VECTOR BORNE DISEASES AND CLIMATIC CHANGES - India @ Cop...
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VECTOR BORNE DISEASES AND CLIMATIC CHANGES Conserving Now, Preserving Future Dr. Neeraj Dhingra Additional Director National Vector Borne Disease Control Porgramme (NVBDCP Ministry of Health & Family Welfare Government of India
Transcript of VECTOR BORNE DISEASES AND CLIMATIC CHANGES - India @ Cop...
VECTORBORNEDISEASESANDCLIMATICCHANGES
Conserving Now, Preserving Future
Dr.NeerajDhingraAdditionalDirector
NationalVectorBorneDiseaseControlPorgramme (NVBDCPMinistryofHealth&FamilyWelfare
GovernmentofIndia
Conserving Now, Preserving Future
PREVENTIONANDCONTROLOFVECTORBORNEDISEASESININDIA
NATIONALVECTORBORNEDISEASESCONTROLPROGRAMME(NVBDCP)- UnderMinistryofHealth&FamilyWelfare,GovernmentofIndiadealswith
followingvectorbornediseases- Malaria- Dengue- Chikunguniya- JapaneseEncephilitis- Kala- azar- Filairiasis- Zika Virus
Website:www.ndvbcp.gov.inMOHwebsite:www.mohfw.gov.in
MALARIA IN INDIA
Conserving Now, Preserving Future
0.00
10.00
20.00
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40.00
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60.00
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0
1000000
2000000
3000000
4000000
5000000
6000000
7000000
MalariainIndia
PV Pf Pv% Pf% ABER API SPR SfR
GEOGRAPHICALDISTRIBUTIONOFTOTALMALARIA&Pf.CASES
Conserving Now, Preserving Future
RAJASTHAN
ORISSA
GUJARAT
MAHARASHTRA
MADHYA PRADESH
BIHAR
KARNATAKA
UTTAR PRADESH
JAMMU & KASHMIR
ASSAM
TAMIL NADU
TELANGANA
CHHATTISGARH
ANDHRA PRADESH
PUNJAB
JHARKHANDWEST BENGAL
ARUNACHAL PR.
HARYANA
KERALA
UTTARAKHAND
HIMACHAL PRADESH
MANIPUR
MIZORAM
MEGHALAYANAGALAND
TRIPURA
SIKKIM
GOA
A&N ISLANDS
D&N HAVELI
PONDICHERRY
LAKSHADWEEP
N
EW
S
API - 2016<1>1-2>2-5>5-10>10 & Above
RAJASTHAN
ORISSA
GUJARAT
MAHARASHTRA
MADHYA PRADESH
BIHAR
KARNATAKA
UTTAR PRADESH
JAMMU & KASHMIR
ASSAM
TAMIL NADU
TELANGANA
CHHATTISGARH
ANDHRA PRADESH
PUNJAB
JHARKHANDWEST BENGAL
ARUNACHAL PR.
HARYANA
KERALA
UTTARAKHAND
HIMACHAL PRADESH
MANIPUR
MIZORAM
MEGHALAYANAGALAND
TRIPURA
SIKKIM
GOA
A&N ISLANDS
D&N HAVELI
PONDICHERRY
LAKSHADWEEPN
EW
S
SFR - 2016<1>1-2>2-5>5-10>10 & Above
- NorthernStatesandsouthernstates– nearlyoneliminationphase- Malariamostlyconcentratedineastern&NEpartsofIndia
Conserving Now, Preserving Future
DENGUEININDIA(2010-2017)
2829218860
50222
75808
40571
99913
129166
291500.4
0.9
0.5
0.3 0.3
0.2 0.2 0.2
0.00.10.20.30.40.50.60.70.80.91.0
0100002000030000400005000060000700008000090000
100000110000120000130000140000
2010 2011 2012 2013 2014 2015 2016 2017
CaseFatality
Ratio
Cases
Cases
• CFR brought down from 3.3%
(1996) to 0.2% in 2016• States reporting most number of
Dengue cases in 2017 :
Kerala – 14606, Tamil Nadu –
5968, Karnataka – 4643, Andhra
Pradesh – 798 Gujarat – 734, Maharashtra- 718, West Bengal -
571
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DENGUEININDIA(SEASONALTREND)
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10000
15000
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25000
30000
35000
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No.ofC
ases
2014 2015 2016 2017
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CHIKUNGUNYA IN INDIA
16049
27553
64057
18805
0
10000
20000
30000
40000
50000
60000
2014 2015 2016 2017
No.
of c
ases
CLIMATICCHANGESANDVECTORBORNEDISEASETRANSMISSION
Conserving Now, Preserving Future
VBDtransmissionisdependentupon
SufficientnumbersofAnopheline,Culex orAedesmosquitoes
Largeenoughreservoirofpoolofinfectioninhumansandanimals
Mosquitoesproliferationstronglyinfluencedby:
Temperature
Rainfall
Humidity
Wind
Sunlight
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CLIMATICCHANGESWHICHIMPACTVBD• Increaseintemperature• Increaseinhumidity• Flooding
– INCREASEDMOSQUITOGENICPOTENTIAL
• INFECTONRESERVOIRPRESENT
• FREQUENTOUTBREAKS(Malaria,Dengue,chikunguniya
RAJASTHAN
ORISSA
GUJARAT
MAHARASHTRA
MADHYA PRADESH
BIHAR
KARNATAKA
UTTAR PRADESH
JAMMU & KASHMIR
ASSAM
TAMIL NADU
TELANGANA
CHHATTISGARH
ANDHRA PRADESH
PUNJAB
JHARKHANDWEST BENGAL
ARUNACHAL PR.
HARYANA
KERALA
UTTARAKHAND
HIMACHAL PRADESH
MANIPUR
MIZORAM
MEGHALAYANAGALAND
TRIPURA
SIKKIM
GOA
A&N ISLANDS
D&N HAVELI
PONDICHERRY
LAKSHADWEEP
N
EW
S
API - 2016<1>1-2>2-5>5-10>10 & Above
TargetedforMalariaEliminationby2027 GAINSMADETILLNOWMAYBEREVESRED
CLIMATICCHANGESININDIA
Conserving Now, Preserving Future
• Meltingglaciers-
Floodinginrivers,valleysfollowedbydiminishedflowanddroughts
• Generalwarminginmeanannualtemperaturewithdecreasedrangeofdiurnal
temperaturevariation
Warmingof0.50Cby2030
MaximumincreaseinnorthernareasofIndia
• Increasedprecipitation- includingmonsoons
Fewerrainydaysbutmoredaysofextremerainfallevents
IMPACTOFCLIMATICCHANGESONVBDININDIA
Conserving Now, Preserving Future
• Increasednumberofmonthsofhighhumidity,precipitationandincreasedtemperatureandpoolingofwaterwouldleadto:- SeasonalityofVBDmaychange- Earlyonsetofdiseasesormaybethroughouttheyear- Diseaseburdenmaychange- LikelyhighertransmissionratesforVBD– severeformsofdiseasewouldincrease– morePfmalaria- TypicalpreventivemeasureslikeLLINmaynotwork- peoplemaynotsleepunderthem- Healthservicescapacitiestodealwiththisincrease- Quickeronsetofdrugandinsecticideresistance
• Socioeconomicimpact- Healthinequity– poorermoreaffected- Longerdurationofhospitalization– outofpocketexpenseswouldincrease- Impactontourism- Refugees- movetowardslargerinhabitations– urbanization– poorinfrastructure- moreCulexmosquitoes– Lymphaticfiliarisis- Deforestation,etc
MITIGATINGEFFECTOFCLIMATICCHANGESONVBD
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1. Adaptabilitytoadjusttoclimaticchanges– Nopredictionmodelsavailable- researchneedeD
– LongitudinalStudies– changesinVBDbasedonclimaticstudies- multi-disciplinarystudies
– Responsemechanismsweakerinlessendemicareasasofnow
– Shiftingofhumaninfrastructurebasedonendemicity
– Addingnewerskilledstaffonenvironmentmanagementinthehealthprogrammes
– Capacitybuildingandsensitization
– Increasedresources– budgetandmanpower
MITIGATINGEFFECTOFCLIMATICCHANGESONVBD
Conserving Now, Preserving Future
2. Monitoringofclimaticchangesinco-relationtoVBD– Mappingthepresentlandscapeintermswatercollections,rivers,lakes,etc– Informationexchangeonclimaticchanges– rainfall,humidity,floods,glacier
melting,etc.withhealthprogrammesespeciallyVBD
– GIS/spatialmapswithclimaticchanges/waterpoolingatlocallevels– MonitoringtheVBDincidenceinnorthernareasofIndia– trackofanyslight
increase- involveallfacilitiesgovernment,private,NGOs,etc.– Mapping/Monitoringthemobility- intrastate,interstate,etc.
Conserving Now, Preserving Future
By2030s-FewfociinHimalayanregionarelikelytoopen;intensityoftransmissionmoreinNEstates;reductionineast-coastprojected
Transmission Windows of malaria based on T & RH (A1B Scenario, by 2030)Baseline and A1B Scenario Projected Map of Open Months for Malaria Transmission
(Based on T. & RH.)
Conserving Now, Preserving Future
Transmission Windows of dengue (A1B Scenario)
TWcriteria:20-320 CInconclusive,nomatchingwith
currentdistribution
MITIGATINGEFFECTOFCLIMATICCHANGESONVBD
Conserving Now, Preserving Future
3.ChangesintheapproachestoVBD– HighlyskilledmanpowerintheNVBDCP– capacitytopredictchangesinclimateandVBD
– EnhancementofstaffatState/regional/districtlevels
– Verystrongandinstitutionalmechanismsofinter-sectoralcoordination
– Newerresearchesondiagnostics,drugandinsecticidesandbettermethodstodetectresistance
– Sensitizationandcapacitybuildingofnorthernstates
– Highlyflexiblestructure– decisionmakingandresourceallocationmaychangefromyeartoyearorwithanyearaswell
MALARIAKEEPSCOMINGBACK–BEPREPARED
