malaria. In 2002 fishes were released to control mosquitoes
0
10000
20000
30000
40000
50000
60000
70000
80000
90000
1993 1994 1995 1996 1997 1998 1999 2000 2001 2002
Four PHCs
Population in 4 PHCs 1.3 million
SP Spraying No SprayingFishes
Malaria cases
Year DDT sprayed in mt
against 200 mt% Coverage
Chloroquine Tablets in Lakhs
Total malaria cases
P. falciparum cases
1990 496 91
1991 949 281
1992 4.00 2.0 5.00 805 1961993 1.60 0.8 5.10 626 213
1994 4.90 3.0 5.40 1503 602
1995 2.30 1.0 6.20 1820 739
1996 7.40 3.5 7.70 2290 662
1997 9.90 5.0 9.80 5279 1764
1998 14.9 7.5 9.60 8872 3340
1999 10.2 5.0 13.88 14133 3919
2000 18.0 9.0 20.30 16764 7126
SITUATION ANALYSIS OF BETUL DISTRICT, MADHYA PRADESH
Bioenvironmental Control of Malaria in Betul District, Madhya Pradesh
Results of Monitoring Malaria Incidence in Betul District
02000400060008000
100001200014000160001800020000
Malaria cases
Pf cases
0
100
200
300
400
500
600
Malaria cases
Pf cases
Impact of Fishes on Malaria(Rise in 2000 was due to epidemic in adjacent villages)
Population 85672 in 160 villages
0
2000
4000
6000
8000
10000
12000
1993 1994 1995 1996 1997 1998 1999 2000 2001 2002
PHCs Banavara and Kanakatte
Malaria cases
Impact of Bioenvironmental Interventions in 100 million population in Maharashtra
204969
165985
137712
8140656043
3556819897
0
50000
100000
150000
200000
250000
1997 1998 1999 2000 2001 2002 2003
Interventions Started in 1997
Total Malaria Cases
P. falciparum Cases
Impact of Fishes on Malaria
0
200
400
600
800
1000
1200
1400
1600
1993 1994 1995 1996 1997 1998 1999 2000 2001 2002
Gambusia (PHC Kamasamudram)
Population 38000 in 93 villages
Malaria cases
Malaria cases
Impact of Bioenvironmental Interventions in 100 million population in Maharashtra
204969
165985
137712
8140656043
3556819897
0
50000
100000
150000
200000
250000
1997 1998 1999 2000 2001 2002 2003
Interventions Started in 1997
Total Malaria Cases
P. falciparum Cases
Editorial United against malaria “WHO’s Global Malaria Eradication
Campaign achieved some notable successes but it also proved that, without a much more flexible and variable strategy combined with poverty reduction, self reliance and sound environmental management, the war against this disease could not be won.”
Dr. Hiroshima Nakajima
Director General of WHO
World Health. 51st Year, No.3, May-June 1998
Dr. Halfdan Mahler, Former Director-General, World Health Organization who initiated the
imaginative Small Pox Eradication Programme said
“All countries benefit from the fruits of India’s TB research-all countries except India”
Health Catastrophe of 21stCentury- Future Impact of Malaria
Malaria problem will prove a great hindrance to socio-economic
development in the fields of health, education, land exploitation, mining, road
construction, agriculture, tourism et al. leading to greater poverty and under-
development
SHARPENED OLD TOOLS AND UTILIZATION OF NEW TOOLS AND STRATEGIES
WILL PRODUCE MORE FOCUSED AND SUSTAINABLE
MALARIA CONTROL
New Tools in Malaria Control• MALARIA DIAGNOSIS
• Dipstick/pLDH tests• TREATMENT
• Artemisinin & Drug Combination• ENVIRONMENT
• Health Impact Assessment• VECTOR CONTROL
• Situation specific based on stratification, An. Sibling species, Bioenvironmental Methods, Treated Bed Nets, Bacillus thuringiensis, Neem Based Repellents, Selective Spraying
ENHANCED COMMUNITY AWARENESS WILL HELP IN MALARIA PREVENTION
AND EARLY CASE DETECTION AND PROMPT
TREATMENT
ACKNOWLEDGEMENTS
Late Professor V.Ramalingaswami, FRSProfessor M.G.K. Menon, FRS
THE INDIAN COUNCIL OF MEDICAL RESEARCHTHE NATIONAL ANTI MALARIA PROGRAMME
HEALTH DEPARTMENTS OF THE STATE GOVERNMENTS
SCIENTISTS AND TECHNICAL STAFF OF THE MALARIA RESEARCH CENTRE
AND ITS FIELD STATIONS
NATIONAL AND INTERNATIONAL COLLABORATING INSTITUTIONS